    [Senate Hearing 116-39]
    [From the U.S. Government Publishing Office]

                                                             S. Hrg. 116-39

                           DRUG PRICING IN AMERICA:
                       A PRESCRIPTION FOR CHANGE, PART II

    =======================================================================

                                    HEARING

                                   before the

                              COMMITTEE ON FINANCE
                              UNITED STATES SENATE

                         ONE HUNDRED SIXTEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                               FEBRUARY 26, 2019

                                   __________

                 [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                Printed for the use of the Committee on Finance

                                        ________

                           U.S. GOVERNMENT PUBLISHING OFFICE

    37-143 PDF                       WASHINGTON: 2019

                              COMMITTEE ON FINANCE

                         CHUCK GRASSLEY, Iowa, Chairman

    MIKE CRAPO, Idaho                    RON WYDEN, Oregon
    PAT ROBERTS, Kansas                  DEBBIE STABENOW, Michigan
    MICHAEL B. ENZI, Wyoming             MARIA CANTWELL, Washington
    JOHN CORNYN, Texas                   ROBERT MENENDEZ, New Jersey
    JOHN THUNE, South Dakota             THOMAS R. CARPER, Delaware
    RICHARD BURR, North Carolina         BENJAMIN L. CARDIN, Maryland
    JOHNNY ISAKSON, Georgia              SHERROD BROWN, Ohio
    ROB PORTMAN, Ohio                    MICHAEL F. BENNET, Colorado
    PATRICK J. TOOMEY, Pennsylvania      ROBERT P. CASEY, Jr., Pennsylvania
    TIM SCOTT, South Carolina            MARK R. WARNER, Virginia
    BILL CASSIDY, Louisiana              SHELDON WHITEHOUSE, Rhode Island
    JAMES LANKFORD, Oklahoma             MAGGIE HASSAN, New Hampshire
    STEVE DAINES, Montana                CATHERINE CORTEZ MASTO, Nevada
    TODD YOUNG, Indiana

                 Kolan Davis, Staff Director and Chief Counsel

                  Joshua Sheinkman, Democratic Staff Director

                                      (ii)

                                C O N T E N T S

                                  ----------

                               OPENING STATEMENTS

                                                                       Page
    Grassley, Hon. Chuck, a U.S. Senator from Iowa, chairman,
      Committee on Finance...........................................     1
    Wyden, Hon. Ron, a U.S. Senator from Oregon......................     3

                                   WITNESSES

    Gonzalez, Richard A., chairman and chief executive officer,
      AbbVie Inc., North Chicago, IL.................................     6
    Soriot, Pascal, chief executive officer, AstraZeneca, Wilmington,
      DE.............................................................     8
    Caforio, Giovanni, M.D., chairman of the board and chief
      executive officer, Bristol-Myers Squibb Company, New York, NY..     9
    Taubert, Jennifer, executive vice president, worldwide chairman,
      Janssen Pharmaceuticals, Johnson & Johnson, New Brunswick, NJ..    11
    Frazier, Kenneth C., chairman and chief executive officer, Merck
      and Company, Inc., Kenilworth, NJ..............................    12
    Bourla, Albert, DVM, Ph.D., chief executive officer, Pfizer, New
      York, NY.......................................................    14
    Brandicourt, Olivier, M.D., chief executive officer, Sanofi,
      Bridgewater, NJ................................................    15

                   ALPHABETICAL LISTING AND APPENDIX MATERIAL

    Bourla, Albert, DVM, Ph.D.:
        Testimony....................................................    14
        Prepared statement...........................................    63
        Responses to questions from committee members................    66
    Brandicourt, Olivier, M.D.:
        Testimony....................................................    15
        Prepared statement...........................................   134
        Responses to questions from committee members................   144
    Caforio, Giovanni, M.D.:
        Testimony....................................................     9
        Prepared statement...........................................   474
        Responses to questions from committee members................   475
    Frazier, Kenneth C.:
        Testimony....................................................    12
        Prepared statement...........................................   495
        Responses to questions from committee members................   497
    Gonzalez, Richard A.:
        Testimony....................................................     6
        Prepared statement...........................................   527
        Responses to questions from committee members................   528
    Grassley, Hon. Chuck:
        Opening statement............................................     1
        Prepared statement...........................................   704
    Soriot, Pascal:
        Testimony....................................................     8
        Prepared statement...........................................   705
        Responses to questions from committee members................   713
    Taubert, Jennifer:
        Testimony....................................................    11
        Prepared statement...........................................   839
        Responses to questions from committee members................   845
    Thune, Hon. John:
        Submission, 340B Health...................................... 1,053
    Wyden, Hon. Ron:
        Opening statement............................................     3
        Prepared statement........................................... 1,054

                                 Communications

    AARP............................................................. 1,057
    American Society of Health-System Pharmacists.................... 1,058
    Coalition for Affordable Prescription Drugs...................... 1,062
    George, Linda.................................................... 1,064
    Huszagh, Robin K................................................. 1,065
    Interfaith Center on Corporate Responsibility.................... 1,066
    National Association of Free and Charitable Clinics.............. 1,070
    National Business Group on Health................................ 1,072
    National Coordinating Committee for Multiemployer Plans.......... 1,076
    Oxfam America.................................................... 1,078
    Patients for Affordable Drugs Now................................ 1,080
    Pharmaceutical Care Management Association....................... 1,084
    Raffle, Debra L.................................................. 1,089
    Ricci, Laura T................................................... 1,091
    Rowland, Rhonda.................................................. 1,099

                            DRUG PRICING IN AMERICA:
                       A PRESCRIPTION FOR CHANGE, PART II

                                  ----------

                           TUESDAY, FEBRUARY 26, 2019

                                           U.S. Senate,
                                          Committee on Finance,
                                                        Washington, DC.
        The hearing was convened, pursuant to notice, at 10:15
    a.m., in room SD-215, Dirksen Senate Office Building, Hon.
    Chuck Grassley (chairman of the committee) presiding.
        Present: Senators Roberts, Enzi, Cornyn, Thune, Isakson,
    Portman, Toomey, Scott, Cassidy, Lankford, Daines, Young,
    Wyden, Stabenow, Cantwell, Menendez, Carper, Cardin, Brown,
    Bennet, Casey, Whitehouse, Hassan, and Cortez Masto.
        Also present: Republican staff: Chris Allen, Senior Advisor
    for Benefits and Exempt Organizations; Brett Baker, Health
    Policy Advisor; Stuart Portman, Health Care Policy Advisor;
    Karen Summar, Chief Health Policy Advisor; and Jeff Wrase,
    Deputy Chief of Staff and Chief Economist. Democratic staff:
    Michael Evans, General Counsel; Peter Gartrell, Investigator;
    Matt Kazan, Senior Health Policy Advisor; Kristen Lunde,
    Winston Fellow; and Joshua Sheinkman, Staff Director.

     OPENING STATEMENT OF HON. CHUCK GRASSLEY, A U.S. SENATOR FROM
                  IOWA, CHAIRMAN, COMMITTEE ON FINANCE

        The Chairman. I want to welcome and to thank our witnesses
    for being here. We know that you put a lot of hard work into
    it, and staffs and the Senators have done the same thing.
        The information that these witnesses will share will help
    inform the committee as it addresses the issues of high
    prescription drug prices. America has a problem with the high
    cost of prescription medicines.
        Whether it is about EpiPen, insulin, or other
    prescriptions, in the thousands of letters that I have
    received, Iowans have made clear that high drug prices are
    hurting. I have heard from people about skipping doses of their
    prescription drugs to make them last until the next paycheck.
        Of course, I am not a doctor, but rationing one medicine
    does not sound like the safe prescription for health and
    wellness that Americans want. Others have told me about leaving
    their prescription on the pharmacy counter because it costs too
    much.
        There is no question that researchers and doctors have
    developed treatments and cures for diseases where there were
    once no such cures or treatments. And such innovations take
    time and money. I think all of us at this table--and most
    people who are not at this table--if they study at all the
    pharmaceutical industry and the FDA process, they know it takes
    time and money. But we are all trying to understand the sticker
    shock that many drugs generate, especially when some of these
    drugs have been around for a long, long time.
        There is a balance then between incentivizing innovation
    and keeping prices affordable for consumers and taxpayers. And
    the taxpayers are involved, because the Federal Government is a
    great purchaser of drugs through a lot of health programs.
        Like all systems, things can get out of balance. The good
    news is that we are here to discuss solutions. And we thank all
    of you for cooperating with us in that effort today.
        In fact, we are here today thanks to a system of checks and
    balances that is within our Constitution. Congress has a
    constitutional responsibility to be a meaningful check on the
    spending of taxpayers' money. That responsibility includes not
    just holding hearings, but also holding the private sector and
    the government accountable through oversight, just like a
    doctor. That doctor has to properly diagnose a disease before
    it can be treated. Congress needs to understand what is going
    on in the drug pricing supply chain in order to respond in a
    measured and effective way.
        As part of that fact-finding, as of the last Friday Ranking
    Member Wyden and I launched an inquiry into the high cost of
    insulin. This hearing is not about scapegoating any one group
    regarding high drug costs. That is why we are holding a series
    of bipartisan hearings on this issue.
        Without a doubt, drug pricing is a complex issue. But I
    think we should also be asking whether or not it is too complex
    or whether it should be so complex. We cannot allow anyone to
    hide behind the current complexities to shield the true cost of
    drugs. And we should not turn a blind eye to industry practices
    that thwart laws and regulations designed to promote
    competition and generic drug entries into the marketplace.
        Health and Human Services Secretary Alex Azar, FDA
    Commissioner Scott Gottlieb, and the Federal Trade Commission
    have identified a number of tactics that undermine competition,
    like withholding samples, pay-for-delay, product hopping, and
    rebate bundling. And that just names a few. While these
    agencies are taking enforcement action or looking at regulatory
    changes, we here in Congress are exploring legislative options
    to deter companies from engaging in these practices that keep
    drug prices high for patients.
        Today we expect open, honest answers from the
    pharmaceutical industry to figure out how we got where we are
    today and to see what ideas they have to make things better.
        One of the first things that we need to talk about is
    pretty simple: list price. Now you folks are probably going to
    tell us it is not that simple. Secretary Azar has said that
    pharmaceutical companies believe that the list price is
    meaningless. In fact, some of your testimony today will echo
    that.
        However, for a patient taking a drug that has no
    competition, the list price then becomes very meaningful. For
    seniors on Part D or paying coinsurance as a percentage of list
    price, then for that person, list price is very meaningful. For
    people who have high-
    deductible plans and pay thousands of dollars towards the list
    price, then for those people, the list price is very
    meaningful.
        For pharmacy benefit managers, providing drugs with a high
    list price can be more attractive than providing a less
    expensive drug. Therefore, for the taxpayers then, the list
    price becomes very meaningful.
        We have all seen the finger-pointing. Every link in the
    supply chain has gotten skilled at that finger-pointing. But
    like most Americans, I at least--I think like most members of
    Congress--am sick and tired of the blame game.
        It is time then for solutions. One way or another, we are
    going to get some clarity. The American people deserve straight
    answers and real solutions.
        On that note, I want to remind each of our witnesses that
    it is a crime under title 18, section 101 to provide false
    testimony to Congress. I thank you all for coming.
        [The prepared statement of Chairman Grassley appears in the
    appendix.]
        The Chairman. Senator Wyden?

                 OPENING STATEMENT OF HON. RON WYDEN,
                       A U.S. SENATOR FROM OREGON

        Senator Wyden. Thank you very much, Mr. Chairman.
        And I just want to note, at the outset, our focus on
    bipartisanship. We began that with our effort to go after price
    gouging with hepatitis C. Recently we have gone after
    manufacturers ripping off Medicaid. You noted our investigation
    to look at insulin prices that just soar and soar and soar some
    more. So I just very much appreciate the fact that we are
    tackling this in a bipartisan way.
        Colleagues, prescription drugs did not become outrageously
    expensive by accident. It is not the result of a system too
    complicated for Americans to understand. Drug prices are
    astronomically high because that is where pharmaceutical
    companies and their investors want them. The brakes have come
    off pharmaceutical pricing, and American families are hurtling
    along in the passenger seat terrified about what comes next.
        Today the committee is going to hear about uplifting
    stories and miracle cures. Yet it is morally repugnant when
    patients cannot afford those miracles. It is morally repugnant
    when ailing patients are forced to choose between filling the
    next prescription or putting food on the table because they
    cannot afford both. It is morally repugnant when patients are
    forced to skip doses.
        Pharma executives, all of you who are here today, are here
    because the way you have been doing business is unacceptable.
    Ten companies accounted for half of all the profits in the
    health-care sector last year. Nine of them were drug
    manufacturers. All but one of today's witnesses represent
    companies on this list.
        Drugmakers behave as if the patients and the taxpayers are
    unlocked ATMs full of cash to be extracted, and their
    shareholders are the customers whom they value above anybody
    else. So I am going to go through a short list of examples
    starting with AbbVie, which manufactures the top-selling
    prescription drug in America, the arthritis medication Humira.
        Over 6 years, the company doubled the price of a 12-month
    supply from $19,000 to $38,000. Can the patients opt for a less
    expensive alternative? They cannot, because AbbVie protects the
    exclusivity of Humira like Gollum with his ring--thick cobwebs
    of patents and legal tricks and shadowy deals with other
    drugmakers. All of them are in place to keep the cash flowing.
        Now I also want to address some very troubling information
    we just got from AbbVie's proxy statement. It is a document
    every publicly traded company has to file with the SEC. Page 37
    shows that in 2017, a portion of CEO Richard Gonzalez's multi-
    million-dollar bonus was directly tied to sales of Humira. It
    appears the same incentive was in place in 2015 and 2016. In
    fact, the committee's review shows that all of AbbVie's top
    executives have the same arrangement.
        Mr. Gonzalez is welcome to respond, but the implication
    ought to be clear. From top down, AbbVie's leadership had
    reason to keep pushing prices and sales up.
        Now Pfizer, that company gets first prize for the emptiest
    pricing gesture in 2018. After stern Trump tweets, Pfizer said
    it would temporarily freeze the prices. But once the President
    got his flashy headlines, his gaze went elsewhere. Pfizer's
    former CEO told investors it was back to normal, another round
    of price hikes in 2019, including the pain medication Lyrica.
    Lyrica has increased 163 percent in price since 2012. Just one
    drug allowed Pfizer to pull in $4.5 billion in 2017.
        Merck gets second prize for emptiest pricing gesture of
    2018. They made sweet-sounding promises after coming under
    criticism, but they cut prices for drugs that essentially
    produce no revenue for the company. Left untouched were the
    cash cows Keytruda and Januvia, which account for more than a
    quarter of the company's revenue. It is like promising car
    shoppers a great deal, except the only discounted model on the
    lot is an Edsel.
        Sanofi--this is a company wringing more and more cash out
    of people with an incurable disease. In 2010, a vial of this
    insulin cost less than $100. In 2018, it cost nearly $300. The
    company raised prices again in 2019. Considering the landmark
    breakthrough on insulin came early in the roaring 20s, nothing
    could justify this sudden price hike a century later. Diabetics
    who cannot afford the cost now self-ration and endanger their
    lives. But you know what? Investors are happy.
        AstraZeneca--a lesson in saying the quiet part out loud. In
    an interview earlier, the CEO complained that his $12-million
    salary made him the lowest-paid CEO in the whole industry, and
    he said it was annoying to some extent. His company, meanwhile,
    continues to raise the price of Symbicort, its $3-billion
    asthma drug. For some asthmatics, being able to breathe costs
    hundreds of dollars a month.
        And Johnson & Johnson gets the record today for flip-
    flopping. This January 7th at the JP Morgan Health Conference,
    the CEO said the pharmaceutical industry needs self-policing on
    prices. That sounded good, but 3 days later the company hiked
    the prices of hundreds of its drugs, including drugs that
    account for billions in Medicare spending.
        And finally, there is Bristol-Myers Squibb. In 2017, the
    company spent roughly $11 billion on dividends, stock buybacks,
    marketing, sales, and administrative costs that roughly triple
    the amount spent on R&D.
        Now I am going to close by saying that I want us to compare
    these concrete examples of two-faced scheming and profiteering
    with the central arguments that we are going to get this
    morning. The central argument from pharma is basically, the
    fault is always somebody else's. The health plans are at fault,
    the pharmaceutical benefit managers are at fault, regulators
    are at fault. What we know for certain is the history that
    pharma CEOs always say somebody else is at fault.
        We are also going to hear that the list price does not
    matter, that the true costs are just so complicated. But
    companies do not set and raise list prices for fun. Those
    prices are directly tied to the amount patients pay out-of-
    pocket at pharmacy windows from sea to shining sea. They are
    directly tied to what taxpayers spend on health-care programs.
        Then drugmakers point the finger at middlemen, the pharmacy
    benefit managers. I have said for years these pharmacy managers
    are wasteful and secretive, and take their cut without proving
    their worth to anybody. They are going to have their day before
    the committee too. But those pharmacy managers do not set list
    prices. The manufacturers do.
        And by the way, the manufacturers do not offer rebates for
    nearly 40 percent of Part D brand-name drugs. Those prices are
    going up. That is on the drug companies, not on the pharmacy
    managers.
        We are also going to hear that any changes in business as
    usual hurt research and development. A quick look at company
    finances shows that that is a fable. Revenue generated from
    American patients alone dwarfs what they spend on R&D
    worldwide.
        Drugmakers spend as much, if not more, on those
    exhilarating TV ads and office-to-office salesmen as they spend
    on research and development. And if lower prices would diminish
    R&D, why don't costly dividends? Why don't stock buybacks? Is
    the stock price more important than inventing that next miracle
    cure? Even if you buy the specious argument that a drug's list
    price at launch is driven by research costs, what could justify
    arbitrary price increases year after year, long after the
    research and development spending is done?
        Finally, we are going to hear about how patients can get
    coupons. But if this was so generous, why can't drug companies
    just lower prices across the board? I believe it is just more
    slick branding, branding that allows companies to keep the
    status quo cash cow rolling along.
        I will close with this. I was there when seven big tobacco
    CEOs testified in a committee room just like this one. They
    lied that day. This committee, the chairman and I, expect
    better than that this morning.
        Your profits are outsized compared to others in the
    industry. You get a massive portion of your revenue from
    American taxpayers, and you bear none of the consequences of
    these skyrocketing prices. It is long past time to drop the
    excuses and take concrete action to make medicine in America
    more affordable.
        Thank you, Mr. Chairman.
        [The prepared statement of Senator Wyden appears in the
    appendix.]
        The Chairman. Now I will introduce our seven witnesses, but
    once again, thank you for participating in this very important
    hearing on a very important topic. We are grateful for your
    participation and cooperation with our committee.
        The first witness is Richard Gonzalez, chairman and chief
    executive officer of AbbVie, Incorporated. Then we will hear
    from Pascal Soriot, DVM, executive director and chief executive
    officer of AstraZeneca. Then we will hear from Giovanni
    Caforio, M.D., chairman of the board and chief executive
    officer, Bristol-Myers Squibb; then Jennifer Taubert, executive
    vice president and worldwide chairman of pharmaceuticals for
    Johnson & Johnson; Kenneth C. Frazier, chairman and chief
    executive officer of Merck and Company; Albert Bourla, DVM,
    Ph.D., chief executive officer of Pfizer; and Dr. Olivier
    Brandicourt, M.D., chief executive officer of Sanofi.
        We welcome all of you, and we will start in that direction.
    And you have been given 5 minutes. I do not gavel you down at
    the end of 5 minutes, but I wish when the red light would come
    on, you would start to summarize, if you have not finished.
        So we will start with Mr. Gonzalez.

    STATEMENT OF RICHARD A. GONZALEZ, CHAIRMAN AND CHIEF EXECUTIVE
                OFFICER, ABBVIE INC., NORTH CHICAGO, IL

        Mr. Gonzalez. Thank you, Chairman Grassley, Ranking Member
    Wyden, and members of the committee.
        I am Richard Gonzalez, and I am the chief executive officer
    of AbbVie, a company dedicated to developing new innovative
    medicines for some of health care's most challenging diseases,
    such as cancer, Alzheimer's, viral infections, and autoimmune
    diseases.
        Since our inception in 2013, AbbVie has invested
    approximately $50 billion in pursuit of that goal. However,
    because we were tackling some of medicine's most challenging
    problems, solutions do not come easily, nor without significant
    risks.
        Where we have succeeded, we have been able to provide cures
    for fatal diseases like hepatitis C and significantly alter the
    disease progression for certain cancers, lessening the burden
    of illness on patients and on the health-care system. This is
    what the 30,000 employees of AbbVie are dedicated to doing.
        We agree that access to life-saving medicines is a critical
    issue, and we look forward to sharing our perspectives with
    you. There is no one solution to this complex issue, but AbbVie
    is committed to working with the committee and others on how we
    can better partner in your efforts to address pharmaceutical
    pricing and access. AbbVie and the rest of our industry must
    play a role in solving these issues and be prepared to work
    together with the insurance industry, the administration, and
    you to find a better path for American patients.
        My remarks today will focus on one aspect of this inquiry,
    the Medicare Part D benefit design, which, even after
    pharmaceutical list prices are lowered, still contributes to
    making innovative therapies cost-prohibitive for many Medicare
    patients.
        In general, the Medicare Part D program has worked well.
    Its market-based structure and utilization of formularies
    encourages competitive price discounts that have yielded
    significant savings to the government since the Part D benefit
    went into place back in 2006. However, despite these cost
    savings, Part D patient out-of-pocket costs have significantly
    increased. Some would blame that solely on high drug prices,
    and we agree that price should be part of the discussion. But
    it is also important to acknowledge that science has enabled us
    to advance the standard of care far beyond what was possible
    when the Part D benefit was originally designed.
        Many of today's specialty medicines offer significant
    advancements in treating or curing serious chronic or life-
    threatening conditions and save significant amounts of money
    for the health-care system by decreasing overall health-care
    costs. Yet these therapies are also costly.
        Due to the structure of the Part D benefit design, patients
    are charged out-of-pocket costs on a medicine's list price,
    which does not reflect the market-based rebates or discounts
    that Medicare receives. We are encouraged by the proposed rule
    that would reflect manufacturer's discounts in patient's Part D
    out-of-pocket payments. This is an important step in the right
    direction, but we believe more must still be done to help Part
    D patients.
        Let me give you a recent real-world example that
    demonstrates the challenge with the current Part D benefit
    design, and why the focus solely on list price does not fully
    address the access challenges. An uninsured hepatitis C
    infection leads to downstream medical costs for surgery,
    chemotherapy, and radiation for patients who progress to
    needing a liver transplant or having liver cancer. Today we can
    cure hepatitis C with drugs. This cure is highly cost-effective
    for the overall health-care system.
        In 2017, AbbVie launched Mavyret, a highly effective cure
    for HCV. At the time, the list prices for the competitive
    alternatives were as high as $94,500 for the most commonly
    prescribed treatment duration. We launched Mavyret at a list
    price that was 72 percent lower. But even though we cut the
    list price of an HCV cure--for most patients by 72 percent--
    Medicare Part D patients' out-of-pocket obligations are still
    too high for many patients to access this medicine.
        We believe it is important that discussions about access
    and affordability include a focus on how to alleviate Medicare
    Part D out-of-pocket burdens above and beyond just lowering
    list price. We are prepared to step up and discuss how
    companies like ours can shoulder more of the burden of the
    patient out-of-pocket expense as we do in other areas.
        We believe AbbVie, the rest of the pharmaceutical industry,
    and the insurance providers should come together with the
    administration and you to work towards solutions that make
    life-changing medicines more affordable to Part D patients. I
    can assure you AbbVie is committed to doing its part, and we
    look forward to working with you.
        Thank you.
        [The prepared statement of Mr. Gonzalez appears in the
    appendix.]
        The Chairman. Mr. Soriot?

         STATEMENT OF PASCAL SORIOT, CHIEF EXECUTIVE OFFICER,
                      ASTRAZENECA, WILMINGTON, DE

        Mr. Soriot. Chairman Grassley, Ranking Member Wyden, and
    members of the committee, good morning. I appreciate the
    invitation to address concerns regarding the pricing of
    medicines in the United States.
        My name is Pascal Soriot, and I am the CEO of AstraZeneca.
    Our company is dedicated to science and innovation. And in
    2018, we invested nearly $6 billion in research and
    development, 28 percent of our product sales, which is well
    above the industry average.
        In the past 2 years, our commitment to R&D has resulted in
    18 significant FDA approvals and 5 breakthrough designations.
    However, I know that these statistics are meaningless unless
    patients can actually afford our medicines and those medicines
    reduce overall health-care costs.
        I am here to discuss how we can work with other
    stakeholders to take specific actions that address pricing
    concerns. My first proposal is that we move away from the
    current rebate system while continuing to work with payers and
    PBMs to ensure robust negotiations.
        The current system is built on high list prices coupled
    with rebates. This is not sustainable, and all of us have a
    role to play. For example, the estimates for 2018 show that
    across our medicines, our average rebate is nearly 50 percent
    of our gross revenues in the U.S. Despite this, in recent years
    in our primary care portfolio, we have seen flat to declining
    net effective prices for most of our medicines. As a company
    dependent upon government action for eliminating rebates in
    commercial and in Part D, we are prepared to reduce our list
    prices by an equivalent amount of rebates, less the appropriate
    market-based fees, to those in the supply chain. This will
    actually reduce overall costs not only for patients, but also
    for the government.
        My second proposal is that if a change of the current
    system is not possible, a portion of discounts and rebates
    could be used to create out-of-pocket caps for Medicare
    patients. This approach is used successfully in some other
    countries. Actually, it gives patients greater certainty in
    their out-of-pocket cost.
        Third, I believe that value-based agreements have the
    potential to transform how medicines are priced and reimbursed
    in the U.S. In our own value-based agreements, the price of a
    medicine is directly linked to the value it provides to
    patients, to payers, and to the health-care system.
        For example, last month we announced an agreement for
    University of Pittsburgh Medical Center Medicare patients who
    are prescribed Brilinta. This innovative contract directly
    reduces the cost for patients, and it ties price to clinical
    value, basing our payments on patient outcome. These types of
    agreements can be especially effective for medicines where
    there is limited competition. As an example, for one of our
    oral oncology medicines we agreed to reimburse a large payer
    for discontinued use because patients did not respond to
    treatment. And we have reimbursed the payer under those
    agreements 20 percent of the time.
        To that end, I appreciate the support of Senator Warner and
    Senator Cassidy for value-based agreements, as demonstrated by
    their request for input on the Patient Affordability, Value,
    and Efficiency, the PAVE Act.
        My fourth proposal is that we must encourage biosimilars
    and eliminate policy and commercial barriers to their greater
    use. Biologics are actually making very important contributions
    to medicine, and I believe a vigorous biosimilar market would
    reduce costs like generics do for small molecules. In fact,
    biosimilars have gained up to 85 percent market share in the 5
    largest countries in Europe, and the average biosimilar
    discount is between 40 and 80 percent.
        In closing, I would like to emphasize my strong commitment
    to addressing the concerns raised by the committee. I believe
    that we can work together to find solutions that continue to
    allow manufacturers to innovate, while creating a more
    efficient and more affordable system.
        There are no easy answers, it is very clear, but we want to
    be a constructive partner. Thank you, and I look forward to the
    discussion.
        [The prepared statement of Mr. Soriot appears in the
    appendix.]
        The Chairman. Dr. Caforio?

    STATEMENT OF GIOVANNI CAFORIO, M.D., CHAIRMAN OF THE BOARD AND
      CHIEF EXECUTIVE OFFICER, BRISTOL-MEYERS SQUIBB COMPANY, NEW
                                YORK, NY

        Dr. Caforio. Chairman Grassley, Ranking Member Wyden, and
    members of the committee, good morning, and thank you for the
    opportunity to be here today on behalf of the 24,000 employees
    of Bristol-Myers Squibb. I look forward to working together to
    align incentives to ensure all Americans have access to the
    medicines they need.
        I am a physician. I joined the pharmaceutical industry 30
    years ago because of the impact companies like ours have on
    patients.
        We should all be proud that American companies lead our
    industry. Our researchers have contributed to the development
    of medicines that have reduced mortality from cardiovascular
    disease, helped transform HIV/AIDS into a chronic disease, and
    are now making significant progress with the treatment of
    cancer.
        Just 10 years ago, the idea of harnessing the immune system
    to treat cancer was viewed with great skepticism. But our
    researchers saw the promise of that approach and ignited an era
    of scientific innovation that has changed survival expectations
    in multiple tumors. Prior to the availability of immuno-
    oncology treatments, only 25 percent of patients diagnosed with
    metastatic melanoma were alive after 1 year. Today, thanks to
    immuno-oncology therapies, that number has increased to 74
    percent.
        The potential of this approach has also been seen in lung
    cancer, kidney cancer, and many other difficult-to-treat
    tumors. These patients now have a chance for quality and long-
    term survival.
        But not all patients respond to current immunotherapies.
    And so we must do more. We recently opened a new facility
    dedicated to investigating what we call immuno-oncology
    resistance. And we continuously seek external innovation to
    augment our pipeline. In fact, in this context, we recently
    announced our plans to acquire Celgene. Our goal is to bring
    together the drive and dedication of two science-driven
    companies to do even more for patients.
        As a physician, I do recognize that medicines are only
    helpful if patients and health-care systems can afford them. We
    share the committee's concern with escalating health-care costs
    and believe that our responsibility extends to ensuring that
    patients have access to and can afford our medicines. For this
    reason, the average net pricing across our U.S. portfolio of
    medicines increased by 5 percent or less year-over-year for the
    last 5 years. Importantly, it did not increase at all in 2018.
    And we expect that it will not increase in 2019.
        Despite this fact, we do recognize that patients' out-of-
    pocket costs continue to increase. We believe it is possible to
    work together to realign incentives to ensure patients can
    afford medicines without stifling scientific innovation. So
    what are the solutions? We are supportive of the proposed rule
    aimed at reforming the rebate system with a focus on what is
    best for patients.
        We need to ensure more generics are available whenever
    permissible under our system. We support value-based purchasing
    arrangements that tie payments to value. These models can
    reduce costs, improve access and patient adherence, and
    contribute to better outcomes.
        We applaud efforts by Health and Human Services and this
    committee in all of these areas. We do believe the U.S. should
    not adopt policies that stifle innovation in other countries.
    Outside of the U.S., reimbursement of new medicines often takes
    more than 2 years. For example, nearly 4 years ago our Opdivo
    and Yervoy regimen was first approved to treat metastatic
    melanoma in the U.S. Today, 6 of the 16 countries included in
    the international price index proposal still do not provide
    reimbursement for this combination, which is the standard of
    care for the treatment of this cancer. This is why we do not
    support the proposed international price index model for
    Medicare Part B drugs.
        I would like to leave you with a few thoughts. First, we
    recognize the need for change. We are witnessing a historic era
    in biomedical innovation. American research-based companies are
    leading the way to help patients whose diseases cannot be
    adequately treated with today's medicines. But we must ensure
    that patients have affordable access to new innovations. And we
    should work on policies that support and reward access and
    these investments. I look forward to working together to
    implement real change that broadens access to innovative
    medicines for patients.
        In closing, on behalf of my colleagues at Bristol-Myers
    Squibb and the patients we serve, my sincere thanks for your
    time and attention today.
        The Chairman. Thank you very much.
        [The prepared statement of Dr. Caforio appears in the
    appendix.]
        The Chairman. Now, Ms. Taubert?

       STATEMENT OF JENNIFER TAUBERT, EXECUTIVE VICE PRESIDENT,
    WORLDWIDE CHAIRMAN, JANSSEN PHARMACEUTICALS, JOHNSON & JOHNSON,
                           NEW BRUNSWICK, NJ

        Ms. Taubert. Chairman Grassley, Ranking Member Wyden,
    members of the committee, thank you for the opportunity to be
    here today. I am Jennifer Taubert, and I lead the Janssen
    Pharmaceutical Companies of Johnson & Johnson. We focus on
    discovering and developing transformational medicines for some
    of the world's most challenging diseases, including multiple
    myeloma, prostate cancer, HIV, schizophrenia, and Crohn's
    disease, among others.
        Like many of you, I know what it is like when a loved one
    faces serious illness. My own mother died of lung cancer while
    in her 40s, and at that time there was very little that could
    be done for her. I have committed my career to bringing
    families hope: hope for years of life, for the chance to be
    there for a daughter's wedding or for a grandson's birth.
        Janssen invested $8.4 billion in research and development
    last year in the search for medical breakthroughs, making us
    one of the world's top R&D investors in any industry. In fact,
    our investment in R&D last year was 86 percent more than we
    spent on sales and marketing. And this substantial investment
    is changing lives. It has helped turn HIV from a death sentence
    to a manageable disease. Our targeted cancer medicines have
    helped patients with some of the most deadly cancers live
    longer, in some cases for many years.
        Medicines not only help patients and families. They also
    help lower overall health-care costs by keeping people well,
    preventing the need for expensive procedures and
    hospitalizations. But medicines cannot make a difference if the
    patients who need them cannot afford them. We understand the
    concerns about the cost of health care.
        Our approach recognizes our responsibility to patients
    today and patients tomorrow. Patients today need access to our
    medicines. Patients tomorrow count on us to deliver cures and
    treatments for the most challenging diseases. When we price our
    medicines, we balance the value to patients, the importance of
    affordable access, and the importance of developing future
    breakthroughs. The list price is a starting point that is
    reduced by required discounts to government programs and
    rebates to payers so they will grant patients access to our
    medicines.
        Last year our discounts and rebates amounted to $21 billion
    and our net price decreased 6.8 percent. Unfortunately, while
    our overall price decreased for the past 2 years, patients have
    seen their out-of-pocket costs go up. One reason is increased
    enrollment in health plans that require patients to pay more
    for their prescriptions. As one recent analysis shows, patients
    are required to pay 13 percent of overall pharmaceutical costs,
    versus only 3 percent of hospital costs, even though medicine
    can help keep patients out of the hospital.
        Above all, we need an American solution to this American
    challenge. We must ensure that today's medicines are
    affordable, while at the same time preserving the innovation
    that has delivered so much and promises even more. We must
    maintain the hallmarks that make American health care
    remarkable: access to innovative therapies, personal choice,
    and doctors and patients making decisions based on what is
    right for each individual.
        At Janssen, we are committed to being a part of the
    solution. We believe open dialogue is essential. That is why in
    2016, we began issuing the Janssen Transparency Report, sharing
    information about how we invest our resources, price our
    medicines, and help people access them. And we recently
    announced our plan to include list price and potential patient
    out-of-pocket costs in our direct-to-consumer TV advertising.
    In the same spirit of open dialogue, we have consistently
    brought forward ideas and perspectives to both Congress and the
    administration to fix what is not working while preserving what
    is.
        We have included more details in our submitted testimony,
    but I want to touch on a few points today. First, while
    Medicare Part D is working for many seniors and has been
    effective in containing costs, we believe an out-of-pocket cap
    is a needed protection.
        Second, in Medicare Part B, we have proposed options that
    would allow Medicare to continue to achieve negotiated savings
    through market competition while reducing costs.
        And third, we support rebate reforms that ensure patients
    benefit from the negotiated rebates and discounts--$150 billion
    in total in 2017 alone--and as a result, have patients see
    lower out-of-pocket costs at the pharmacy.
        We are on the verge of extraordinary progress that could
    change our lives and the lives of our children and
    grandchildren. At Janssen, we are committed to bringing that
    promise to life.
        Thank you very much.
        The Chairman. Thank you.
        [The prepared statement of Ms. Taubert appears in the
    appendix.]
        The Chairman. Mr. Frazier?

     STATEMENT OF KENNETH C. FRAZIER, CHAIRMAN AND CHIEF EXECUTIVE
            OFFICER, MERCK AND COMPANY, INC., KENILWORTH, NJ

        Mr. Frazier. Mr. Chairman, Ranking Member Wyden, and
    members of the committee, thank you for the opportunity to
    appear here today.
        Merck's mission is to save and improve lives around the
    world by bringing forward breakthrough medicines and vaccines.
    Research is at the core of Merck. Last year we invested $10
    billion in R&D, 23 percent of product sales. And we have
    invested nearly $70 billion over the past decade.
        Over the last 5 years, we have also made capital
    investments of over $5 billion in the United States, and we
    plan to invest more than $9 billion more over the next few
    years to increase manufacturing capacity and to open two new
    research centers in the United States.
        We go where the science leads us, which means we do not
    focus only on diseases in wealthier countries. For example, we
    are proud to have deployed 70,000 doses of our experimental
    Ebola vaccine in the Congo, working in partnership with the
    United States government. The goal is to save lives even where
    no viable commercial opportunity exists. We do all this to
    serve patients.
        We fully understand that U.S. patients are having a harder
    and harder time affording the medicines they need. While
    medicine costs are growing at the slowest rate in years, our
    patients are too often being asked to pay more out of pocket. I
    am here to suggest some ways that together we can address this
    problem. First, we want to be clear that our industry has a
    duty to be responsible in our pricing practices and to
    contribute to solutions that address patient affordability.
        Merck has a history of responsible pricing. We publish
    information about our prices, and the rebates and discounts we
    provide to payers. Last year we pledged that we will not
    increase our average net prices across our portfolio by more
    than the rate of inflation annually
        Second, we must ensure that patients get the benefit of
    these large rebates and discounts. The incentives in the
    current system are badly misaligned with the growing gap
    between list and net prices, creating incentives to favor
    products with higher list prices. This misalignment hurts
    patients because their cost sharing is often based on the list
    price of a drug. We urge you to support action to ensure that
    patients benefit from these discounts.
        Third, we can significantly reduce drug spending for
    patients in the health-care system by ensuring that we have a
    viable biosimilars market in the United States. We urge
    Congress to encourage and support greater biosimilar
    utilization.
        Fourth, we believe that prices can better align with a
    drug's value, when manufacturers and payers are able to
    negotiate innovative contracts that base payment on a drug's
    benefit. We need to move to this type of system, but there
    remain major regulatory and operational obstacles to such
    value-based arrangements, which we urge Congress to address. We
    agree that manufacturers should be rewarded based on the value
    that our therapies deliver.
        Fifth, we support efforts to encourage generic competition.
    A version of Chairman Grassley's CREATES Act and similar
    policies could make needed reforms to encourage generic
    competition and ensure there is no inappropriate gaming of the
    system. We also support eliminating coupons in cases where
    brand name generic competition exists.
        Finally, we would like to work with the committee to find
    ways to end price gouging by some who excessively increase off-
    patent drug prices where there is no competition. These high
    prices hurt patients, and they do not create incentives for
    research. These changes could bring real relief to today's
    patients while preserving the incentives to invest in
    tomorrow's breakthroughs. Decades of research investment are
    now yielding life-changing discoveries. If we damage the
    biomedical ecosystem that thrives on these investments, we will
    surely limit what can be achieved for patients and society.
        The single most important thing we do at Merck is to
    persist in making large and risky investments in R&D that allow
    our thousands of researchers to sit at their lab benches to try
    to create something transformative despite the overwhelming
    odds that their efforts will not succeed, since more than 9 out
    of 10 compounds fail.
        I would like to end on a brief personal note. My mother
    died when I was a child, and my siblings and I were raised by
    my father. He was a giant in my life, and I was devastated when
    Alzheimer's took him away from us.
        Last year, after spending many years and over $1 billion,
    Merck had to end development of a promising Alzheimer's therapy
    because it did not work. Yet we continue on, seeking better
    approaches, and I truly believe that Merck or one of the other
    companies at this table will find a medicine that will avoid
    the pain of seeing a loved one taken away from them in this
    way.
        This vital work depends on having a U.S. market that is
    free, competitive, and predictable. We must work together to
    solve the affordability challenges of today's patients without
    jeopardizing the hopes of those waiting for tomorrow's cures.
    The changes I have discussed today have the potential to vastly
    improve the market while lessening the financial hardships many
    people face.
        I am here to pledge Merck's cooperation with you in
    creating such changes. Thank you very much.
        The Chairman. Thank you, Mr. Frazier.
        [The prepared statement of Mr. Frazier appears in the
    appendix.]
        The Chairman. Now, Dr. Bourla?

                STATEMENT OF ALBERT BOURLA, DVM, Ph.D.,
             CHIEF EXECUTIVE OFFICER, PFIZER, NEW YORK, NY

        Dr. Bourla. Good morning. Chairman Grassley, Ranking Member
    Wyden, and members of the committee, thank you for the
    invitation. My name is Albert Bourla. I have been with Pfizer
    26 years and just last month became its chief executive
    officer.
        I have to say that today I am particularly humbled to take
    part in such an important policy discussion within the United
    States Senate. When I immigrated into the United States 18
    years ago, I could never have imagined such an honor.
        In that frightening moment when you hear that you or a
    loved one has been diagnosed with a serious disease, one
    question comes to mind: is there a treatment available? The
    answer to this question will change your life. Happily the
    answer, increasingly, is ``yes.''
        New breakthroughs are coming quickly to treat many
    difficult and devastating diseases. But these breakthroughs
    will not do anyone any good if patients cannot afford them. And
    unfortunately, the horribly misaligned incentives within our
    health-care system often make medicines unaffordable for
    American patients. We need to fix this. Today, we would like to
    propose four ideas to drive meaningful savings for patients.
        The first idea is passing all rebates to patients. Pfizer
    supports a system in which transparent up-front discounts
    directly benefit patients, rather than the system where rebates
    are swallowed up by the supply chain. In the current system,
    for example, none of the approximately $12 billion that Pfizer
    paid in rebates, in 2018, found its way to American patients.
    If the proposed rule to share rebates with consumers at the
    point of sale is finalized, we estimate that seniors taking
    Pfizer medicines could save hundreds of dollars a year, on
    average.
        The second idea is less volume, less pay. Imagine a system
    where Pfizer gets paid based on the number of heart attacks we
    prevent, rather than on the number of pills we sell. In such a
    system, if our medicines do not produce good results, we should
    be paid less. And if they do, we should be paid more.
        Such value-based payment arrangements, if done correctly,
    can align the interests of patients, insurance companies, and
    biopharmaceutical companies around one shared goal, ensuring
    positive health outcomes for patients. I understand that
    several members of this committee are working on legislation to
    pave the way for these types of arrangements. And we applaud
    this effort.
        The third idea is around capping seniors' out-of-pocket
    medicine costs. Patients are increasingly being required to
    take on a disproportionately higher share of their medicines'
    costs. Today patients pay on average 14 percent of the cost of
    their medicines, but they pay only 3 percent of the cost
    associated with hospital stays, for example. This is forcing
    patients to forego taking needed medications or to limit their
    doses. This is bad, not only for patients, but also for overall
    system costs. Patients who do not take their medicines often
    end up in the hospital, costing much more to the system. An
    important first step is capping out-of-pocket costs seniors
    experience in the medical drug program.
        And the fourth idea is to knock down barriers to lower-cost
    biosimilars. Others have spoken about it. Adverse incentives
    that favor higher-cost biologics are keeping biosimilars from
    reaching patients. In many cases, insurance companies declined
    to include lower-cost biosimilars in their formularies because
    they would risk losing the rebates from covering higher-cost
    medicines. I cannot think of a more concerning example of a
    broken system, and we need to do something about it.
        In closing, Pfizer is all about breakthroughs that change
    patients' lives. This is why our more than 90,000 colleagues,
    many of whom work in laboratories and manufacturing plants in
    States represented by members of this committee, come to work
    every day. And it is why we are here today, to work with you
    and all stakeholders to find ways to ensure that we can
    continue to discover medicines that can change patients' lives.
        The Chairman. Thank you.
        [The prepared statement of Dr. Bourla appears in the
    appendix.]
        The Chairman. Now to Dr. Brandicourt.

        STATEMENT OF OLIVIER BRANDICOURT, M.D., CHIEF EXECUTIVE
                    OFFICER, SANOFI, BRIDGEWATER, NJ

        Dr. Brandicourt. Chairman Grassley, Ranking Member Wyden,
    and members of the committee, thank you for the opportunity to
    appear before the Senate Committee on Finance to discuss
    pharmaceutical pricing, affordability, and patient access. I am
    Olivier Brandicourt, the chief executive officer of Sanofi. I
    understand the anger about rising out-of-pocket costs for many
    medicines, including insulins.
        I appreciate the confusion as to why patient costs continue
    to rise, even when the amount that PBMs and health plans pay
    declines. This situation is unacceptable and unsustainable for
    too many patients. My goal today is to have an honest
    discussion about how the system works, and how it can be
    improved. As you may know, 2 years ago Sanofi announced our
    progressive and industry-leading principles.
        First, we made a pledge to keep price increases at or below
    the U.S. national health expenditure projected growth rates.
    Second, we committed to providing a clear rationale for pricing
    when we launch new medicines. And third, we have increased
    transparency by providing each year information about our list
    and net prices across all of our medicines.
        In 2018, the average aggregate least-price increase across
    all Sanofi medicines in the U.S. was 4.6 percent, while the
    average aggregate net price--that is the price actually paid to
    Sanofi--declined by 8 percent. So declining average aggregate
    net price in 2018 represents a third consecutive year in which
    the amount paid by payers across all of our medicines went
    down.
        I feel a special obligation to address the pressing issues
    around access and affordability of our insulins. Insulin is a
    clear example of the growing gap between list and net prices.
    Since 2012, the net price of Sanofi insulins has declined 25
    percent. Yet patient out-of-pocket costs have continued to
    rise. If you take Lantus, for instance, our most prescribed
    insulin, the net price has fallen by 30 percent since 2012. Yet
    over the same period, average out-of-pocket costs have risen
    approximately 60 percent for patients with commercial insurance
    and Medicare. It is my belief that declining net prices should
    result in lower out-of-pocket costs for patients. But clearly,
    this is not always the case.
        Addressing these prices alone will not be sufficient to
    solve the problem of patients' out-of-pocket costs. As we look
    for solutions, we must have protections for patients and link
    responsible pricing to both access and affordability. Every
    actor in the system has a role to play, and Sanofi takes this
    call to action seriously. There are different ways to
    accomplish these goals, and Sanofi could support options that
    align to our core principles. First, changes to the drug
    pricing and reimbursement system must be holistic, factoring in
    all actors in the system. And the majority of benefits should
    accrue to patients.
        And second, to maintain a strong environment for innovation
    in the United States, the government should not directly
    control the price of medicines, either through Federal
    Government price controls, or worse, outsourcing price
    decisions to other countries.
        To ensure that responsible pricing translates to better
    access and affordability for patients, Sanofi supports the
    policy solutions outlined in my written testimony, including
    several policies introduced by members of this committee, such
    as the CREATES Act, the C-THRU Act, and the SPIKE Act.
        So thank you for the invitation to speak with you today,
    and I look forward to answering your questions.
        The Chairman. I thank all of you for your testimony.
        [The prepared statement of Dr. Brandicourt appears in the
    appendix.]
        The Chairman. And I think I heard from each of you that you
    are willing to work with us and people in the administration to
    find solutions to these problems. I welcome that sort of
    cooperation and just implore you that that cooperation will
    have to go on weeks beyond this hearing, because we would not
    expect to get all the information we need just at this hearing.
        Now, we will go to questioning. Do not start my clock yet.
    I have not asked my questions yet. [Laughter.]
        Before I ask questions, if I could have--obviously, we have
    a very important meeting here. We have seven witnesses. We have
    24 or 25 members of this committee.
        I think I am fairly liberal in letting people ask
    questions. But I want to repeat something I have said before,
    and that is that if you will take your 5 minutes, and if there
    are a few seconds left, you ask a question then--hopefully, it
    is a short question at that point, and hopefully there is a
    short answer at that point.
        What irritates me about that process is when somebody
    thinks they can have back and forth for 3 or 4 minutes after
    you ask your last question. So I am asking you, if you would
    please be tolerant towards people who abide by the 5 minutes,
    to be respectful of that so that everybody gets a chance to ask
    questions.
        Now my 5 minutes starts. [Laughter.]
        I want to thank those of you who are here who said you
    would be supportive of legislation that I have been backing for
    a long period of time: CREATES, which is sponsored by Senator
    Leahy and this Senator, and Pay-for-Delay by Senator Klobuchar
    and this Senator. So those are bipartisan bills.
        One other bipartisan bill that you probably do not know
    about yet--it was introduced by Senator Wyden and me a couple
    weeks ago--is called the Right Rebate Act, which would close a
    loophole that was exploited by Mylan in the EpiPen case.
        So leading to my questions, starting off, Ranking Member
    Wyden and I have been working--before I became chairman of this
    committee again, we investigated a lot about Gilead's pricing
    decisions for hepatitis C drugs. During that investigation, we
    acquired a document that listed some factors that Gilead
    considered when it priced those drugs.
        Those factors included the risk of ``public outcry'' or
    ``the likelihood of a letter from Congress'' or the
    ``likelihood of a congressional hearing.'' So taking off from
    that point, here is a very simple question to answer, I think.
    So I want a ``yes'' or ``no'' from each of you.
        When your company prices its drugs, do you consider the
    risk of negative public opinion in the pricing of that drug? We
    will start with AbbVie.
        Mr. Gonzalez. Senator----
        The Chairman. Can you answer ``yes'' or ``no''?
        Mr. Gonzalez. Yes, we do.
        The Chairman. Yes, you do. Okay.
        What about AstraZeneca?
        Mr. Soriot. Yes, we do, Senator. Amongst other factors, of
    course, but we do.
        The Chairman. Okay.
        What about Bristol-Myers?
        Dr. Caforio. Yes, we do, Senator, among many factors.
        The Chairman. Okay.
        Johnson & Johnson?
        Ms. Taubert. Yes, we do, Senator, as well as affordable
    access to the medicines for the patients.
        The Chairman. Okay.
        What about Merck?
        Mr. Frazier. Yes, we do, among other factors.
        The Chairman. Okay.
        And what about Pfizer?
        Dr. Bourla. Yes, we do, among other factors.
        The Chairman. And what about Sanofi?
        Dr. Brandicourt. Yes, we do, among other factors.
        The Chairman. Okay. Thank you.
        Another ``yes'' or ``no'' question: when determining list
    price, do you consider the likelihood of a congressional
    inquiry? Let's start with AbbVie.
        Mr. Gonzalez. No, we do not.
        The Chairman. What about AstraZeneca?
        Mr. Soriot. No, we do not, Senator.
        The Chairman. What about Bristol-Myers?
        Dr. Caforio. No, Senator, we do not.
        The Chairman. And what about Johnson & Johnson?
        Ms. Taubert. No, Senator, we do not.
        The Chairman. Okay; and Merck?
        Mr. Frazier. Not explicitly.
        I would say we do care what the public thinks.
        The Chairman. Okay.
        And what about Pfizer?
        Dr. Bourla. No, we do not think----
        The Chairman. Okay. What about Sanofi?
        Dr. Brandicourt. Same, Senator; we do not.
        The Chairman. Okay.
        Then I would have another ``yes'' or ``no'' question. When
    your company prices its drugs, do you take into account the
    fact that a key player is the Federal Government?
        Let us start with AbbVie.
        Mr. Gonzalez. We evaluate all the channels when we make
    determinations on price and affordability.
        The Chairman. Okay.
        So that obviously would include the Federal Government.
        Mr. Gonzalez. Correct.
        The Chairman. AstraZeneca?
        Mr. Soriot. Yes, we use the same approach, and of course
    the Federal Government is a very key aspect of our
    deliberations.
        The Chairman. Okay.
        Bristol-Myers?
        Dr. Caforio. Yes, Senator, because the Federal Government
    is a large part of our----
        The Chairman. Okay.
        Johnson & Johnson?
        Ms. Taubert. Yes, we take into account the value to
    patients, the health-care system, and society, and the
    government is a key part of that.
        The Chairman. Okay.
        And Merck?
        Mr. Frazier. Yes.
        The Chairman. Okay.
        And Pfizer?
        Dr. Bourla. Absolutely.
        The Chairman. And then Sanofi?
        Dr. Brandicourt. Yes.
        The Chairman. Okay.
        My last question. ``Yes'' or ``no'': some of you have
    voiced support for the recent rebate rule proposed by the
    administration. Should the administration finalize this rule,
    will you commit to lowering your drug prices?
        Mr. Gonzalez. Mr. Chairman, we are supportive of the rule.
    We would like to see it in its final form, obviously, to make a
    final decision. But we are supportive of taking the discount to
    the patient at the point of sale.
        The Chairman. Okay.
        AstraZeneca?
        Mr. Soriot. The same for us, Senator. I would go one step
    further: if the rebates were removed from the commercial sector
    as well, we would definitely reduce our list prices.
        The Chairman. Okay.
        And Bristol-Myers?
        Dr. Caforio. We have the same position, sir.
        The Chairman. Okay.
        And Johnson & Johnson?
        Ms. Taubert. Yes, we are supportive, and that definitely
    would be my goal. We would just need to see the final
    legislation, provided that there are not additional fees that
    are added into the system to compensate for the rebates.
        The Chairman. Okay.
        Merck?
        Mr. Frazier. I would expect that our prices would go down
    if we change the system, again, on the commercial side as well
    as the Medicare side.
        The Chairman. Okay.
        Pfizer?
        Dr. Bourla. It is our very clear intention that we will not
    keep a single dollar from these rebates. We will try to move
    every single penny to the patients. And we think if this goes
    also to the commercial plans, that would be even better for
    more patients.
        The Chairman. Okay.
        Sanofi?
        Dr. Brandicourt. Lowering list price has to be linked to
    better access and affordability at the counter for the
    patients.
        The Chairman. Okay.
        I want fellow colleagues to know that I stopped at 5
    minutes and 26 seconds.
        Senator Wyden?
        Senator Wyden. Thank you, Mr. Chairman.
        Let me start, if I could, with you, Mr. Bourla, on this
    list price question. And I want to see if we can do a couple of
    ``yes'' or ``no'' questions.
        Is it correct that your company, and nobody else, sets the
    starting price for all drugs sold by Pfizer? That is a ``yes''
    or ``no.''
        Dr. Bourla. It is a negotiation with PBMs, and they are
    very powerful.
        Senator Wyden. But you still get to set the list price?
        Dr. Bourla. Yes, but we set----
        Senator Wyden. Okay.
        Dr. Bourla [continuing]. The list price and the rebates
    based on----
        Senator Wyden. Is it correct when a hypothetical patient--
    let us call her Mrs. Jones--goes to pay for her drug at the
    pharmacy counter, her coinsurance is based on the price of the
    drug you set?
        Dr. Bourla. It is correct in many cases.
        Senator Wyden. Okay.
        I just want you all to know that the number one reason
    consumers are getting hammered is because these list prices--
    and you have the last word with respect to where they are--are
    unaffordable. And the high prices are tied to what the consumer
    pays at the pharmacy counter. And all this other stuff you talk
    about--the rebates and the discounts and the coupons--all this
    other stuff is window dressing, all of it. And the fact is on
    Part D, 40 percent of the drugs do not even have a rebate.
        So I want it understood--particularly, because I have asked
    you, Dr. Bourla--I think you and others in the industry are
    stonewalling on the key issue, which is actually lowering list
    prices. And reducing those list prices is the easiest way for
    American consumers to pay less at the pharmacy counter.
        Now, Mr. Gonzalez, I want to ask you some questions
    relating to the international pricing situation. Drug prices
    are much higher in the United States than in other developed
    countries, on average 40 percent higher. In 2017, AbbVie made
    $9.9 billion in revenue outside the United States.
        So my first question to you is, do you make a profit on the
    drugs that you sell in Germany or in France?
        Mr. Gonzalez. Yes, we do.
        Senator Wyden. So if you do, and you have said that that is
    the case, if you can turn a profit in a country with
    dramatically lower prices, you can do the same thing in the
    United States. How is that not gouging the American consumer
    with high prices, even though you are giving other people in
    Western industrialized countries a better deal?
        Mr. Gonzalez. Senator, it is a great question. And the
    reality is--and I do not think it is just unique to AbbVie--
    that prices vary dramatically around the world. There is no
    question, at least in AbbVie's business for the most part, the
    U.S. has some of the highest prices in the world.
        That is not universally true. The government has some
    relatively low prices in comparison. But I think the
    fundamental issue is this: our system is built around a variety
    of pricing around the world, but that overall system supports
    our R&D model.
        If a market the size of the United States were to collapse
    to the lower end of that pricing model, then I can just tell
    you AbbVie would not be able to invest the level of R&D that it
    invests today. So that is the reality.
        Senator Wyden. Well, I think time is short.
        As I noted in my opening statement, global R&D spending is
    far less than the revenue you make in America. American
    patients bring in more than enough revenue to cover your R&D
    costs.
        I mean, I am going to have town meetings in a few days at
    home, and people will say, ``Ron, this is ridiculous that we
    are getting gouged when people around the world are getting a
    better deal.'' And what you have told me today is: (a) they are
    getting a better deal and you can make a profit; and (b) it is
    somehow tied to research and development. And the fact is that
    research and development is less than the revenue that you are
    making in this country, and that is why people are so angry.
        And I would also like to note that a Humira biosimilar was
    launched in Europe last year, and due to AbbVie's anti-
    competitive behavior in the United States, that same biosimilar
    will not be available here until 2023. You have a double
    standard. You are willing to sit by and hose the American
    consumer and give the breaks to people overseas.
        So I am going to wrap up and stick to the chairman's time
    limit by asking you for a response in writing. So that we can
    better understand the situation for the drugs you sell in other
    countries, I would like to know, for the drugs you sell in
    other Western industrialized countries--just the Western
    industrialized countries--does your company make or lose money?
    Can you get that to me in writing within 10 days?
        Mr. Gonzalez. I can give it to you right now.
        Senator Wyden. Okay.
        Mr. Gonzalez. We make money in any country that we sell in
    unless we choose to donate the product into those countries.
    And we do that in certain countries that cannot afford it, but
    not the Western----
        Senator Wyden. I would like it in writing.
        Mr. Gonzalez. Okay.
        One thing I would like to point out that I do not think is
    totally accurate that you described, at least for AbbVie, is we
    spend $5.2 billion dollars in R&D. We make $5.6 billion dollars
    in earnings.
        So our R&D is almost equivalent to what our earnings are.
        Senator Wyden. Well----
        The Chairman. I am going to----
        Senator Wyden. We will continue that.
        The Chairman. I am going to list four names at a time.
    Roberts will be next, and then Stabenow, and then Enzi, and
    then Cantwell. So if you are irritated about how you might be
    on this list, take it out with one of your colleagues on the
    committee, because I am reading it just the way the staff gave
    it to me.
        So, Senator Roberts?
        Senator Roberts. Thank you, Mr. Chairman. I will try to be
    timely.
        This whole situation reminds me of when Mark Twain, i.e.,
    Samuel Clemens, went to Missouri--that was his first mistake--
    and made some remarks to a small town. The mayor afterwards
    said, ``Well now, we have the tar and the feathers and a rail.
    We would like to ride you out of town on a rail.'' He said,
    ``If it was not for the honor of it, I'd just as soon not do
    that.''
        And I think in some ways that is where you are sitting
    right now. I worry about the cost. I worry about the access. I
    worry about the value. I worry about the fact that when I go--I
    did just last night, and all of a sudden I found out that the
    prescription I had cost twice as much. I still have not quite
    figured that out. I do not know which one of you to blame.
        But at any rate, I worry about HHS. I worry about CMS. I
    worry about the Federal Government taking over with regards to
    the decisions that you make. I also worry about what the
    distinguished Senator from Oregon described as a terrified
    public, and certainly we do not want any liars.
        I want to ask you one simple question. Staff has arranged
    about seven good questions. I will submit them for the record.
        Under the banner of certainty and predictability, what
    keeps you up at night? In other words, if in fact we invited
    you back and you could come back--well, let me put it another
    way. What would happen if you ran into some things that were
    unprecedented and you would not be here? We would not have the
    Magnificent Seven, if in fact that's why we won a ``W.''
        What I want to know is, what is the thing that keeps you up
    at night, so you could be a viable company now and down the
    road to achieve what we all want in terms of access and cost?
    And I am going to start with Dr. Brandicourt, because I want to
    go from right to left for a change.
        Dr. Brandicourt. Thank you, Senator. What keeps me up at
    night is ensuring that I have a pipeline of new products which
    is innovative enough to alleviate, you know, some of the
    disease burdens in the countries where we are. So it is making
    our company meaningful and delivering what we are supposed to
    do best.
        Senator Roberts. Thank you.
        Dr. Bourla. Mr. Senator, the reason we exist is to bring
    breakthroughs that change patients' lives. And this is what
    keeps me up, and this is the reason why our employees come to
    work. This is the reason why our investors invest in us.
        If our pipeline will not deliver on the promise--and this
    is very challenging, because you are dealing with very
    difficult diseases to crack--then we will not be able to
    fulfill our promise to society and will not be able to fulfill
    our promise to investors.
        Senator Roberts. Mr. Frazier, thank you for your five-point
    plan. What say you?
        Mr. Frazier. I would say, Senator, the thing that keeps me
    most up at night is the concern that we will not have a viable,
    predictable market that will allow people to continue to put
    the very large amounts of money at risk for a long period of
    time in an attempt to find solutions to some of the hardest
    problems, like Alzheimer's, that have evaded solutions.
        And what really concerns me is when we do not treat these
    issues as systemic issues and the public thinks that they have
    to have outrageous solutions to the problem where, in the
    future, we will not get these drugs.
        So I would hope that we could talk about these things
    systemically and try to come up with the kinds of solutions
    that will, in fact, make patients have access to medicines
    today while allowing tomorrow's breakthroughs to happen. Thank
    you.
        Senator Roberts. Thank you.
        Ms. Taubert?
        Ms. Taubert. Senator, the easy diseases have largely been
    solved. It gets harder and harder as we go after new treatments
    and new cures for ever more challenging diseases.
        So from our perspective, what keeps me up at night is that
    investment in innovation and the ability to continue to invest
    to be able to go after the cures and the diseases that we
    really want to solve.
        Senator Roberts. Thank you.
        Dr. Caforio?
        Dr. Caforio. Mr. Senator, I am a physician, as I said
    earlier. What keeps me up at night is our patients who still do
    not have an opportunity for their cancer to be treated. And as
    a result of that, I am really focused on, first, continuing to
    invest in R&D together with the 7,000 scientists at Bristol-
    Myers Squibb, and also making sure that every patient who needs
    one of our medicines has access to it.
        Senator Roberts. Mr. Soriot?
        Mr. Soriot. Senator, two things, actually. One is making
    sure we have the best science, the best scientists, and an
    environment that stimulates their innovation. The second is
    really to come up with ways to demonstrate the value of our
    products. I believe that medicines are actually part of the
    solution, not part of the problem. And it is sad that we are
    talking about those difficulties patients are facing.
        In the last 15 years, the mortality for cardiovascular
    disease has declined by 35 percent. Most of this is due to good
    treatments for hypertension, cholesterol. And in fact, it is
    cost-effective. We keep patients out of the hospital.
        So the one thing that really keeps me up at night is, how
    do we demonstrate the value we bring, and how do we reduce
    overall health-care costs?
        Senator Roberts. Mr. Gonzalez, I am out of time.
        The Chairman. No, he can answer. You asked your question.
        Go ahead.
        Senator Roberts. Thank you for being so liberal.
    [Laughter.]
        Mr. Gonzalez. Thank you, Senator.
        There are two things that keep me up at night. The first is
    we, like many around this table, are working on some of the
    toughest diseases that are out there, which takes on tremendous
    amount of risk--I am sure you heard that many, many times.
        But the reality is, when we work on these diseases, like
    Alzheimer's as an example, when someone comes up with a
    beneficial treatment for Alzheimer's, it is going to change the
    lives of patients, families, and it is going to reduce
    dramatically health-care costs. But not necessarily the cost of
    medicine.
        The cost of medicine is going to go up. The cost of nursing
    homes is going to go down. And systems have a very difficult
    time trying to measure that benefit, but the reality is, when
    you are working in these areas with these kind of intractable
    diseases, that is the ultimate payback that the system has to
    be able to evaluate.
        Senator Roberts. Thank you.
        The Chairman. Senator Stabenow?
        Senator Stabenow. Thank you very much, Mr. Chairman and
    Ranking Member.
        Thank you for being here. I will tell you what keeps people
    in Michigan up late at night. It is the cost of life-saving
    medicine for themselves, their children, their parents. And so
    that is why it is important that we are here, and I am glad we
    are talking about research, because I would like to step back a
    moment and talk about who basically is funding research, and I
    hope you will say ``thank you'' to the American taxpayer,
    because American families fund the National Institutes of
    Health.
        A recent report found that NIH-funded research contributed
    to every single one of the 210 new drugs approved by the FDA
    from 2010 to 2016, and that American taxpayers contributed more
    than $200 billion in grants--$200 billion in grants to your
    companies and others. Grants, not loans; grants to develop
    these drugs.
        That is about 200,000 years of accumulated research. And I
    support that, because the basic research is something that I
    believe we all need to share in. At the same time, when you
    then go from there and are doing R&D, you can write that off
    your taxes, so American taxpayers subsidize you again.
        Now, according to the most recent SEC filings, the seven
    companies--all of you here today--have spent about $80 billion
    on selling, marketing, and administrative expenses last year,
    which was $22 billion more than you spent on R&D.
        So let us just be clear on this: American taxpayers, we are
    happy to help you be able to develop these drugs, but I can
    tell you, people in Michigan just feel that the bargain ought
    to be that they ought to be able to afford the medicine after
    they have helped to develop it.
        Between 2006 and 2015, the largest 25 drug companies
    enjoyed an average annual profit of between 15 and 20 percent.
    Most other large Fortune 500 companies saw between 4 and 9
    percent.
        I know the auto industry would love to get the kind of
    profits that you have. But the reality is that, if people do
    not buy a car, they do not buy furniture, their life is not
    threatened. If they cannot buy your product, it may be. So that
    is why this is so important today.
        And, Mr. Gonzales, I want to specifically start with you,
    because Humira is the world's best-selling drug. It treats
    arthritis, Crohn's disease as we know, also ulcerative colitis.
    And you introduced the drug in 2003, and in 2017 it generated
    $18.4 billion in revenue. And if Humira was its own company, it
    would be among the Fortune 500 companies all by itself.
        So let us talk about this, because the average person on
    Medicare is earning $26,000 a year. The price of your drug
    started high and has gone higher, to a point now where it is as
    much as $50,000 a year.
        So, Mr. Gonzales, your primary patent expired in the U.S.
    in 2016. Is that correct?
        Mr. Gonzalez. That is correct.
        Senator Stabenow. And you have more than a hundred other
    kinds of patents for processes and techniques and so on. In
    fact, according to a report, ``Broad U.S. Humira Patent
    Estate,'' some of the patents go up to 2034, which gives you
    about 31 years of patent protection. That is a pretty good deal
    on this successful drug.
        When we look at what is happening around--well, let me
    first ask this. Has the drug itself gotten any better with all
    the new patents?
        Mr. Gonzalez. I think as you look at the evolution of the
    patent portfolio that is around Humira, it is important to keep
    in perspective that that patent portfolio evolved as we
    discovered and learned new things about Humira, in particular,
    as we discovered that this particular molecule could be
    utilized across a large number of different disease states.
        Senator Stabenow. And I am going to, unfortunately, in the
    interest of time--I appreciate that and would want to follow up
    in writing, but as I understand it, the chemical formula is the
    same. And so it is a question of how we use the patent system.
        But to look at, in Europe, when your patents expired in the
    fall of 2018 and biosimilars came out on the market, your
    prices there were already lower than in the U.S., but now you
    are offering, I understand, up to 80 percent discounts to be
    able to continue to compete in Europe. Why do you not--with all
    of the support from American taxpayers on this drug, why do you
    not offer the same low price to American families?
        Mr. Gonzalez. Because Humira plays a very important role in
    AbbVie's overall funding of R&D. And I think it is
    fundamentally underpinned by the fact that if you look at these
    inventions that we have created, that were patented, as I said,
    they included a number of different diseases for which Humira
    was effective, and they evolved over time.
        We think we have struck a reasonable balance. We have now
    licensed seven biosimilar players to the entire portfolio. So
    they can use that portfolio to go out and copy Humira. We have
    given licenses to them, and they will all enter the market in
    2023.
        The earliest patent to expire in that portfolio is June of
    2022. So, literally seven biosimilars will come within a year.
        Senator Stabenow. Mr. Gonzales, I know my time is up. Let
    me just say, I think that you charge more here because you can.
    And American taxpayers are subsidizing all of you to be able to
    have incredibly high profits, the fastest-growing part of the
    health-care system. And I think the people in Michigan and
    across the country deserve better. They need to be able to
    afford the medicine and not have to go to another country to
    get it.
        The Chairman. Senator Cantwell?
        Senator Cantwell. Thank you, Mr. Chairman.
        I wanted to get feedback on the market-type mechanisms and
    whether they would drive down costs to purchasers and to
    consumers. So concepts like allowing States to negotiate on
    behalf of a population for health-care plans, like the basic
    health plan in New York--do they drive down cost?
        [No response.]
        Senator Cantwell. No one wants to take that on?
        Mr. Frazier. Thank you, Senator. I did not know who the
    question was addressed to.
        I think first of all, it is important to recognize that
    there is no single market for drugs in this country. So for
    example----
        Senator Cantwell. We are on limited time, and I appreciate
    the chairman's great efforts. No, I am just trying to get
    ``yes'' and ``no'' answers whether these concepts drive down
    costs--whether you believe they do. If it is a hard question to
    answer, it just tells me something about how willing you are
    going to be to help us with this problem.
        So my point is this. States negotiating on drug prices on
    behalf of a group of citizens, does it drive down prices for
    consumers in your opinion, ``yes'' or ``no''?
        Mr. Frazier. I would have to say, depending on the system,
    it could very well do that. But I think it will do that at the
    expense of a system, for example, our Medicare system that has
    come in at 50 percent of what it was projected to be.
        I want to come back to an issue that was raised at the
    beginning about the affordability, if you will just allow me. A
    significant issue in our system is that patients pay 13 percent
    against the list price for drugs when they pay 3 percent
    against a lower negotiated price for other medical services.
        I think the primary issue in our country now is out-of-
    pocket costs--13 percent is much higher than 3 percent. And if
    we were designing a system, we would never design a system that
    actually taxes the sicker people to pay for the healthy people.
        Senator Cantwell. Okay.
        I am asking a really basic question. Like the VA's ability
    to negotiate on drug prices, do you think that States having
    that same ability drives down price?
        Mr. Frazier. I would say that the VA would get a lower
    price and the States would get a lower price if you are willing
    to go into an environment where that could be imposed by
    States.
        Senator Cantwell. Well, or the Federal Government. But in
    one example--which I think you are familiar with, because I do
    think you are involved with hepatitis C drugs--Washington's
    Medicaid program is continuing to think about a Netflix model
    where you buy the best, the lowest per-unit costs, and cover
    more people. Do you think that model works in driving down
    costs to consumers?
        Mr. Frazier. I think that could work to drive down cost to
    consumers, no question, as long as you have the State
    ``negotiating.'' I would object to the word. Very frequently,
    when we deal with governments outside the United States, people
    use the word ``negotiations.'' Those prices are imposed.
        Senator Cantwell. Well, someone who is negotiating on
    behalf of the patients they are trying to cover negotiates with
    you or other drug companies on whether they are going to meet
    that discount. They are using market forces of bundling up and
    leverage. I call it a Costco model. If you buy in bulk, you get
    a discount. We are clearly doing it with the VA.
        The question debated here is whether we should spread that
    out to cover more Federal programs, which is what is being done
    in Canada, and whether we should use those same market forces
    in allowing States to negotiate, at least for the working poor
    in this country, a better deal than they can get because they
    work for employers that do not cover them.
        So I think if you guys cannot even agree that these basic
    market functions that allow people to buy in bulk and get a
    discount are good ideas for consumers, then I do not think you
    are going to come up with anything we are going to agree on
    here, because these are market functions, basic market
    functions.
        Does anybody else want to add whether they believe in these
    market functions?
        Mr. Gonzalez. Yes, Senator. I would just illustrate one
    point.
        I think your point is a valid one for the overall system
    costs, but I think what Mr. Frazier was describing is a
    critical issue.
        There are two affordability issues here. There is the
    affordability to the system, and there is the affordability to
    the patient. Both have challenges, but the affordability to
    patients now has really gotten out of hand.
        I will give you an example, my HCV example. We cut the
    price by 72 percent, the list price by 72 percent. The out-of-
    pocket cost in Medicare is $3,250. The same patient who could
    not afford the out-of-pocket cost at $7,000, unfortunately
    cannot afford $3,250.
        Senator Cantwell. Well, I will tell you what is absurd is
    the fact that you got a $6.3-billion tax break in the last tax
    bill and you cannot even say that you are for basic market
    functions like giving people discounts when they are bundled
    and you get volume.
        So I guess we will have a tough time coming to something--
    but I know people here are going to want basic market functions
    to drive down costs for consumers.
        Thank you, Mr. Chairman.
        The Chairman. Senator Cornyn?
        Senator Cornyn. Thank you, Mr. Chairman.
        Mr. Gonzalez, I want to focus on Humira. Obviously it
    generates about $18 billion of revenue for your company each
    year. Is that right?
        Mr. Gonzalez. That is correct.
        Senator Cornyn. Please understand that I get it. We want to
    make sure that we maintain the most innovative pharmaceutical
    drug companies in the world, because we want to provide
    lifesaving cures for our people. And I get the idea that that
    is the purpose of the patent system, which is to protect the
    exclusivity of that drug that you have sunk a lot of money into
    the research and development for. And I support our patent
    system. I think it is very important.
        But what I do not understand is, according to my
    information here, Humira has 247 patents. And some of those
    patents do not expire until 2034. As Senator Stabenow pointed
    out, Humira first was sold to patients in 2003.
        So is it your company's position that it should have an
    exclusive monopoly on that medication for 31 years?
        Mr. Gonzalez. Senator, no, it is not. It is essentially
    that the patents cover innovations that we created. And I think
    one of the things that has been lost here is, it does not
    matter how many patents you have--and those are applications
    that you described, not actual patents. But there is a large
    portfolio of patents. It has 136 patents, and together----
        Senator Cornyn. So you have 247 patent applications, but
    you have 61 patents? How many patents do you----
        Mr. Gonzalez. No. I am sorry. A hundred and thirty-six
    patents.
        Senator Cornyn. A hundred and thirty six patents on one
    drug?
        Mr. Gonzalez. But well, remember, Humira is like 9
    different drugs or 10 different drugs. So----
        Senator Cornyn. I thought you said to Senator Stabenow it
    was the same molecule.
        Mr. Gonzalez. It is the same molecule, but it treats
    different conditions. And if you look at that patent
    portfolio----
        Senator Cornyn. So you use the same molecule to treat
    different conditions, and you can get a patent on that
    treatment?
        Mr. Gonzalez. Certainly. Now, an example of one of the
    areas that got a significant number of patents is inflammatory
    bowel disease. After we developed it for RA, we realized that
    Humira might work in that area. That was an area that was
    under-treated. Most drugs had failed.
        We did 20 clinical trials to determine how to make Humira
    work in those patients. And we were issued a large number of
    patents for the discovery work that we did in that area.
        But in the end, the number of patents is not something that
    protects a product. If a competitor wants to make a generic
    version of a product--there are patents everywhere. The
    question is, does the invention stop the biosimilar player from
    making the product? If the invention does not, the patent is
    meaningless. If the invention and----
        Senator Cornyn. The patent gives you an exclusive right to
    produce a drug.
        Mr. Gonzalez. No, we do not block any biosimilars.
    Biosimilars can make the product----
        Senator Cornyn. No, no. Maybe you misunderstood. A patent,
    during its term, gives you exclusive rights to produce a drug.
    Correct?
        Mr. Gonzalez. No.
        Senator Cornyn. No?
        Mr. Gonzalez. No. The composition-of-matter patent would
    give you exclusive rights to produce the drug. But the patents
    that are covered in this portfolio are for individual
    innovations that were created. And in many cases, when we go
    into an area, there are always patents. The first thing you do
    is, you look to see, can I design around those patents?
        If ultimately you determine you cannot design around those
    patents, then you go to the player who has the patent and you
    negotiate a license. And we have now given license to virtually
    every single biosimilar player--with the exception of one--and
    we have done it literally 10 years before the last patent
    expires in that portfolio.
        So we have tried to strike what we think is a reasonable
    balance. I realize it may not be popular, but I think it is a
    reasonable balance. Those----
        Senator Cornyn. But what I am concerned about is--as I told
    you at the outset, I support drug companies covering a profit,
    based on their R&D and their development of innovative drugs.
    But at some point, that patent has to end, that exclusivity has
    to end so that the patients get access to those drugs at a much
    cheaper cost.
        It is true that you, your company, blocked Amgen for a
    number of years from seeking to produce a Humira biosimilar or
    equivalent; correct?
        Mr. Gonzalez. Amgen has a license in the United States
    right now to be able to produce----
        Senator Cornyn. But you blocked them for 5 years, right?
        Mr. Gonzalez. No, we did not block them.
        Senator Cornyn. You sued them.
        Mr. Gonzalez. They came to us, and they wanted access to
    the portfolio that we had. And we licensed them.
        Senator Cornyn. Did you sue them?
        Mr. Gonzalez. We did, yes.
        Senator Cornyn. And you entered into an agreement with them
    that accommodated both your needs and their needs, I assume.
        Mr. Gonzalez. We licensed them a patent portfolio. They pay
    us a royalty on the patent portfolio when they come to market,
    and that is essentially just like any other license.
        Senator Wyden. Mr. Chairman, I do not want to interrupt.
    Senator Cornyn is dead right, and that is exactly the same
    point I was going to make.
        Senator Cornyn. Mr. Chairman, could I just make a
    suggestion that----
        The Chairman. Go ahead.
        Senator Cornyn. I know this topic is within the
    jurisdiction of the Finance Committee, but those of us like you
    and me who are also on the Judiciary Committee, which has
    jurisdiction over the patent system, I think this is an area
    that we need to look into through our Judiciary Committee
    authorities as well.
        The Chairman. Why don't you take that up with Senator
    Graham, and I will make sure that I back you up on it.
        Senator Cornyn. I will look forward to your back-up.
        The Chairman. And let me know what your conversation
    produces.
        Senator Cornyn. Thank you.
        The Chairman. The next four would be Menendez, Thune,
    Carper, and Isakson.
        Senator Menendez?
        Senator Menendez. Thank you, Mr. Chairman.
        Let me say a few words before asking some questions. To the
    New Jersey companies here today, thank you for coming. I am
    proud our State is at the forefront of innovation.
        But even in New Jersey, where the pharmaceutical industry
    and related fields like medical research employ hundreds of
    thousands of people, the overwhelming majority of the more than
    9 million New Jerseyans believe drug prices are too high. And
    so I think we all have to be responsive to that challenge
    collectively.
        Americans everywhere reject the notion that reducing
    prescription drug costs means reducing innovation. They are
    uniting around this issue. And it is not a Democratic or
    Republican priority. It is bipartisan. Maybe it is for
    political reasons, but President Trump is talking more and more
    about executive action.
        A Republican chairman of the Finance Committee, Senator
    Grassley, has convened this hearing today, the second of two on
    prescription drugs. And reducing prescription drug prices has
    become a focal point of virtually every Democratic presidential
    campaign.
        So consider it a friendly warning from someone who believes
    in the hope that you provide patients in need of new cures and
    treatments: it is time to be proactive, because if you do not
    make the meaningful action to reduce prescription drug prices,
    policymakers are inevitably going to do it for you. So I just
    hope you will take that to heart.
        Let me ask you, many corporations--not just pharmaceutical
    ones--received a huge windfall from the Trump tax bill. Your
    companies spent well over $40 billion buying back your own
    stock in the past year. Going down the row, can you just give
    me the ballpark number? Did any of you use your tax breaks to
    lower the costs of any of your prescription drugs?
        Mr. Gonzalez. We did not use our tax break to lower the
    cost of prescription drugs. We used it for other aspects of
    trying to stimulate the economy and invest further in the
    United States.
        Senator Menendez. No, you did not use it to lower the cost.
        Mr. Soriot. Senator, the tax break for us, being based in
    the UK, had a very marginal impact on our profitability. So I
    think the question is----
        Senator Menendez. The question is--it is a simple ``yes''
    or ``no.'' Whatever the tax break was, did you use any part of
    it to lower the cost of prescription drugs?
        Mr. Soriot. Well, the cost of our prescription drugs on the
    net basis has been declining for many years now. Senator Wyden
    took----
        Senator Menendez. I am sorry to interrupt you, Mr. Soriot.
    It is a simple question. Did you use any part of the tax break
    that you got to lower the cost of your prescription drugs?
        Mr. Soriot. In a roundabout way, yes, we did, because the
    minimal tax benefit we got helped us sustain our profitability
    at the same time as our prices were declining.
        Senator Menendez. Dr. Caforio?
        Dr. Caforio. We did not.
        Ms. Taubert. Hello, Senator. It provided us the opportunity
    to invest an incremental $30 billion in R&D and capital
    investments in the U.S. over the next 4 years. We think that
    that is the best way for us to be able to deliver for patients.
        Senator Menendez. Mr. Frazier?
        Mr. Frazier. Senator, our effective tax rate went up from
    19.1 to 19.8 percent.
        Dr. Bourla. We did use this tax break to do many things,
    among them reduce our prices. Prices in 2018, for the first
    time since I remember, went down at Pfizer.
        Dr. Brandicourt. As a French company headquartered in
    Paris, we did not get much from the tax break. On the GAAP
    basis, we lowered our global tax rate by 1.5 percent.
        Senator Menendez. All right.
        Now, in November 2017, FDA Commissioner Scott Gottlieb
    called on pharmaceutical companies to ``end the shenanigans
    when it comes to the ability of potential competitors to
    purchase branded doses at full market price.'' He stated, ``I
    see this clearly, for example, in steps branded companies
    sometimes take to make it hard, or altogether impossible, for
    generic firms to get access to the doses of the branded
    companies needed in order to complete bioequivalence studies
    that the FDA requires for a generic approval.''
        I have co-sponsored legislation called CREATES that ends
    the gamesmanship by certain companies, where they prevent
    generic manufacturers from accessing the necessary samples they
    need to develop generics. Last year the FDA published its first
    list of medicines that generic companies have had trouble
    accessing. That list includes more than 170 complaints covering
    50 medicines.
        So can you go down the line and tell me, ``yes'' or ``no,''
    does your company in any way restrict access to, or block the
    purchase of samples at full market price?
        Mr. Gonzalez. No, we do not.
        Mr. Soriot. No, we do not.
        Dr. Caforio. We do not. We support the current version of
    the CREATES Act.
        Ms. Taubert. No, we do not.
        Mr. Frazier. No, we do not.
        Dr. Bourla. No, we do not, and we support CREATES.
        Dr. Brandicourt. No, we do not, and we support CREATES too.
        Senator Menendez. I have other questions. I am going to
    submit them for the record. Thank you.
        The Chairman. Thank you.
        Senator Carper?
        Senator Carper. Thanks to each of you for joining us today.
    My wife lost her mother when she was 11 years old. My wife said
    it put a hole in her heart. She has never gotten over it. My
    own mother, her mother, and her grandmother, by the time they
    were 80, they did not know who they were, or where they were,
    or who we were.
        For all of us this is personal, and it is political, and it
    is economic. When we have a hearing of this nature, one of the
    things I like to do with disparate witnesses like these--you
    are all from the same industry, but you have different views,
    come from different parts of the world. But I am going to, in a
    minute, give you--what I am looking for is consensus. What I
    think we are looking for is consensus agreement on what is the
    right thing to do to make sure that what we are producing is
    effective and affordable for us, for the government, for our
    constituents.
        I am going to give you three items and ask you to tell us
    what you think. If we do nothing else, those three items, we
    can all agree on those. Okay, and I will give them to you right
    now.
        The first is eliminating rebates to PBMs. That is the first
    one: eliminating rebates to PBMs. The second is value-based
    arrangements. And the third is increasing transparency
    industry-wide on how you set your prices--increasing
    transparency industry-wide on how you set your prices.
        If you would like to take a moment--and we would just start
    with you, Mr. Gonzalez. We will just start with this question
    first and see if we have time to get it done. I hope we do,
    those three.
        Mr. Gonzalez. I would say that we clearly support providing
    the discount at the patient level, so eliminating rebates,
    essentially.
        We absolutely support value-based pricing, because that is
    the business we are in and the kinds of diseases we are trying
    to treat and cure.
        And we absolutely support transparency. And I would say
    transparency even more broadly across the entire system,
    including everyone that is in the supply chain. And that would
    also include where government rebates are, such as the 340B
    program. We would support total transparency across that.
        Senator Carper. Thank you. I would ask each of our other
    witnesses to also keep your responses short.
        Mr. Soriot?
        Mr. Soriot. Senator, I would give the same responses. We
    support all three items.
        I would go one step beyond, which is if the rebates--as I
    said earlier--were to be removed from Part D and the commercial
    sector, we would actually reduce our list prices by the
    rebates' amount, less the fees that are probably single-digit
    type fees to be paid to wholesalers and other stakeholders in
    the system.
        Since you talked about a disease that is very common and
    becoming more common and a tragedy for people who suffer from
    it, Senator, I would just like to say that, as Mr. Frazier said
    a bit earlier, his company spent a billion dollars on
    developing a drug for Alzheimer's. Our company together with
    Lilly, we spent $900 million to try to develop an Alzheimer's
    drug that failed.
        And that is a really good reminder of the risks that we
    take as an industry. We spent $900 million, many years of work,
    and at the end of the day, nothing.
        Senator Carper. Thank you.
        Dr. Caforio?
        Dr. Caforio. Yes, Senator. First of all, I am very sorry--
    --
        Senator Carper. Please be very brief.
        Dr. Caforio. I would say that not only do we support all
    three elements that you mentioned, but I do believe those three
    elements together with the continued effort to develop a
    generic and biosimilar market would mean significant change,
    and would clearly alleviate the concerns that patients have
    today.
        Senator Carper. Great. Thank you, sir.
        Ms. Taubert?
        Ms. Taubert. Senator, first of all, I am very sorry for
    your wife's family and also for your family. It underscores----
        Senator Carper. While I said that, everybody in this room
    could probably point to similar experiences. All of us have had
    them.
        Ms. Taubert. Absolutely.
        Senator Carper. Thank you.
        Ms. Taubert. We are very supportive of all three elements
    that you outlined. So the elimination of----
        Senator Carper. That is all I need.
        Ms. Taubert. Perfect.
        Senator Carper. Thank you.
        Mr. Frazier?
        Mr. Frazier. We too support all three.
        Senator Carper. Thank you.
        Dr. Bourla. Senator, all three elements are
    transformational for our industry, will disrupt it. However, we
    do agree that these are the three things that need to be done,
    and also I believe that they will have significant, meaningful
    results if we do them.
        Senator Carper. Thank you, sir.
        Dr. Brandicourt. We strongly support the three, Senator,
    but we want to keep in mind at the end of the chain, the
    patient has to benefit. So if rebates are removed, it has to be
    to the benefit of patients.
        Senator Carper. Good. Thanks.
        Mr. Chairman, I am going to do a follow-up question in
    writing, asking your responses, your reaction to what is going
    on in Germany on this front--what do you like about it, what
    concerns you might have about it. But that is a different
    question, but it relates to this discussion.
        Thank you.
        The Chairman. Before Senator Thune goes, can I ask Dr.
    Caforio, did you say you support the CREATES Act as well?
        Dr. Caforio. I did, Chairman Grassley.
        The Chairman. Thank you. As sponsor of that, I appreciate
    that very much.
        Dr. Caforio. Thanks for your work in that area.
        The Chairman. Senator Thune?
        Senator Thune. Thank you, Mr. Chairman.
        I would like to ask unanimous consent to insert for the
    record a one-page document from 340B Health that shows that
    manufacturer discounts account for less than 2 percent of the
    total drug market.
        The Chairman. Without objection, so ordered.
        [The document appears in the appendix on p. 1,053.]
        Senator Thune. Thank you.
        Each of you has referenced the recently proposed rebate
    rule, which outlined several different scenarios of how drug
    companies and others would react, as well as the impact on Part
    D premiums.
        Mr. Frazier and Dr. Bourla, if the rule were finalized,
    could you please discuss how you would set list price and how
    your negotiations would work with others in the supply chain?
        Mr. Frazier. Okay, assuming that--as I said when I answered
    the question before, assuming that we do change the systems on
    the commercial side and the Medicare side so that no one
    company faces a disadvantage, we would be lowering list prices.
        We have been asked to lower list prices. We have lowered
    list prices in the past and found that it creates a financial
    disadvantage for the company, and it does not get us more
    volume because of the incentives in the system. So if we change
    all the incentives at one time, then list prices can come down.
        Senator Thune. Dr. Bourla?
        Dr. Bourla. Fifty percent of the American people are in
    commercial plans, and these rebate rules apply to Medicare. If
    the rules apply to all, definitely the list price will go down.
        But also, during the Medicare-only application, we pledge
    and we commit that every single dollar will go to the patients.
        As the chairman said, the list price is not irrelevant. It
    is very relevant for a lot of people, because they have to pay
    list price during the deductible period. However, if the rebate
    rule is applied, then it becomes irrelevant because the
    patients will not be paying the list price at the purchase
    point. And this is a significant win.
        What I want to say is that, even if we do not move it to
    commercial, which I overwhelmingly support, I think it is a
    significant win for the American people if we do it even in
    Medicare only.
        Senator Thune. So Medicare-only would be an improvement,
    but you pointed out in your testimony the challenges associated
    with the bifurcated market with respect to rebate reform. So
    how would manufacturers respond if the rebate rule were
    finalized for government programs? I mean, what does that mean
    for the commercial market?
        Dr. Bourla. Senator, as I said before, all these proposals
    we are discussing, including eliminating the rebate rule, are
    transformational and will disrupt the way we do business. I do
    not know exactly how the system will evolve, and I really do
    not favor a bifurcated system. I would like to have a
    transparent, single system across both parts. So we need to see
    how the whole thing will evolve.
        Senator Thune. Okay.
        You have each expressed support, and this was alluded to
    earlier by Senator Carper, for paying for value as well as the
    value your medicines bring to the health-care system. I am a
    believer in value-based insurance design as a way to lower the
    overall health-care costs, and I have worked on legislation to
    advance this principle.
        As we drive toward paying for value, how do we make sure
    that you as drug manufacturers still have the incentives to
    keep your prices low and that we are not just shifting money
    around in the system?
        Dr. Bourla. I think by definition that a value-based
    arrangement will align the incentives, not only of us, but
    those of the insurance companies, around one common goal: the
    good for the patient, clinical outcomes, measurable clinical
    outcomes for the patient and the health-care system.
        In this case, if we fail to produce drugs through our
    research efforts that will have meaningful clinical benefits
    for the patients, yes, we will not be paid. And this system
    also will ensure the medicines that do not add value will be
    paid much much less. So to create space for medicines that do
    create value is the best way of aligning the incentives of
    everyone around the interest of the patients.
        Senator Thune. Does anybody else want to react to that?
        Mr. Soriot. Yes, Senator, if you allow me.
        We have an example that I quoted before. We have a product
    that is used for the treatment of patients who have experienced
    a heart attack.
        If you experience a heart attack, when you are discharged
    from the hospital, your chance of getting a second heart attack
    is pretty high. So we contracted with an organization and
    committed to reducing the percentage of patients who have a
    second heart attack.
        In return, the University of Pittsburgh Medical Center, for
    these Medicare patients, committed to ask these patients to pay
    a very low co-pay to make sure they were complying with their
    treatment. And that actually delivers value to the system,
    because patients are kept healthy. Of course, good for them,
    but also they do not go back to the hospital. This is how we
    deliver value.
        Senator Thune. Okay. Thanks.
        Mr. Gonzalez. Senator, I would just add one point. I think
    your point is a valid one. Look, an innovative pharmaceutical
    cannot capture 100 percent of the value that it saves. It has
    to capture less than that.
        And I think the way that will evolve the best is if there
    is strong market competition. I remember back in HCV, if you
    look at the health economic data around that drug, it would
    have suggested that you could justify a price well north of
    $100,000 per patient. And the prices were relatively close to
    that when there was one player in the market. Today prices have
    gravitated down to about $25,000-$26,000 per patient.
        It is the market force that created that, the market
    competition of more than one player being in that market and
    competing on an active basis. We were obviously part of that
    competition that drove those prices in that direction.
        So I do not think it is realistic to assume that a
    pharmaceutical, just because it can save $150,000, as an
    example, that it can charge $150,000. It has to charge less
    than that so that the overall system can benefit from the value
    of that medicine. But it has to be able to charge a price that
    is reasonable enough to be able to achieve and continue to fund
    the programs going forward.
        The Chairman. Senator Isakson, and then Senator Cardin.
        Senator Isakson. Thank you, Mr. Chairman.
        I thank all of you for being here. This is a terrific
    hearing, and we are going to have a lot of hearings on this
    subject. I told my staff a couple of weeks ago, I said, ``You
    know, I have been a solid supporter of the pharmaceutical
    industry all my career,'' and I have, and I appreciate all that
    you do.
        I go to work every day because of levodopa. I would not be
    able to be here today if it was not for the pharmaceutical
    industry, and I have Parkinson's disease. But I can function
    every day and do my job because of that, and I appreciate it
    every day.
        My first chief of staff called me Sunday night from
    Children's Hospital in Atlanta to say his youngest son had just
    been diagnosed with juvenile diabetes. His first child, a
    daughter, had juvenile diabetes 12 years ago. But the thing he
    said was, ``At least I know that you can live a normal, happy
    life because of insulin and because of pharmaceutical care.''
    So I am not softening you up, but I am softening you up,
    because those are good stories that we cannot forget. And that
    is the value of innovation and research development, and we
    appreciate it.
        However, when you cannot explain it and you are elected to
    the U.S. Senate--and I appreciate your comment about how
    honored you are to be in the U.S. Senate, Dr. Bourla--but the
    fact of the matter is, when I cannot explain it, it is tough.
    And I cannot explain the cost increases I have seen a lot of
    recently.
        One medicine I take--I take eight a day--one of the ones I
    take every day went up. When I went to get my new prescription
    in January, it was $90 more than it was at the end of last
    year.
        I just said, ``How can that be?'' And the guy said this and
    that and the other. But he said, ``Let me call you back.'' He
    said, ``I will call you in the next hour and see if I cannot
    find a better price.''
        In an hour's time he had four prices for the same
    pharmaceutical. If I did not use insurance, it was one price.
    If I used cash, it was another price. If I took discounts, it
    was another price. If you had coupons, it was another price.
        I do not remember the name of all of them, but I know it
    was very complicated, and it reminded me of my business. When I
    sold real estate, the price of a mortgage was not just the
    interest rate that you paid and the sticker price, but you take
    the effect of discount points and rebates and other things that
    go into the annual percentage rate return of the product, and
    that is what you are doing with discounts and with rebates, I
    assume. And it is going into the cost and ultimately into your
    product, which caused me to ask this question: who sets the
    discount and who sets the rebate?
        Pardon my finger. We will start with you, Mr. Gonzalez.
        Mr. Gonzalez. Thank you, Senator.
        I think the best way to illustrate what you are describing
    is to give you an example.
        Senator Isakson. A short example, please.
        Mr. Gonzalez. Okay.
        Humira--we raised the price in 2019 6.2 percent. The actual
    fall-through to the company, the realized increase in 2019,
    will be .9 percent. So the part in between there is rebates
    that have gone up and channel mix, primarily. But it does give
    you some idea of the massive change that can occur between list
    and realized price.
        We raised the price to try to offset inflation, merit
    increases that we give our employees, and increases in R&D----
        Senator Isakson. So you set the discount or the rebate?
        Mr. Gonzalez. Well, we negotiate with payers. So managed
    care----
        Senator Isakson. You are a supplier, though. So you
    negotiate with the PBMs and those people? Is that right?
        Mr. Gonzalez. Correct, and they negotiate aggressively.
        Senator Isakson. Is that pretty much true, everybody, that
    they are the major component between the end retail consumer
    price and the origin of the product?
        Mr. Gonzalez. Yes, Senator.
        Senator Isakson. Well, that seems like some place we ought
    to focus, because that is where the distorted numbers come in.
        Johnson & Johnson--and I'm sorry. Janssen, is that right?
    Is that the subsidiary?
        Ms. Taubert. Yes, Janssen; correct.
        Senator Isakson. In your testimony you talk about your
    average list price of 8.1 percent up, but an average net price
    change of only 4.6 percent. So, while your gross went up 8.6,
    your net went down 4.6 in the same pricing period.
        How does that happen? How does it not go up on the bottom?
        Ms. Taubert. Yes, and in fact in 2018, our net price
    actually declined 8.6 percent, so even more than that. So the
    intermediaries in the system are very very effective
    negotiators.
        Senator Isakson. Tell me who the intermediaries are.
        Ms. Taubert. Those would be the PBMs and the insurers.
        Senator Isakson. And the insurance companies?
        Ms. Taubert. Right, and they set the formularies for
    patients.
        Senator Isakson. And they are not the same, because they
    are two different people?
        Ms. Taubert. Yes, correct.
        And so what they do----
        Senator Isakson. Excuse me for interrupting Ms. Taubert. I
    want to make sure I get all of this in. And I apologize. You
    are a nice lady, and I am being ugly to do that. But I am
    sorry.
        Ms. Taubert. I am fine.
        Senator Isakson. All right. We have the PBMs and we have
    the insurance companies.
        Ms. Taubert. Yes.
        Senator Isakson. Is there anybody else between the
    wholesale price by the manufacturer at the beginning and the
    retail price it is sold for at the end, at the drugstore? Is
    there anybody else that contributes to the cost, other than the
    discount and the rebate?
        Dr. Brandicourt. Several actors, Senator, in the supply
    chain are rewarded on the listing price: wholesalers
    themselves, and----
        Senator Isakson. Is that a consumption bonus? Is that a
    sales bonus? They are rewarded for doing what?
        Dr. Brandicourt. Well, to be a wholesaler and distribute
    our products. What we need to do in order to realign the
    incentive is to get rid of the reward being based on a listing
    price.
        Senator Isakson. I have to stop, because the chairman is
    mean and he will cut me off the next time.
        So I will end by saying this. You answered my question, but
    it does point out that the one person who is not benefiting
    from the rebates, not benefiting from the cost negotiation, is
    the customer. And we are here for the customer today. We
    represent them. So we have to get to the bottom of this so we
    can have something we can explain, and they can experience.
        I apologize, Mr. Chairman.
        The Chairman. I let the Senator go because he was echoing
    my beliefs.
        Go ahead, Senator Cardin.
        Senator Cardin. Thank you, Mr. Chairman. And let me thank
    all of our witnesses. I also want to say how proud I am of the
    results of the pharmaceutical industry and the discoveries that
    you have made, innovations that you have brought to market, the
    impact you have had on quality of life and on cost, overall
    cost of health care, by the discoveries that you have been able
    to advance.
        The challenge that we all have is, why should Americans be
    shouldering the lion's share of the cost and burden of research
    and development and bringing new drugs to market? You talk
    about burden-sharing, you talk about the fact that there should
    be a fair allocation on the global market--and by the way, also
    within our domestic market, we know that a lot of people are
    being denied access to these innovative drugs because of the
    pricing mechanisms within the United States.
        So let me try to drill down on those points. Really, am I
    defending an administration policy? So let me break with my
    normal tradition and talk about the international pricing
    mechanism that the Trump administration is proposing that would
    set target prices or international pricing indexes over a 5-
    year period for Part B drugs pinned to the price in comparable
    industrial nations, phasing it in over a period of time and
    allowing a cushion for even higher prices in the United States.
        So if, in fact, these drugs are already priced
    competitively, that should not be a problem. But as I
    understand it, there are so many drugs that we pay, American
    consumers pay, a lot more for than consumers in other
    industrial nations. So why not move towards a process in which
    American consumers share a similar price as consumers in other
    industrial nations in the world, particularly on the Part B
    program? I think it could also be extended to Part D.
        The only explanation I have heard is that in some
    countries, it takes a little bit longer to get new drugs
    admitted. We are not talking about new drugs. We are talking
    here about drugs that already have an existing price mechanism.
    Or do you support it?
        Dr. Caforio. Senator, thanks for your question.
        I did mention this in my opening remarks. So I am happy to
    elaborate further. I think it is a very important point.
        So we take the perspective that we should always start from
    patient access to medicines.
        Senator Cardin. I am going to try to drill down, because I
    only have 2 minutes.
        Dr. Caforio. Thank you.
        Senator Cardin. So what is wrong with a model of comparing
    U.S. prices to prices in other industrial nations?
        Dr. Caforio. So 55 percent of new cancer medicines that are
    available to American patients are not reimbursed in at least--
    --
        Senator Cardin. We are talking about where there is a
    market price in another country, because if there is no target
    price, there is no price to compare it to. So there has to be a
    price in another country. So we are talking about drugs that
    are commonly available.
        Dr. Caforio. I believe, Senator, many of the most recently
    introduced drugs are not available in----
        Senator Cardin. Then that would not apply. If I understand,
    it only deals with prices where there is a target price that
    already exists. If the drug is not on the market, it is not
    going to have a target price. But if the drug is on the market,
    you have a target price, and as I understand it, that would
    bring down the cost here in the United States.
        Dr. Caforio. I believe, Senator, it would be very important
    for us to be thinking about policies that continue to reward
    innovation.
        We do need your support to make sure that----
        Senator Cardin. So you are basically saying we overpay on
    available drugs so that you can make more profit from the
    American consumer to underwrite R&D which benefits the global
    community. That is basically, as I understand that point--to me
    that is a disconnect in the pricing mechanism.
        I want to ask, Ms. Taubert, you are the one who mentioned
    the advantages of the free market in negotiations under Part D.
    So let me just change the equation. Suppose you were on the
    other side of the table. Why not allow the Health Secretary to
    combine the entire Medicare market in order to negotiate a
    larger market share to bring down costs for Medicare?
        Ms. Taubert. Yes, so we really believe that open
    competition and a free market are the right way to go for
    patients.
        Senator Cardin. But isn't market share that you can offer,
    as a person seeking the cost, a driver for bringing down costs?
        Ms. Taubert. So the PBMs and the insurers are
    extraordinarily effective negotiators. And they do negotiate
    now on behalf of Part D members quite aggressively.
        In fact, I mentioned our $21 billion----
        Senator Cardin. And my question is, is it not true that the
    larger the market share, the better the price you are going to
    get?
        Ms. Taubert. The larger the market share, the better the
    price? It depends on a number of factors, including the number
    of competitors and the companies that are bidding to try to
    get----
        Senator Cardin. If you control more of the market, isn't
    that going to bring down your price? I learned that in
    Economics 101.
        The Chairman. Answer the question, and then we will go to
    Senator Hassan.
        Ms. Taubert. Yes; I am not sure I understand the last piece
    of that question.
        Senator Cardin. With a larger consumer base on a drug,
    because you represent all the Medicare market, are you not in a
    stronger negotiating position? Yes, you are.
        Ms. Taubert. I think conceptually you could be. I would say
    that the PBMs and insurers are pretty darn effective right now.
        The Chairman. Senator Hassan?
        Senator Hassan. Well, thank you, Mr. Chairman. And I want
    to thank you and Ranking Member Wyden for this hearing today.
        I want to thank all of the witnesses for being here today
    as well. A couple of observations; one is that breakthroughs
    are not breakthroughs if people cannot afford the medicine that
    produces the breakthrough.
        Secondly, as you have all mentioned the importance of a
    viable and predictable system, it has to be a viable and
    predictable system for patients. And right now it is so
    convoluted and so non-transparent that my constituents cannot
    figure out what the price of their medication is going to be
    day to day. And despite a wonderful staff, I feel like I need a
    Ph.D. in prescription drug pricing to understand how the heck
    this industry works. And that should not be the way we proceed
    in this country to get these breakthroughs to people.
        But I want to talk about a slightly different aspect of
    your industry right now. We have been talking about drug
    pricing, which is one part of how drug companies make money.
    The other part is how you maximize sales.
        So, Ms. Taubert, I would like to focus on how your company
    maximizes sales for a particular class of drugs--opioids. Can
    you define for me please, Ms. Taubert, what pseudo-addiction
    is?
        Ms. Taubert. I am sorry. I am not sure. I am not familiar
    with that term.
        Senator Hassan. Let me fill you in, then. Pseudo-addiction
    is an unproven and dubious concept that asserts that certain
    patients present signs of addiction because they were
    prescribed insufficient doses of opioids. Those peddling this
    pseudo-addiction concept say that instead of providing
    addiction treatment when somebody shows the signs of addiction,
    the doctor should increase their opioid doses. Even one of the
    original doctors who pushed this theory now admits it was ``an
    excuse to give patients more drugs.''
        He has told us that Janssen promoted this made-up concept
    of pseudo-addiction on a website that it approved and funded
    that was called ``Let's Talk Pain.'' Since then, your company
    has repeatedly said that your action ``in the marketing and
    promotion of our opioid pain medicines was appropriate and
    responsible.'' So, Ms. Taubert, how can you possibly claim that
    promoting the theory of pseudo-addiction--the doctor should
    prescribe more opioids to patients showing signs of addiction--
    was appropriate and responsible?
        Ms. Taubert. Senator, thank you so much for that question.
    Abuse and addiction, particularly opioid abuse and addiction,
    are very serious public health concerns, and we recognize the
    impact on the American public.
        Senator Hassan. So then the question is--and again like
    everybody else, I have only a few minutes here. The question
    is, looking back at what your company did promoting pseudo-
    addiction--an unproven theory that was just used to maximize
    sales of a deadly drug--why is that something that you are
    calling appropriate and responsible?
        Ms. Taubert. So, I am sorry. I am not familiar with the
    term.
        What I can say is, on behalf of our company, opioids
    represent less than 1 percent of our product.
        Senator Hassan. All right, let me stop you right there,
    because my constituents do not care about the percentage. They
    care about the behavior to maximize sales in an industry.
        Do you know how many Americans died from drug overdoses in
    2017?
        Ms. Taubert. Far too many.
        Senator Hassan. It was 70,237. In 1 year, more Americans
    died from drug overdoses than died fighting the entire war in
    Vietnam. And the vast majority of those overdose deaths, about
    50,000, were from opioids.
        My constituents are dying. Nearly 500 people in New
    Hampshire died from overdoses last year. And nearly 500 the
    year before that. And companies like Janssen and Purdue Pharma
    fueled this epidemic, employing deceptive and truly
    unconscionable marketing tactics despite the known risks so you
    could sell more drugs to maximize your profits.
        And now you are refusing to take responsibility for your
    company's role in this crisis. So one more time, do you truly
    think that Janssen's opioid marketing practices were
    appropriate and responsible, or will you finally take
    responsibility for your company's role in helping create this
    crisis that is killing more than 100 Americans every day?
        Ms. Taubert. Everything that I have seen leads me to
    conclusively believe that everything that we have done with our
    products, when we promoted opioid products, which we stopped
    marketing a long time ago, was very appropriate and
    responsible.
        However, that being said, we do believe that we have a
    leadership position to take in helping with this. And so we are
    doing a number of things in terms of mothers and babies, and
    physician and patient education to help----
        Senator Hassan. So let me--again----
        [Simultaneous speech.]
        Ms. Taubert. We recognize we all play a part in trying to
    help this, because we realize that----
        Senator Hassan. Our time is done, but right now it is hard
    for me to take the industry's goal here as promoting good
    health seriously when its behavior to maximize sales of opioids
    created an epidemic.
        The Chairman. Senator Lankford?
        Senator Lankford. Thank you, Mr. Chairman.
        Thank you all for being here. And there are people alive in
    the United States, around the world right now, because of your
    companies and the work they have done with R&D along with the
    National Institutes of Health. And I fully acknowledge that,
    and I am grateful to the people who are researching and working
    right now, who are not watching this hearing because their face
    is in a microscope actually going through things to be able to
    research today and what they are doing.
        With that said--it is all of us who acknowledge that. We
    are trying to figure out the issue on drug pricing, because
    people in my State, whether they are on insulin or whether on
    Parkinson's drugs, or whether my own family or other people in
    my neighborhood, it is a very significant issue for them to try
    to figure out how to be able to manage this. So we have to get
    to the bottom of how we manage this.
        All of you have mentioned that the rebate issue has been a
    problem and that insurance companies and PBMs are very
    effective negotiators. Part of the challenge of this is, health
    insurance companies pay their PBM based on the quality of their
    negotiation skills, cutting a price off the list price. And so,
    if a list price is higher and a rebate is higher, that also
    gives preference to them. So the difficulty is, as you raise
    list price and the rebate gets larger, the insurance company
    gives that preference, making it harder for biosimilars. Am I
    tracking this correctly?
        So the challenge that we have with this is, how do we
    figure out how to break this down? Because we have insurance
    companies, PBMs, your companies that are creating the list
    prices, and then the biosimilars trying to be able to get into
    this.
        So, Mr. Frazier, you mentioned this, in particular about
    biosimilars and the difficulty of trying to be able to break
    into the market. Would you identify why it is hard for
    biosimilars to get into the market, which are inherently less
    expensive?
        Mr. Frazier. I would make two suggestions very quickly,
    because I know you only have a little bit of time here. One is,
    I think we have to educate physicians and other health-care
    providers about the value of biosimilars. I think, secondly, it
    would be very helpful if we could relieve patients of their
    obligation to pay copays for the cheaper biosimilars.
        Those would be two specific recommendations that I would
    make.
        Senator Lankford. Thank you. I appreciate that. For the
    Part B drugs, those physicians are paid a percentage of the
    drug costs. So a biosimilar, when it comes into the market in
    the Part B world, is, on its own, less attractive to a
    physician because a physician gets a higher percentage amount
    prescribing the more expensive drug, which then feeds down to
    the patient and the taxpayers, right?
        Mr. Frazier. That is correct.
        Senator Lankford. How do we break that chain?
        Mr. Frazier. I think that we--there are many ways that we
    would have to look at it. I do not have a specific suggestion
    here.
        I do think educating physicians is important here, and I
    think relieving patients, but we also have to look at the
    incentives.
        Dr. Bourla. Maybe I can----
        Senator Lankford. Dr. Bourla, please jump in, because you
    had mentioned this in your testimony as well.
        Dr. Bourla. I did, Senator, and thank you for giving me the
    opportunity.
        Let me give you a statistic that I think will present the
    magnitude of the problem. Here in the U.S., the penetration of
    biosimilars is much lower than in other places, but it is
    disproportional to different parts of the U.S. health-care
    system.
        For example, in open systems, systems where the decision-
    maker is a PBM, one biosimilar or two has a market of 5 percent
    in the U.S. In closed systems, in systems like Kaiser, for
    example, with their integrated health-care systems--where the
    one who decides has the whole cost of the health-care system in
    its interest--we have 73 percent. Five percent versus 73
    percent for the same product.
        I agree with what Mr. Frazier said, that we need to create
    incentives, but I would add also that we need to break this
    rebate trap that creates significant disincentives for
    providers, and the health-care system, and insurance companies.
        Senator Lankford. Does anybody else want to jump in on
    that?
        Dr. Brandicourt. I can give you an example, Senator.
        The insulin market has a reputation of not being very
    competitive. In fact, it is, and we have biosimilars which have
    reached the market and have grabbed a very significant market
    share.
        We believe that when insulin will not be treated as a drug,
    but will be considered a biologic and can be submitted to
    biosimilar regulation in 2020, the biosimilar market share and
    penetration will be even higher.
        Senator Lankford. Thank you.
        My State, in particular, is working very hard on our
    Medicaid side, working on value-based pricing. I know that is
    something that several of you have mentioned before. It is the
    grand challenge of not pricing a drug based on the fact that it
    would be more expensive to do surgery and so we want to be
    slightly under the cost of surgery.
        We do have to be able to break through that model. Of
    course surgery would be more expensive than most of our
    treatments, but I think there is a benefit that we continue to
    experiment with if the drug is effective and we have a reducing
    price on it. And we can get a chance to be able to work through
    that, as we have done in our State.
        Mr. Frazier. We would support that.
        Senator Lankford. Well, we will continue to be able to work
    through other creative mechanisms. At the end, we cannot just
    have the taxpayer pay more and the consumer pay less, because
    that is really the consumer still paying. It just moves it to
    another spot.
        Mr. Chairman, thank you.
        The Chairman. Senator Cassidy?
        Senator Cassidy. First, think of innovation. As a doctor, I
    have seen cures for hepatitis C and therapies to control HIV,
    other inflammatory conditions, cancers that 30 years ago, when
    I graduated from medical school, were either death sentences or
    were a ticket to a lifetime of morbidity and complications. So
    I thank you for that. But I also say that some of my patients
    could not afford the medicine. And for them, it is as if the
    innovation never took place. And that is one concern.
        Secondly, another concern is, I think in some cases we do
    not have value. Now, Ms. Taubert, you suggested that PBMs are
    very effective negotiators. One drug that I want to bring up is
    Duexis, which is a combination of over-the-counter generic
    ibuprofen and Pepcid. Now, if I were to take this--and this is
    not the cheapest I could find it--in the doses that are used
    for Duexis, it would cost me 200 bucks a month. But it lists at
    over $2,400 to $2,600 a month.
        Now, that does not seem like very good negotiations on
    behalf of the PBM. And if the taxpayer is paying that money for
    something which over the counter is 200 bucks a month, and we
    are paying $2,600 a month, it is almost as if the taxpayer has
    ``stupid'' written on their face, which they should not. That
    is unfair.
        This is not your medicine, but I use it to make the point
    that, right now, Medicare has a very limited ability to
    negotiate based on marginal value. And I think that is one of
    the fundamental problems in this.
        So that said, all things considered, since Medicare does
    have this very low ability, Ms. Taubert, do you think that
    Medicare should have the ability--if the PBM's negotiation does
    not work--should Medicare have the ability to negotiate based
    on value?
        Ms. Taubert. So we are very supportive of the notion of
    value-based contracting and results and----
        Senator Cassidy. This is a little bit different though,
    because we have been describing, on value-based contracting, is
    the cancer cured or not, is the hepatitis C cured or not? This
    is, my gosh, you are taking two generic medicines and charging
    ten times what they would cost over the counter.
        Ms. Taubert. Yes, and I agree that that example does not
    make any sense.
        Senator Cassidy. So is it reasonable then to ask that
    Medicare would have the ability to make some sort of judgment
    based upon relative value of a therapy?
        Ms. Taubert. I think, as we have talked about, if the PBMs
    are very effective in negotiating, we do not know that the
    government would be as effective in negotiating as the
    professional negotiators.
        Senator Cassidy. We do not know. I agree with that, but on
    the other hand it does--I have limited time. I do not mean to
    be rude. I do apologize. But there is this kind of shining
    example of where the PBM is not an effective negotiator. Yes,
    sir, Mr. Frazier?
        Mr. Frazier. I think this is where Chairman Grassley's
    opening statements about transparency come in. I think one of
    the keys of transparency is, it empowers patients and it
    empowers other payers to actually make informed choices about
    which of those two medicines makes sense.
        Senator Cassidy. Now, let me ask, because someone brought
    up the fact that Humira is now sold at an 80-percent discount
    in Denmark. And there is a Bernstein analysis which states that
    AbbVie still makes a profit because marginal cost in
    manufacturing is only about 5 percent of the manufacturing.
        So would this same entity have the ability to look not just
    at value, but at comparable drugs and at that which would bring
    value, because clearly biosimilars have had a much greater
    penetration in Europe, and the United States continues to pay
    top dollar for the same class of drugs. Something is
    fundamentally broken in our system when the Danes get an 80-
    percent discount and we do not.
        Yes, sir?
        Mr. Frazier. I think we have to look at the way in which
    generic penetration happens outside the biosimilars market.
    When a drug goes off-patent----
        Senator Cassidy. Well, hang on, Mr. Frazier. I am sorry. I
    just get limited time, and I am going to hold you on that.
    Okay, I do not mean to--one of the things I have heard is that,
    if there is some limit on that profit, it may have a negative
    impact upon R&D. I think that has been a message here.
        But, Dr. Brandicourt, France has a committee on
    transparency which evaluates the relative added clinical
    benefit of a new drug. Price is then negotiated based upon that
    added benefit as well as other drugs in the market.
        Is it safe to say that your company has found that it still
    pays to innovate and to do R&D in France and to offer them
    access to the best cutting-edge drugs?
        Dr. Brandicourt. As a global company, we do have R&D in
    France. However, I would not use the French system as the
    benchmark of a good system.
        Senator Cassidy. But they do have access to these--I have
    limited time. I am sorry. They do have access to these drugs?
        Dr. Brandicourt. Well, that is a very good point. Some
    drugs are not put on the market because you do not get to the
    right pricing and therefore the right----
        Senator Cassidy. But if I am--I will finish with this. I do
    not mean to be rude. I apologize.
        In the international pricing index, we may quibble about
    the details, but if the U.S. would be paying 1.3 times a market
    basket of developed countries--a Germany, a France, a Canada,
    not smaller countries--we would still be paying more than they,
    but it would still have some relationship to reasonableness.
    And right now, it seems as if Medicare--in the absence of the
    ability to judge value--is almost a price taker when it should
    not be, as the largest purchaser.
        Dr. Brandicourt. You would ask countries where there is no
    negotiation, where prices are imposed, to set up your U.S.
    pricing. And I do not think that would be good policy.
        Senator Cassidy. It is imposed now, but it is imposed from
    the other side.
        The Chairman. Of the people who are still here, Bennet
    would be next, and then Whitehouse, and then Cortez Masto.
        Go ahead, Senator Bennet.
        Senator Bennet. Thank you, Mr. Chairman. Thank you so much
    for holding this hearing.
        There is not a town hall in Colorado where I do not hear
    how expensive drugs are forcing people to choose between life-
    saving treatments or food and utilities. In our last hearing
    here, we heard from a mother whose son ate once a day in order
    to ration his insulin, because the full cost of the monthly
    treatment was $1,700. I do not think anybody here understands
    how that could be the case, but it is the case.
        And there has been a lot said here today about the
    important research and development that is going on in this
    country. And I, for one--and I know others share this view--
    want to keep that in the United States. Having said that, I am
    trying to understand how Federal spending goes into
    prescription drug development, distribution, treatment, and
    pricing and yet Americans cannot afford their medications.
        The estimates of annual spending on prescription drugs
    range from $320 to $480 billion a year. The fact that we cannot
    even get a more precise number than that tells you something
    right off the bat, but those numbers include almost $100
    billion in Medicare Part D spending never paid for. Of that,
    $25 billion is in Medicare Part B. Medicaid spends almost $60
    billion on prescription drugs. This is what the taxpayer spends
    every year on prescription drugs.
        DoD and VA spending is about $11 billion. That number alone
    dwarfs the R&D budgets of some of your companies. Over 6
    years--slightly different point--but over 6 years between 2010
    and 2016, more than $100 billion was spent in NIH funding
    toward research that contributed to drug patents. Between $1
    and $2 billion is claimed annually through the orphan tax
    credit for drugs that treat rare diseases. Another $1 billion
    is annually claimed through the research and development tax
    credit. About $12 billion dollars is claimed annually through
    the direct-to-consumer advertising tax credit.
        I would ask you guys if I missed anything, but I think that
    is a pretty complete list of what we have. Yet notwithstanding
    that almost $500 billion, half a trillion dollars--by the way
    Medicare, you know, to spend all that money in Medicare, we are
    spending $2 for every dollar we are collecting. That delta is
    largely because of drug prices in the unfunded part of Medicare
    Part D.
        And here is what Coloradans have recently reported. In a
    recent survey on high drug prices, 22 percent did not fill a
    prescription, and 20 percent reported cutting pills in half or
    skipping doses.
    Seventy-four percent believe drug companies are charging too
    much money, and 91 percent believe the government should
    authorize the Attorney General to take legal action to prevent
    price gouging or unfair prescription drug price hikes--over 90
    percent.
        And that does not necessarily give you their legal
    judgment, but that is how keenly they are feeling the problem.
    And 90 percent believe the government should require drug
    companies to provide advance notice of price increases and
    information to justify those increases.
        So, I would ask all of you, or anybody who would care to
    answer, this question: how do we explain to our constituents on
    the one hand that we have this massive outlay of Federal funds,
    it is their taxpayer funds, and the on the other hand, the
    drugs they are buying are not affordable?
        And I realize there are all kinds of layers to this. I
    accept that. You know, there are the higher co-pays that you
    guys mentioned earlier from the insurance companies. That is a
    huge issue too.
        But I think that in a world where opacity or opaqueness has
    been, from the public's point of view, a business model for
    everybody in health care, whether it is the Federal Government
    or drug companies or insurance companies or doctors, nobody
    knows what anything actually costs. Nobody knows what anything
    will pay.
        My question, I guess, is, how do we better align the
    incentives here so that that huge outlay of money every year
    comes with affordable drugs at the end of the process?
        Mr. Gonzalez, thank you.
        Mr. Gonzalez. Senator, I can just tell you there is
    probably not anybody at this table who does not agree not a
    single American should go without drugs that they need. And I
    can tell you, that is the case at AbbVie.
        We do a lot of things to try to provide drugs for patients
    who cannot afford them. But there are certain patients whom we
    are unable to do that for based on the laws and the
    regulations, and in particular, most of Medicare Part D falls
    into that situation.
        And so I believe fundamentally we have to do two things.
    There are substantial discounts or rebates that are going into
    this system. Take Humira as an example. In the United States,
    there are rebates or discounts on that product that range from
    87 percent down to 26 percent. Okay, and it is the Federal
    Government that gets the highest form of discount or rebate on
    Humira, even though it represents a relatively small percentage
    of the volume, less than 20 percent of the overall volume.
        Now that does not mean that we could not do more. But what
    we are asking is, we do believe that there is a situation now
    where the co-pays for patients are such that it is extremely
    difficult for them to afford it. And what we are asking for
    is--``we,'' meaning AbbVie and I am sure others here, would
    like to do more. There is more we can do to help patients
    afford their medicines, but we have to eliminate some barriers
    that are blocking that.
        Today we give away to 81,000 patients free drugs; half of
    those are Humira. Of those Humira patients, half of them are
    Medicare Part D. They are patients who make less than 500
    percent of poverty, so they make less than $128,000 per year
    for a family of four.
        Those patients we can provide free drug for. Anybody above
    that, we cannot. It is considered an inducement.
        And when you look at the copay for a drug like Humira,
    commercial patients, Medicaid patients, the low-income subsidy
    patients in Medicare, pay less than $100 per year of copay for
    Humira. A standard Part D patient pays $5,500. They make
    $26,000, so they cannot afford it.
        Senator Bennet. I apologize. I know I am out of time. Thank
    you.
        The Chairman. Senator Whitehouse?
        Senator Bennet. Could I, Sheldon, just make one point,
    which is, I think what we ought to be doing is figuring out how
    people do not have to cut their prescription drugs in half, and
    that would be a worthy goal for this committee and the people
    on this panel.
        The Chairman. Senator Whitehouse?
        Senator Whitehouse. I would like to ask about a particular
    segment of the pharmaceutical market. Chairman Grassley opened
    his remarks by talking about patients taking a drug that has no
    competition as being a cause for concern.
        Mr. Frazier, your testimony included the statement that
    price gouging by those who jack up the prices of off-patent
    drugs that have no competition is a problem. Let me ask if
    there is anyone on this panel who disagrees, who disagrees that
    there are de facto off-patent monopolies now in the
    pharmaceutical market? Does anybody disagree with that as a
    fact?
        Mr. Frazier. I do not disagree.
        Senator Whitehouse. In fact it is true.
        Mr. Frazier. There are.
        Senator Whitehouse. There are.
        Mr. Frazier. That is what I was saying.
        Senator Whitehouse. And indeed, is it also not true that
    sometimes these off-patent monopolies are used to impose
    monopoly pricing?
        Mr. Frazier. It is true, and I think the most egregious
    examples that we have seen recently have been exactly in that
    situation.
        Senator Whitehouse. Does anybody disagree with that?
    Everybody agrees.
        Now are there, among those entities that are in that
    category with off-patent monopolies that are extracting
    monopoly pricing by virtue of that, entrants who are not even
    really in the pharmaceutical industry?
        Mr. Frazier. Absolutely there are.
        Senator Whitehouse. They invest nothing in R&D.
        Mr. Frazier. Exactly.
        Senator Whitehouse. They do not even come from the
    pharmaceutical industry.
        Mr. Frazier. Yes.
        Senator Whitehouse. They are more or less corporate raiders
    who have bought something in order to jack up prices and take
    advantage of monopoly rents. Correct?
        Mr. Frazier. There are many people like that.
        Senator Whitehouse. There are many people like that. Does
    anybody disagree that that is a feature right now within the
    pharmaceutical market? Everybody agrees?
        Dr. Bourla. And I would add also, Senator, that they are
    not allowed to be part of the Pharma Association.
        Senator Whitehouse. So here is the problem: it is not
    difficult, in my view as a lawyer of many years and a
    prosecutor of many years, to prove the existence of a monopoly.
    We have been proving the existence of de facto monopolies in
    courtrooms and in regulatory proceedings for decades.
        So we can identify where these monopolies exist, even if
    you let all the ties go to the runner so that, wherever there
    is a real question, you throw that one out. There still would
    remain a significant population of entities where it is beyond
    dispute that they are pricing based on monopoly power. And as I
    look around, there is no place to address that. There is no
    organization in the Federal Government that is taking an
    interest in that, and it is the scandal, I view, of the
    pharmaceutical industry. And you guys take a hit for it.
        Here is the problem: when we try to do anything about that,
    the people you pay to lobby us here in Congress come out and
    say, ``Nope, we cannot do anything like that. That might look
    like price control.'' We are not interested in taking any look
    at this monopoly problem in your industry. I should not even
    say it is in your industry, because I think a lot of these
    people are raiders into your industry who are not really part
    of your industry. They do not really develop drugs.
        I see a lot of head-nodding here. So help us solve at least
    that problem. You know, there are lots of other problems that
    we are going to have to look through with your pricing. Help us
    solve at least that problem. Turn off your lawyers and your
    lobbyists as antagonists when we try to solve that problem.
        Mr. Frazier. We will. Senator----
        Senator Whitehouse. In fact, switch them on and say, let us
    figure out how we deal with these modern monopolists who are
    not even really in the pharmaceutical industry.
        Mr. Frazier. I could not agree more. These people are at
    best tone-deaf, at worse abusive.
        I would also point out that there are companies here--I
    know, for example, my company. There is a very important cancer
    drug called TICE BCG. It was an invention of Merck. It has been
    off-patent for many many years. It is an incredibly essential
    drug for bladder cancer patients.
        A number of companies that were making it went out of the
    business. And so now we have had to double supply. Over the
    last nearly 12 years the cost of that drug has increased by
    $16. That is not how we make money at Merck. We make money at
    Merck by inventing new drugs that did not exist before.
        It is those people, I think, that contributed to the
    villainizing of an industry. The public cannot distinguish
    those people from the research-based companies.
        Senator Whitehouse. You all say that here. There is a lot
    of head-nodding here. There is a lot of agreement here.
        When your lobbyists come, everybody is in and they are not
    going to let anybody lose in all of this. We have to at least
    cut off these people.
        Mr. Frazier. Thank you for telling me that, because I never
    knew that our lobbyists were opposed to that.
        Senator Whitehouse. We have no support for working against
    these monopoly raiders.
        Dr. Brandicourt. Well, Senators, the message is very clear.
    And we are going to take that very seriously as a task.
        The Chairman. Senator Brown came back. So you will go ahead
    of the Senator from Nevada.
        Go ahead.
        Senator Brown. Thank you, Mr. Chairman. Thank you for doing
    this hearing.
        Thank you all for joining us. I want to thank Senator
    Hassan for her questions on opioids. Eleven people a day die in
    my State from opioid addiction, and there is a responsibility
    shared more widely than we sometimes say.
        I so appreciated Chairman Grassley's ``yes'' or ``no''
    questions, and I appreciated the seven of you going along with
    his ``yes'' or ``no.'' And I would like to ask a series of
    ``yes'' or ``no'' questions, and please keep it to ``yes'' or
    ``no.'' They really are ``yes'' or ``no'' questions.
        Mr. Gonzales, let's start with you. Is it true that the
    pharmaceutical industry benefits from U.S. taxpayer-funded
    research? ``Yes'' or ``no''?
        Mr. Gonzalez. It is, yes.
        Senator Brown. Across, each of you.
        Mr. Soriot. Yes.
        Dr. Caforio. Yes.
        Ms. Taubert. Yes.
        Mr. Frazier. Yes.
        Dr. Bourla. Yes.
        Dr. Brandicourt. Yes.
        Senator Brown. Okay. Thank you.
        Is it true that no other nation invests more taxpayer
    dollars in basic research that directly and indirectly benefits
    the industry?
        Mr. Gonzalez. Yes.
        Mr. Soriot. Yes.
        Dr. Caforio. Yes.
        Ms. Taubert. Yes.
        Mr. Frazier. Yes.
        Dr. Bourla. I am not sure I understood the question.
        Senator Brown. Is it true that no other nation on earth
    invests more taxpayer dollars in basic research?
        Dr. Bourla. Yes.
        Dr. Brandicourt. Is it proportional to GDP, Senator?
        Senator Brown. I am not asking that, but that is close
    enough. Thank you.
        Is it true that the U.S. Government allows drug companies
    the longest period of exclusivity on biologics?
        Mr. Gonzalez?
        Mr. Gonzalez. I believe that is true.
        Mr. Soriot. I believe that is true.
        Dr. Caforio. I believe that is true.
        Ms. Taubert. Yes.
        Mr. Frazier. Yes.
        Dr. Bourla. Yes.
        Dr. Brandicourt. Yes.
        Senator Brown. We know Medicare limits prices with doctors
    and hospitals. Is it true that Medicare cannot negotiate to
    lower prices with drug companies?
        Mr. Gonzalez. That is true directly.
        Mr. Soriot. Yes.
        Dr. Caforio. Yes.
        Ms. Taubert. Yes; other agents work on their behalf to
    negotiate, but they do not negotiate directly.
        Mr. Frazier. Yes, they cannot negotiate directly.
        Dr. Bourla. Yes.
        Dr. Brandicourt. Yes.
        Senator Brown. Thank you.
        Is it true U.S. taxpayers subsidize pharmaceutical
    advertising and marketing activities through the tax code's
    business expense deduction?
        Mr. Gonzalez?
        Mr. Gonzalez. Yes.
        Mr. Soriot. Yes.
        Dr. Caforio. Yes.
        Ms. Taubert. Yes.
        Mr. Frazier. Yes, no different from any other advertising,
    but yes.
        Dr. Bourla. Yes.
        Dr. Brandicourt. Yes.
        Senator Brown. Thank you.
        We note the United States is the world's largest market for
    pharmaceuticals. Is it true that we pay the highest--in the
    overwhelming number of cases, is it true that we pay the
    highest drug prices in the world?
        Mr. Gonzalez?
        Mr. Gonzalez. The average government price would--that
    would not be the case.
        Senator Brown. No, that we as Americans individually pay
    the highest drug prices in the world?
        Mr. Gonzalez. As an average, that would be true.
        Mr. Soriot. I am not sure that it would be true, Senator,
    because the generic prices are some of the lowest in the world,
    and government prices, for many of our drugs even before patent
    expiry, are sometimes as low as Europe or lower.
        So on average, probably it is true, but there are many many
    different kinds of----
        Senator Brown. I know there are exceptions. I am looking
    for an average.
        Dr. Caforio?
        Dr. Caforio. Yes, on average I would say.
        Senator Brown. Ms. Taubert?
        Ms. Taubert. I would say that the list prices are higher,
    but the net price in the United States is more comparable to
    much of the pricing outside the U.S.
        Senator Brown. Mr. Frazier?
        Mr. Frazier. Yes, outside Medicaid and other things, yes.
        Senator Brown. Okay.
        Dr. Bourla. Nine out of 10 products in the U.S. are
    generics. So the pricing of the generic products is much lower
    in the U.S. than other countries.
        Senator Brown. Yes, but generics----
        Dr. Bourla. But you are right about branded----
        Senator Brown. Do not confuse generic numbers of drugs sold
    with cost in the aggregate? Your answer?
        Dr. Bourla. But nine out of 10, I am telling you--you are
    right that in the innovation, the prices outside the U.S. in
    many cases are much higher.
        Dr. Brandicourt. So I would agree with that: patented
    drugs, yes, generics, no.
        Senator Brown. Okay. Thank you. Last question.
        Is it true that drug manufacturers set the--what Ms.
    Taubert talked about--list prices? Is it true that you, the
    drug manufacturers, set those list prices?
        Mr. Gonzalez. That is correct.
        Mr. Soriot. That is correct, but of course, there is a
    negotiation that takes place with PBMs and insurers about the
    price and the rebate level.
        Senator Brown. Dr. Caforio?
        Dr. Caforio. It is true for list price, but the delta
    between list and net price is the highest in the U.S.
        Senator Brown. Ms. Taubert?
        Ms. Taubert. Correct. Yes, we set the list price.
        Senator Brown. Mr. Frazier?
        Mr. Frazier. Yes, we set list price.
        Senator Brown. Dr. Bourla?
        Dr. Bourla. Actually, I would not agree that we set the
    list price. It is the result of a major negotiation. And I have
    to say that the problem in the U.S. health-care system it is
    that everything is geared around list price, a lot of
    incentives, which creates a hydraulic effect for the list
    prices to go down.
        I would be very happy to have much less list prices and the
    same net.
        Senator Brown. Dr. Brandicourt?
        Dr. Brandicourt. Ultimately, we set the listing price.
        Senator Brown. Okay. Thank you.
        So taxpayers subsidize your research, subsidize your
    marketing, and you continue to raise drug list prices on them.
    The median income of a person on Medicare is $26,000 a year,
    while the average annual cost for a single specialty medication
    was more than $52,000 in 2015. Americans cannot afford to pay
    for prescription drugs that cost more money than they make in a
    year. We cannot continue to give big pharma the blank check
    that you have had to pay for high-priced prescription drugs.
        But I guess it is not surprising that big drug companies
    take all the taxpayer money they can. What is so troubling is
    that this Congress continues, because of the lobbyists that
    Senator Whitehouse talked about and other pressures, that this
    Congress continues to allow you to do so.
        Thank you for answers.
        The Chairman. The Senator from Nevada.
        Senator Cortez Masto. Thank you for being here. Thank you,
    Mr. Chairman and Ranking Member, for this important hearing,
    one of four.
        Let me follow up on Senator Brown's line of questioning. Do
    any of you invest more in R&D than you spend on marketing and
    administration? If we could start ``yes'' or ``no'' to the
    right here.
        Dr. Brandicourt. No.
        Dr. Bourla. No.
        Mr. Frazier. Spend more on R&D versus marketing?
        Senator Cortez Masto. More in R&D than you spend on
    marketing and administration. Do you invest more in R&D than
    you do on marketing?
        Mr. Frazier. On marketing, but not if you include general
    administration, facilities, and all of that stuff. But yes,
    more than marketing.
        Senator Cortez Masto. Okay.
        Dr. Bourla. I would correct my answer also if it is only
    marketing. Yes, we spend more on R&D.
        Senator Cortez Masto. Let us just do marketing.
        Dr. Brandicourt [indicating agreement with Dr. Bourla].
        Ms. Taubert. Yes, we spend 86 percent more on R&D than we
    do on sales and marketing.
        Senator Cortez Masto. Okay.
        Dr. Caforio. Yes, we do more on R&D.
        Mr. Soriot. Same, more than marketing, but excluding
    administrative costs.
        Mr. Gonzalez. Significantly more in R&D than sales and
    marketing.
        Senator Cortez Masto. But if you included administration
    with the marketing, that would be the reverse. Is that correct?
        Mr. Gonzalez. That is correct.
        Senator Cortez Masto. Yes from the rest of you?
        Mr. Frazier. It is about tied at Merck.
        Senator Cortez Masto. Okay.
        So let me just ask this question. Apart from New Zealand,
    nowhere else in the world will you see drug ads on television--
    and I have asked this question for some of you. My
    understanding is--the answer that I have been given is that you
    maintain that television ads are a critical public health tool
    that helps patients identify their symptoms and seek treatment.
        Would you all agree with that? Is that a ``yes''? ``No''?
    Why do we have television ads when it----
        Dr. Brandicourt. Yes, you are right.
        Senator Cortez Masto. Is that why? Is that a ``yes''?
        Dr. Brandicourt. Yes.
        Dr. Bourla. Yes.
        Mr. Frazier. Yes.
        Ms. Taubert. Yes.
        Dr. Caforio. Yes.
        Mr. Soriot. Yes.
        Mr. Gonzalez. Yes.
        Senator Cortez Masto. Okay. So if you maintain that
    television ads are a critical public health tool, then how can
    that be if our health outcomes are not significantly better
    than in those countries where it is outlawed?
        Dr. Bourla. Thank you, and you are raising a very good
    point.
        I think that the health-care outcomes and life expectancy--
    there are a lot of factors that influence them. For example,
    exercise, diet, lifestyle, and I feel that our Nation needs to
    improve a lot in many of these cases. But I can assure you,
    Senator, that if you get cancer or another serious disease, you
    want to be treated in this country.
        Senator Cortez Masto. Okay.
        Dr. Bourla. There is no comparison.
        Senator Cortez Masto. All right. So let me jump back then
    to this discussion on authorized generics. And I am trying to
    understand this, I think, along with all of my colleagues, to
    address how we reduce the cost and get the drugs in the hands
    of the people who need them--where the R&D came in, where they
    were created--for individuals who actually need the drugs.
        I want to ask about the concept of authorized generics.
    Those, as you know, are the drugs that are identical to the
    brand, manufactured by the brand, but marketed without the
    brand on its label.
        Yet the companies, my understanding is, keep selling the
    higher-cost brand drug to consumers who, according to press
    reports, do not realize that the same product from the same
    company is available at a better price.
        All of you manufacture authorized generics to maintain your
    market share once your patent expires. Is that true?
        Dr. Brandicourt. No.
        Senator Cortez Masto. That is not true?
        Dr. Bourla. We do have authorized generics.
        Dr. Brandicourt. We do have authorized generics, but do not
    do it with the goal that you just highlighted.
        Senator Cortez Masto. So you do have authorized generics?
    Do all of you have authorized generics?
        Mr. Frazier. For some brands.
        Senator Cortez Masto. Okay.
        Ms. Taubert. Very selectively.
        Dr. Caforio. Very selectively.
        Mr. Soriot. We do not.
        Senator Cortez Masto. You do not?
        Mr. Gonzalez. I do not believe we do.
        Senator Cortez Masto. You do not have authorized generics?
    So for those of you who have authorized generics, explain to
    me, if you do have those, why do you continue selling the
    brand?
        Mr. Frazier. Okay, so in our case when we have had
    authorized generics, we have allowed a third-party to bring a
    generic product to market. The issue that you are really
    getting to, again, is the issue that Senator Cassidy talked
    about, which is transparency.
        At the end of the day, if patients really understood what
    their options were, they would not make these choices. But we
    have an opaque system, which is something that I think we have
    to change. We have to empower patients to be able to choose the
    cheapest medication. And Merck strongly supports generics.
        What I said in my introduction is, we will never use
    coupons when there is a generic.
        Senator Cortez Masto. What are you doing to empower the
    patients? What are you doing to empower the patients to
    understand that the generics are out there?
        Mr. Frazier. It is very hard. We do not connect with the
    patients in all those situations. That is why there is
    legislation saying, for example, that pharmacists must tell
    patients at the counter what the cheapest alternative is for
    them at the counter. We do not----
        Senator Cortez Masto. So you rely on others to tell----
        Mr. Frazier. Yes. We do not meet them at the counter,
    Senator.
        Senator Cortez Masto. Okay. Let me ask one final question,
    because I am running out of time here. I want to get a sense
    from all of you what types of policies you could support. I
    have heard some of those, but let me ask you this. Democrats
    have proposed to require manufacturers to submit advanced
    justification for price hikes that outpace inflation and make
    that information public.
        Given that many of you have already committed to tapering
    price hikes, is this something you could support, ``yes'' or
    ``no''?
        Dr. Brandicourt. We can support such legislation, yes.
        Dr. Bourla. Yes.
        Senator Cortez Masto. Thank you.
        Dr. Caforio. Yes.
        Ms. Taubert. We are very supportive of increased pricing
    transparency. Advance notification can cause problems in the
    supply chain and could cause outages for certain States. So we
    are very supportive of the notion of transparency. Advance
    notification can be problematic.
        Senator Cortez Masto. Okay.
        Dr. Caforio. We disclose our price increases.
        Senator Cortez Masto. Okay.
        Mr. Soriot. We support it.
        Mr. Gonzalez. We support it, but we would like to see
    consistency. As you probably know, California has that right
    now, but if we had a consistent standard that we operated with,
    that would certainly be helpful.
        Senator Cortez Masto. Thank you. Thank you very much.
        The Chairman. Senator Daines?
        Senator Daines. It is very clear from what is going on
    today that there are ultimately not any silver bullets to cure
    the high cost of prescription drugs. I am pleased that we can
    have this discussion. My hope is that we can truly find some
    ways to incentivize the system here to deliver a lower price,
    ultimately, for the consumer as well as incentivizing
    innovation.
        As manufacturers, you are responsible for setting this list
    price, this ethereal list price. But the more I hear what is
    going on here today, I am convinced we probably should call
    this the asking price. I am sure ``list price'' is a bit of a
    misnomer, because after hearing all about coupons, rebates,
    discounts, the pricing volatility--yes, I spent 13 years at
    Procter and Gamble, and once upon a time we drove a business
    with a lot of coupons, with rebates, pricing incentives. It was
    a very elastic pricing model. Oftentimes, we had a high-margin
    business. There is elasticity in the pricing, and you are an
    example of that.
        I spent 12 years in the cloud computing business after
    that. The margins were even higher. We saw great volatility in
    pricing and elasticity in pricing. We eventually, years ago of
    course, went to the everyday low price, EDLP, model. It, again,
    may or may not apply to Pharma. But it was just trying to take
    out all of that in between the manufacturer and the consumer
    nonsense that was going on, that was lacking transparency.
        And ultimately, I think the consumer was not winning in
    that equation, because the prices--they were not seeing really
    the true everyday low price. There are a lot of perverse
    incentives in the system today, as best I can tell. So my
    question is, who pays list price?
        Dr. Brandicourt. Unfortunately, the patient at the end, at
    the pharmacy counter, is probably one of the few paying the
    list price.
        Mr. Frazier. There is a small percentage of people who have
    no insurance who could actually be charged the list price.
        Senator Daines. So the people who can afford it the least,
    arguably, are paying list price.
        Mr. Frazier. Senator, that to me is what I meant by saying,
    in some ways the reimbursement system here is regressive. The
    people who can least afford it are paying the most.
        Senator Daines. Do you think that that is a good system?
        Mr. Frazier. I do not. I can tell you that is, to me, the
    biggest problem that we have as a country, that we now have a
    system where the poorest and the sickest are subsidizing
    others.
        Senator Daines. Okay. So with insurance companies that now
    own the PBMs and the supply chain from the time you list the
    price until the consumer eventually gets it, is it fair to say
    the list price is really a starting point for, then, a
    negotiation?
        Mr. Frazier. Yes.
        Senator Daines. Does anybody disagree with that premise?
        Ms. Taubert. No.
        Senator Daines. So what are some of the incentives? And
    maybe we will start with Mr. Frazier. What are the incentives
    that contribute to high list prices that are being paid by
    those who can afford them least?
        Mr. Frazier. The real answer, Senator, is, if you went back
    a few years ago when we negotiated to get our drugs on
    formulary, our goal was to have the lowest copay for patients.
        Today the goal is to pay into the supply chain the biggest
    rebate. And so that actually puts the patient at a
    disadvantage, since they are the only ones who are paying a
    portion of the list price. The list price is actually working
    against the patient.
        Senator Daines. So why do we have a system today where you
    all are setting--I will just say very very high list prices,
    which is our starting point for negotiation? Why?
        Dr. Brandicourt. Senator, we are trying to get formulary
    position with those high list prices, high rebates. It is a
    preferred position. Unfortunately, the preferred position does
    not automatically ensure affordability at the end of the day.
        Mr. Frazier. And, Senator, if you bring a product to the
    market with a low list price in this system, you get punished
    financially and you get no uptake, because everyone in the
    supply chain makes money as a result of a higher list price.
        Senator Daines. Chairman Grassley, if I could just ask a
    follow-up question here. And that is, the GAO report said that
    generics might fall 20 percent for each new generic entrant
    into the market.
        I appreciate the chairman's efforts here with the CREATES
    Act. It is going to crack down on some of these bad actors who
    block or delay competing generic drugs from entering the
    market. I have co-sponsored the bill, and I think that will
    help us provide better access to low-cost generics.
        Here is my question: has your company ever withheld samples
    from generic manufacturers?
        Dr. Brandicourt. No.
        Dr. Bourla. No.
        Mr. Frazier. No.
        Ms. Taubert. No.
        Dr. Caforio. No.
        Mr. Soriot. No.
        Mr. Gonzalez. No.
        Senator Daines. Right. Do you believe the CREATES Act would
    be a positive step forward, ensuring generics enter the market
    in a timely fashion? I would love to poll the team here.
        Mr. Frazier. I said in my testimony, legislation like the
    CREATES Act would be positive in that regard.
        Dr. Bourla. Yes.
        Dr. Brandicourt. Yes.
        Dr. Caforio. Yes.
        Mr. Soriot. Yes.
        Mr. Gonzalez. We are supportive.
        Ms. Taubert. We are supportive of efforts to make sure that
    there are no abuses of that sample system.
        Senator Daines. All right; I am out a time now. Thank you.
        The Chairman. Senator Young?
        Senator Young. Thank you, Mr. Chairman.
        I want to move to the issue of Medicaid best price. In the
    Trump administration's blueprint, they suggest that because
    drug manufacturers have to give Medicaid the best price drugs,
    there is no incentive to offer deeper discounts to other
    payers, both government and commercial, than what is already
    offered under the Medicaid drug rebate program.
        So first of all, I would ask each of you, is the Trump
    administration's assessment accurate?
        Mr. Gonzalez. In concept, I would say I understand the
    concept. In other words, if you have best price, you obviously
    have to be conscious of where that price is going, because it
    is going to be compared against that.
        I would tell you in practice, because of the negotiation
    that occurs in the formula around Medicaid, I do not believe
    that that is actually, today, resulting in higher prices in the
    Medicare program.
        Senator Young. You have anticipated my follow-up question.
    So I appreciate that.
        So the best price requirement does not encourage
    manufacturers to increase initial prices? You have thoughts on
    that?
        Mr. Gonzalez. I would say it does not necessarily encourage
    you to set a higher list price. I think what happens with list
    price is this negotiation you have heard of, going forward,
    where you are looking for a certain amount of impact to fall
    through, but the rebates and the other aspects of the value
    chain in between absorb a large chunk of that, which drives
    list prices, increases up higher.
        Senator Young. Okay. Others?
        Mr. Frazier. I think where best price really is an issue
    is, again, it is a barrier to the kind of value-based pricing
    that we want to have within the marketplace, where if, for
    example, a drug did not work, you might reimburse that payer
    for that unit, where that becomes a problem for value-based
    pricing.
        Dr. Brandicourt. Another example, Senator, is when you want
    to put on the market a second NDC, like we did recently where
    it had a much lower list price, then the best price potentially
    becomes a problem because it is calculated with the other
    version, the higher list price version, which has stayed on the
    market. So that is something to pay attention to.
        Senator Young. What changes, if any--if I could pivot a
    bit--would you suggest making to the program?
        Dr. Caforio. Senator, I believe that flexibility with
    value-based arrangements is really important, because I think
    we have all expressed a strong support for a system where we
    are paid based on the clinical results that our medicines
    produce in patients and having greater flexibility to do that.
        It would be very, very important. It would be very valuable
    for patients. It would reduce health-care costs overall.
        Senator Young. General agreement?
        Ms. Taubert. Yes, we agree.
        Mr. Frazier. Yes.
        Senator Young. Okay.
        So would you be willing to work with the administration on
    a different model, one you regard as more optimal?
        Ms. Taubert. Absolutely.
        Senator Young. Very good. Thank you.
        With respect to reducing drug prices and the subsidies that
    U.S. payers provide with respect to research and development to
    much of the rest of the wealthy world, the President and the
    administration have gone so far as to issue proposals, like the
    international pricing index, which we all are familiar with, to
    bring down prescription drug prices.
        So with the increased scrutiny of the industry and of the
    drug supply chain as a whole in the U.S., have any of your
    companies re-evaluated your business strategy in foreign
    countries?
        Mr. Frazier. That is a common question that we get asked.
    And the answer to that question is, we do everything in our
    power to ensure that there is less freeloading by governments
    outside the United States. But the reality of the world is, the
    greatest opportunity we have is to walk away.
        And that is really challenging when you have the kinds of
    essential medicines that make a big difference to people's
    lives. And frankly, they know that. They know that they can
    establish a price, and that ultimately what we have is an
    option to walk away, leaving patients behind.
        I would also make the point that has been made several
    times here, that in the course of negotiating for
    reimbursement, often those countries take a very deliberate
    approach, such that these medicines are available many years
    later than they are here.
        So they not only negotiate on a low price, but they
    actually provide very few of these medicines early on to their
    populations. If you look at, for example, lung cancer, where in
    this country now, there is data showing that certain medicines
    can reduce the risk of death by 50 percent in newly diagnosed
    lung cancer patients, compare that to the UK, where people die
    regularly of lung cancer because they do not have these
    medicines.
        Mr. Soriot. Senator, I think it is important to keep in
    mind that all these investments, number one, create a lot of
    very good jobs in the U.S. and economic value that really
    benefits the country. And second, they allow patients to get
    access to important new medicines much, much, much earlier than
    in Europe, for instance, sometimes 3, 4 years before.
        And I share Mr. Frazier's comment here. I have many
    examples that I could share where medicines that save lives are
    available here. We are still waiting in Europe.
        The Chairman. Just three more questions. One from--if some
    of you want to answer yet, I did not mean to interrupt you. Go
    ahead.
        Mr. Gonzalez. The only thing I would add is, if we could
    develop a model where, as in the early days of HIV when
    countries ultimately shared the burden, knowing that you would
    have to provide HIV treatments at a very low cost in certain
    countries, there was a tiered pricing system that came through
    where, yes, the U.S. paid the highest price, but the Europeans
    paid a fairly significant price for very important specialty
    medicines. If we could negotiate through trade or other
    mechanisms, we would be able to get a more balanced sharing of
    the investment that is made, not keeping all of that burden on
    the U.S., because the U.S. does bear the bulk of the burden of
    innovation in our business. That is absolutely true.
        Senator Young. So that is a really interesting idea. If you
    or your team are aware of any academic paper you might bring to
    my attention----
        The Chairman. Okay. That is the end.
        Senator Young. Thank you, Mr. Chairman.
        The Chairman. Yes.
        Now we have three questions, one from Senator Wyden, then
    Senator Cassidy, then me. And then that will be it.
        Senator Wyden. Thank you very much, Mr. Chairman.
        This is going to be one question and then a very brief
    closer. And the question is for you, Mr. Gonzalez.
        I have the company's proxy statement here. And financial
    disclosures show that you were paid $22.6 million in 2017, and
    that included a $4.3-million bonus. That is what I want to look
    at.
        On page 37 in this proxy statement, it says your bonus was
    tied to the financial performance of Humira. And it seems that
    was the case in 2015 and 2016. That strikes me as problematic,
    since AbbVie reported that the higher prices in the U.S. were
    responsible for increasing sales of Humira.
        Would you make a smaller bonus if you dropped the price of
    Humira?
        Mr. Gonzalez. Humira was one element of a set of financial
    factors that were evaluated as part of my compensation. It is
    obviously a very significant product for us. So it is clear
    that it would be a part of that evaluation.
        Senator Wyden. I would like that in writing. It looks to me
    like you would be making a smaller bonus if you dropped the
    price of Humira. I would like that in writing within 10 days.
        My last point--Mr. Chairman, I appreciate being able to do
    this for a closer--is that I have heard a lot of happy talk
    this morning, things like, well, if you get rid of rebates,
    drug prices are going to go down. But what people are taking
    away from this hearing is--I have seen it said and reported--
    well, no firm commitments have been made to lower list prices.
        So I am just going to tell you what I would like in writing
    is, I would like an answer in writing to the question, if
    rebates go away, will you support a black letter law that
    requires that you reduce list prices by the amount of the
    rebate?
        I am going to get that to you right away. I would like an
    answer within 10 days, because that is right at the heart of
    this issue, and after the ``happy talk'' is over, that is what
    is really going to help people at pharmacy counters from sea to
    shining sea.
        Thank you, Mr. Chairman.
        The Chairman. Senator Cassidy?
        Senator Cassidy. Thank you, Mr. Chairman.
        Thank you, again. This has been incredibly provocative. And
    if there is a tension here, the tension is, how do we support
    innovation, but at the same time make it that the patient can
    afford that innovation?
        Mr. Frazier, you may have guessed that--it seems like we
    have a mirror image, in my mind. Either the plans impose a
    price or the government imposes a price. But either way, the
    side having it imposed upon them is not very wild about that.
        And you just mentioned to Todd Young that you can walk
    away. If France offers you too low a price, you just walk away
    from France. The UK does not have a deal right now. But in some
    areas, Medicare cannot walk away. So it is back to that mirror
    image. And you started to say something and I was out of time.
    But my question is, in the six protected classes--and if there
    is a new drug, like Sovaldi was at the beginning, right now the
    commercials can walk away, the commercials can delay, but
    Medicare cannot.
        So help me resolve this. How do we give the patient, the
    taxpayer, the same sort of tools that--and by the way, CBO says
    unless you can walk away, negotiations will not lower prices.
        Mr. Frazier. So my point was, for all practical purposes,
    we cannot walk away from our European colleagues, even though
    they give us low prices, because we think it would be immoral
    to leave those patients----
        Senator Cassidy. Now some of your colleagues have, because
    there are drugs not yet available in the UK.
        Mr. Frazier. Well, the problem with the UK is that they
    delay. Just like they can set the price, they delay when they
    put the drug on the market. It is the UK's delay, it is not our
    delay. So I want to clarify that point.
        But coming back to your six protected classes, those
    protected classes are there because many, many sick vulnerable
    people need medicines in those classes. And we believe that
    there are ways of lowering the prices, stimulating innovation,
    without violating the compact that was around those six
    protected classes, because patients are particularly needing
    those medicines.
        Senator Cassidy. Well, we will have to leave it there, but
    I am not sure that is--you know, that seems almost status quo.
    And status quo is kind of not working.
        But again, thank you all very much, and I thank you again
    for your innovation.
        Dr. Bourla. I would add, Senator, I believe the
    administration should try, through trade agreements, to protect
    the American innovation, because by and large the
    pharmaceutical innovation is happening in this country. And
    right now, I think rightly, these price control mechanisms are
    for multiple well-developed countries. It is in reality free-
    riding on American innovation.
        Senator Cassidy. Okay.
        Well, thank you.
        The Chairman. My last question is very general, but I would
    like to know if there are any policies affecting Medicaid or
    Medicare that are in your control to change? In other words,
    from the company level, is there anything in your control that
    you could change on Medicare or Medicaid?
        I will start with you on my right here.
        Dr. Brandicourt. I do not think we can change directly any
    policy, Senator, on Medicare or Medicaid. We can talk about
    different solutions, but I do not think we can change. We have
    no power to change.
        The Chairman. But if you lowered your list price, it would
    help. That is one thing you could do.
        Dr. Brandicourt. If we were able to lower our list price,
    that would certainly help, again, the patient at the end, at
    the pharmacy, to have a copay which they could afford.
        However, we could not do that independently of a major
    reform because we would lose formulary placement if we were
    doing that in isolation, and especially in very competitive
    areas where you do have, you know, brands and generics. And
    again, I am referring to the insulin market, which has become
    extremely, extremely competitive. That would not work.
        The Chairman. Do you have anything?
        Dr. Bourla. Mr. Chairman, I think the most impactful thing
    I can do right now it is to make the pledge that, as leader of
    this company, Pfizer, I would be taking very seriously the
    responsible pricing of our products. This is something that we
    have already started.
        Pricing at Pfizer in the past was growing in the mid-single
    digits, even more in some cases. This is not something that we
    continued doing. Pricing at Pfizer went down last year, went
    down this year.
        And when I spoke to our investors, not to the Senate, to
    our investors, I made it very clear that pricing will not be a
    growth driver for this company now or in the years to come. Why
    do I think this is the most important? Because I think the tone
    is set from the top.
        The Chairman. Mr. Frazier?
        Mr. Frazier. Senator, I understand the dissatisfaction with
    our industry. I understand why patients are frustrated, because
    they need these medicines and they cannot afford them.
        I would pledge to do everything that we could, but I would
    urge you to recognize that the system itself is complex, and it
    is interdependent. And no one company can unilaterally lower
    list prices without running into financial and operating
    disadvantages that make it impossible to do that. But if we
    bring all the parties together around the table with the goal
    of doing what is best for the patient, I think we can come up
    with a system that works for all Americans.
        Thank you for giving us the time today.
        The Chairman. I did not mean to--for the rest of you,
    before you answer, I did not mean to say list price. I just
    said, well, that is kind of obvious. Yes, I did not want to
    concentrate just on that.
        Ms. Taubert?
        Ms. Taubert. We really want to be a part of the solution,
    and we want patients to be able to access and pay for the
    medicines that they so desperately need. So we do strongly
    advocate for rebate reforms that would allow us to lower our
    list prices that would then end up helping patients get access.
        The Chairman. Dr. Caforio?
        Dr. Caforio. Mr. Chairman, I would echo. Our perspective is
    that it starts with a very responsible and thoughtful approach
    to pricing and price increases. That is what Bristol-Myers
    Squibb does.
        The second point that I would like to make is that, today
    we have discussed a number of very concrete policies, from
    addressing the issue of rebates to value-based pricing to
    supporting the development of a generic and biosimilar market.
    And you have my commitment that our company is looking forward
    to working with this committee and the administration to make
    sure that many of those policies can be enacted, because they
    would make a very big difference for our patients.
        The Chairman. Mr. Soriot?
        Mr. Soriot. Senator, we actually cannot influence policy.
    What we can do is, indeed, apply reasonable pricing and also
    continue pushing for value-based pricing. But I would like to
    make a general comment, which is that hopefully--you know,
    hopefully my colleagues will share this. This view is that I
    really do not think we are blaming anybody in the system. In
    his introduction, Senator Wyden thought that we were placing
    the blame on PBMs and others. I really do not think we are
    doing this.
        I think what it is is that we are in a system that used to
    be fit for purpose and really drove enormous savings over the
    last few years but is no longer fit for purpose. And it is one
    of those situations where nobody in the system can do anything,
    can fix it by themselves. The government has to step up and
    change the rules, and those rebates have to go.
        The Chairman. Mr. Gonzalez?
        Mr. Gonzalez. I think I would agree with many of the points
    that were already raised. We as an industry have to continue to
    do everything we can to be responsible about pricing in both
    how we set pricing and price increases over time. I think we
    have seen a positive trend in that area. But ultimately, the
    final fixes here to realign the system appropriately would
    require legislative-type changes.
        The only other thing I would say is, as I mentioned a
    moment ago, we are absolutely committed that no patient goes
    without medicine of ours that they need. And we have an
    extensive patient assistance program, but we are talking about
    how we more broadly ensure all patients understand they can get
    that support from us if they cannot afford their medicines.
        The Chairman. I want to inform all members of the committee
    that I will set a deadline of March 12th if you have questions
    you want to submit to the panel for answers in writing. And
    then for you folks, after you get those questions, I hope you
    can get back to us very quickly.
        And so, all of the people besides the witnesses who have
    attended either here or off-site for this hearing, I thank you
    for your interest in this issue. And I want to once again thank
    our witnesses for being here today and sharing your knowledge
    and expertise. And I indicated that this is the start of a
    dialogue I hope to have with you so that we can correct some of
    these things that have been pointed out at this committee
    meeting that we think need to be corrected.
        Thank you all very much.
        Meeting adjourned.
        [Whereupon, at 1:25 p.m., the hearing was concluded.]

                                A P P E N D I X

                  Additional Material Submitted for the Record

                                  ----------

               Prepared Statement of Albert Bourla, DVM, Ph.D.,
                        Chief Executive Officer, Pfizer
        Chairman Grassley, Ranking Member Wyden, and members of the
    committee, thank you for the opportunity to speak with you today. My
    name is Albert Bourla. I have been with Pfizer for 26 years, and just
    last month had the honor of becoming its chief executive officer.

        Today, I am pleased to take part in such an important policy
    discussion within the United States Senate. Pfizer shares an important
    goal with this committee: to ensure that America remains the leader
    when it comes to innovative medicines, and that our citizens have
    affordable access to these modern miracles when they need them.

        In that frightening moment when you hear that you or a loved one
    has been diagnosed with a serious disease, one question comes to mind:
    ``Is there a cure or treatment available?'' The answer can change your
    life. And happily, the answer to that question increasingly is ``yes.''

        Breakthrough medicines are coming quickly across a wide range of
    conditions. Most of them are discovered here, by the American
    Biopharmaceutical Industry, which is the crown jewel of innovation. Let
    me share a few examples. In 2015, Pfizer launched a life-changing new
    treatment for metastatic breast cancer that can delay the progression
    of the disease two times longer than previous treatments. Thanks to our
    meningitis B vaccine, parents can send their teens to college confident
    in the knowledge that being vaccinated helps protect them in the event
    of an outbreak on campus. In 2018, we brought 4 new cancer treatments
    to the market to treat varying forms of breast cancer, lung cancer and
    leukemia. And we are currently working on a non-opioid alternative with
    the potential to address the serious unmet needs of the more than 27
    million Americans living with osteoarthritis and the more than 33
    million suffering chronic low back pain.

        But all of these breakthroughs won't do anyone any good if patients
    can't afford them.

        That's why at Pfizer we are so committed to our purpose:
    breakthroughs that change patients' lives. Pfizer's more than 90,000
    colleagues around the world come to work every day focused not only on
    creating breakthrough medicines, but also on making sure those
    medicines get into the hands of the patients who need them.

        To create solutions that make medicines affordable for patients and
    our entire health-care system, I believe that all players in the
    industry must come together and play a part. Whether it's hospitals or
    providers, pharmacy benefit managers or insurance companies, or
    biopharmaceutical companies, we all have a role to play. The series of
    hearings being held by Congress can be a catalyst for this much-
    needed collaboration.

        There are two indisputable truths that make this the exact right
    moment for change:

            1.  Medicines alleviate human suffering and reduce overall
            system costs.

            2.  The horribly misaligned incentives within our health-care
            system often prevent medicines from getting into the hands of
            patients.

        Our health-care system is broken, and we need to fix it. The system
    needs to be simpler and more transparent. It needs to incentivize
    innovation while simultaneously ensuring access. Simply put, it needs
    to put patients--and their health--first.

        How will we know when the health-care system is fixed? When
    patients feel real relief at the pharmacy counter--the kind of relief
    that means cost will no longer be a determining factor in whether
    someone picks up, and adheres to, their prescription. Too often,
    Americans are forced to choose between buying a medication that will
    improve, extend or save their lives or paying their bills. Too often,
    they fill their prescriptions, but take less than the prescribed dose
    in an effort to save money. Too often, lower-cost, FDA-approved generic
    and biosimilar alternatives are not made available to patients who
    desperately need them.

        We must take bold actions to ensure these scenarios do not play out
    time and time again across America.

        Pfizer intends to be a productive participant in this policy making
    and has come to the table with solutions. As such, we would like to
    propose four ideas to drive meaningful reductions in costs for
    patients.
                        passing all rebates to patients
        Today's current drug rebate system is good for two things: driving
    up both drug list prices and consumer out-of-pocket costs. In fact, in
    2018, the average net price of Pfizer's medicines in the United States
    declined 1 percent. However, I am certain that patients using our
    medicines had a very different experience at the pharmacy counter since
    their costs in the current system are more closely related to the list
    price than the net price. This is impactful when patients pay a
    coinsurance or are in the deductible phase of their benefits coverage.
    In these instances, patients are being asked to pay an average of 10
    percent to 20 percent or more out of their own pockets for many Pfizer
    products.

        There are two reasons for this disconnect: changes in benefit
    designs are pushing more and more of the medicines' cost to the pockets
    of the patients, and none of the close to $12 billion of rebates that
    Pfizer paid in 2018 found their way to American patients. As long as
    rebates serve as profit drivers, we will continue to see a major
    disconnect between list prices and prices people pay at the counter.

        Pfizer supports reforms that would create a system in which
    transparent, up-front discounts benefit patients at the pharmacy
    counter, rather than a system driven by rebates that are swallowed up
    by companies in the supply chain.

        The way to alleviate sticker shock at the pharmacy counter is by
    changing the incentives in the supply chain so that more of the $150
    billion in negotiated rebates and discounts actually reach patients.
    This can be accomplished by applying the discounts paid by the
    pharmaceutical manufacturer to the price actually paid by patients at
    the pharmacy. In 2019, Pfizer expects to pay billions in rebates to
    ensure patients with pharmacy benefits coverage in Medicare Part D and
    patients in commercial plans have access to our medicines. If the
    proposed rule to share rebates with consumers at the point of sale is
    finalized, we estimate that seniors taking Pfizer medicines could save
    $270 on average per year, and up to $574 per year for certain Pfizer
    medicines, through lower cost sharing--and that would outweigh any
    premium increases.

        Research also shows that sharing discounts at the pharmacy counter
    could reduce total health-care spending, and that reductions in overall
    out-of-pocket costs would outweigh any premium increases.

        We realize that the transition away from rebates toward a point-of-
    sale discount model will result in a lowering of our net prices.
    Despite this potential negative financial impact, we support efforts to
    eliminate rebates because we believe the new model will be good for
    patients.

        Importantly, we believe any reform should apply to all market
    segments as this will also lead to further reduction in list prices. A
    bifurcated market in which we eliminate rebates in government programs
    but maintain rebates for commercial plans will make it difficult for
    manufacturers to reduce list prices because it applies to all markets.

        We will work with other leaders in the healthcare sector to advance
    these reforms, and we're committed to lowering list prices if the
    rebate rule applies to the commercial market.
                              less value, less pay
        Pfizer supports the move to value-based health care and is prepared
    to stand behind the benefits that our medicines deliver to patients and
    to the United States health-care system.

        Medical science is advancing so rapidly that payment models simply
    haven't been able to keep up. That's why Pfizer is focusing not only on
    scientific innovation, but also on commercial innovations that will
    allow us to get breakthrough medicines into the hands of patients,
    while simultaneously holding all participants in the system--including
    Pfizer--accountable for the health outcomes they help produce.

        This will require a fundamental shift in the way we think about the
    value that medicines deliver and how all participants in the system are
    reimbursed with regard to that value. It will also require the
    evolution of insurance designs to advance value-based insurance plans
    that removebarriers to high-value treatments.

        Imagine a system in which hospitals are rewarded for keeping
    patients from being readmitted; where physicians get paid more to
    prevent disease than they do to simply treat it; and where companies
    like Pfizer get paid based on the number of strokes we prevent or the
    number of cancer patients who go into full remission, rather than the
    number of pills we sell.

        In such a system, if our medicines do not produce results, we would
    be paid less. And if they do produce results, we would be paid more. If
    done correctly, these arrangements--focused on the appropriate
    therapeutic areas--can align the interests of patients, health plans
    and biopharmaceutical companies around one shared goal: ensuring
    positive health outcomes for the patient.

        To make this a reality, we need Congress's help to remove the
    roadblocks in the current system for the good of patients. I understand
    several members of this committee are drafting a legislative effort to
    pave the way for broader adoption of outcomes-based arrangements, and
    we applaud these efforts.
                 capping seniors' out-of-pocket medicine costs
        Patients are increasingly being required to take on a bigger share
    of their medicines' costs, and that is particularly true when it comes
    to innovative and expensive treatments. Today, patients are made to pay
    on average 14 percent of the cost of their medicines, but only 3
    percent of the costs associated with hospital stays.

        This is forcing patients to forgo taking needed medications, to cut
    their pills in half, or to limit their doses in ways that are not
    medically prescribed. In fact, there is evidence that at least a
    quarter of new Medicare Part D prescriptions are abandoned at the
    pharmacy counter if beneficiaries are asked to pay $50 or more, which
    unfortunately is often the case. This number can exceed 50 percent for
    new prescriptions.

        This is bad not only for patients, but also for overall health-care
    system cost. Patients who do not take their medications often end up in
    the hospital, costing the health-care system much more. This needs to
    be fixed.

        Excessive cost-sharing is one of the greatest barriers to patient
    adherence and leads to more frequent discontinuation of therapy. While
    spending on medicines has been growing at a slower rate than in prior
    years, the number of patients with high deductible plans and high co-
    insurance are growing rapidly. Since 2009, enrollment in high
    deductible plans has grown 250 percent, and since 2010 the number of
    patients exposed to high specialty tiers has grown 60 percent. In fact,
    I've heard from several members of this committee that their
    constituents--or they themselves--have recently gone to the pharmacy
    counter only to be shocked by an excessively high co-pay. That's why
    the time is now to review cost-sharing burdens in the Medicare
    prescription drug program and to take steps to ensure seniors don't
    have to make the difficult decision of forgoing their needed
    prescription.

        We commit to working with the committee on meaningful policy
    solutions that remove the burdens seniors face in paying for their
    medicines, and we believe an important first step is capping the out-
    of-pocket costs seniors experience in the Medicare drug program.
                knocking down barriers to lower-cost biosimilars
        Medicines are the only segment of the health-care system with a
    built-in cost containment mechanism. When a medicine's patent expires,
    lower-cost generics are made available, often at just 5 percent of the
    cost of the original branded product.

        This system is working well for generic drugs. In fact, nine out of
    10 drugs sold in the U.S. today are lower-cost generics. However, the
    system is not yet working in the biologics space where the adoption of
    biosimilars is facing resistance.

        Establishing a robust biosimilars market can help to lower the
    overall health-care costs in the United States, and Pfizer is committed
    to bringing these more affordable treatment options to patients. That's
    why we must incentivize the use of biosimilars, which can be as much as
    40 percent less expensive than the branded biologic for Medicare
    patients.

        Unfortunately, adverse incentives that favor higher-cost originator
    biologics are keeping biosimilars from reaching patients. In many
    cases, payers decline to include lower-cost biosimilars or generics in
    their formularies because they would risk losing the rebates they can
    get by covering higher-cost medicines. I can't think of a more
    concerning example of a broken U.S. healthcare system that is directly
    impacting the pocketbooks of Americans.

        We have also witnessed exclusionary contracting or misleading
    marketing practices that mischaracterize important elements of
    biosimilar criteria. This creates doubt and confusion among patients,
    and it must end. Interestingly, the rebate reform I referenced earlier
    would go a long way toward removing the perverse incentives that lead
    to such exclusionary contracts.

        At Pfizer, we believe there are several solutions that could help
    patients and providers share savings associated with biosimilars and
    reduce costs to the Medicare program. Let me touch on two:

              A Shared Savings Biosimilars Model: Congress could direct
            the CMS Innovation Center (CMMI) to test a biosimilar ``shared
            savings'' approach in which Medicare savings associated with
            prescribing a biosimilar, as compared to a reference
            biological, would be shared with providers.

              Reduced Patient Cost Sharing for Biosimilars: CMS could
            provide reduced or zero-dollar cost sharing for biosimilars for
            patients for a certain period.
                                    closing
        In 2018, we estimate \1\ that Pfizer vaccines protected more than
    65 million babies and elderly patients; our medicines helped reduce the
    risk of heart attack or stroke for more than 48 million cardiovascular
    patients; and oncologists used our therapies to treat more than 1.2
    million people battling cancer.
    ---------------------------------------------------------------------------
        \1\ Patient counts are estimates derived from multiple data
    sources.

        Overall more than 784 million people around the world used a Pfizer
    medicine or vaccine to improve their health and, in many cases, save
    ---------------------------------------------------------------------------
    their lives.

        These are staggering and humbling numbers. More important, they
    represent real people; real people who rely on our innovations. They
    also serve as a reminder that we--like our industry peers--are among
    the biggest contributors of good to humanity.

        This is why we come to work every day. It's why the researchers in
    our labs in California, Connecticut, Massachusetts and New York work
    day-in and day-out to perfect a formula. It's why our manufacturing
    colleagues in Georgia, Kansas, Michigan, Missouri, North Carolina,
    Ohio, Pennsylvania and Wisconsin--many of whom are represented by
    members of this committee--work to ensure the reliable supply and
    highest standards of quality of our products.

        And it's why we are here today to work with our peers, other
    participants in the healthcare system, and Congress to find ways to
    ensure the patients who need our medicines can access them so our
    industry's breakthroughs can continue to change patients' lives.

                                     ______

        Questions Submitted for the Record to Albert Bourla, DVM, Ph.D.
                   Questions Submitted by Hon. Chuck Grassley
        Question. At the hearing, you testified that Pfizer does not
    withhold samples from generic manufacturers in order to block generic
    versions of your drug from entering the market. You also expressed your
    support for the ``Creating and Restoring Equal Access to Equivalent
    Samples Act,'' also known as the CREATES Act.

        However, the FDA has a list on its website which identifies
    reference listed drug (RLD) access inquiries where brand manufacturers
    may have prevented generic companies from obtaining samples of products
    necessary to support FDA approval. Pfizer is on this FDA list. This
    would appear to contradict your testimony at the hearing that Pfizer
    has not withheld samples of their products to delay generic
    competition.

              Could you please explain in detail why Pfizer is on the FDA
            list?
              Could you please explain in detail the discrepancy between
            your testimony and the FDA list?
              Has Pfizer ever blocked access to samples?

        Answer. As a patient-focused company and leading manufacturer of
    innovative, generic, and biosimilar medicines, Pfizer supports
    innovation and a strong, competitive marketplace. Consistent with these
    values, Pfizer does not block generic manufacturers from purchasing our
    products, and it has never been our policy to do so. Generic
    manufacturers are treated the same as any other customer seeking to
    purchase our products. Pfizer is not aware of any current, unfulfilled
    requests from a generic manufacturer to purchase a Pfizer product.

        Generic manufacturers seeking to purchase Pfizer products should
    request the product from Pfizer's authorized distributors or, if the
    product is not available at a distributor, from Pfizer directly, the
    same as any other Pfizer customers. Pfizer's website includes a list of
    our authorized distributors, from which customers (including generic
    companies) may purchase most Pfizer products (see https://www.
    pfizer.com/products/medicine-distributors). For products that are not
    available via our authorized distributors and that are not in extreme
    drug shortage or unavailable due to a recall, customers can contact
    Pfizer's Customer Service center at 1-800-TRY-FIRST (1-800-879-3477) to
    purchase product directly from Pfizer. The telephone number for
    Pfizer's Customer Service center is also included on our website at
    https://www.pfizer.com/contact. Pfizer makes its products available for
    sale to appropriately licensed entities at Pfizer's listed price and on
    Pfizer's standard terms of sale. We do not have any agreements with
    authorized distributors that block the sale of Pfizer's products to
    generic manufacturers.

        Regarding the FDA List (the List), while Pfizer supports FDA's (the
    agency) goal of providing transparency, Pfizer is concerned that the
    List lacks certain key information and context and, as currently
    presented, may create the misleading impression that all products on
    the List are the result of bad faith attempts to block generic
    manufacturer access to samples. The appearance of a product on the FDA
    List means only that a generic manufacturer informed the agency at some
    point in time that it was having difficulty purchasing the listed
    product. FDA's own disclaimer states that the agency has not
    independently investigated or confirmed whether a generic manufacturer
    actually made a request to purchase product, and to whom.\1\ The FDA
    List also lacks several important pieces of information that would
    enable a New Drug Application (NDA) holder to investigate its
    appearance on the List. The List does not include: (1) which generic
    manufacturer made the request; (2) when and to whom the generic
    manufacturer made the request (e.g., to a wholesaler or directly to the
    NDA holder); (3) whether the generic manufacturer that made the inquiry
    was thereafter able to obtain product; and (4) any reason(s) why a
    generic manufacturer may not have been able to obtain product (e.g., a
    recall). Finally, Pfizer notes that FDA does not currently inform an
    NDA holder in real time when a generic manufacturer notifies the agency
    that it is having difficulty obtaining product. Had the agency informed
    Pfizer at the time it received the inquiries noted on the FDA List,
    Pfizer could have then undertaken its own efforts to resolve the issue.
    Pfizer communicated its concerns about the FDA List to the agency in
    May 2018. For your information we have included Pfizer's letter to FDA
    on this topic and the agency's response (see Exhibits 1 and 2 in the
    Appendix).
    ---------------------------------------------------------------------------
        \1\ (https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm).

        There are three new drug applications owned by Pfizer on the FDA
    List: Embeda (NDA 022321), Tikosyn (NDA 020931) and Hemabate (NDA
    017989). Embeda offers a good example of the List's shortcomings.
    Pfizer acquired King Pharmaceuticals (the previous NDA holder of
    Embeda) in March 2011, and two weeks later determined that Embeda
    needed to be recalled from the U.S. market due to stability issues.
    After diligently addressing the issues that led to the recall, Pfizer
    relaunched Embeda to the U.S. market in January 2015, and it is
    available for purchase via Pfizer's authorized distributors. However,
    one consequence of the recall was that Embeda was not available in the
    U.S. market for almost 4 years which may explain why a generic
    manufacturer had a problem obtaining it during those years. The FDA
    List does not specify when the generic manufacturer's inquiry regarding
    Embeda was made nor does the FDA List indicate that several generic
    applications for Embeda had been submitted to FDA in 2010 (which means
    that before the recall, several generic manufacturers were successfully
    able to purchase Embeda, conduct the necessary testing, and file
    Abbreviated New Drug Applications (ANDAs)). Pfizer has not identified
    any recent inquiries from generic manufacturers seeking to purchase
    ---------------------------------------------------------------------------
    Embeda that have not been fulfilled.

        The circumstances around Tikosyn also illustrate the List's
    shortcomings. Pfizer was able to identify a single inquiry made by a
    generic manufacturer directly to Pfizer to purchase Tikosyn in 2014. At
    that time, Tikosyn was subject to an FDA imposed Risk Evaluation and
    Mitigation Strategies (REMS) with Elements to Assure Safe Use
    (``ETASU'') that restricted distribution, so Pfizer responded by asking
    the manufacturer to obtain written confirmation from the FDA that
    Pfizer's provision of the product to the generic manufacturer would not
    be considered a violation of its REMS. The generic manufacturer did not
    contact Pfizer further, and Pfizer never received any written
    correspondence from the agency. FDA subsequently removed the REMS for
    Tikosyn in 2016, and multiple generic versions of Tikosyn are now
    approved, the first generic approval occurring in June 2016. This
    context is not reflected in FDA's List.

        Finally, with respect to Hemabate, this product was previously
    subject to certain restrictions on distribution (i.e., it was sold only
    to customers with medical and surgical intensive care centers) to
    ensure its safe and appropriate use. This distribution approach was
    established by the previous NDA holder (Pharmacia) and it continued
    following Pfizer's acquisition of Pharmacia in 2003. Pfizer
    discontinued this approach in early 2018 after determining that it was
    no longer necessary, and this product is now available through our
    authorized distributors. During the time when Hemabate was under
    restricted distribution, it was not available at Pfizer's authorized
    distributors, but had a generic manufacturer approached Pfizer's
    Customer Service center directly, we would have been able to address
    the inquiry. Pfizer's Customer Service was not able to identify any
    specific requests from a generic manufacturer to purchase Hemabate that
    have not been fulfilled.

        We hope that this information explains the apparent discrepancy
    between Mr. Bourla's testimony and the appearance of these Pfizer
    products on the FDA List, and demonstrates Pfizer's diligence on these
    issues and commitment to a competitive marketplace.

        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant. If the HHS proposed rule is finalized, can you assure the
    committee that your company will offer up-front discounts? If not, why?

        Answer. Yes, if finalized, price concessions negotiated with
    intermediaries, including Pharmacy Benefit Managers (PBMs) and plan
    sponsors, will be provided as discounts that will be applied at the
    point of sale. These discounts will lower patient out-of-pocket costs
    since the net price will be used to determine the cost to the patient
    when they are in the deductible, co-insurance, and coverage gap phases
    of their benefits.

        Question. Please describe how you expect your company to respond to
    the HHS proposed rule to eliminate safe harbor protection for back-end
    rebates in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. If finalized, the rule will result in lower out-of-pocket
    patient costs at the pharmacy counter and help address the perverse
    incentives in the system that have been contributing to higher list
    prices for medicines. We realize that the transition away from rebates
    toward a point-of-sale discount model will result in a lowering of our
    net prices. Despite this potential negative financial impact, we
    support efforts to eliminate rebates because we believe the new model
    will be good for patients.

        As currently written, the proposed rule only applies to the
    Medicare and Medicaid managed care segments of the market. It will be
    important to have any rebate reform apply to both government programs
    and the commercial market as that will also lead to a lowering of list
    prices as well. A bifurcated market will make it more challenging for
    manufacturers to reduce list price since the commercial market covers
    more than 50 percent of Americans with insurance and represents over
    half of the business for most manufacturers.

        If the proposed rule is modified to apply to all market segments,
    we would evaluate the best options to arrive at a net price that
    ensures patients have access to our medicines. Decisions would be made
    on a product by product basis given that each therapeutic class has its
    own set of competitive and access dynamics. As such, we expect to use
    both list price reductions and up-front discounts to achieve these
    lower net prices. To ensure these benefits reach patients, it will be
    important for Congress to ensure that plans do not create new barriers
    or restrictions that hinder patient access and undermine the spirit of
    the rule.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. Pfizer's contracts with Part D Health Plans and PBMs
    negotiating on their behalf do not make rebates contingent on market
    share.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

        Answer. Pfizer's prescription pharmaceutical products are sold
    principally to wholesalers, and therefore the Company does not have
    sufficient visibility into wholesaler distribution at the channel level
    to provide responses as requested. We welcome the opportunity to
    discuss with your committee staff the confidential information
    requested and what we maintain in the ordinary course of business.

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees?

        Answer. No.

        Question. To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. Pfizer is committed to the principle of transparency--the
    disclosure of activities reflecting participation in efforts of public
    interest. These activities include such areas as funding for
    educational activities, the status of Pfizer's U.S. pharmaceutical
    post-marketing commitments, Pfizer's pipeline of experimental
    medicines, the registration and reporting of results of clinical
    trials, political contributions in the United States and payments to
    U.S. health care professionals. The information we report includes
    grants to support independent medical education, support for
    fellowship, scholarship and visiting professorship programs, grants to
    patient organizations, medical and scientific associations, and
    academic or other medical centers, charitable contributions, health
    care-related support to civic organizations and health care-related
    non-promotional sponsorships to organizations. For descriptions of
    types of support, please visit https://www.pfizer.com/purpose/
    independent-grants/transparency-in-grants. Any Medicaid specific
    advocacy funding we provide would be captured in these reports.

        Question. Please describe how the costs of programs are accounted
    for within your company's financial statements. Please also describe
    the types of market information, such as prescribing and use patterns,
    that your company collects from different types of patient assistance
    programs and patient hub services.

        Answer. Pfizer's patient assistance program is a charitable free
    drug program that provides commercially available Pfizer medicines free
    of charge to financially eligible uninsured and underinsured patients.
    Separate from the Pfizer patient assistance program, Pfizer also offers
    patient support programs, which are limited access reimbursement
    support offerings to patients to assist with obtaining access to and
    coverage of a prescribed Pfizer medicine.

        The product and administrative costs for the patient assistance
    program are charged against Pfizer's Selling, General and
    Administrative Expenses line in the income statement.

        Pfizer gathers data in the course of providing free drugs to
    patients via the patient assistance program. We can bucket data
    collection in several ways:

            (1)  Transactional data--Utilized to determine patient
            eligibility to receive free access to a physician-prescribed
            therapy.

            (2)  Operational data--The operational data is utilized to
            provide free access to medicines to the eligible patient and
            the following is reported at an aggregated level: (i) program
            utilization trends; (ii) application processing trends; (iii)
            patient coverage trends; (iv) channel utilization (distribution
            versus pharmacy); (v) fulfillment and order processing days;
            and (vi) call metrics.

        Pfizer gathers the following two categories of data when providing
    patient support programs:

            (1)  Transactional--Utilized to assist in accessing prescribed
            therapy and to determine insurance coverage for the patient.
            This information contains data such as the outcome of a
            benefits investigation, information to determine the financial
            need and eligibility for patient support, and disposition of
            the patient case (i.e., sent to a specialty pharmacy for
            fulfillment, sent to Pfizer patient assistance program, triaged
            to other financial options, or rejected/denied).

            (2)  Operational--These fields could include primary and
            secondary payers, out-of-pocket costs borne by the patient,
            turnaround time to obtain insurance approval, prior
            authorization requirements, number of cases requiring appeals,
            and other data elements on access dynamics. In addition to
            these elements, Pfizer will collect relevant adverse events as
            required by Pfizer drug safety.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. For each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. Information about Pfizer's charitable giving is listed on
    Pfizer.com. Please see the annual reports dating back to 2008 available
    at https://www.pfizer.
    com/purpose/independent-grants/transparency-in-grants, which include
    the recipient name, the contribution amount and the annual quarter in
    which it was made, and a description of the relevant program or
    project. This data is updated each quarter. Data from Q4 2018 is
    currently being analyzed and will be available at the end of March
    2019. The annual reports include various funding types and recipient
    types. However, in collating this data, Pfizer does not characterize
    the organizations as working on issues related to drugs within product
    lines, or contributions as restricted or unrestricted. Consequently,
    the requested data is not available in that format.

        Note that information regarding charitable contributions from the
    Pfizer Foundation is not included in these reports, so Pfizer has
    included a Pfizer Foundation Grant Summary as Exhibit 3. The Pfizer
    Foundation has been working to expand health-care access to people
    around the world for nearly 65 years. The impact of this work is
    significant and far-reaching, helping underserved individuals from
    diverse backgrounds in remote corners of the globe. Through the Pfizer
    Foundation's global health strategy, we provide grant and investment
    funding to support organizations and social entrepreneurs in an effort
    to improve health care delivery in low-and middle-income countries and
    increase access to health care for underserved communities.

        Question. Pay for delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the ``Preserve Access to
    Affordable Generics and Biosimilars Act,'' which would help put an end
    to these deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Answer. Pfizer wants to work with you on this issue because we
    agree that gaming the patent system is unacceptable. The company's
    patent settlements do not involve ``pay for delay.'' On the contrary,
    when Pfizer settles patent litigation with generic firms, it does so on
    terms that generally enable entry of generic competition earlier than
    the expiration of its patents and that do not involve unlawful reverse
    payments. Pfizer's patent settlements thus involve lawful compromises
    that accelerate patient access to lower cost generics relative to the
    expiration of its patents.

        Question. Has your company ever entered into these kinds of
    settlements with a generic company?

        Answer. No. On the contrary, when Pfizer settles patent litigation
    with generic firms, it does so on terms that generally enable entry of
    generic competition earlier than the expiration of its patents and that
    do not involve unlawful reverse payments. Pfizer's patent settlements
    thus involve lawful compromises that appropriately resolve patent
    disputes and accelerate patient access to lower cost generics relative
    to the expiration of its patents. While Pfizer has been the target of
    plaintiff lawyer driven class action lawsuits challenging certain of
    its settlements with generic companies, we believe these lawsuits are
    without merit and are vigorously asserting the pro-competitive nature
    of these settlements in court.

        Question. Do you support the pay for delay bill?

        Answer. Pfizer agrees that gaming the patent system is
    unacceptable. We hope to work with you on legislation that prohibits
    anticompetitive patent settlements that is prospective, clearly defines
    violations and what is deemed to be an improper settlement and does not
    presume all patent settlement agreements are per se illegal and
    anticompetitive. Laws or actions to restrict certain kinds of
    pharmaceutical patent settlements could prevent some pro-consumer
    settlements that bring generics to market prior to patent expiration--
    patent settlements often include an agreement that enables generics to
    enter the market earlier than the date of patent expiration, speeding
    patient access to more affordable generic options.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Answer. Pfizer does currently bundle rebates over multiple
    products. Pfizer does offer bundling arrangements to obtain formulary
    positions that allow patients to access our medicines that otherwise
    might be restricted.

        Question. Does your company view these practices as anticompetitive
    or harmful to patients' access to quality, lower cost medicine?

        Answer. Pfizer does not believe bundling is inherently
    anticompetitive and in certain circumstances can be procompetitive.
    However, Pfizer does not tie bundled rebates to blocking lower cost
    competitive agents and believes that when a firm with monopoly power
    uses such practices to block lower cost alternatives the conduct is
    anticompetitive.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. A policy that moves rebates to discounts would not in and
    of itself eliminate the ability of a market leader to block a lower
    priced medicine. In both Medicare and commercial, the Health Plan is
    still responsible for the majority of the drug cost and would therefore
    receive the majority of the discount. The Health Plan or PBM would
    still need to transition patients from the higher priced market leader
    to the lower priced product in order to realize the savings from the
    discount. Based on internal analysis, Pfizer expects that moving from a
    rebate to a discount model will weaken a market leader's ability to
    restrict other less expensive products, but it would not eliminate the
    possibility.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        Answer. The Food and Drug Administration is the primary regulatory
    body for the pharmaceutical industry and is largely focused on the
    safety, quality, and efficacy of medicines. The price of a new medicine
    is most directly influenced by the value that the medicine may bring to
    patients and society. Inherent in the value any product Pfizer brings
    to the market are the quality, safety, delivery, efficacy, and
    reliability of our medicines. These regulatory and compliance factors
    are part of the underlying investments to identify a product's value
    and are amongst the many factors we consider when we determine a launch
    price or make a decision to change a price.

        Question. When setting the list price of a drug, does your company
    consider the risk of liability or litigation? If so, how specifically
    do those factors affect the list price of a drug? Please provide at
    least one specific example, if applicable, from your current product
    portfolio.

        Answer. Liability and litigation are not primary considerations
    when setting the list price of a medicine; the value that a product may
    bring to patients and society is the most important factor considered.

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see value-based agreements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        Answer. Value-based agreements (VBA) provide a framework for
    manufacturers to be compensated based on a product's value to patients
    and the overall health-care system. Although there are different
    constructs for VBAs, the basic premise is that the net price for a
    product will ultimately be derived based on an agreed upon performance
    metric (e.g., clinical, financial, adherence, etc.). Therefore, VBAs
    can play a role in reducing prescription drug costs by ensuring that
    net prices are linked to value.

        As we shift to a system that rewards value, manufacturers will be
    incentivized to focus research and development (R&D) investments in
    disease areas where there are unmet needs, to focus on best in class or
    first in class medicines, and to design trials that provide the
    necessary evidence to demonstrate the value of a medicine beyond the
    regulatory standards of safety and efficacy to include the evidence to
    support reimbursement. If manufacturers deliver medicines of value, the
    system will reward the manufacturer which encourages innovation of new
    drugs.

        Question. How can VBAs help lower what patients pay out-of-pocket?

        Answer. Value-based agreements (VBA) provide a framework for
    manufacturers to be compensated based on a product's value to patients
    and the overall health-care system. There are many different types of
    VBAs including those based on clinical and/or financial performance
    metrics for a product. Based on the outcomes achieved, payers use this
    information to inform how they cover products. Products that perform
    better should be covered in a more favorable manner which often
    includes lower out-of-pockets costs for patients which is a benefit to
    patients in the near term. In the long term, patients can also benefit
    from other savings either directly, (e.g., reducing spending on other
    medications, lowering medical costs from reduced hospitalizations,
    doctor's visits, etc.), or indirectly through lower premiums based on
    reductions in total cost of care.

        Question. Can Congress do more to allow for and encourage the use
    of VBAs?

        Answer. VBAs are in the very early stages of development in the
    United States. Many payers and manufacturers have tested different
    concepts, but to date VBAs have not achieved scale. There are multiple
    reasons why VBAs represent a small fraction of manufacturer/payer
    contracts (e.g., access to data, difficult and costly to administer,
    etc.). There are certain aspects of the current U.S. regulatory
    landscape that are perceived by many as not only complicating VBA
    implementation but in some cases limiting their rapid uptake.
    Stakeholders have frequently identified two key regulatory hurdles as
    limiting the expanded adoption of VBAs: (i) the Anti-Kickback Statute
    and (ii) the Medicaid Best Price calculation requirement. While these
    regulations serve important roles within the current volume-based
    reimbursement system they do not contemplate innovative value-based
    arrangements which have resulted in a lack of clarity on how to account
    for these under the current regulatory framework. Ultimately, an
    expansion of VBAs will require reforms to existing regulations that
    enable more flexibility in designing VBAs.

                                     ______

                  Questions Submitted by Hon. Michael B. Enzi
        Question. More than 10 years ago, I worked on a bipartisan basis
    with my good friends Ted Kennedy and Orrin Hatch to develop a
    biosimilars approval pathway. One of the difficult things was
    accounting for the differences between biosimilars and generics. I have
    said before that if a drug was a three-bedroom, two-bath home, a
    biologic would be a skyscraper. The size and complexity of the items
    are just that different. I understand that it is much harder to build a
    skyscraper without blueprints than a house. Even though the science has
    come a long way since then, there aren't as many biosimilars on the
    market as we might have hoped. Do you think the incentives in the law
    appropriately account for the differences between biosimilars and
    generics?

        Answer. The Biologics Price Competition and Innovation Act (BPCIA)
    created an abbreviated pathway for the licensure of biosimilars,
    including interchangeable biologic products, and created the framework
    biosimilar applicants and reference product sponsors use to resolve
    patent disputes. There are currently seven biosimilars on the market in
    the United States, and there are a number of biosimilars currently in
    development. The FDA has approved a total of 18 biosimilars to date.
    Nevertheless, the success of the BPCIA lies in the increased use of
    these products, which will provide savings to both the patient and the
    taxpayer.

        To date, there have been two key policies that have helped support
    the biosimilars marketplace: 340B pass-through status for biosimilars
    and the separate billing/J code policy for biosimilars.

        The separate billing/J code policy for biosimilars has aided in the
    prompt reimbursement of biosimilars for physicians, which is critical
    in supporting uptake of biosimilars. The separate billing/J code also
    provides Congress and CMS with transparency on the average sales price
    of the biosimilar versus the reference biologic. Below is a table
    outlining the latest Medicare published average sales prices for the
    reference biologic Remicade and both of the biosimilars on the market
    for Remicade, Pfizer's Inflectra and Merck's Renflexis.\2\ It is
    important to note that the average sales price (ASP) for both
    biosimilars is lower than the ASP of the reference biologic. Yet, the
    market share of the Inflectra biosimilar remains at 6 percent in open
    systems (which excludes the VA and Kaiser, which are closed systems
    where the insurer is the payer, the prescriber and the provider).
    ---------------------------------------------------------------------------
        \2\ https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Part-B-
    Drugs/McrPartBDrugAvg
    SalesPrice/2019ASPFiles.html.

    ------------------------------------------------------------------------
                                       Q4 2018 CMS  Q1 2019 CMS  Q2 2019 CMS
                           HCPCS Code      ASP          ASP          ASP
    ------------------------------------------------------------------------
    Remicade (reference         J1745      $743.71      $723.10      $677.60
     biologic)
    ------------------------------------------------------------------------
    Inflectra                   Q5103      $569.01      $529.37      $502.72
     (biosimilar)
    ------------------------------------------------------------------------
    Renflexis                   Q5104      $599.20      $575.64      $552.00
     (biosimilar)
    ------------------------------------------------------------------------

        The 340B pass-through policy for biosimilars has been another
    positive policy to support uptake of biosimilars in 340B hospitals. The
    340B pass-through policy provides a temporary ``level playing field''
    for the biosimilar and the reference biologic. Under the reimbursement
    model of ASP + x%, providers are incentivized to use a higher cost
    product to drive a higher ``+ x%'' reimbursement. As in the case of
    biosimilars, when the biosimilar has a lower ASP the reimbursement is
    lower to the health-care provider/340B hospital. The pass-through
    policy provides temporary reimbursement parity for lower cost
    biosimilars. This policy has encouraged 340B hospitals to adopt
    biosimilars and gain experience and confidence in using them.

        Despite these current policies, other adverse incentives that favor
    higher-cost originator biologics are keeping biosimilars from reaching
    patients. In many cases, payers decline to include lower-cost
    biosimilars or generics in their formularies because they would risk
    losing the rebates they could receive by covering higher-cost
    medicines.

        Question. I know there are proposals to essentially pay more for
    biosimilars to make them more attractive, but that is not exactly what
    we were intending when we wrote the law. Can you talk about adverse
    incentives in the market and any barriers to market penetration that we
    might address to help improve patient access to these lower cost
    products?

        Answer. Ninety percent of the medicines Americans take are generics
    and competition from these drugs keeps prices low in most cases. The
    biologics market, where some of the most expensive drugs exist, needs
    similar competition. The market today has already seen demonstrated
    savings as high as 40 percent relative to the branded product. In
    Europe, biosimilars have obtained a market share of over 60 percent on
    some products. However, in the United States, our biosimilar,
    Inflectra, has captured only 6 percent, despite the fact that its
    average selling price (ASP) is more than 25 percent lower than the
    originator product. With more competition, Pfizer hopes even further
    savings can be realized. We believe some of the adverse incentives and
    barriers to market penetration include:

            1.  The Rebate Trap: Brand-name biologic companies are using
            maneuvers to block biosimilar competition such as higher
            rebates and exclusionary contracts.

            2.  Misinformation: We believe that some physician and patient-
            directed materials created by brand companies mischaracterize
            biosimilars, creating doubt and confusion about the safety and
            efficacy of biosimilars. As defined by statute, an approved
            biosimilar must be highly similar to and have no clinically
            meaningful differences from the reference product and must have
            the same mechanism of action (to the extent the mechanism(s) of
            action of the reference product are known) as the reference
            product. Thus, by definition, biosimilars are safe and
            efficacious treatments relative to the reference product and
            must work in the same way as the reference product. Any
            information disseminated by reference product sponsors to
            suggest or imply otherwise should be promptly addressed by the
            FDA.

            3.  Need for incentives: Legislative ideas to promote
            biosimilar uptake could include a shared savings biosimilar
            model; reduced patient cost sharing for biosimilars.

               Although the biosimilar market in the United States is still
            relatively new, Pfizer's experience has been that
            anticompetitive conduct by brand-name biologic manufacturers,
            combined with the lack of policy measures to support
            appropriate uptake of biosimilars, have contributed to a slow
            uptake. Therefore, we encourage you to consider measures to
            help incentivize the use of biosimilars, which can
            substantially lower Medicare costs with demonstrated savings to
            date as high as nearly 40 percent relative to the branded
            biologic.

               In addition to stopping anticompetitive behavior (either
            through government enforcement or in the courts through private
            litigation), some key policy initiatives we believe will
            support the uptake of biosimilars in the United States include:

                Waiver of Part B Patient Coinsurance for Biosimilars for a
            certain period of time. CMS should waive Part B patient
            coinsurance amounts for biosimilars. Cost-sharing changes could
            be applied at the Healthcare Common Procedure Coding System
            (HCPCS) level. This would not change the overall payment for a
            biosimilar; however, it would change the beneficiary's payment
            percentage.

                CMS should pursue a CMMI model designed to increase access
            to biosimilars, including a ``shared savings'' model whereby
            Medicare savings associated with prescribing a biosimilar, as
            compared to a reference biological, would be shared with
            providers.

                CMS should maintain the current biosimilar pass-through
            status as this provides biosimilars with a ``level playing
            field'' with their higher priced reference biologic
            competitors.

                CMS should create payment incentives for plans by
            contracting with a measure developer for a biosimilar use
            measure for the STARS program, which would correct other
            adverse incentives for biosimilar uptake for Medicare Advantage
            plans.

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad.

        Pharmacy benefit managers and plans have argued that rebates are
    used to lower premiums across the board and that it is the best way to
    seek a price concession on otherwise expensive drugs.

        Your industry argues that these payers are insisting on higher
    rebates that can only be achieved by raising list prices.

        But patients often lose under this system, with out of pocket costs
    being tied to list price. Insulin patients appear to be routinely
    impacted by this perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        Answer. If finalized, the rule would result in lower out-of-pocket
    patient costs at the pharmacy counter and help address the perverse
    incentives in the system that have been contributing to higher list
    prices for medicines.

        In 2019, Pfizer expects to pay billions of dollars in rebates to
    ensure patients with pharmacy benefits coverage in Medicare Part D and
    patients in commercial plans have access to our medicines. If the
    proposed rule to share rebates with consumers at the point of sale is
    finalized, we estimate that seniors taking Pfizer medicines could save
    $270 on average per year, and up to $574 per year for certain Pfizer
    medicines, through lower cost sharing--and that would outweigh any
    premium increases.

        As currently written, the proposed rule only applies to the
    Medicare and Medicaid managed care segments of the market. It will be
    important to have rebate reform changes apply to both government
    programs and the commercial market. A bifurcated market will make it
    more challenging for manufacturers to reduce list price since the
    commercial market covers more than 50 percent of Americans with
    insurance and represents over half of the business for most
    manufacturers.

        If the proposed reform is modified to apply to all market segments,
    we would evaluate the best options to arrive at a net price that
    ensures patients have access to our medicines. Decisions would be made
    on a product by product basis given that each therapeutic class has its
    own set of competitive and access dynamics.

        Question. What assurance can you provide that you would in fact
    lower your prices?

        Answer. If the rule is finalized consistent with the aforementioned
    concerns, Pfizer is confident patients will benefit from savings of any
    price concessions at the point of sale.

        Question. What actions should be taken to ensure that patients are
    actually seeing the benefits of lower out of pocket costs?

        Answer. We strongly support ensuring that patients receive the
    benefit of rebates at the pharmacy counter and look forward to working
    with Congress and HHS on this issue. We encourage Congress to ensure
    that plans do not impose new barriers or restrictions to access that
    undermine the spirit of the rule and prevent patients from benefiting
    from the savings.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        There are rebates involved with infusion medicines (Medicare Part B
    drugs), and Pfizer is willing to engage with your staff in general
    terms to explain the relationship and negotiations between
    manufacturers and payers such as insurers and PBMs for drugs in this
    space.

        Pfizer also believes there are other ways to reform the Part B
    payment system to move away from incentivizing the use of more costly
    drugs. One solution we support for reforming Part B is a Competitive
    Acquisition Program (CAP) to allow vendors to deliver and bill Medicare
    for drugs, starting in a few cities. We believe this will inject
    competition into the program.

        Biosimilars are another solution. Pfizer is fully committed to the
    goals set by Congress to bring new biosimilars to market, ensuring that
    patients have access to a wide range of treatment options at a
    competitive, affordable price. The market today has already seen
    demonstrated savings as high as 40 percent relative to the branded
    product. With more competition, we hope even further savings can be
    realized.
                                  rebate traps
        Question. Pfizer's biosimilar to Janssen's Remicade has struggled
    to gain market share, despite being priced at a significant discount to
    the biologic.

         Please explain the market challenges you are seeing with this
    product. How does the practice of drug companies ``bundling'' the
    prices of product portfolios and rebates associated with these drugs
    limit competition and access to lower-cost biosimilars?

        Answer. As more fully laid out in Exhibit 4, the primary barrier to
    Inflectra's uptake is an anticompetitive contracting scheme that
    targets both the payer (i.e., insurer) channel and the health-care
    provider (i.e., hospitals, clinics and doctors) channel. The
    centerpiece of the scheme is the ``rebate trap'' that uses pricing
    penalties (i.e., the loss of significant rebates) to coerce insurers to
    enter into exclusive deals that cover Remicade while effectively
    blocking Inflectra from coverage. Multi-
    product bundling is just one aspect of the conduct. Despite bringing a
    lower-cost version of Remicade to market, this biosimilar has captured
    less than 10 percent of the market.

        Question. Do you attribute this to exclusionary contracts or
    ``paying for position'' to keep your product off formularies? Please
    explain this practice and how it keeps lower-cost drugs out of the
    hands of patients.

        Answer. Pfizer attributes low uptake to an anticompetitive
    contracting scheme as described above in response to Question 1.

        This is particularly concerning not only because of the direct
    impact regarding the health-care system's spend, but also because it
    could become the playbook by which innovator biologics thwart entry by
    biosimilars in the future. This could inhibit significant competition
    to biologics going forward and act as a disincentive for companies to
    invest in developing biosimilars.

                                     ______

                    Questions Submitted by Hon. Steve Daines
        Question. As an advocate for improving Montanans' access to low-
    cost medications, I've been a champion of the Creating and Restoring
    Equal Access to Equivalent Samples (CREATES) Act, which would combat
    anticompetitive practices used by some brand-name pharmaceutical
    companies to block or delay competing generic drugs from entering the
    market.

        During the hearing when I asked if your company had ever withheld
    samples from generic manufacturers, you answered emphatically no. Yet,
    according to the Food and Drug Administration (FDA), generic drug
    makers have made inquiries with the agency claiming they were unable to
    access samples provided by Pfizer and AstraZeneca that are needed to
    conduct studies to produce low-cost generic drugs.

        Do you agree that denying generic drug manufacturers access to
    samples keeps drug costs high for patients due to lack of competition?

        Has your company refused to sell samples or placed any barriers in
    the way of generic drug makers acquiring samples?

        Are you aware of any outstanding requests for samples?

        How does your company work to prevent abuses in the sample system?

        Answer. As a patient-focused company and leading manufacturer of
    innovative, generic, and biosimilar medicines, Pfizer supports
    innovation and a strong, competitive marketplace. Consistent with these
    values, Pfizer does not block generic manufacturers from purchasing our
    products, and it has never been our policy to do so. Generic
    manufacturers are treated the same as any other customer seeking to
    purchase our products. Pfizer is not aware of any current, unfulfilled
    requests from a generic manufacturer to purchase a Pfizer product.

        Generic manufacturers seeking to purchase Pfizer products should
    request the product from Pfizer's authorized distributors or, if the
    product is not available at a distributor, from Pfizer directly, the
    same as any other Pfizer customers. Pfizer's website includes a list of
    our authorized distributors, from which customers (including generic
    companies) may purchase most Pfizer products (see https://www.
    pfizer.com/products/medicine-distributors). For products that are not
    available via our authorized distributors and that are not in extreme
    drug shortage or unavailable due to a recall, customers can contact
    Pfizer's Customer Service center at 1-800-TRY-FIRST (1-800-879-3477) to
    purchase product directly from Pfizer. The telephone number for
    Pfizer's Customer Service center is also included on our website at
    https://www.pfizer.com/contact. Pfizer makes its products available for
    sale to appropriately licensed entities at Pfizer's listed price and on
    Pfizer's standard terms of sale. We do not have any agreements with
    authorized distributors that block the sale of Pfizer's products to
    generic manufacturers.

        Regarding the FDA List (the List), while Pfizer supports FDA's (the
    agency) goal of providing transparency, Pfizer is concerned that the
    List lacks certain key information and context and, as currently
    presented, may create the misleading impression that all products on
    the List are the result of bad faith attempts to block generic
    manufacturer access to samples. The appearance of a product on the FDA
    List means only that a generic manufacturer informed the agency at some
    point in time that it was having difficulty purchasing the listed
    product. FDA's own disclaimer states that the agency has not
    independently investigated or confirmed whether a generic manufacturer
    actually made a request to purchase product, and to whom.\3\ The FDA
    List also lacks several important pieces of information that would
    enable a New Drug Application (NDA) holder to investigate its
    appearance on the List. The List does not include: (1) which generic
    manufacturer made the request; (2) when and to whom the generic
    manufacturer made the request (e.g., to a wholesaler, directly to the
    NDA holder); (3) whether the generic manufacturer that made the inquiry
    was thereafter able to obtain product; and (4) any reason(s) why a
    generic manufacturer may not have been able to obtain product (e.g., a
    recall). Finally, Pfizer notes that FDA does not currently inform an
    NDA holder in real time when a generic manufacturer notifies the agency
    that it is having difficulty obtaining product. Had the agency informed
    Pfizer at the time it received the inquiries noted on the FDA List,
    Pfizer could have then undertaken its own efforts to resolve the issue.
    Pfizer communicated its concerns about the FDA List to the agency in
    May 2018. For your information we have included Pfizer's letter to FDA
    on this topic and the agency's response (see Exhibits 1 and 2 in the
    Appendix).
    ---------------------------------------------------------------------------
        \3\ (https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm).

        There are three new drug applications owned by Pfizer on the FDA
    List: Embeda (NDA 022321), Tikosyn (NDA 020931) and Hemabate (NDA
    017989). Embeda offers a good example of the List's shortcomings.
    Pfizer acquired King Pharmaceuticals (the previous NDA holder of
    Embeda) in March 2011, and two weeks later determined that Embeda
    needed to be recalled from the U.S. market due to stability issues.
    After diligently addressing the issues that led to the recall, Pfizer
    relaunched Embeda to the U.S. market in January 2015, and it is
    available for purchase via Pfizer's authorized distributors. However,
    one consequence of the recall, was that Embeda was not available in the
    U.S. market for almost 4 years which may explain why a generic
    manufacturer had a problem obtaining it during those years. The FDA
    List does not specify when the generic manufacturer's inquiry regarding
    Embeda was made nor does the FDA List indicate that several generic
    applications for Embeda had been submitted to FDA in 2010 (which means
    that before the recall, several generic manufacturers were successfully
    able to purchase Embeda, conduct the necessary testing, and file
    Abbreviated New Drug Applications (ANDAs)). Pfizer has not identified
    any recent inquiries from generic manufacturers seeking to purchase
    ---------------------------------------------------------------------------
    Embeda that have not been fulfilled.

        The circumstances around Tikosyn also illustrate the List's
    shortcomings. Pfizer was able to identify a single inquiry made by a
    generic manufacturer directly to Pfizer to purchase Tikosyn in 2014. At
    that time, Tikosyn was subject to an FDA imposed Risk Evaluation and
    Mitigation Strategies (REMS) with Elements to Assure Safe Use
    (``ETASU'') that restricted distribution, so Pfizer responded by asking
    the manufacturer to obtain written confirmation from the FDA that
    Pfizer's provision of the product to the generic manufacturer would not
    be considered a violation of its REMS. The generic manufacturer did not
    contact Pfizer further, and Pfizer never received any written
    correspondence from the agency. FDA subsequently removed the REMS for
    Tikosyn in 2016, and multiple generic versions of Tikosyn are now
    approved, the first generic approval occurring in June 2016. This
    context is not reflected in FDA's List.

        Finally, with respect to Hemabate, this product was previously
    subject to certain restrictions on distribution (i.e., it was sold only
    to customers with medical and surgical intensive care centers) to
    ensure its safe and appropriate use. This distribution approach was
    established by the previous NDA holder (Pharmacia) and it continued
    following Pfizer's acquisition of Pharmacia in 2003. Pfizer
    discontinued this approach in early 2018 after determining that it was
    no longer necessary, and this product is now available through our
    authorized distributors. During the time when Hemabate was under
    restricted distribution, it was not available at Pfizer's authorized
    distributors, but had a generic manufacturer approached Pfizer's
    Customer Service center directly, we would have been able to address
    the inquiry. Pfizer's Customer Service was not able to identify any
    specific requests from a generic manufacturer to purchase Hemabate that
    have not been fulfilled.

        We hope that this information explains the apparent discrepancy
    between Mr. Bourla's testimony and the appearance of these Pfizer
    products on the FDA List, and demonstrates Pfizer's diligence on these
    issues and commitment to a competitive marketplace.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices.

        With the increased scrutiny of the industry and of the drug supply
    chain as a whole in the United States, have any of your companies re-
    evaluated your business strategy in foreign countries?

        Answer. Pfizer's purpose is breakthroughs that change patients'
    lives; all aspects of Pfizer's business model are infused with this
    purpose. It is Pfizer's priority to make our medicines and vaccines
    available and accessible to all patients who need them, regardless of
    where they live.

        Proposals to implement international reference pricing for the U.S.
    market would have far-reaching consequences to patient access,
    innovation and our business strategies both in the United States and in
    foreign countries.

        If the United States were to implement the proposed International
    Price Indexing (IPI) model, we believe that a change of this scale
    could be very disruptive, challenging our ability to reach patients
    both inside and outside of the United States in a timely manner while
    fulfilling commitments to our shareholders and further investing in
    R&D.

        Question. If not, then why?

        Answer. Pfizer agrees that more must be done to address foreign
    pricing differentials. We want to continue to work with policymakers on
    solutions to ensure other countries appropriately recognize the value
    of innovation. Pfizer supports the concept of ``shared value for
    innovation'' because it promotes global fairness. This means that all
    nations recognize the importance and benefits of medicines to patients
    and society and the significant investments required to develop them,
    and that all patients should benefit, no matter where they live.

        If foreign countries were to increase their support for shared
    value for innovation, American patients would benefit based on
    increased innovation, drug launches, competition and more access to new
    medicines.

        Question. If a proposal, like IPI, were implemented, would it force
    your companies to potentially ``walk away from the negotiating table
    when other countries demand low prices subsidized by America's
    seniors,'' as HHS Senior Advisor for Drug Pricing Reform John O'Brien
    has said?

        Answer. While the IPI could lead to potential situations in which a
    company would ``walk away'' as noted by John O'Brien, pricing is not
    the only determinant of reimbursement negotiations in foreign
    countries, many of which employ access controls, restricting patients'
    ability to receive new innovative medicines.

        We have concerns with the IPI model. The use of reference pricing
    is strongly associated with market and patient access delays in
    countries that have adopted reference pricing, among other cost-
    containment mechanisms. Pfizer works with governments and health
    systems around the world to support patients' access to the medicines
    they need. We strongly believe that flexibility in our ability to set
    global prices improves access to medicines.

        Question. What are some of your ideas on how we can ensure
    Americans aren't shouldering the full cost of pharmaceuticals?

        Answer. Pfizer believes that developed countries have an important
    role to play in supporting global innovation ecosystems. As such, we
    would encourage the United States Government to continue to elevate the
    innovation agenda in multilateral discussions, with an emphasis on
    rewarding innovation in health-care delivery, science policy and
    pharmaceutical breakthroughs (e.g., through the G7). U.S. trade
    negotiations, such as those with Japan, also provide important
    opportunities for the United States to secure robust commitments that
    ensure countries protect intellectual property, provide fair market
    access for U.S. companies, and appropriately recognize the value of
    innovation.

        Pfizer also believes that there are other ways to reform the Part B
    payment system to move away from incentivizing the use of more costly
    drugs. One solution we support for reforming Part B is a Competitive
    Acquisition Program (CAP) to allow vendors to deliver and bill Medicare
    for drugs, starting in a few cities. We believe this will inject
    competition into the program.

        Biosimilars are another solution. Pfizer is fully committed to the
    goals set by Congress to bring new biosimilars to market, ensuring that
    patients have access to a wide range of treatment options at a
    competitive, affordable price. The market today has already seen
    demonstrated savings as high as 40 percent relative to the branded
    product. With more competition, Pfizer hopes even further savings can
    be realized.
                  foreign countries' pricing and reimbursement
        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year.

        ``When foreign governments extort unreasonably low prices from U.S.
    drug makers, Americans have to pay more to subsidize the enormous cost
    of research and development. . . . It's unfair and it's ridiculous, and
    it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing medical advances?

        Answer. Pfizer agrees that more must be done to address foreign
    pricing differentials. Wealthy countries should reimburse innovative
    medicines based on fair value. As stated above, ``foreign free-
    loading'' has a significant impact on the U.S. biopharmaceutical
    industry's investments in continued innovation. If the United States
    secures agreements that ensure countries protect intellectual property,
    provide fair market access for U.S. companies, and appropriately
    recognize the value of innovation, this will help ensure U.S. patients
    continue to have access to innovative medicines.

        Question. How do foreign countries' pricing and reimbursement
    systems affect our prescription drug costs?

        Answer. The U.S. health-care system offers patients more choice and
    faster availability of innovative medicines. While government-run
    health systems aim to provide care to their people, they are often
    challenged to provide fast and easy access to the latest innovations.
    These governments often have to make choices between paying for health
    care and other government priorities.

        The United States allows companies and providers to set prices that
    reflect the benefits to patients and societies. This includes ensuring
    that health-care professionals and patients have choices for
    individualized care, that there is competition among companies, and
    that their expectations for access to the latest medical advances are
    met.

        Some developed countries rely on price controls and other
    government regulations to set the prices of health care, including
    medicines. This may result in some lower prices but can also result in
    restrictions on who is eligible to receive a covered medicine. A recent
    op-ed in The Wall Street Journal pointed out that of the 45 new drugs
    that FDA approved in 2015, all were covered by Medicare in the United
    States in 2017, but only 19 in France, 13 in Canada and 11 in
    Australia.\4\
    ---------------------------------------------------------------------------
        \4\ https://www.wsj.com/articles/how-to-reduce-prescription-drug-
    prices-first-do-no-harm-1155
    0100537.

        However, prices are not always higher in the United States. Nine
    out of ten drugs that patients pick up at the pharmacy are generics,
    and these drugs are less expensive than they are in Europe, Japan,
    China or many countries around the world. The U.S. system is the most
    ---------------------------------------------------------------------------
    efficient system for delivering lower-cost generics to patients.

        Pfizer supports the concept of ``shared value for innovation''
    because it promotes global fairness. This means that all nations
    recognize the importance and benefits of medicines to patients and
    society and the significant investments required to develop them, and
    that all patients should benefit, no matter where they live.

        If foreign countries were to increase their support for shared
    value for innovation, American patients would benefit based on
    increased innovation, drug launches, competition and more access to new
    medicines.

        Question. Are foreign governments taking note of the concerns being
    raised by the Trump administration and have they responded in any way?

        Answer. Pfizer believes that other governments are indeed taking
    note of the administration's focus on health-care spending.

        Question. Has there been any noticeable change in any of our trade
    agreements since these concerns have been raised by the Trump
    administration?

        Answer. The Trump administration recently signed the U.S.-Mexico-
    Canada Agreement (USMCA), which includes important commitments that
    will help companies like Pfizer continue to innovate to bring new
    therapies to patients. For example, the agreement includes a commitment
    to provide 10 years of regulatory data protection for biologics. This
    commitment had not been included in any trade agreement negotiated
    prior to USMCA and is an important achievement. The Trump
    administration is also pursuing new bilateral trade negotiations with
    Japan, the EU, and the UK; because the negotiations have not yet
    concluded, however, it is premature to comment on how those agreements
    may compare to other U.S. trade deals.
                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various States
    have been exploring whether to exclude certain drugs from its Medicaid
    program. For example, the State of Massachusetts' recently asked CMS
    for permission to create a closed formulary where the State Medicaid
    program would pick at least one drug per therapeutic class. CMS denied
    their waiver request citing violation of Federal law, but this proposal
    does bring up important questions on how to contain drug prices in
    State Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to State Medicaid programs,
    do you think it lower drugs costs while ensuring access to patients?

        Answer. Pfizer supports efforts to ensure patients have access to
    medicines. Studies suggest that allowing more choice of medications has
    positive results for patients: lowering the chances of drug
    interactions and adverse events and increasing the efficacy of
    treatment.\5\ Years of research have also shown that limiting
    formularies correlates to poor medication adherence outcomes.\6\
    Studies featuring Medicaid recipients with severe health conditions
    indicate that in many instances, these restrictions can result in
    negative health outcomes and other outcomes (such as increased
    incarceration rates) without generating program savings or other
    intended benefits (and sometimes increasing overall State costs).\7\
    ---------------------------------------------------------------------------
        \5\ See, e.g., DiMasi, ``Competitiveness in follow-on drug R&D: a
    race or imitation?'', 10 Nat. Rev. Discov. 23-27 (Jan. 2011); Turner
    et. al, ``Parsing Interindividual Drug Variability: An Emerging Role
    for Systems Pharmacology,'' Wiley Interdiscip. Rev. Syst. Biol. Med.
    221-41 (2015); Mullins et. al, ``Persistence, Switching, and
    Discontinuation Rates Among Patients Receiving Sertraline, Paroxetine,
    and Citalopram,'' 25 Pharmacotherapy 660-67 (2005).
        \6\ See, e.g., Happe et. al, ``A Systematic Literature Review
    Assessing the Directional Impact of Managed Care Formulary Restrictions
    on Medication Adherence, Clinical Outcomes, Economic Outcomes, and
    Health Care Resource Utilization,'' 20 Manag. Care Spec. Pharm. 677-84
    (2014).
        \7\ See, e.g., U.S.C. Schaffer, ``Medicaid Access Restrictions on
    Psychiatric Drugs: Penny-Wise or Pound Foolish?'', (Feb. 2015), http://
    healthpolicy.usc.edu/documents/USC%20Issue%20Brief
    %20No.%202%20Final.pdf (indicating increased incarceration rates
    associated with certain access restrictions); Lu, et. al, ``Unintended
    Impacts of a Medicaid Prior Authorization Policy on Access to
    Medications for Bipolar Illness,'' 48 Medical Care 4 (Jan. 2010)
    (finding that while a prior authorization policy in Maine Medicaid was
    associated with a marked decrease in rates of initiation of bipolar
    treatments associated with reduction in initiation of nonpreferred
    agents, the policy had no discernable impact on rates of switching
    therapy among patients currently on treatment); Farley, et al.,
    ``Retrospective Assessment of Medicaid Step-Therapy Prior Authorization
    Policy for Atypical Antipsychotic Medications,'' 30 Clinical
    Therapeutics 1524 (April 2008) (showing, for a group of Medicaid
    patients with schizophrenia who were subject to a prior authorization
    policy for atypical antipsychotic medications, significant increases in
    per member per month outpatient expenditures far exceeded the
    associated savings in atypical antipsychotic expenditures).
    ---------------------------------------------------------------------------
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        Answer. Medicaid Best Price is not a factor in setting our launch
    prices.

        Question. What, if any, changes would you suggest we make to the
    program?

        Answer. Pfizer encourages HHS to consider how to address the
    challenges that Medicaid Best Price poses for value-based agreement
    (VBAs). Specifically, we recommend that:

              To allow for innovative approaches and risk sharing, a poor
            outcome should not set a new price for Medicaid. This would
            allow manufacturers to share more risk with commercial health
            plans.

              Approaches to reporting VBAs should be as simple as
            possible. This would help avoid creating operational challenges
            for companies that may prevent development of innovative
            approaches.

              Manufacturers should continue to have flexibility to make
            reasonable assumptions in their price reporting, so that
            reporting approaches can evolve to reflect changes in the
            dynamic market and contracting environment.
                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        Answer. Value-based agreements (VBA) provide a framework for paying
    for medicines based on their value to patients and the overall health-
    care system. There are many different types of VBAs including those
    based on clinical and/or financial performance metrics for a product.
    Based on the outcomes achieved, payers use this information to inform
    how they cover products. Products that perform better should be covered
    in a more favorable manner which often includes lower out-of-pockets
    costs for patients which is a benefit to patients in the near term. In
    the long term, patients can also benefit from other savings either
    directly, (e.g., reducing spending on other medications, lowering
    medical costs from reduced hospitalizations, doctor's visits, etc.), or
    indirectly through lower premiums based on reductions in total cost of
    care.

        Question. How will they lower overall health-care costs for our
    Federal programs?

        Answer. VBAs can be implemented in Federal programs so that the
    benefits described above can accrue to the Federal programs.

        Question. What have the preliminary results looked like so far?

        Answer. VBAs are in the very early stages of development in the
    United States. Many payers and manufacturers have tested different
    concepts but to date, VBAs have not achieved scale. There are multiple
    reasons why VBAs represent a small fraction of manufacturer/payer
    contracts (e.g., access to data, difficult and costly to administer,
    etc.). There are certain aspects of the current U.S. regulatory
    landscape that are perceived by many as not only complicating VBA
    implementation but in some cases limiting their rapid uptake.
    Stakeholders have frequently identified two key regulatory hurdles as
    limiting the expanded adoption of VBAs: (i) the Anti-Kickback Statute
    and (ii) the Medicaid Best Price calculation requirement. While these
    regulations serve important roles within the current volume-based
    reimbursement system they do not contemplate innovative value-based
    arrangements which has resulted in a lack of clarity on how to account
    for these under the current regulatory framework. Ultimately, an
    expansion of VBAs will require reforms to existing regulations that
    enable more flexibility in designing VBAs.
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point of sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        Answer. Pfizer acknowledges that providing discounts pursuant to
    the safe harbor for point-of-sale price discounts will enhance
    transparency of net pricing strategies and potentially drive downward
    pressure on net prices. Nonetheless, Pfizer believes that the proposed
    safe harbors are good for patients and lay the groundwork for the
    systemic change needed to create a simpler, more cost effective, and
    more transparent U.S. health-care system, and we are fully committed to
    operating in this new system. We are concerned, however, that plans and
    PBMs could impose new formulary restrictions and utilization barriers
    to make up for lost rebates that undermine the spirit of the rule and
    create new access challenges to patients. For patients to receive the
    benefits of the rule, we urge policymakers to ensure that no new access
    barriers are created as a way to compensate for lost rebate.

        Question. If so, would this transparency bring down drug costs--
    overall and for specialty drugs?

        Answer. Only through such transparency can Pfizer and other
    industry players ensure that discounts and other price reductions
    directly benefit the patient, which is a critical factor driving
    Pfizer's support for the Proposed Rule.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the Pharmacy Benefit Manager. But there's
    another side of the equation that I'd like to ask about: how do
    wholesalers negotiate pricing with manufacturers?

        Answer. Wholesalers pay list price for our products. They may
    receive prompt pay discounts, which would reduce their net price.
    Wholesalers also can earn bona fide service fees based on performing
    services that are important to pharmaceutical manufacturers.

        Question. What impact does this have on drug costs?

        Answer. These discounts and fees are relatively consistent across
    products and do not significantly impact drug costs.

        Question. What incentives or disincentives do they have to contain
    price increases?

        Answer. As a result of the competitive nature of their business,
    wholesalers do have an incentive to contain price increases.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price.

        Like many Oregonians, I am skeptical drug manufacturers would
    voluntarily lower their prices. Therefore, would you support
    legislation that would (1) make similar changes the administration has
    put forward related to Part D and Medicaid managed care, (2) change the
    rebate system in a similar way to the proposal for the commercial
    market, and (3) require drug makers to lower the list price of their
    drugs equal to the amount of rebates provided today?

        Answer. Pfizer would support legislation that reforms the current
    system of rebating to one in which payers are required to use
    manufacturer provided discounts to ensure that the patient gets the
    benefit of the discount at the point of sale. We support this reform
    across all segments of the market where private sector negotiations
    result in lower net prices including Medicare Part D, Medicaid managed
    care and the commercial markets.

        We realize that the transition away from rebates toward a point-of-
    sale discount model will result in a lowering of our net prices.
    Despite this potential negative financial impact, we support efforts to
    eliminate rebates because we believe the new model will be good for
    patients.

        As currently written, the proposed rule only applies to the
    Medicare and Medicaid managed care segments of the market. It will be
    important to have any rebate reform apply to both government programs
    and the commercial market as that will also lead to a lowering of list
    prices as well. A bifurcated market will make it more challenging for
    manufacturers to reduce list price since the commercial market covers
    more than 50 percent of Americans with insurance and represents over
    half of the business for most manufacturers.

        If the proposed rule is modified to apply to all market segments,
    we would evaluate the best options to arrive at a net price that
    ensures patients have access to our medicines. Decisions would be made
    on a product by product basis given that each therapeutic class has its
    own set of competitive and access dynamics. To ensure these benefits
    reach patients, it will be important for policymakers to ensure that
    plans do not create new barriers or restrictions that hinder patient
    access and undermine the spirit of the rule.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        For each drug listed in response to question 1, please also provide
    a list of which quarters and years each drug hit the cap.

        Answer. Given the highly confidential nature of the information
    requested, we would need to discuss the scope of this request with your
    staff.
                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. For example, an analysis by the U.S.
    Department of Health and Human Services Office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.
    Accordingly, please describe the following: your company's current
    compliance plan and procedures used to ensure compliance with the
    requirements of the Medicaid Drug Rebate Program including internal
    audits or other checks you use to identify compliance vulnerabilities;
    any past or ongoing issues of non-compliance; any corrective actions
    taken to address identified problems or issues of non-compliance with
    the MDRP and how such steps were communicated to the Centers for
    Medicare and Medicaid Services; and any steps taken to improve
    compliance and ensure that all Medicaid drug rebates owed to the
    Federal Government and the States are paid in full.

        Answer. It is Pfizer's policy to comply with all legislation,
    regulations, provisions, requirements, terms and conditions of the
    MDRP.

        In order for its outpatient drugs to be covered by the Medicaid
    program, a manufacturer must enter into a national rebate agreement
    with the Secretary of HHS. This agreement generally requires
    manufacturers to offer Medicaid agencies the mandated discounts for
    covered prescription drugs. Pfizer is responsible for calculating and
    reporting to the Federal Government on a monthly and quarterly basis
    various metrics for each of Pfizer's products and, ultimately, for
    paying corresponding rebates based on Medicaid recipients' purchases of
    the company's covered drugs. In return for these rebates, State
    Medicaid agencies must pay for all of the drug company's covered drugs
    (with certain limited exceptions). If the price of the manufacturer's
    drug rises faster than the inflation rate, States may require an
    additional rebate. Pfizer and/or its predecessor entities have signed a
    Rebate Agreement with HHS for all Pfizer labeler codes and Pfizer
    remains vigilant of its obligations under the Medicaid Drug Rebate
    Program.

        The Company has robust policies and procedures to ensure compliance
    with government price calculations, certification and reporting under
    MDRP including Pfizer's certification, reporting, payment obligations,
    records retention and audit obligations. The Company's policies and
    procedures are also meant to impart to Pfizer employees an
    understanding of the government pricing metrics calculated under the
    MDRP. Consistent with Pfizer's policies and procedures and available
    CMS guidance, if Pfizer becomes aware of any instances of non-
    compliance with the MDRP, Pfizer reports and/or communicates with CMS.
    Based on our current information and belief, Pfizer complies with CMS
    regulations and interacts with CMS to take corrective action as
    instructed.
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus, or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus or other compensation was tied.

        Answer. No. Dr. Bourla's salary, bonus, or other compensation is
    not nor has ever been tied to the sales or revenue targets of a single
    product.

        Question. Is your salary, bonus, or other compensation tied to
    either revenue or net income of the company as a whole? Has it ever
    been? If yes, please explain what assumptions about price increases are
    used when the compensation committee sets revenue or net income goals.
    Does the compensation committee provide any guidance to executives in
    regards to the amount of revenue that the company will generate from
    price increases versus volume growth?

        Answer. Dr. Bourla, along with over approximately 48,000 other
    colleagues, participates in Pfizer's annual bonus plan, Pfizer's Global
    Performance Plan (GPP), which is funded annually based on Pfizer's
    performance measured against three financial metrics: revenue, adjusted
    earnings per share and cash flow from operations and has been since
    2008.

        Therefore, any annual bonuses through Pfizer's GPP, determined by
    the Compensation Committee of the Board of Directors and ratified by
    the independent members of the Board, is in part based on company
    revenue and net income as adjusted earnings per share is derived from
    net income. In determining Dr. Bourla's bonus, the Compensation
    Committee also takes into account other factors such as his individual
    performance against his annual performance objectives and overall
    company performance (e.g., pipeline). Neither Dr. Bourla's salary nor
    other compensation is tied to revenue or net income of the company as a
    whole.

        In setting the corporate financial goals for compensation purposes,
    the Compensation Committee uses the company's annual budget as the
    starting point and it is adjusted accordingly based on the final
    business plan discussion which accounts for various factors, including
    access, rebates, losses of exclusivity and expected price adjustments.

        The Compensation Committee does not provide any guidance with
    regard to the amount of revenue that the company will generate from
    price increases versus volume growth.
                                   net prices
        Question. In your testimony, you stated, ``In 2018, the average net
    price of Pfizer's medicines in the United States declined 1 percent.''
    Please describe how the company's year-over-year aggregate net price is
    calculated.

        Answer. The Net Sales Price impact versus the Prior Year reflects
    the year-over-year change in average net selling price (calculated as
    net sales / units) multiplied by the current year's units. This
    calculation is performed at a product NDC level, and then aggregated up
    to the product and then the total business level.

        The company's aggregate year-over-year impact of price on growth is
    the summation of the sales price impact versus prior year from all
    products in dollars, divided by the prior year's total net revenues. In
    2018, the year-over-year impact on price on growth for the U.S.
    pharmaceutical business was negative 1 percent.

        Question. How many products are included in the calculation of the
    average net price change? What was the median net price change?

        Answer. For 2018, there are a total of 399 products included in the
    U.S. portfolio; median net price impact on growth is negative 4
    percent.

        Question. Is net price weighted? If so, how? For example, in
    determining the aggregate net price does the company assign different
    weights to different products based on volume or other factors? Are
    ``on patent'' and ``off patent'' drugs weighted identically? Are other
    statistical weights used or are all products treated equally?

        Answer. Aggregate change in net price is weighted based on product
    volume (units) and mix. All products--both ``on patent'' and ``off
    patent''--are treated identically.

        Question. Does the figure that you provided during your testimony
    account for U.S. prices, international prices, or both? Generally
    speaking, when your company reports net price changes, does it
    differentiate between U.S. and international prices?

        Answer. The figure of negative 1 percent price impact on growth
    provided during the testimony is for the United States. Generally
    speaking, when we respond to inquiries on the impact of price on
    growth, we have responded on a global basis, a U.S. only basis, or
    both, dictated by how the inquiry is posed.

        Question. Please list the five drugs your company sold in the U.S.
    that had the greatest year-over-year net price increase in 2018, noting
    the increase for each drug by dollar figure and percentage.

        Answer. The following products had the greatest positive impact of
    sales price on growth in the United States in 2018: Prevnar, Lyrica,
    Chantix, Pristiq, Relpax.

        Question. Please list the five drugs your company sold in the U.S.
    that had the lowest year-over-year net price increase (and/or the
    greatest decrease) in 2018, noting the increase (or decrease) for each
    drug by dollar figure and percentage.

        Answer. The following products had the greatest negative impact of
    sales price on growth in the United States in 2018: Xeljanz, Viagra,
    Inflectra, Ibrance, Celebrex.

        Question. For 2018, what was the average net price change in the
    U.S. market for (1) drugs with no competition, (2) drugs with only
    branded competition, and (3) drugs with generic competition?

        Answer. The 2018 impact of price on growth from branded products in
    the United States was 2 percent. 2018 impact of price on growth from
    remainder of portfolio (excluding Branded Products) in the United
    States was negative 5 percent.

        Question.Pfizer has lost exclusivity for several products in recent
    years, including Viagra, Zyvox, Relpax, Tygacil, and Pristiq. For each
    of these products, please provide the percentage and dollar change in
    the average net price from (1) the last full year in which Pfizer
    maintained product exclusivity to the (2) first full year in which
    generic competition was present in the market.

        Answer. Pfizer has lost exclusivity on several products in recent
    years, including: 2014: Detrol, Rapamune, Celebrex; 2015: Zyvox; 2016:
    Relpax, Tygacil; and 2017: Viagra, Pristiq.

        In all but one case, the net price impact of the branded products
    listed above was negative the year after exclusivity was lost,
    reflecting market dynamics and the competitive environment.

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. During the hearing, when I asked whether your company
    engaged in tactics to delay generic production of your products, you
    answered ``no''. However, Pfizer appears on the FDA's list of companies
    who have access complaints against them. Can you explain the
    discrepancy between your answer and the FDA list? The FDA list can be
    found here: https://www.fda.gov/Drugs/DevelopmentApproval
    Process/HowDrugsareDevelopedandApproved/ApprovalApplications/
    Abbreviated
    NewDrugApplicationANDAGenerics/ucm607738.htm.

        Answer. As a patient-focused company and leading manufacturer of
    innovative, generic, and biosimilar medicines, Pfizer supports
    innovation and a strong, competitive marketplace. Consistent with these
    values, Pfizer does not block generic manufacturers from purchasing our
    products, and it has never been our policy to do so. Generic
    manufacturers are treated the same as any other customer seeking to
    purchase our products. Pfizer is not aware of any current, unfulfilled
    requests from a generic manufacturer to purchase a Pfizer product.

        Generic manufacturers seeking to purchase Pfizer products should
    request the product from Pfizer's authorized distributors or, if the
    product is not available at a distributor, from Pfizer directly, the
    same as any other Pfizer customers. Pfizer's website includes a list of
    our authorized distributors, from which customers (including generic
    companies) may purchase most Pfizer products (see https://www.
    pfizer.com/products/medicine-distributors). For products that are not
    available via our authorized distributors and that are not in extreme
    drug shortage or unavailable due to a recall, customers can contact
    Pfizer's Customer Service center at 1-800-TRY-FIRST (1-800-879-3477) to
    purchase product directly from Pfizer. The telephone number for
    Pfizer's Customer Service center is also included on our website at
    https://www.pfizer.com/contact. Pfizer makes its products available for
    sale to appropriately licensed entities at Pfizer's listed price and on
    Pfizer's standard terms of sale. We do not have any agreements with
    authorized distributors that block the sale of Pfizer's products to
    generic manufacturers.

        Regarding the FDA List (the List), while Pfizer supports FDA's (the
    agency) goal of providing transparency, Pfizer is concerned that the
    List lacks certain key information and context and, as currently
    presented, may create the misleading impression that all products on
    the List are the result of bad faith attempts to block generic
    manufacturer access to samples. The appearance of a product on the FDA
    List means only that a generic manufacturer informed the agency at some
    point in time that it was having difficulty purchasing the listed
    product. FDA's own disclaimer states that the agency has not
    independently investigated or confirmed whether a generic manufacturer
    actually made a request to purchase product, and to whom.\8\ The FDA
    List also lacks several important pieces of information that would
    enable a New Drug Application (NDA) holder to investigate its
    appearance on the List. The List does not include: (1) which generic
    manufacturer made the request; (2) when and to whom the generic
    manufacturer made the request (e.g., to a wholesaler, directly to the
    NDA holder); (3) whether the generic manufacturer that made the inquiry
    was thereafter able to obtain product; and (4) any reason(s) why a
    generic manufacturer may not have been able to obtain product (e.g., a
    recall). Finally, Pfizer notes that FDA does not currently inform an
    NDA holder in real time when a generic manufacturer notifies the agency
    that it is having difficulty obtaining product. Had the agency informed
    Pfizer at the time it received the inquiries noted on the FDA List,
    Pfizer could have then undertaken its own efforts to resolve the issue.
    Pfizer communicated its concerns about the FDA List to the agency in
    May 2018. For your information we have included Pfizer's letter to FDA
    on this topic and the agency's response (see Exhibits 1 and 2 in the
    Appendix).
    ---------------------------------------------------------------------------
        \8\ (https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm).

        There are three new drug applications owned by Pfizer on the FDA
    List: Embeda (NDA 022321), Tikosyn (NDA 020931) and Hemabate (NDA
    017989). Embeda offers a good example of the List's shortcomings.
    Pfizer acquired King Pharmaceuticals (the previous NDA holder of
    Embeda) in March 2011, and two weeks later determined that Embeda
    needed to be recalled from the U.S. market due to stability issues.
    After diligently addressing the issues that led to the recall, Pfizer
    relaunched Embeda to the U.S. market in January 2015, and it is
    available for purchase via Pfizer's authorized distributors. However,
    as a consequence of the recall, Embeda was not available in the U.S.
    market for almost 4 years which may explain why a generic manufacturer
    had a problem obtaining it during those years. The FDA List does not
    specify when the generic manufacturer's inquiry regarding Embeda was
    made nor does the FDA List indicate that several generic applications
    for Embeda had been submitted to FDA in 2010 (which means that before
    the recall, several generic manufacturers were successfully able to
    purchase Embeda, conduct the necessary testing, and file Abbreviated
    New Drug Applications (ANDAs)). Pfizer has not identified any recent
    inquiries from generic manufacturers seeking to purchase Embeda that
    ---------------------------------------------------------------------------
    have not been fulfilled.

        The circumstances around Tikosyn also illustrate the List's
    shortcomings. Pfizer was able to identify a single inquiry made by a
    generic manufacturer directly to Pfizer to purchase Tikosyn in 2014. At
    that time, Tikosyn was subject to an FDA imposed Risk Evaluation and
    Mitigation Strategies (REMS) with Elements to Assure Safe Use
    (``ETASU'') that restricted distribution, so Pfizer responded by asking
    the manufacturer to obtain written confirmation from the FDA that
    Pfizer's provision of the product to the generic manufacturer would not
    be considered a violation of its REMS. The generic manufacturer did not
    contact Pfizer further, and Pfizer never received any written
    correspondence from the agency. FDA subsequently removed the REMS for
    Tikosyn in 2016, and multiple generic versions of Tikosyn are now
    approved, the first generic approval occurring in June 2016. This
    context is not reflected in FDA's List.

        Finally, with respect to Hemabate, this product was previously
    subject to certain restrictions on distribution (i.e., it was sold only
    to customers with medical and surgical intensive care centers) to
    ensure its safe and appropriate use. This distribution approach was
    established by the previous NDA holder (Pharmacia) and it continued
    following Pfizer's acquisition of Pharmacia in 2003. Pfizer
    discontinued this approach in early 2018 after determining that it was
    no longer necessary, and this product is now available through our
    authorized distributors. During the time when Hemabate was under
    restricted distribution, it was not available at Pfizer's authorized
    distributors, but had a generic manufacturer approached Pfizer's
    Customer Service center directly, we would have been able to address
    the inquiry. Pfizer's Customer Service was not able to identify any
    specific requests from a generic manufacturer to purchase Hemabate that
    have not been fulfilled.

        We hope that this information explains the apparent discrepancy
    between Mr. Bourla's testimony and the appearance of these Pfizer
    products on the FDA List, and demonstrates Pfizer's diligence on these
    issues and commitment to a competitive marketplace.

        Question. When new products enter the market, do drug companies set
    high initial rebates and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. Launch pricing is driven by a multitude of factors, the
    most important being the medicine's impact on patients and their
    health. We also may consider other factors like the medicine's
    potential to reduce other health-care costs, such as hospital stays;
    the availability of other treatments and generic options; affordability
    for patients, insurers and governments; and investments to maintain the
    quality, safety, delivery, and reliability of our medicines.

        Given the consolidation that has taken place in the U.S. market,
    the vast majority of retail prescriptions are managed by a few large
    PBMs. Pharmaceutical manufacturers must successfully negotiate with
    these PBMs to gain access to their formularies or risk having their
    products disadvantaged or even excluded from coverage.

        The system has evolved in a manner where rebates play a significant
    role in how the PBM business is transacted and in the decisions
    regarding product placement on formularies. PBMs often win or lose
    business on the basis of rebate guarantees and are therefore
    incentivized to favor products with high list prices and deep rebates
    assuming comparable safety and efficacy. Because the PBMs have enormous
    leverage and depend on rebates to attract and retain clients, many
    manufacturers will enter the market with higher list prices and deeper
    rebates in order to ensure patients have access to their medicines.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. Launch pricing will be driven by product value and
    competitive intensity of the specific therapeutic category.
    Importantly, if finalized, the rule could result in lower out-of-pocket
    patient costs at the pharmacy counter and help address the perverse
    incentives in the system that have been contributing to higher list
    prices for medicines.

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D? In
    the health insurance plans that you offer your employees, do you ask
    your insurers to pass through the full manufacturer rebates to the
    beneficiaries?

        Answer. It is unclear if the 40 percent of drugs that do not offer
    rebates in Medicare Part D are brand medicines or generics. However,
    Pfizer pledges to bring more affordable treatment options to the
    market. Our mid-to late-stage pipeline contains five biosimilar
    candidates expected to launch in the next 2 to 3 years. Ninety percent
    of medicines Americans take are generics, and competition from these
    drugs keeps prices low in most cases. We need to bring similar
    competition to the biologics market, where some of the most expensive
    drugs exist. The market today has already seen demonstrated savings as
    high as 40 percent relative to the branded product. With more
    competition, we hope even further savings can be realized.

        Pfizer's plan design is generous and corresponding employee cost
    sharing for prescription drugs is already very limited--in fact, for
    many products, Pfizer employees experience no cost sharing at all.
    Given this, the terms of contract with our PBM for our employee
    benefits does not include a requirement to pass on rebates to Pfizer
    employees at the point of sale.

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand. What are your recommendations for
    increasing transparency in how your companies set the list prices for
    drugs, and for improving transparency in the supply chain for
    prescription drugs? Would you support Federal standards for
    transparency in setting the list prices for drugs?

        Answer. Pfizer supports system-wide price transparency that is
    thoughtful, purpose-driven, and that can result in improved patient
    care, an enhanced understanding of the comparative value of all medical
    services, and a more patient-centered use of health-care resources.

        We would be interested in exploring with the committee ways to
    ensure transparency across the health care system, including hospitals,
    plans, PBMs, etc., so that we can make informed judgments about the
    root of cost inflators in the system. We are also committed to ensuring
    that patients, health-care professionals and payers understand our
    commitment to pricing our medicines responsibly.

        Regarding a Federal transparency standard, we believe that an
    appropriately crafted, balanced piece of Federal legislation that
    applies to all stakeholders in the health care system and preempts
    future State laws could be beneficial for patients. However, Pfizer
    believes that mandating disclosure of research and development,
    manufacturing, or marketing costs to assess the value of medicines is
    inconsistent with purpose-driven transparency.

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently. How many of your drugs are included in
    value-based contracts and how many patients are benefiting from them?

        Answer. Patient outcomes should determine our reimbursement and
    Pfizer pledges that we will aggressively pursue value-based
    arrangements. We should not be rewarded for treatments that do not
    work.

        Currently, Pfizer has value-based contracts for twelve drugs in our
    portfolio.

        The agreements are in place with commercial and Medicare payers
    with millions of covered lives. In addition, Pfizer has a multi-product
    innovative agreement that has been offered to the majority of States
    for the Medicaid program, but currently only a small number of States
    compromising less than five million lives have taken or are actively
    considering the offer.

        Question. How do these value-based contracts work to lower drug
    prices for both patients and taxpayers?

        Answer. Value-based agreements (VBA) provide a framework for
    manufacturers to be compensated based on a product's value to patients
    and the overall health-care system. There are many different types of
    VBAs but the optimal structure of a VBA includes clinical and/or
    financial performance metrics for a product. Based on the outcomes
    achieved, payers use this information to inform how they cover
    products. Products that perform better should be covered in a more
    favorable manner which often includes lower out-of-pockets costs for
    patients which is a benefit to patients in the near term. In the long
    term, patients can also benefit from other savings either directly,
    (e.g., reducing spending on other medications, lowering medical costs
    from reduced hospitalizations, doctor's visits, etc.), or indirectly
    through lower premiums based on reductions in total cost of care.

        VBAs can be implemented in Federal and State programs so that the
    benefits described above can accrue to the Federal programs thereby
    benefitting taxpayers.

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    Federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack. Are any of your
    companies providing medical necessity paperwork to doctors in order to
    get your drugs covered by Medicare?

        Answer. Consistent with industry practice, Pfizer provides a sample
    statement of medical necessity and appeals letters through our patient
    support programs for patients, their caregivers and prescribing
    physicians to help guide these individuals in gaining access to certain
    Pfizer medicines after a physician has determined that a Pfizer product
    is right for a patient and a prescription has been written. These
    sample letters are generally PDF documents that describe the type of
    information payers require to approve access/coverage of a particular
    medication based upon the payers' formulary requirements, such as step
    therapy (therapeutic agents that must be tried first), proof of
    diagnosis or other common utilization management techniques that payers
    determine. Pfizer does not customize these letters, and patients,
    caregivers and physicians are advised that they are responsible for the
    accuracy of the information that they submit to the payer to obtain
    coverage and/or reimbursement. Sample letters are available from
    Pfizer's third-party call centers which specialize in product access
    triage with payers, field based reimbursement specialists and Pfizer
    product websites. Pfizer sales representatives do not provide this
    information to physicians.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers. What is delaying the
    uptake of biosimilar drugs in the United States? What policies do you
    recommend to increase the development of biosimilar drugs?

        Answer. Pfizer believes that some of the adverse incentives and
    barriers to market penetration include:

            1.  The Rebate Trap: Brand-name biologic companies are using
            maneuvers to block biosimilar competition such as higher
            rebates and exclusionary contracts.

            2.  Misinformation: Some physician and patient-directed
            materials created by brand companies mischaracterize
            biosimilars, creating doubt and confusion about the safety and
            efficacy of biosimilars. As defined by statute, an approved
            biosimilar must be highly similar to and have no clinically
            meaningful differences from the reference product and must have
            the same mechanism of action (to the extent the mechanism(s) of
            action of the reference product are known) as the reference
            product; thus, by definition, biosimilars are safe and
            efficacious treatments relative to the reference product and
            must work in the same way as the reference product. Any
            information disseminated by reference product sponsors to
            suggest or imply otherwise should be promptly addressed by FDA.

            3.  Need for incentives: Legislative ideas to promote
            biosimilar uptake could include a shared savings biosimilar
            model; reduced patient cost sharing for biosimilars. More
            detail is provided below.

        Although the biosimilars market in the United States is still
    relatively new, our experience has been that anticompetitive conduct by
    brand-name biologic manufacturers, combined with the lack of policy
    measures to support appropriate uptake of biosimilars, have contributed
    to a slow uptake. Therefore, we encourage you to consider measures to
    help incentivize the use of biosimilars, which can substantially lower
    Medicare costs with demonstrated savings to date as high as nearly 40
    percent relative to the branded biologic.

        Some key policy initiatives we believe will support the uptake of
    biosimilars in the United States are the following:

              Waiver of Part B Patient Coinsurance for Biosimilars for a
            certain period of time:

                  CMS should waive Part B patient coinsurance
            amounts for biosimilars. Cost-sharing changes could be applied
            at the HCPCS level. This would not change the overall payment
            for a biosimilar; however, it would change the beneficiary's
            payment percentage.

              CMS should pursue a CMMI model designed to increase access
            to biosimilars, including a ``shared savings'' model whereby
            Medicare savings associated with prescribing a biosimilar, as
            compared to a reference biological, would be shared with
            providers.

              CMS should maintain the current biosimilar pass-through
            status as this provides biosimilars with a ``level playing
            field'' with their higher priced reference biologic
            competitors.

              CMS should create payment incentives for plans by
            contracting with a measure developer for a biosimilar use
            measure for the STARS program, which would correct other
            adverse incentives for biosimilar uptake for Medicare Advantage
            plans.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach.

        Researchers say that this type of imagery, combined with viewing
    hours of drug commercials each month, leads consumers to underestimate
    the risks associated with medications. For the past decade, studies
    have shown that aggressive direct-to-consumer advertising is associated
    with rising drug prices and an increase in inappropriate drug
    prescriptions.

        Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. Pfizer wants patients to have access to our drugs and part
    of this is making sure patients have the information they need. Pfizer
    believes that direct-to-
    consumer (DTC) advertising should be, first and foremost, a tool
    through which we can provide patients with useful information to inform
    them about their medical conditions, and the potential benefits and
    risks of available treatment options so they can have a discussion with
    their doctors and take an active role in managing their health.

        The Office of Prescription Drug Promotion at the FDA, which has
    responsibility for reviewing prescription drug advertising and
    promotional labeling to ensure that the information contained in them
    is not false or misleading, studies advertising so that regulations are
    grounded in evidence on how best to ensure ads are accurate, balanced
    and not misleading. The FDA's website describes in detail the many ways
    that its Office of Prescription Drug Promotion ensures that DTC
    advertising is not misleading.\9\
    ---------------------------------------------------------------------------
        \9\ https://www.fda.gov/aboutfda/centersoffices/
    officeofmedicalproductsandtobacco/cder/ucm
    090142.htm.

        DTC advertising is of significant educational importance to
    patients, especially as the provision of health care becomes more
    patient-centric. Over the last 2 decades, consumer research sponsored
    by the industry and the FDA has underscored that clear, relevant
    communication allows DTC advertising, when executed thoughtfully, to
    have a positive impact on public health. For example, in 2004, a study
    by FDA found that ``DTC ads help patients have better discussions with
    their physicians and provide greater awareness of treatments. The study
    demonstrated that when a patient asked about a specific drug, 88
    percent of the time they had the condition that the drug treated. And
    80 percent of physicians believed their patients understood what
    ---------------------------------------------------------------------------
    condition the advertised drug treats.''

        More recently, according to a 2017 survey, conducted by Princeton
    Survey Research Associates International on behalf of PhRMA, Americans
    overwhelmingly reported that DTC advertisements help inform people
    about new treatments (88 percent), alert people to symptoms that are
    related to a medical condition they may already have (81 percent), and
    allow people to be more involved in their health care (79 percent).\10\
    Similarly, a research survey published in 2017 with 4,481 U.S. adults
    and sponsored by a working group of pharmaceutical companies has shown
    DTC advertising conveys useful information.\11\ DTC ads raise awareness
    about medications and effectively communicate potential risks and
    benefits, but they also increase concern about potential side effects.
    ---------------------------------------------------------------------------
        \10\ 2017 Direct to Consumer Advertising Survey Results, presented
    by Princeton Survey Research Associates International, prepared for
    PhRMA, https://www.phrma.org/report/2017-direct-to-consumer-
    advertising-survey-results.
        \11\ DIA, Therapeutic and Regulatory Science, https://
    journals.sagepub.com/doi/abs/10.1177/2168479017708226iii, https://
    www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProducts
    andTobacco/CDER/ucm090276.htm#Completed.

        Pfizer believes that PhRMA, individual companies, academics and FDA
    should continue to study DTC advertising to ensure that pharmaceutical
    consumer communications are achieving their intended goals to educate,
    inform information-seeking consumers and facilitate better discussions
    with health-care professionals.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organization for Economic Cooperation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price.

        One of the most well-known examples is Mylan's increase of the
    price of EpiPen from less than $100 in 2007 to more than $600 in 2016.
    Another example, is the ever-increasing price of insulin. Sanofi
    increased the price of a vial of Lantus from $88.20 in 2007 to $307.20
    in 2017. And those are just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. There are a number of reasons that the price of medicines
    can change over time. While these reasons often include more obvious
    changes such as discovery of new indications and new formulations, they
    can also include less obvious changes such as improvements in the
    manufacturing and supply chain and market-based factors.

        Pfizer has reduced the price of many of our older off-patent
    medicines in the United States, and we are committed to bringing more
    affordable treatment options to the market to induce competition,
    including generic and biosimilar medicines. Competition is the best way
    to promote affordable access to quality, safe and effective medicines;
    competition means more and better medicines, more options for patients,
    and more affordable drugs.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market.

        These ``pay-for-delay'' patent settlements benefit both brand-name
    pharmaceutical companies by helping them avoid costly patent litigation
    and general manufacturers by rewarding them a hefty sum to delay
    entering the market with a cheaper drug alternative. However, these
    deals do not benefit consumers. According to an FTC study, these
    anticompetitive deals cost consumers and taxpayers $3.5 billion in
    higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Answer. No. On the contrary, when Pfizer settles patent litigation
    with generic firms, we do so on terms that generally enable entry of
    generic competition earlier than the expiration of its patents and that
    do not involve unlawful reverse payments. Pfizer's patent settlements
    thus involve lawful compromises that appropriately resolve patent
    disputes and accelerate patient access to lower cost generics relative
    to the expiration of its patents. While Pfizer has been the target of
    plaintiff lawyer driven class action lawsuits challenging certain of
    its settlements with generic companies, we believe these lawsuits are
    without merit and are vigorously asserting the pro-competitive nature
    of these settlements in court.

        Question. Why would a pharmaceutical company enter into a pay-for-
    delay agreement?

        Answer. Pfizer does not enter into these types of settlements and
    cannot speculate on why others might.

        Question. Do you think these agreements stifle competition and
    prevent generic alternatives to your branded medications?

        Answer. Pfizer's patent settlements do not ``stifle competition''
    or ``prevent generic alternatives.'' On the contrary, when Pfizer
    settles patent litigation with generic firms, it does so on terms that
    generally enable entry of generic competition earlier than the
    expiration of its patents and that do not involve unlawful reverse
    payments. Pfizer's patent settlements thus involve lawful compromises
    that accelerate patient access to lower cost generics relative to the
    expiration of its patents.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) Office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections.

        The rule is predicted to increase net drug costs in its early
    years. The CMS actuaries estimate it would cost $196 billion over 10
    years. Despite this high price tag, the beneficiary benefits are
    limited. The proposed rule notes that under the CMS Actuary's analysis,
    the majority of beneficiaries would see an increase in their total out-
    of-pocket payments and premium costs; reductions in total cost sharing
    will exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. If finalized, the rule could result in lower out-of-pocket
    patient costs at the pharmacy counter and help address the perverse
    incentives in the system that have been contributing to higher list
    prices for medicines. In 2019, Pfizer expects to pay billions of
    dollars in rebates to ensure patients with pharmacy benefits coverage
    in Medicare Part D and patients in commercial plans have access to our
    medicines. If the proposed rule to share rebates with consumers at the
    point of sale is finalized, we estimate that seniors taking Pfizer
    medicines could save $270 on average per year, and up to $574 per year
    for certain Pfizer medicines, through lower cost sharing.

        Importantly, we believe any reform should apply to all market
    segments as this could also lead to further reduction in list prices. A
    bifurcated market in which we eliminate rebates in government programs
    but maintain rebates for commercial plans will make it difficult for
    manufacturers to reduce list prices because a single list price applies
    to all markets.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spent nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9 percent of all medical marketing, in 1997 to $9.6
    billion, or 32 percent of total spending, in 2016.

        Can each of you please provide what your ratio of spending on sales
    and marketing to research and development is today?

        Answer. In order to fulfill Pfizer's mission to create breakthrough
    medicines that change patients' lives, we invest in several areas to
    ensure an innovative pipeline, top-quality manufacturing, and education
    of patients and physicians to ensure they have the information they
    need to make knowledgeable decisions about patient care.

        In 2018, Pfizer spent approximately $6.9 billion on direct sales
    and marketing and approximately $8 billion on research and development
    globally.
                            biosimilars/rebate traps
        Question. In many of your testimonies, you mention that encouraging
    the development of generics and biosimilars will help bring down the
    cost of drugs. However, while 17 biosimilars are now approved in the
    US, only 7 are actually on the market and available to patients. There
    are growing concerns about rebate traps, which are ways of gaming the
    system to ensure a biosimilar is not able to enter the market.

        Dr. Bourla, in your testimony, you said: ``Adverse incentives that
    favor higher cost originator biologics are keeping biosimilars from
    reaching patients. In many cases, payers decline to include lower cost
    biosimilars or generics in their formularies because they would risk
    losing the rebates they can get by covering higher cost medicines.''
    Your company has filed lawsuits challenging rebate traps as antitrust
    violations. What do you think should be done about these rebate
    practices?

        Answer. Anticompetitive conduct should be stopped through
    government enforcement of the antitrust laws and in the courts. Brand-
    name biologic companies should not be permitted to abuse the rebate
    system to effectively block lower-cost biosimilars from coverage

        For more details, see Pfizer's Exhibit 4 attached.
                                 price-gouging
        Question. Sanofi, as I understand it, has made a pledge to the
    public to limit its price increases to the national health expenditures
    growth projection.

        Would your company commit to a cap on annual price increases as
    part of your PhRMA membership criteria?

        Answer. We are unable to answer this question as it requires
    analysis under the antitrust laws.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. At Pfizer, we are committed to our purpose: breakthroughs
    that change patients' lives. Pfizer's more than 90,000 colleagues
    around the world come to work every day focused not only on creating
    breakthrough medicines, but also on making sure those medicines get
    into the hands of the patients who need them.

        The launch prices for our medicines reflect the value that they
    bring to patients and society. The relationship between the price of a
    medicine and a patient's out-of-pocket cost is not always clear. Out-
    of-pocket costs continue to rise due to insurance designs that place a
    disproportionate burden on consumers who use medicines than other
    interventions. Consumers on average pay 15 percent of medicine costs
    but only 2 percent of hospitalization and other health-care costs. We
    encourage Congress to continue its efforts to understand the complexity
    of the pricing and reimbursement system in the United States, and to
    identify ways in which patient out-of-pocket expenditures can be
    reduced.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates do
    not rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. Pfizer is committed to working toward greater transparency
    along the supply chain, so patients can better understand what they are
    paying for and why. We believe pricing transparency policies should
    seek to inform consumers about the costs of health-care items and
    services across the industry and should promote a definition of value
    that considers impact to health and costs over time and across all
    industry stakeholders.

        Pfizer believes that the proposed safe harbors lay the groundwork
    for the systemic change needed to create a simpler, more cost
    effective, and more transparent U.S. health-care system, and we are
    committed to operating in this new system.

        Question. Senator Thune asked if this administration rule would
    lead you to lowering list prices. Both of you answered that you would
    be likely to lower your prices. However, if this rule were finalized
    tomorrow as proposed, would any of your companies be required to lower
    the list price of any of your drugs?

        Answer. As long as rebate reform extends to both the commercial
    market and government programs, there could be a reduction in list
    prices. The commercial market covers more than 50 percent of Americans
    with insurance, and the safe harbor will not affect it at all. However,
    in Medicare, the rebate rule will make list prices less relevant
    because the entire rebate will be converted to a point of sale discount
    so that patient out-of-pocket costs, when they are in the deductible,
    coinsurance, and coverage gap phases of the benefit, will be based off
    the lower net price. If we ensure that rebates paid out to commercial
    plans find their way to patients, the patients will see savings of
    hundreds of dollars.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health-care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        Answer. Yes, we contract with a PBM to administer our prescription
    drug benefits and we work with them to establish criteria for
    negotiating lower drug costs on our employees' behalf.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, how do you utilize the
    rebates your PBM negotiates to lower health-care costs or drug costs
    for your employee plans, and what does your company do with that
    savings? Specifically, do the savings go toward lowering premiums?

        Answer. Pfizer's medical and prescription drug coverage is generous
    in terms of what we subsidize as an employer; therefore we work to
    ensure that our employees benefit from our investment in our workforce
    and any savings in the form of affordable plan premiums and
    substantially lower cost sharing responsibilities for prescription
    drugs.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, does your PBM offer
    point-of-sale rebates to your employees?

        Answer. Pfizer's plan design is generous and corresponding employee
    cost sharing responsibility for prescription drugs is already very
    limited--in fact, for many products, Pfizer employees experience no
    cost sharing at all. Given this, the terms of contract with our PBM for
    our employee benefits does not include a requirement to pass on rebates
    to Pfizer employees at the point of sale.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. Pfizer would support legislation that reforms the current
    system of rebating to one in which payers are required to use
    manufacturer provided discounts to ensure that the patient gets the
    benefit of the discount at the point of sale. We support this reform
    across all segments of the market where private sector negotiations
    result in lower net prices including Medicare Part D, Medicaid managed
    care and the commercial markets. It is important to understand that
    even if rebates are prohibited, manufacturers will still negotiate
    discounts with plans consistent with safe harbors in exchange for
    formulary access, though those discounts will be reflected in lowered
    drug prices at the pharmacy counter rather than retrospective payments
    benefitting plans or their PBM instead of the beneficiaries who are
    underwriting premiums for others.

        To ensure these benefits reach patients, it will be important for
    Congress and the administration to ensure that plans do not create new
    barriers or restrictions that hinder patient access and undermine the
    spirit of the rule.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)?

        Answer. The biopharmaceutical industry is one of the most research-
    intensive industries in the United States. In 2017, NIH had a budget of
    $39.2 billion, only a fraction of which, $3.2 billion, was dedicated to
    drug discovery. The industry invested over $90 billion in R&D--almost
    30 times more. For Pfizer alone, we invested approximately $8 billion
    in R&D last year.

        NIH's strength is its focus on important basic scientific research
    and the industry does derive important insights from basic scientific
    research conducted by NIH-funded researchers and scientists worldwide.
    There is, however, a large gap between understanding basic scientific
    principles and the discovery, development, and delivery of medicines to
    patients. For example, the initial NIH-funded basic science discovery
    of cell division and cell signaling proteins in yeast led researchers
    to identify similar proteins in humans. This early research later
    informed the thinking of Pfizer scientists and helped pave the way for
    the discovery and development of targeted cancer drugs like
    palbociclib, a new treatment for breast cancer.

        The discovery of cell division in yeast is a long way from
    discovering and developing a drug that prevents cancer tumors from
    growing. As stated above, the government plays a role in advancing
    basic science such as identifying cellular pathways underlying disease.
    However, the ability to translate knowledge about biological processes
    into a medicine or vaccine, with appropriate drug-like properties and a
    clinically meaningful benefit, remains the primary function of the
    biopharmaceutical industry. The drug discovery and development process
    involves harnessing existing knowledge of underlying disease biology to
    chart and execute a research agenda that often encompasses ten to 15
    years of discovery research, preclinical testing, clinical development
    (for dosing, safety, and efficacy) and pharmaceutical science to ensure
    the quality of the compound to be delivered. Disciplines like medicinal
    chemistry, process and formulation chemistry and formulation, drug
    metabolism, pharmacokinetics and safety sciences are practiced at a
    scale and expertise in the biopharmaceutical industry that extends well
    beyond government and academic research endeavors to deliver life-
    savings therapies for patients.

        Question. How many of your company's products are based, at least
    in part, on NIH research, and how many are the result of research
    funded solely by your company?

        Answer. We have not identified readily available information in
    response to this request that is maintained in the ordinary course of
    business. We would need to discuss the scope and terms of this question
    with your staff to respond appropriately.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer. In order to fulfill Pfizer's mission to create breakthrough
    medicines that change patients' lives, we invest in several areas to
    ensure an innovative pipeline, top-quality manufacturing, and education
    of patients and physicians to ensure they have the information they
    need to make knowledgeable decisions about patient care.

        Over the last 5 years, Pfizer spent approximately $34 billion on
    advertising and marketing and approximately $40 billion on R&D
    globally. Advertising and marketing expenses include advertising,
    promotion and field selling.

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. The size of any list price reductions relative to the size
    of rebates Pfizer is currently providing would depend on all components
    of the final rule and how the point of sale discount model that
    replaces rebates will function.

        Question. How will this proposal affect how your company sets the
    list prices for new drug products?

        Answer. At Pfizer, we are committed to our purpose: breakthroughs
    that change patients' lives. Pfizer's more than 90,000 colleagues
    around the world come to work every day focused not only on creating
    breakthrough medicines, but also on making sure those medicines get
    into the hands of the patients who need them.

        Launch pricing is driven by a multitude of factors, the most
    important being the medicine's impact on patients and their health. We
    also may consider other factors like the medicine's potential to reduce
    other health-care costs, such as hospital stays; the availability of
    other treatments and generic options; affordability for patients,
    insurers and governments; and investments to maintain the quality,
    safety, delivery and reliability of our medicines.

        Question. If the proposal is finalized and not extended to the
    private market, will your company make any list price reductions? If
    so, how large would the reductions be relative to the size of the
    rebates your company is currently providing?

        Answer. Because there is no specific requirement for plans and PBMs
    to shift away from negotiating contracted rebates in the commercial
    market, it is possible that a bifurcated market, with the same perverse
    incentives and the same mechanism to drive list prices higher, will
    result. If reform does extend to the commercial marketplace, it could
    result in lowering of list prices. However, we cannot speculate on the
    amounts until we see the specifics of the rule and the changes that are
    made to the supply chain.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\12\
    ---------------------------------------------------------------------------
        \12\ MACPAC: ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wp-content/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        This requirement created an unintended loophole. Rather than use
    the price of the authorized generic, drug companies can sell its
    authorized generic to a corporate subsidiary at an artificially lower
    price, and use that lower price to bring down the AMP, which in turn
    ---------------------------------------------------------------------------
    lowers the rebate obligation.

        Does your company engage in this practice? Has your company ever
    engaged in this practice in the past?

        Answer. Pfizer has a number of Authorized Generics (AGs)
    arrangements, both with affiliates and non-affiliates. CMS's Medicaid
    Covered Outpatient Drugs Final Rule, 81 Fed. Reg. 5170 (Feb. 1, 2016)
    (the ``Final Rule'') included an extensive discussion of when a primary
    manufacturer should include or exclude sales of AGs to secondary
    manufacturers in its average manufacturer price (AMP). Pfizer has
    developed reasonable assumptions that it believes are consistent with
    the guidance CMS set forth in the Final Rule for purposes of
    determining when to include or exclude sales of AGs in its AMP
    calculation. Pfizer disclosed its assumptions with respect to its
    approach both in written correspondence and in an onsite meeting with
    CMS representatives. In addition, Pfizer disclosed its assumptions to
    the OIG in response to a January 2018 survey.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. According to public filings, in 2015 Pfizer collected
    U.S. revenues that were more than double the amount you invested in
    R&D. Is this still true--do you collect more in revenue in the U.S.
    alone than you invest in R&D?

        Answer. The biopharmaceutical industry is one of the most research-
    intensive industries in the United States In 2017, NIH had a budget of
    $39.2 billion, only a fraction of which, $3.2 billion, was dedicated to
    drug discovery. The industry invested over $90 billion in R&D--almost
    30 times more. For Pfizer alone, we invested approximately $8 billion
    in R&D last year.

        Pfizer's number one priority is always the care of our patients,
    and we are proud of the investments Pfizer makes to insure we continue
    to bring new, innovative cures to patients. These responsibilities
    require investments in R&D, manufacturing and other areas to accomplish
    our mission of creating breakthrough medicines that change people's
    lives.

        In 2018, Pfizer spent approximately $20 billion on global R&D and
    manufacturing. This includes investing in state-of-the-art labs so we
    can attract the finest scientists in the world and continuing to invest
    in innovative, high-tech manufacturing to ensure the high quality of
    our products. Pfizer's revenues in the United States in 2018 totaled
    approximately $25 billion.

        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? For those drugs is
    your list price equal to your net price?

        Answer. Approximately one third of Pfizer's revenue comes from
    products that are not Medicare Part D eligible. This product group
    includes generics, vaccines, and physician administered products. Of
    the remaining two thirds of our revenue, 92 percent comes from products
    that offer Medicare Part D or commercial rebates. The remaining 8
    percent is from products that have lost patent exclusivity, have
    generic alternatives, and offer no rebates. It is not possible to
    determine at this time whether that portion will increase because
    rebating on future products will be based on numerous factors,
    including product value and the competitive intensity of the
    therapeutic area. For products that do not rebate, there are additional
    deductions from sales such as prompt payment fees and distribution
    service fees resulting in the net price being lower than list price.

        Question. Do you invest more in R&D than you generate in U.S. sales
    revenue? Please include specific figures.

        Answer. The biopharmaceutical industry is one of the most research-
    intensive industries in the United States In 2017, NIH had a budget of
    $39.2 billion, only a fraction of which, $3.2 billion, was dedicated to
    drug discovery. The industry invested over $90 billion in R&D--almost
    30 times more. For Pfizer alone, we invested approximately $8 billion
    in R&D last year.

        Pfizer's number one priority is always the care of our patients,
    and we are proud of the investments Pfizer makes to insure we continue
    to bring new, innovative cures to patients. These responsibilities
    require investments in R&D, manufacturing and other areas to accomplish
    our mission of creating breakthrough medicines that change people's
    lives.

        In 2018, Pfizer's revenues in the United States totaled
    approximately $25 billion and Pfizer spent approximately $20 billion on
    global R&D and manufacturing. This includes investing in state-of-the-
    art labs so we can attract the finest scientists in the world and
    continuing to invest in innovative, high-tech manufacturing to ensure
    the high quality of our products.

        Question. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. In order to fulfill Pfizer's mission to create breakthrough
    medicines that change patients' lives, we invest in several areas to
    ensure an innovative pipeline, top-quality manufacturing, and education
    of patients and physicians to ensure they have the information they
    need to make knowledgeable decisions about patient care.

        In 2018, Pfizer spent approximately $14 billion on selling,
    informational and administrative expenses and approximately $8 billion
    on R&D. Selling, informational and administrative costs are expensed as
    incurred. Among other things, these expenses include the internal and
    external costs of marketing, advertising, shipping and handling,
    information technology and legal defense.

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. In order to fulfill Pfizer's mission to create breakthrough
    medicines that change patients' lives, we invest in several areas to
    ensure an innovative pipeline, top-quality manufacturing, and education
    of patients and physicians to ensure they have the information they
    need to make knowledgeable decisions about patient care.

        In 2018, Pfizer spent approximately $6.9 billion on direct sales &
    marketing and approximately $8 billion on R&D globally. Direct sales
    and marketing expenses include, among other things: direct promotion or
    sale of the company's products.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. Pfizer believes that direct-to-consumer (DTC) advertising
    should be, first and foremost, a tool through which we can provide
    patients with useful information about their medical conditions, the
    availability of treatments and the potential benefits and risks of
    available treatment options so they can have a discussion with their
    doctors and take an active role in managing their health. Research has
    confirmed that this communication channel delivers on this goal.\13\
    ---------------------------------------------------------------------------
        \13\ See 2017 Direct to Consumer Advertising Survey Results,
    presented by Princeton Survey Research Associates International,
    prepared for PhRMA, https://www.phrma.org/report/2017-direct-to-
    consumer-advertising-survey-results; DIA, Therapeutic and Regulatory
    Science, https://journals.sagepub.com/doi/abs/10.1177/2168479017708226;
    https://www.fda.gov/AboutFDA/CentersOffices/
    OfficeofMedicalProductsandTobacco/CDER/ucm090276.htm#Completed.

        We may consider several factors when making decisions about our
    consumer communications. Some of these may include the information
    needs of patients who might benefit from one of our medicines and/or
    the extent to which a health condition is un- and under-diagnosed and
    ---------------------------------------------------------------------------
    treated.

                                     ______

                                  Pfizer Inc.

                                 500 Arcola Rd.

                             Collegeville, PA 19426

                      Tel: 484-865-8937  Fax: 484-865-0090

                                 www.pfizer.com

                           Peter Honig, M.D., M.P.H.

                             Senior Vice President

                        Worldwide Safety and Regulatory

    May 30, 2018

    Scott Gottlieb, M.D.
    Commissioner
    Food and Drug Administration
    10903 New Hampshire Avenue
    Silver Spring, MD 20993-0002
    CommissionerFDA@fda.hhs.gov

    Re:  Reference Listed Drug (RLD) Access Inquiries Website and NDA
    022321 for Embeda (morphine sulfate; naltrexone hydrochloride)
    Extended-
    Release Capsules; NDA 017989 for Hemabate (carboprost tromethamine)
    Injection; and NDA 020931 for Tikosyn (dofetilide) Capsules

    Dear Dr. Gottlieb:

    We write in reference to the newly posted page on the FDA website
    entitled ``Reference Listed Drug (RLD) Access Inquiries.'' \1\ We note
    that several new drug applications (NDAs) owned by Pfizer Inc. or
    wholly-owned subsidiaries of Pfizer (collectively, ``Pfizer'') are
    included in the list published on this site (``List''):
    ---------------------------------------------------------------------------
        \1\ https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm.

        1.  Embeda (morphine sulfate; naltrexone hydrochloride), NDA
    022321;
        2.  Hemabate (carboprost tromethamine), NDA 01 7989; and
        3.  Tikosyn (dofetilide), NDA 020931.

    We write to the Agency for several reasons. First, we wish to inform
    the Agency about Pfizer's internal practice for handling drug
    purchasing inquiries from prospective generic applicants, as well as
    provide some context for why the Agency may have received inquiries
    about these particular products, and Pfizer's diligence in addressing
    these issues. We believe that this information demonstrates Pfizer's
    commitment to supporting innovation and a competitive marketplace.
    Second, we wish to provide our suggestions on additional, non-
    confidential information to add to the List in order to provide context
    critical to understanding the List and its value. Additionally, we wish
    to express our concerns that the Agency's announcement surrounding the
    new webpage and how the information is currently presented implies that
    the companies listed have engaged in ``gaming'' or anti-competitive
    behavior, which is untrue with respect to Pfizer, and not supported by
    the facts currently included in the List.

    Pfizer was surprised and disappointed to discover that FDA had been
    informed by prospective generic applicants that they had difficulty
    obtaining some of our products to conduct the testing necessary to
    support submission of an abbreviated new drug application (ANDA).
    However, we note that the Agency included a disclaimer on the webpage
    stating that ``[w]e note that FDA has not independently investigated or
    confirmed the access limitations described in the inquiries received.''
    \2\ As discussed in more detail below, without having any additional
    information about these inquiries, Pfizer is unable to confirm whether
    those inquiries were made to Pfizer, and if so, whether they were
    handled in accordance with Pfizer's practice to make its drug products
    available to applicants for purchase.
    ---------------------------------------------------------------------------
        \2\ https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm.

    Following publication of the List, Pfizer conducted internal due
    diligence to identify whether Pfizer was contacted by prospective
    generic applicants for the listed products, and whether Pfizer was able
    to provide those customers with the requested drug product. By way of
    background, our standard approach is to ensure that drug product is
    available to licensed generic manufacturers at the listed price and on
    Pfizer's standard terms of sale.\3\ The vast majority of Pfizer's
    products are available through traditional wholesale channels (i.e.,
    available through one or more of Pfizer's authorized distributors). If
    Pfizer receives an inquiry about a product that is available at
    wholesale, Pfizer will refer a prospective buyer to a publicly
    available list of its authorized distributors, and indicate that the
    prospective buyer should obtain product from an authorized distributor
    on that list. For the limited number of products that are not available
    at wholesale, requests made to Pfizer by a generic manufacturer wishing
    to purchase drug samples should be fulfilled in accordance with
    Pfizer's standard practice. If such requests involve a product with a
    REMS that restricts distribution, Pfizer's position is that a Safety
    Determination Letter (SDL) needs to be provided prior to sale. Pfizer
    developed an internal process to handle such requests in early 2015,
    upon realizing that such requests come into Pfizer via multiple
    departments and colleagues.
    ---------------------------------------------------------------------------
        \3\ If a drug product is in critical short supply, Pfizer will ship
    products to fulfill orders for dispensing to patients before fulfilling
    orders for product for testing.
    ---------------------------------------------------------------------------

    Tikosyn

    The List indicated that the Agency had received four inquiries
    regarding Tikosyn. To the best of its knowledge, Pfizer is aware of
    only one request for Tikosyn from a prospective generic applicant. At
    the time of that request, Tikosyn was approved with a REMS with
    elements to assure safe use (ETASU) that restricted distribution. When
    contacted by the applicant, Pfizer requested that the applicant provide
    us with written confirmation from the Agency that Pfizer's sale of the
    product to the applicant would not be considered a violation of our
    REMS. The applicant did not contact Pfizer further and Pfizer never
    received any written correspondence from the Agency. The Agency removed
    the REMS in 2016, and Pfizer notes that the Access Inquiries Webpage
    indicates that FDA never issued any SDLs for this drug product.

    We note despite the inquiries submitted to the Agency identified in the
    List, ANDAs have been submitted and approved for the drug product.
    There are three approved ANDAs for the drug product, with the first
    approved on June 6, 2016,\4\ and two additional ANDAs approved in
    2018.\5\ Additionally, the Agency's paragraph IV certification list
    indicates that the first ANDA containing a paragraph IV certification
    was submitted on May 1, 2014, when the REMS was still in place.\6\ This
    additional information indicates that applicants were able to obtain
    product, submit ANDAs, and obtain approval from the approval even while
    the REMS was in place.
    ---------------------------------------------------------------------------
        \4\ ANDA 207058, see https://www.accessdata.fda.gov/scripts/cder/
    ob/results_product.cfm?Ap
    pl_Type=A&Appl_No=207058, accessed May 23, 2018.
        \5\ ANDA 208625, see https://www.accessdata.fda.gov/scripts/cder/
    ob/results_product.cfm?Ap
    pl_Type=A&Appl_No=208625, accessed May 23, 2018; ANDA 207746, see
    https://www.
    accessdata.fda.gov/scripts/cder/ob/
    results_product.cfm?Appl_Type=A&Appl_No=207746, accessed May 23, 2018.
        \6\ See https://www.fda.gov/downloads/Drugs/
    DevelopmentApprovalProcess/HowDrugsareDe
    velopedandApproved/ApprovalApplications/
    AbbreviatedNewDrugApplicationANDAGenerics/UC
    M293268.pdf.

    As the REMS has been removed by the Agency, Pfizer now makes Tikosyn
    available at wholesale through its authorized distributors.

    Embeda

    The List indicated that the Agency received one inquiry regarding
    Embeda. We note that despite the inquiry submitted to the Agency, ANDAs
    containing a paragraph IV certification were submitted to the Agency
    for Embeda from May 3, 2010, through May 28, 2010, covering five of the
    six approved strengths of Embeda.\7\ Pfizer acquired King
    Pharmaceuticals (and with it, Ernbeda) on March 1, 2011. Two weeks
    later, Pfizer recalled Embeda from the market due to stability issues
    with the product. Pfizer spent the next several years diligently
    addressing the issues that led to the recall, and Pfizer was able to
    re-launch the product in January 2015. However, as a result of these
    issues, from March 2011 through January 2015, there was no Embeda
    product available for sale in the U.S. market.
    ---------------------------------------------------------------------------
        \7\ See https://www.fda.gov/downloads/Drugs/
    DevelopmentApprovalProcess/HowDrugsareDe
    velopedandApproved/ApprovalApplications/
    AbbreviatedNewDrugApplicationANDAGenerics/UC
    M293268.pdf.

    Pfizer was not able to identify any request from a generic applicant to
    purchase Embeda. Embeda is now available at wholesale through Pfizer's
    authorized distributors.

    Hemabate

    Finally, the List indicated that FDA had received one inquiry for
    Hemabate, an older drug owned by Pharmacia and Upjohn Co., which was
    acquired by Pfizer in 2003. Pharmacia, and later Pfizer, limited
    Hemabate distribution to customers with medical and surgical intensive
    care facilities to help ensure the drug product was used in accordance
    with the product's labeling. While this limited distribution may have
    prevented a prospective generic applicant from acquiring the drug
    product from a wholesaler, it would not have prevented an applicant
    from contacting Pfizer directly to buy the drug product. Pfizer ceased
    the limited distribution of Hemabate to ensure patients and healthcare
    professionals had appropriate access to the drug product. The product
    is now available at wholesale through Pfizer's authorized distributors
    since January 2018. Pfizer was not able to identify any request from a
    generic applicant to purchase Hemabate.

    Proposed Revisions to the List

    We encourage the Agency, in accordance with its goal ``[t]o help
    address this issue and to provide transparency regarding these
    inquiries,'' \8\ to add further information to the List. The
    information Pfizer suggests the Agency include will provide critical
    context to help clarify to the stakeholders involved, i.e., the
    American public, the United States Government, and industry, whether an
    NDA bolder may be preventing generic applicants from obtaining the drug
    products necessary to support submission of an ANDA Without this
    information, stakeholders may come away with the false impression that
    every company on the List has impeded access, as demonstrated by the
    news coverage of the List and FDA's statements.\9\
    ---------------------------------------------------------------------------
        \8\ https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm.
        \9\ See, e.g., Sara Koblitz, FDA's Version of the Scarlet Letter,
    FDA Law Blog (May 23, 2018), http://www.fdalawblog.net/2018/05/fdas-
    version-of-the-scarlett-letter/; Sheila Kaplan, ``F.D.A. Names and
    Shames Drug Makers to Encourage Generic Competition,'' The New York
    Times (May 17, 2018), https://www.nytimes.com/2018/05/17/health/drug-
    prices-generics-fda.html; Sy Mukherjee, ``The FDA Is Naming and Shaming
    Companies Accused of Blocking Cheap Generic Drugs,'' Fortune (May 17,
    2018), http://fortune.com/2018/05/17/fda-database-generic-drug-delays/.

    ---------------------------------------------------------------------------
    We recommend that the List include:

          The date the inquiry was made to FDA, and if furnished by the
    prospective generic applicant, the date(s) the applicant attempted to
    acquire the drug product and failed;
          If available, whether the prospective generic applicant directly
    approached the NDA holder or manufacturer , and was unable to obtain
    product that way;
          The identity of the NDA holder at the time the inquiry was made;
          Whether there are approved generic products for the drug
    product, and when those were approved;
          Whether and when an applicant submitted an ANDA with paragraph
    IV certification; and
          Whether a particular inquiry for a product with a REMS with
    ETASU restricting distribution included a protocol, and whether the
    Agency issued an SDL relating to that inquiry.

    While the Agency includes a disclaimer on the Access Inquiries Webpage
    that it has not investigated or confirmed the access limitations
    described in the inquiries it received,\10\ the Agency's statements,
    both on its website and in public statements, strongly suggest that the
    Agency endorses the claim that access to biosamples was blocked for all
    products on the list. In reality, however, the only certain fact about
    the inquiries on the List is that a prospective applicant complained to
    FDA that it was unable to obtain the drug product. Neither Pfizer nor
    the FDA knows whether that is in fact the case, or, if it is, whether
    there are reasons the applicant did not obtain product that are not the
    result of ``gaming'' or anti-competitive tactics by NDA holders. For
    example, the drug may not be available due to a drug shortage, recall
    (as in the case of Embeda), or because the generic applicant did not
    actually try all avenues to obtain the drug product, such as contacting
    the NOA holder or manufacturer directly.
    ---------------------------------------------------------------------------
        \10\ https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandAp
    proved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.
    htm.

    Including this additional information in the List will shed light on
    the reasons the generic applicant may have been w1able to obtain the
    drug product, as well as indicate whether generic applicants were able
    to obtain the drug product, despite the inquiries received by FDA. For
    example, knowing the dates the inquiries were made could indicate
    whether the requests came during a time when the drug product was not
    being marketed, as in a recall situation, or when a REMS with ETASU
    that restricted distribution was in place that may have triggered the
    need for a review of the prospective generic applicant's protocol. And,
    knowing those dates will help industry perform its own due diligence to
    identify whether a request for drug product was inappropriately denied.
    Likewise, noting whether the prospective generic applicant stated
    whether it contacted the NDA holder or manufacturer will indicate
    whether the applicant reached out to a party that could provide the
    drug product, and will assist a company in determining whether its
    policy on providing drug product, such as Pfizer's, was appropriately
    ---------------------------------------------------------------------------
    followed.

    Additionally, providing the identity of the NDA holder at the time of
    the inquiry will help clarify whether the company that currently owns
    the NDA could potentially be responsible for the failure to provide
    drug product, or whether that failure, if any, could be attributable to
    the prior holder of the NDA. For example, without knowing when the
    inquiry was made or who the NDA holder was at the time of the inquiry,
    Pfizer cannot tell for two of its products on the List (Embeda and
    Hemabate) whether those inquiries came before or after Pfizer's
    acquisition of the companies that originally owned those
    products.Accordingly, Pfizer cannot adequately respond to allegations
    that it may have inappropriately restricted access to its drug
    products.

    Including the dates of generic entry would also demonstrate to
    stakeholders whether generic competition was impeded, or if in fact,
    one or more generic applicants were able to obtain the product needed
    in order to obtain approval from the Agency. While we recognize that
    the Agency may be unable to identify who made the inquiry to FDA, even
    if that applicant has an ANDA approved later, to the extent that
    information can be provided, it would demonstrate whether a particular
    generic applicant was blocked from obtaining product.

    Additionally, providing more information related to products with REMS
    that restrict distribution, e.g., whether an applicant has submitted a
    protocol to the Agency, and whether a particular inquiry on the List
    correlates to the issuance of an SOL, will also indicate whether the
    generic applicant who made the inquiry provided its protocol to the
    Agency, and whether the Agency determined that the protocol contained
    safety protections comparable to the REMS. Currently, there is no
    indication as to whether an applicant who complained about not having
    access to such drug product took appropriate steps to facilitate its
    access to the product when there was such a REMS in place for the drug
    product.

    Finally, we also note that the Agency does not inform an NOA holder in
    real time when an applicant has had difficulty obtaining product. Given
    Pfizer's policy to provide drug product when requested, if the Agency
    had informed Pfizer that it had received such an inquiry on a specific
    date, Pfizer could have then undertaken its own efforts to resolve the
    issue.

    We appreciate the Agency's consideration of the issues raised in this
    letter, and reiterate our commitment to competition and innovation in
    the biopharmaceutical industry.

    Sincerely,

    Peter Honig, M.D., M.P.H.
    Senior Vice President, Worldwide Safety and Regulatory

    cc:  Janel Woodcock, M.D., Janet Woodcock@fda.hhs.gov
       Theresa Toigo, Theresa.Toigo@fda.hhs.gov
       Kathleen Uhl, M.D., Kathleen.Uhl@fda.hhs.gov
       Maryll Toufanian, Maryll.Toufanian@fda.hhs.gov

                                     ______

                    U.S. Food and Drug Administration (FDA)
    July 19, 2018

    Peter Honig , M.D., M.P.H.
    Senior Vice President, Worldwide Safety and Regulatory
    Pfizer Inc.
    Email: Peter.Honig@pfizer.com

    Dear Dr. Honig:

    Thank you for your letter of May 30, 2018, regarding FDA's Reference
    Listed Drug (RLD) Access Inquiries webpage. Your letter informs FDA
    about Pfizer's internal practice for handling inquiries about samples
    from prospective generic applicants, provides suggestions about
    additional information to add to the RLD Access Inquiries webpage, and
    expresses concern about the Agency's announcement surrounding the
    webpage (Letter at 1-2). The Commissioner referred your letter to the
    Center for Drug Evaluation and Research (CDER) for response.

        1.  Pfizer's internal practice for handling drug purchasing
    inquiries from prospective generic applicants

    Your letter provides a synopsis of Pfizer's internal practices for
    handling the inquiries that it receives related to RLD access to its
    products and the circumstances surrounding the Pfizer products that
    appear on the RLD Access Inquiries webpage (Letter at 2-3). We
    appreciate the insight provided by Pfizer on its internal processes. As
    you are aware, inclusion on the list of products on the RLD Access
    Inquiries webpage signifies that FDA has received an RLD access inquiry
    related to limited distribution of the product. As we state on the
    webpage, FDA has not independently investigated or confirmed the access
    limitations as described in the inquiries received.

    You also state that FDA ``does not inform an NDA holder in real time
    when an applicant has had difficulty obtaining product'' and that ``if
    [FDA] had informed Pfizer that it had received such an inquiry on a
    specific date, Pfizer could have then undertaken its own efforts to
    resolve the issue.'' As the webpage explains (and as also described in
    the draft guidance for industry How to Obtain a Letter from FDA Stating
    that Bioequivalence Study Protocols Contain Safety Protections
    Comparable to Applicable REMS for RLD (How to Obtain a Letter
    Guidance)), FDA does notify certain RLD sponsors, after the prospective
    generic applicant has provided appropriate disclosure authorization to
    the Agency. However, to the extent that Pfizer has a process for
    prospective generic applicants to obtain samples, we encourage Pfizer
    to consider making that process public to help ensure both that
    interested developers know what process to use, and that Pfizer has
    access to as much information as possible about any access issues.

        2.  Suggestions for additional information Pfizer believes FDA
    should add to the RLD Access Inquiries webpage

    Your letter also contains a list of six points of information Pfizer
    recommends be added to the RLD Access web page (Letter at 4):

              1.  The date the inquiry was made to FDA, and (if furnished
            by the prospective generic applicant), the date(s) the
            applicant attempted to acquire the product and failed;
              2.  If available, whether the prospective generic applicant
            directly approached the NDA bolder or manufacturer, and was
            unable to obtain product that way;
              3.  The identity of the NDA holder at the time the inquiry
            was made;
              4.  Whether there are approved generic products for the drug
            product, and when those were approved;
              5.  Whether and when an applicant submitted an ANDA with a
            paragraph IV certification; and
              6.  Whether a particular inquiry for a product with a REMS
            with ETASU impacting distribution included a protocol, and
            whether the Agency issued a Safety Determination Letter (SDL)
            relating to that inquiry.

    We note that two of these items (``[t]he identity of the NDA holder at
    the time the inquiry was made,'' and ``whether the Agency issued a
    [Safety Determination Letter] relating to [an] inquiry'') are already
    included on the RLD Access Inquiries webpage. The webpage identifies
    the RLD sponsor associated with each inquiry, and clarifies that this
    is the RLD sponsor that was listed in the Approved Drug Products with
    Therapeutic Equivalence Evaluations (the Orange Book) at the time FDA
    received the inquiry (see footnote on the chart of inquiries). The web
    page also identifies whether FDA issued a Safety Determination Letter
    in connection with a particular RLD access inquiry (and explains that
    receipt of such a letter is preceded by FDA' s review of bioequivalence
    study protocols to assess whether they contain safety protections
    comparable to those in the applicable REMS for the RLD).

    Two of the other points of information (``[w]hether there are approved
    generic products for the drug product, and when those were approved''
    and ``[w]hether an applicant submitted an ANDA with a paragraph IV
    certification'') are already publicly available on FDA's website (via
    the Orange Book or Drugs@FDA and the Paragraph IV Certifications List,
    respectively).\1\ For the remaining points of information, to the
    extent FDA has access to the information you describe, we will take
    your feedback (along with feedback from other stakeholders) into
    account as we consider whether any changes to the RLD Access Inquiries
    webpage should be made in order to best address and improve
    transparency about this topic.
    ---------------------------------------------------------------------------
        \1\  See http://www.accessdata.fda.gov/scripts/cder/ob/index.cfm,
    http://www.accessdata.fda.
    gov/scripts/cder/daf/index.cfm and https://www.fda.gov/downloads/Drugs/
    DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/
    ApprovalApplications/Abbre
    viatedNewDrugApplicationANDAGenerics/UCM293268.pdf, respectively.

        3.  Concerns relating to the Agency's announcement surrounding the
    ---------------------------------------------------------------------------
    RLD Access Inquiries webpage

    Your letter also indicates that FDA's presentation of information about
    this topic ``strongly suggest that the Agency endorses the claim that
    access to biosamples was blocked for all products on the list'' (Letter
    at 4). As you note, however, the RLD Access webpage makes clear that
    FDA has not independently investigated or confirmed the access
    limitations described in the inquiries the Agency received. The webpage
    is one effort under the FDA's Drug Competition Action Plan to provide
    transparency about the potential impact of this important issue. If
    generic companies are unable to purchase the samples they need to
    support their applications, this slows down, or entirely impedes, the
    generic drug development process--leading to delays in bringing
    affordable generic alternatives to patients in need. FDA is committed
    to advancing policies to help bring more competition to the
    prescription drug market, and we will continue to consider how we can
    best advance this goal, including whether any changes to the RLD Access
    Inquiries webpage should be made. We appreciate your feedback on this
    issue.

    Thank you again for contacting us.

                Sincerely,

                Janet Woodcock, M.D.
                Director
                Center for Drug Evaluation and Research

                                     ______

                        PFIZER FOUNDATION GRANT SUMMARY

                                   2015-2018

                               TOTAL: $45,877,000

    GLOBAL HEALTH PROGRAMMING

    NOTE: This report includes information for recipient both U.S. and ex-
    U.S. recipient organizations. Certain Pfizer Foundation grants to non-
    U.S. grantees are facilitated through U.S.-based donor-advised funds
    that specialize in vetting and processing grants to non-U.S. grant
    recipients.

               IMPROVING HEALTHCARE DELIVERY AND LOCAL INNOVATION
    ------------------------------------------------------------------------
        DATE BOARD
         APPROVED          PARTNER             DESCRIPTION          AMOUNT
    ------------------------------------------------------------------------
    November 2015      Swasth           Global Health Innovation  $1,500,000
                        Foundation,      Grants support
                        Afya Research,   organizations that are
                        Jacaranda        advancing innovative
                        Heath,           health models in low
                        Northstar        and middle income
                        Alliance,        countries. The goal of
                        Penda Health,    this portfolio is to
                        World Health     improve healthcare
                        Partners,        delivery for
                        Clinicas del     underserved populations
                        Azucar,          and support local
                        Saluno, APOPO,   innovation in key
                        Ayzh, Last       countries: India,
                        Mile Health,     Kenya, Mozambique,
                        LifeNet          Mexico, Tanzania,
                        International,   India, Liberia, Uganda,
                        One Family       Rwanda, and South
                        Health,          Africa. The grants
                        Operation ASHA   support projects that
                        and Sevamob      align to the
                                         Foundation's 4
                                         strategic elements:
                                         primary healthcare
                                         delivery, women and
                                         children's health,
                                         health technologies for
                                         low resource settings
                                         and innovative
                                         financing mechanisms.
                                         The Foundation
                                         supported $100,000
                                         grants to fifteen
                                         organizations in 10
                                         countries.
    ------------------------------------------------------------------------
    December 2016      Swasth           SECOND CYCLE: The          2,000,000
                        Foundation,      Foundation supported
                        Afya Research,   $100,000 grants to
                        Jacaranda        twenty organizations in
                        Heath,           10 countries.
                        Northstar
                        Alliance,
                        Penda Health,
                        World Health
                        Partners,
                        Clinicas del
                        Azucar,
                        Saluno, Ayzh,
                        Last Mile
                        Health,
                        LifeNet
                        International,
                        One Family
                        Health,
                        Operation ASHA
                        and Sevamob,
                        Purple Source,
                        Unjani,
                        AccuHealth,
                        Bive, Salud
                        Cercana,
                        2020MicroClini
                        c
    ------------------------------------------------------------------------
    March 2018         Swasth           THIRD CYCLE: The           2,000,000
                        Foundation,      Foundation supported
                        Afya Research,   $100,000 grants to
                        Jacaranda        twenty organizations in
                        Heath,           12 countries.
                        Northstar
                        Alliance,
                        World Health
                        Partners,
                        Clinicas del
                        Azucar,
                        Saluno, Ayzh,
                        Last Mile
                        Health,
                        LifeNet
                        International,
                        One Family
                        Health,
                        Operation ASHA
                        and Sevamob,
                        Purple Source,
                        Unjani, Bive,
                        2020MicroClini
                        c, MUSO,
                        Possible, UE
                        Life Sciences
    ------------------------------------------------------------------------
    March 2018         Acumen           The Foundation provided      500,000
                                         catalytic funding to
                                         Acumen America, an
                                         early-stage
                                         philanthropic venture
                                         fund that invests in
                                         companies that are
                                         improving the lives of
                                         low-income Americans
                                         and advancing
                                         innovative solutions to
                                         issues of poverty in
                                         America. Through this
                                         grant, Acumen will grow
                                         its portfolio of health
                                         investments that
                                         transform services for
                                         the poor in the US,
                                         including programs that
                                         will increase access to
                                         care, including
                                         lowering the financial
                                         and time burden of
                                         health and wellness on
                                         low-income individuals,
                                         improve quality of care
                                         to make care more
                                         effective, and improve
                                         patient experience of
                                         care to drive patient
                                         engagement & adherence.
                                         Portfolio companies
                                         include approaches to
                                         use technology to
                                         address and reduce
                                         health disparities for
                                         underserved and
                                         multicultural
                                         populations.
    ------------------------------------------------------------------------

                        IMPACT INVESTING CATALYTIC GRANTS
    ------------------------------------------------------------------------
        DATE BOARD
         APPROVED          PARTNER             DESCRIPTION          AMOUNT
    ------------------------------------------------------------------------
    July 2015          PharmAccess      The Foundation provided   $1,500,000
                                         a grant to support the
                                         development and roll
                                         out of PharmAccess'
                                         innovative healthcare
                                         financing, funding
                                         which will help scale
                                         PharmAccess's mobile
                                         health (mHealth)
                                         wallet, a mobile health
                                         payment platform linked
                                         to M-Pesa in Kenya. The
                                         goal of the
                                         Foundation's grant is
                                         to support user roll-
                                         out of the platform and
                                         increase the number of
                                         people who use the
                                         platform, demonstrating
                                         its usability and
                                         collecting data. The
                                         Foundation's grant will
                                         target 100,000 low
                                         income, urban mothers
                                         who will be enrolled
                                         and receive a financial
                                         subsidy through the
                                         mHealth wallet to pay
                                         for healthcare services
                                         and products for their
                                         children under 5 years
                                         old.
    ------------------------------------------------------------------------
    July 2015          PATH             The Foundation provided      350,000
                                         a grant to support the
                                         expansion of PATH's
                                         Global Health
                                         Innovation Hub in South
                                         Africa, in partnership
                                         with the South Africa
                                         Medical Research
                                         Council. The Hub's
                                         mission is to
                                         accelerate access to
                                         the most promising
                                         technology innovations
                                         by building the
                                         capacity of local
                                         innovators to develop,
                                         manufacture, and deploy
                                         global health
                                         technologies for
                                         vulnerable groups,
                                         leveraging PATH's
                                         expertise and network
                                         in global health and
                                         product development.
                                         The grant will support
                                         activities to build and
                                         accelerate local
                                         innovations and
                                         identify and prioritize
                                         local technologies that
                                         can deliver global
                                         health impact.
    ------------------------------------------------------------------------
    July 2015          UNITUS           The Foundation provided      650,000
                                         a grant to support the
                                         expansion of
                                         `StartHealth,' a health
                                         technology jump-starter
                                         designed to accelerate
                                         the pace of development
                                         of bottom of the
                                         pyramid focused health-
                                         tech startups in India.
    ------------------------------------------------------------------------
    July 2015          Global           The Foundation provided      500,000
                        Partnerships     a grant to this impact
                                         investment fund, which
                                         focuses on providing
                                         products and services
                                         using market based
                                         approaches in Latin
                                         America. This includes
                                         efforts to pilot and
                                         validate high potential
                                         health modes for last
                                         mile and underserved
                                         populations, with a
                                         focus on woman and
                                         children.
    ------------------------------------------------------------------------

     SUPPORT INNOVATIVE APPROACHES TO ENHANCING NON-COMUNICABLE DISEASE CARE
    ------------------------------------------------------------------------
       DATE BOARD
        APPROVED         PARTNER             DESCRIPTION            AMOUNT
    ------------------------------------------------------------------------
    November 2015    FHI360          The Foundation provided a    $1,000,000
                                      grant to support the
                                      ``Suc Khoe Doi Dao''
                                      project that will
                                      establish a community-
                                      based, integrated NCD
                                      prevention and control
                                      program in Vietnam.
    ------------------------------------------------------------------------
    November 2015    George          This partnership will         1,000,000
                      Institute of    pilot implementation of a
                      Global Health   novel primary care
                                      platform to support
                                      communities and
                                      healthcare providers in
                                      the prevention and
                                      management of NCDs in
                                      Indonesia and India.
    ------------------------------------------------------------------------
    April 2016       PATH            As part of Pfizer               500,000
                                      Foundation's work to
                                      advance oncology care,
                                      the Foundation provided
                                      support to PATH in Peru
                                      to reduce the growing
                                      burden of illness and
                                      death from breast cancer
                                      for underserved
                                      populations through early
                                      detection linked to
                                      service and treatment.
    ------------------------------------------------------------------------
    April 2016       Susan G Komen   As part of Pfizer               500,000
                      Breast Cancer   Foundation's work to
                      Foundation      advance oncology care,
                                      the Foundation provided
                                      support to Susan G Komen
                                      Breast Cancer Foundation
                                      in Northeast Brazil to
                                      integrate breast cancer
                                      patient support, early
                                      detection and timely/
                                      quality diagnosis into
                                      existing primary care
                                      services with the goal of
                                      improving health access
                                      and delivery for
                                      underserved women.
    ------------------------------------------------------------------------
    April 2016       Partners in     As part of Pfizer               500,000
                      Health          Foundation's work to
                                      advance oncology care,
                                      the Foundation provided
                                      support to Partners in
                                      Health to increase
                                      accessibility of
                                      treatment for breast
                                      cancer for underserved
                                      patients and document and
                                      disseminate lessons
                                      learned to inform cancer
                                      care in Rwanda.
    ------------------------------------------------------------------------
    April 2016       Indiana         As part of Pfizer               500,000
                      University      Foundation's work to
                      Center for      advance oncology care,
                      Global Health   the Foundation partnered
                                      with AMPATH, through the
                                      Indiana University Center
                                      for Global Health, to
                                      improve breast cancer
                                      services for underserved
                                      women in Kenya including
                                      screening, early
                                      diagnosis, treatment and
                                      palliative and
                                      survivorship care.
    ------------------------------------------------------------------------
    April 2017       FHI360          The Foundation provided         300,000
                                      additional funding of the
                                      ``Abundant Health''
                                      project to support
                                      routine prevention,
                                      screening and management
                                      of hypertension and
                                      diabetes care in five
                                      commune health stations
                                      in Tan Phu district in Ho
                                      Chi Minh City, Vietnam.
    ------------------------------------------------------------------------
    April 2017       PATH            The Foundation provided         350,000
                                      additional funding of the
                                      ``Community Based Program
                                      for Breast Health''
                                      project in Peru.
    ------------------------------------------------------------------------
    August 2018      FHI360          The Foundation provided         437,000
                                      additional funding/phase
                                      two of the ``Abundant
                                      Health'' project to
                                      support routine
                                      prevention, screening and
                                      management of
                                      hypertension (HTN) and
                                      diabetes (DM) care at the
                                      community level.
    ------------------------------------------------------------------------
    August 2018      PATH            The Foundation provided         230,000
                                      additional funding of the
                                      ``Community Based Program
                                      for Breast Health''
                                      project in Peru.
    ------------------------------------------------------------------------
    August 2018      Indiana         The Foundation provided         250,000
                      University      additional funding to
                      Center for      AMPATH, through the
                      Global Health   Indiana University Center
                                      for Global Health, to
                                      improve breast cancer
                                      services for underserved
                                      women in Kenya including
                                      screening, early
                                      diagnosis, treatment and
                                      palliative and
                                      survivorship care.
    ------------------------------------------------------------------------
    August 2018      George          The Foundation additional       150,000
                      Washington      funding to help improve
                      American        health outcomes and
                      Cancer          reduce health disparities
                      Institute       for African-American,
                                      Latina and LGBT women.
    ------------------------------------------------------------------------

        PROVIDING CRITICAL SUPPORT FOR PRESSING U.S. PUBLIC HEALTH NEEDS
    ------------------------------------------------------------------------
       DATE BOARD
        APPROVED        PARTNER              DESCRIPTION            AMOUNT
    ------------------------------------------------------------------------
    April 2016       American        As part of Pfizer            $1,000,000
                      Cancer          Foundation's work to
                      Society         advance oncology care,
                                      the Foundation partnered
                                      with the American Cancer
                                      Society in Los Angeles,
                                      California and Hamptons
                                      Roads, Virginia to
                                      develop a patient
                                      navigation model that
                                      links community health
                                      advisors with federally-
                                      qualified health center
                                      (FQHC) screening and in-
                                      hospital navigation.
    ------------------------------------------------------------------------
    April 2016       George          As part of Pfizer             1,000,000
                      Washington      Foundation's work to
                      American        advance oncology care,
                      Cancer          the Foundation provided
                      Institute       support to George
                                      Washington University
                                      Cancer Institute to help
                                      improve health outcomes
                                      and reduce health
                                      disparities for African-
                                      America, Latina and LGBT
                                      women.
    ------------------------------------------------------------------------
    December 2017    West Virginia   The Foundation provided a       500,000
                      Department of   grant to support opioid
                      Health and      addiction prevention and
                      Human           education programming in
                      Resources       West Virginia.
    ------------------------------------------------------------------------
    December 2017    New Hampshire   The Foundation provided a       500,000
                      Department of   grant to support opioid
                      Education       addiction prevention and
                                      education programming in
                                      New Hampshire.
    ------------------------------------------------------------------------
    December 2017    Office of Drug  The Foundation provided a       500,000
                      Control         grant to support opioid
                      Policy          addiction prevention and
                                      education programming in
                                      Kentucky.
    ------------------------------------------------------------------------
    December 2017    New Mexico      The Foundation provided a       500,000
                      Department of   grant to support opioid
                      Health          addiction prevention and
                                      education programming in
                                      New Mexico.
    ------------------------------------------------------------------------
    December 2017    Utah            The Foundation provided a       500,000
                      Department of   grant to support opioid
                      Health          addiction prevention and
                                      education programming in
                                      Utah.
    ------------------------------------------------------------------------
    December 2017    Commonwealth    The Foundation provided a       500,000
                      of              grant to support opioid
                      Massachusetts   addiction prevention and
                      Department of   education programming in
                      Public Health   Massachusetts.
    ------------------------------------------------------------------------
    December 2017    Rhode Island    The Foundation provided a       500,000
                      Department of   grant to support opioid
                      Health          addiction prevention and
                                      education programming in
                                      Rhode Island.
    ------------------------------------------------------------------------
    December 2017    Foundation for  The Foundation provided a       500,000
                      Appalachian     grant to support opioid
                      Ohio            addiction prevention and
                                      education programming in
                                      Ohio.
    ------------------------------------------------------------------------
    December 2017    Department of   The Foundation provided a       500,000
                      Public Health   grant to support opioid
                                      addiction prevention and
                                      education programming in
                                      CT.
    ------------------------------------------------------------------------
    December 2017    Delaware        The Foundation provided a       500,000
                      Health and      grant to support opioid
                      Social          addiction prevention and
                      Services        education programming in
                                      Delaware.
    ------------------------------------------------------------------------

                 ADDRESSING KEY BARRIERS FOR WOMEN AND CHILDREN
    ------------------------------------------------------------------------
       DATE BOARD
        APPROVED         PARTNER            DESCRIPTION            AMOUNT
    ------------------------------------------------------------------------
    July 2015        Save the        The Foundation provided a      $500,000
                      Children        grant to support a pilot
                                      program offering an
                                      integrated approach to
                                      delivering immunization
                                      and family planning
                                      services. The grant
                                      supported development of
                                      materials and tools for
                                      healthcare workers to
                                      engage women on family
                                      planning services,
                                      including formal
                                      evaluation.
    ------------------------------------------------------------------------
    November 2015    CARE            The Foundation provided a     1,000,000
                                      grant to support
                                      increased access to
                                      family planning and
                                      immunization in Benin by
                                      integrating both services
                                      into comprehensive
                                      delivery and
                                      strengthening of clinical
                                      skills and outreach.
    ------------------------------------------------------------------------
    November 2015    FHI360          The Foundation provided a     1,000,000
                                      grant to support to
                                      develop a global
                                      monitoring and evaluation
                                      framework to assess task
                                      shifting in the delivery
                                      of family planning
                                      products and demonstrate
                                      the effectiveness and
                                      safety of using Community
                                      Health Workers to
                                      administer products.
    ------------------------------------------------------------------------
    November 2015    IRC             The Foundation provided a     1,200,000
                                      grant to support
                                      increased access to
                                      family planning and
                                      immunization in Ethiopia
                                      and Uganda by integrating
                                      both services into
                                      comprehensive delivery
                                      and male engagement. The
                                      project focused on last
                                      mile and hard to reach
                                      communities.
    ------------------------------------------------------------------------
    November 2015    PSI             The Foundation provided a     1,000,000
                                      grant to support
                                      increased access to and
                                      demand for contraception
                                      and reproductive health
                                      services in Uganda for
                                      women and adolescent
                                      girls
    ------------------------------------------------------------------------
    November 2015    U.S. Fund for   The Foundation provided a     1,000,000
                      UNICEF          grant to support
                                      expanding national mobile
                                      health platforms that
                                      improve immunization
                                      coverage and delivery in
                                      Indonesia, Laos and
                                      Uganda in partnership
                                      with MOH.
    ------------------------------------------------------------------------
    November 2015    World Vision    The Foundation provided a     1,000,000
                                      grant to support
                                      increased access to
                                      family planning and
                                      immunization in Kenya by
                                      integrating both services
                                      into comprehensive
                                      delivery, community
                                      mobilization and male
                                      engagement.
    ------------------------------------------------------------------------
    August 2016      World Vision    The Foundation partnered      1,000,000
                                      with World Vision in
                                      Zimbabwe to identify gaps
                                      in immunization coverage
                                      for children, adolescents
                                      and adults and support
                                      efforts to develop a life
                                      course approach to
                                      immunization with the
                                      Ministry of Health. The
                                      focus of the project was
                                      to increase access to and
                                      use of basic childhood
                                      immunizations for
                                      children from birth to
                                      age 5, and HPV
                                      immunization for girls as
                                      well as maternal
                                      immunizations for
                                      pregnant women. In
                                      addition World Vision
                                      worked with the Ministry
                                      of Health to address
                                      adult immunization needs,
                                      barriers and gaps in
                                      community service.
                                      Activities included
                                      training village health
                                      workers, health facility
                                      staff and community and
                                      faith leaders to educate
                                      and mobilize their
                                      communities around
                                      immunization and promote
                                      vaccination. This project
                                      also supported the
                                      development of a national
                                      life course approach.
    ------------------------------------------------------------------------
    August 2016      U.S. Fund for   The Foundation provided a     1,000,000
                      UNICEF          grant to help UNICEF
                                      improve immunization
                                      coverage in urban
                                      underserved communities
                                      in Asia (Cambodia,
                                      Myanmar, Mongolia and the
                                      Philippines), and to
                                      support UNICEF in
                                      conducting operational
                                      research to assess the
                                      feasibility of using
                                      current newborn
                                      immunization delivery
                                      programs to support life
                                      course immunization
                                      strategies and reach
                                      female populations with
                                      additional immunizations
                                      and reproductive health
                                      services. A centerpiece
                                      of this work is
                                      supporting the roll out
                                      of technology platforms
                                      that track immunization
                                      coverage and population
                                      registries.
    ------------------------------------------------------------------------
    August 2016      UN FOUNDATION   The Foundation partnered      1,000,000
                                      with the UN Foundation's
                                      Shot@Life program to
                                      pilot a life course
                                      immunization approach
                                      with a focus on rubella.
                                      Activities include the
                                      development of culturally
                                      specific local
                                      communication materials
                                      on the importance of
                                      vaccination and answering
                                      concerns parents may have
                                      about immunization and
                                      life-long impacts, as
                                      well as an integrated
                                      marketing program
                                      featuring social media,
                                      digital assets and a U.S.-
                                      based media campaign.
    ------------------------------------------------------------------------
    April 2017       IRC             The Foundation provided         800,000
                                      additional funding to
                                      existing programs in
                                      Uganda and Ethiopia to
                                      advance integrated
                                      immunization and family
                                      planning program.
    ------------------------------------------------------------------------
    April 2017       Save the        The Foundation provided         250,000
                      Children        additional funding to
                                      existing programs in
                                      Malawi to advance
                                      integrated immunization
                                      and family planning
                                      program.
    ------------------------------------------------------------------------
    July 2017        CARE            The Foundation provided         250,000
                                      additional funding to an
                                      existing program in Benin
                                      to advance integrated
                                      immunization and family
                                      planning program.
    ------------------------------------------------------------------------
    July 2017        World Vision    The Foundation provided         300,000
                                      additional funding to an
                                      existing program in Kenya
                                      focused on integrated
                                      immunization and family
                                      planning.
    ------------------------------------------------------------------------
    March 2018       CARE            The Foundation provided       1,000,000
                                      additional funding to
                                      support work in Benin,
                                      where mortality of
                                      mothers and children is
                                      high. The project works
                                      in 20 public health
                                      clinics to increase the
                                      uptake of two live saving
                                      interventions, childhood
                                      vaccinations and family
                                      planning, through
                                      integration of the two
                                      services. The project
                                      addresses two main
                                      challenges at the same
                                      time: a weak healthcare
                                      system and sociocultural
                                      barriers in the
                                      community, which both
                                      need to be overcome for
                                      women and children to
                                      have access to quality
                                      health services.
    ------------------------------------------------------------------------
    March 2018       IRC             The Foundation provided       1,500,000
                                      additional funding to
                                      permit the IRC to expand
                                      their work with health
                                      partners in Ethiopia and
                                      Uganda to increase the
                                      use of immunization and
                                      family planning by
                                      reaching women with
                                      information and services
                                      at a critical time--the
                                      12 months following
                                      birth.
    ------------------------------------------------------------------------
    March 2018       Save the        The Foundation provided       1,000,000
                      Children        additional funding to an
                                      existing program in
                                      Malawi to advance
                                      integrated immunization
                                      and family planning
                                      program with Save the
                                      Children.
    ------------------------------------------------------------------------
    March 2018       World Vision    The Foundation provided       1,000,000
                                      funding for the second
                                      phase of this project,
                                      Increasing Use of Family
                                      Planning (FP) and
                                      Immunization Services in
                                      Kenya.
    ------------------------------------------------------------------------

                            DISASTER RELIEF RESPONSE
    ------------------------------------------------------------------------
        DATE BOARD
         APPROVED            PARTNER            DESCRIPTION         AMOUNT
    ------------------------------------------------------------------------
    April 2015         American Red Cross   Cyclone Pam              $10,000
    ------------------------------------------------------------------------
    June 2016          American Red Cross   West Virginia             25,000
                                             relief efforts
    ------------------------------------------------------------------------
    June 2016          American Red Cross   Ecuador Earthquake        75,000
    ------------------------------------------------------------------------
    June 2016          International        Ecuador Earthquake        75,000
                        Medical Corp.
    ------------------------------------------------------------------------
    Sept-Oct 2016      American Red Cross   West Virginia             25,000
                                             relief efforts
    ------------------------------------------------------------------------
    Sept-Oct 2016      American Red Cross   Ecuador Earthquake        75,000
    ------------------------------------------------------------------------
    Sept-Oct 2016      International        Ecuador Earthquake        75,000
                        Medical Corp.
    ------------------------------------------------------------------------
    Sept-Oct 2016      American Red Cross   Louisiana flooding        25,000
    ------------------------------------------------------------------------
    Sept-Oct 2016      Direct Relief        Louisiana flooding        25,000
                        International
    ------------------------------------------------------------------------
    Sept-Oct 2016      One SC Fund          Hurricane Matthew         50,000
                                             in SC
    ------------------------------------------------------------------------
    Sept-Oct 2016      Direct Relief        Hurricane Matthew         50,000
                        International        in the US
    ------------------------------------------------------------------------
    Sept-Oct 2016      Project Hope         Hurricane Matthew         50,000
                                             in Haiti
    ------------------------------------------------------------------------
    Sept-Oct 2016      World Vision         Hurricane Matthew         50,000
                                             in Haiti
    ------------------------------------------------------------------------
    Sept-Oct 2016      PSI                  Zika virus relief        100,000
                                             efforts
    ------------------------------------------------------------------------
    Sept-Oct 2016      The CDC Foundation   Zika virus relief        500,000
                                             efforts
    ------------------------------------------------------------------------
    Sept-Oct 2016      The CDC Foundation   Zika virus relief        500,000
                                             efforts
    ------------------------------------------------------------------------
    Sept-Oct 2016      PAHO Foundation      Zika virus relief      1,000,000
                                             efforts
    ------------------------------------------------------------------------
    Sept-Oct 2016      Florida State Dept   Zika virus relief      1,000,000
                        of Health            efforts
    ------------------------------------------------------------------------
    Sept-Oct 2016      Texas Dept of        Zika virus relief      1,000,000
                        Health               efforts
    ------------------------------------------------------------------------
    December 2016      American Red Cross   Louisiana flooding        25,000
    ------------------------------------------------------------------------
    December 2016      Pinebelt Foundation  Mississippi               25,000
                                             flooding
    ------------------------------------------------------------------------
    December 2016      American Red Cross   Peru and Colombia        100,000
                                             mudslide
    ------------------------------------------------------------------------
    December 2016      UNICEF               Peru and Colombia        100,000
                                             mudslide
    ------------------------------------------------------------------------
    Sept-Oct 2017      Americares           Hurricane Harvey--       125,000
                                             TX and LA
    ------------------------------------------------------------------------
    Sept-Oct 2017      World Vision         Hurricane Harvey--       125,000
                                             TX and LA
    ------------------------------------------------------------------------
    Sept-Oct 2017      American Red Cross   Hurricane Harvey--       250,000
                                             TX and LA
    ------------------------------------------------------------------------
    Sept-Oct 2017      One America Appeal   Hurricane Irma--TX       500,000
                                             and FL
    ------------------------------------------------------------------------
    Sept-Oct 2017      American Red Cross   Hurricane Irma--         400,000
                                             Puerto Rico/U.S.
                                             Virgin Islands
    ------------------------------------------------------------------------
    Sept-Oct 2017      IFRC                 Hurricane Irma--         100,000
                                             Caribbean
    ------------------------------------------------------------------------
    Sept-Oct 2017      American Red Cross   Hurricane Maria--        250,000
                                             Puerto Rico
    ------------------------------------------------------------------------
    Sept-Oct 2017      American Red Cross   Mexico Earthquake        250,000
    ------------------------------------------------------------------------
    Sept-Oct 2017      UNICEF               Mexico Earthquake        250,000
    ------------------------------------------------------------------------
    Sept-Oct 2018      American Red Cross   California                50,000
                                             Wildfires
    ------------------------------------------------------------------------
    Sept-Oct 2018      United Way of North  Hurricane Florence       100,000
                        Carolina
    ------------------------------------------------------------------------
    Sept-Oct 2018      Central Carolina     Hurricane Florence       100,000
                        Community
                        Foundation
    ------------------------------------------------------------------------
    Sept-Oct 2018      International        Hurricane Florence       200,000
                        Medical Corp.
    ------------------------------------------------------------------------
    Sept-Oct 2018      American Red Cross   Hurricane Florence       100,000
    ------------------------------------------------------------------------
    Sept-Oct 2018      International        Hurricane Michael        100,000
                        Medical Corp.
    ------------------------------------------------------------------------
    Sept-Oct 2018      Florida Disaster     Hurricane Michael        100,000
                        Fund
    ------------------------------------------------------------------------
    Sept-Oct 2018      Save the Children    Indonesia Tsunami        100,000
    ------------------------------------------------------------------------
    Sept-Oct 2018      Direct Relief        Indonesia Tsunami        100,000
                        International
    ------------------------------------------------------------------------
    Sept-Oct 2018      World Vision         Indonesia Tsunami        100,000
    ------------------------------------------------------------------------
    Sept-Oct 2018      Physicians for a     California               100,000
                        Healthy California   Wildfires
    ------------------------------------------------------------------------

                                     ______

                          UNITED STATES DISTRICT COURT

                        EASTERN DISTRICT OF PENNSYLVANIA

    PFIZER INC., Plaintiff,             Case No.
    v.                                  JURY TRIAL DEMANDED
    JOHNSON & JOHNSON and JANSSEN
    BIOTECH, INC., Defendants.

                                   COMPLAINT

        For its Complaint, plaintiff Pfizer Inc. (``Pfizer'') alleges
    against defendants Johnson & Johnson and Janssen Biotech, Inc.
    (collectively, ``J&J''), as follows:

                             PRELIMINARY STATEMENT

        1. It is accepted national policy to promote price competition
    among pharmaceutical manufacturers after an originator firm's patent
    protection has expired. This policy extends to biologics, a unique
    category of medications that are derived from living organisms. As one
    lawmaker put it when adopting applicable legislation, such competition
    ``is good for patient safety, consumer choice . . . and the healthcare
    system at large.'' This case is about J&J's efforts to suppress that
    competition and deprive society of those benefits by, among other
    things, imposing a web of exclusionary contracts on both health
    insurers and healthcare providers (e.g., hospitals and clinics) to
    maintain its stranglehold in respect of an important biologic, brand
    named Remicade, also known by its generic name, infliximab.

        2. For many patients suffering from chronic diseases such as
    rheumatoid arthritis, plaque psoriasis, and Crohn's disease, the best--
    and sometimes the only--option for treatment is infusion therapy with
    infliximab. As these conditions are chronic in nature, patients often
    require long-term treatment and multiple infusions per year.

        3. J&J owned patents protecting infliximab and has been amply
    rewarded for its invention: Between 1998 and 2016, Remicade was the
    only infliximab product on the market. This position allowed Remicade
    to become J&J's best-selling drug by far, generating about $4.8 billion
    in U.S. sales in 2016 alone. In fact, Remicade is among the best
    selling drugs in the world. For most uses, at list price Remicade sells
    for about $4,000 per infused dose and about $26,000 for a full year of
    treatment. When Pfizer introduced its competing biologic Inflectra
    (infliximab-dyyb) in 2016, J&J deployed improper exclusionary tactics
    to maintain the dominance of its flagship product.

        4. Inflectra received marketing approval under the Biologics Price
    Competition and Innovation Act (``BPCIA''). Congress recognized the
    growing importance of biologics, as well as the growing costs
    associated with them, and passed the BPCIA in 2010. The purpose of the
    BPCIA, as its name suggests, is to foster meaningful price competition
    for long-entrenched branded biologic products--with the ultimate goal
    of lowering healthcare costs. To facilitate price competition, the
    BPCIA provides an abbreviated FDA approval pathway for ``biosimilar''
    versions of branded biologic drugs. Biosimilars are products that the
    FDA has determined to have ``no clinically meaningful differences''
    from the already approved biologic (sometimes referred to as the
    ``reference listed drug'' or ``RLD'') in terms of safety, purity, and
    potency. Although the BPCIA was enacted in 2010, FDA procedures for
    implementing the Act did not become effective until a few years later,
    and biosimilars are only recently beginning to come onto the market,
    with the first biosimilar approval in 2015.

        5. On April 5, 2016, Inflectra received FDA approval as the first
    biosimilar to Remicade. Pfizer began shipping Inflectra in November
    2016 and set its initial list price, often referred to as the wholesale
    acquisition cost (or ``WAC''), at 15 percent below the then-current WAC
    of Remicade.\1\
    ---------------------------------------------------------------------------
        \1\ WAC is the manufacturer's published list price to wholesalers
    or direct purchasers, not including prompt pay or other discounts,
    rebates, or reductions in price.

        6. The threat from Inflectra did not go unnoticed by J&J. Within
    weeks of Inflectra's launch, J&J began to deploy what it publicly has
    termed its ``Biosimilar Readiness Plan.'' The core features of the plan
    are exclusionary contracts that foreclose Pfizer's access to an
    overwhelming share of consumers, coupled with anticompetitive bundling
    and coercive rebate policies designed to block both insurers from
    reimbursing, and hospitals and clinics from purchasing, Inflectra or
    ---------------------------------------------------------------------------
    other biosimilars of Remicade despite their lower pricing.

        7. J&J's actions with respect to Remicade exclude competition at
    multiple levels:

        8. Exclusive contracts with insurance company payers. Insurer
    decisions regarding reimbursement policies have a dramatic impact on
    which infliximab product will be stocked by healthcare providers such
    as hospitals and clinics. Because providers administer infliximab on
    site (it is an infusion product), they must use their own funds to
    stock the product, purchasing it for later use and relying upon
    subsequent reimbursement from insurers to recoup their expenses. Given
    the cost of biologic drugs generally, and Remicade in particular, there
    is almost no chance that providers will pay for a product that is not
    widely covered by insurers for fear of stocking a product that will not
    be reimbursed after the provider administers it to a patient, as even a
    single unreimbursed dose may cost the provider in excess of $4,000.

         Recognizing this, J&J has induced insurers to enter into
    contracts that require an explicit commitment not to cover Inflectra at
    all or to do so only in the rarest of circumstances--in effect, to make
    Remicade the only covered infliximab. As a direct result of these
    exclusive dealing contractual commitments, Inflectra is either not
    listed on the insurance company's medical policy--a published listing
    of the drugs approved for reimbursement under the insurer's medical
    benefit--or is designated reimbursable only in so-called ``fail first''
    cases. The ``fail first'' exception, which requires that Remicade has
    been tried by and failed with respect to a given patient before a
    biosimilar infliximab can be reimbursed, is medically inappropriate and
    illusory in practice. If Remicade, which is an infliximab product, does
    not work for a patient, a physician would turn to a non-infliximab
    drug, not to Inflectra, which also is an infliximab product and has no
    clinically meaningful differences from Remicade. The spurious nature of
    J&J's ``fail first'' restriction is illustrated by the fact that in
    early 2017, before J&J's contracts took hold, the major insurers listed
    Inflectra at parity with Remicade--indicating that they saw no medical
    reason to favor one over the other.

         J&J's ``fail first'' contractual restrictions therefore have the
    same practical effect as pure exclusive contracts: both operate to
    exclude Inflectra from qualifying for reimbursement under the insurers'
    plans; both prevent the insurer from freely reimbursing for Inflectra
    or another biosimilar without breaching the contracts; and both
    foreclose Inflectra from competing for patients covered by those plans.
    J&J has entered into such contracts with all or nearly all national
    health insurance companies. These ``biosimilar-exclusion'' contracts,
    on their own, have foreclosed Inflectra's ability to vie for at least
    70 percent of commercially insured patients in the United States,
    including a significant number of commercially insured patients who
    reside in the Philadelphia area. But the foreclosure effects of those
    insurer contracts go well beyond the immediate impact on patients
    covered by the affected plans, as discussed below.

        9. Exclusionary rebates and bundling arrangements with insurance
    company payers. A key to J&J's ability to coerce insurers into
    accepting its exclusionary commitments is its denial of rebates to
    insurers that decline J&J's exclusivity commitments, thereby imposing a
    substantial financial penalty. In effect, J&J says to insurers, ``If
    you want to receive attractive rebates on Remicade for all your
    existing Remicade patients''--rebates which, for some insurers, run
    into the tens of millions of dollars annually--``you must agree to not
    reimburse for Inflectra, or to do so in the most limited of
    circumstances.'' In short, insurers that decline J&J's offer face a
    substantial financial penalty, and those that accept receive a payoff
    (multimillion dollar rebate payments) in return for their commitment to
    exclude biosimilars.

         J&J's threatened financial penalty is effective because there is
    a substantial base of patients across the country who are already
    controlling their diseases with Remicade and thus are unlikely to
    switch to a lower-priced biosimilar once available. Although
    biosimilars have no clinically meaningful differences in safety,
    purity, and potency from the biologic originator, they are not
    substitutable without the prescriber's approval (unlike generics for
    non-biologic drugs approved under the Hatch-Waxman structure, which are
    substitutable without a new prescription). And, although the FDA's
    approval permits physicians to switch from the originator to the
    biosimilar, and Pfizer believes they should consider doing so in
    appropriate circumstances, as a practical matter, existing-patient
    Remicade demand is economically incontestable, that is, not a realistic
    candidate for biosimilar firms to compete for. As the head of J&J's
    pharmaceuticals business told investors, ``the 70 percent of patients
    who are [already] stable on Remicade are highly unlikely to switch.''
    \2\ J&J bundles this economically ``incontestable'' demand for Remicade
    with the portion of demand that is ``contestable'' for biosimilar
    firms-- new patients starting therapy with infliximab--by threatening
    to deny rebates on all Remicade prescriptions if any infliximab
    biosimilar prescriptions are reimbursed, effectively meaning insurers
    would have to forfeit their rebates and pay J&J's ever increasing price
    for the incontestable patients.
    ---------------------------------------------------------------------------
        \2\ Johnson & Johnson, Q3 2016 Results Earnings Call Transcript
    (Oct. 14, 2016), available at https://seekingalpha.com/search/
    transcripts?term=johnson+%26+Johnson+biosimilar.

         J&J also bundles rebates on multiple different products, such
    that insurers that refuse to grant exclusivity to Remicade would be
    forced to pay higher prices and/or forego enhanced portfolio rebates.
    The net effect of these anticompetitive bundling practices is that the
    insurers subject to them have no real choice but to agree to J&J's
    exclusivity conditions. Insurers have made it clear to Pfizerthat its
    net cost for Inflectrawould need to be low enough to offset the loss of
    J&J rebates. Pfizer and other biosimilar firms cannot feasibly make up
    the difference for the J&J rebates (on the existing Remicade patient
    base) that insurers would lose if they declined J&J's conditions.
    Insurers have stated a desire to support biosimilars--and the lower
    per-unit prices they bring--but realistically cannot do so without
    incurring a substantial financial penalty imposed by J&J and thus
    potentially placing themselves at a disadvantage relative to insurers
    ---------------------------------------------------------------------------
    accepting J&J's rebates.

        10. J&J-engineered coverage restrictions impact provider purchasing
    behavior and thus magnify foreclosure. The foreclosure created by J&J's
    exclusionary insurer-level contracts goes well beyond the patients
    covered by these health insurers: Inflectra's coverage status has a
    spillover effect on the purchasing decisions of healthcare providers
    (as noted, the clinics, hospitals, and other institutions that purchase
    and administer infliximab) as well as the prescribing decisions of
    physicians affiliatedtherewith. Given the widespread gaps in
    Inflectra's insurance coverage--engineered by J&J--providers have
    overwhelmingly chosen to stock only Remicade (which is essentially
    universally covered given its long tenure and dominant position) rather
    than deal with the risk of possible denials of coverage for Inflectra.
    Thus, providers have declined to purchase Inflectra across the board,
    even for patients covered by insurance plans that do cover the product.
    To take one example, even though Inflectra is covered by Medicare and
    other government programs, providers have been unwilling to stock
    Inflectra even for potential use with such government-insured patients.
    As a result, not only is the federal government forced to continue
    reimbursing for Remicade, the more expensive product, but the effective
    foreclosure of biosimilars is expanded well beyond the 70 percent of
    commercially insured patients directly foreclosed by J&J's insurer
    contracts. Indeed, as of September 1, 2017, about 90 percent of
    healthcare provider accounts using infliximab had purchased no
    Inflectra at all. J&J has stoked providers' reluctance to purchase
    Inflectra by touting with providers the very lack of coverage for
    Inflectra created by J&J's own exclusionary contracts.

        11. Exclusionary rebates and bundling arrangements with healthcare
    providers. Beyond the spillover impact described above, J&J has also
    extended its practices of multi-product bundling and bundling of
    contestable and incontestable demand in contracts with healthcare
    providers.

        12. J&J's exclusionary plan has been remarkably effective at
    stifling competition: Today, almost no national commercial health
    insurer provides coverage for Inflectra (except under the spurious
    ``fail first'' scenario), and the vast bulk of healthcare provider
    accounts using infliximab (approximately 90 percent) have not purchased
    Inflectra at all. Despite some coverage by regional and government
    plans, Inflectra has secured less than 4 percent of total infliximab
    unit sales in the U.S. as of September 1, 2017.

        13. The harm to Pfizer and to competition as a whole--and,
    ultimately, to consumers, businesses, and the U.S. government, who bear
    the brunt of rising healthcare costs nationwide--is manifest. In
    response to a new entrant offering lower prices for a product deemed to
    have ``no clinically meaningful differences'' from the incumbent's
    brand, basic economics would predict that market-wide prices would
    fall. Instead, the opposite has occurred. Since the time the FDA
    approved Inflectra and J&J implemented its publicly-stated plan to
    block biosimilars like Inflectra, J&J has raised the list price of
    Remicade by close to 9 percent and increased the amount the U.S.
    government reimburses for Remicade by more than $190 per infused dose.
    J&J's list price increases are not overcome by increased rebates and
    discounts: Remicade's ``average selling price'' (``ASP'')--which by
    federal law is an average of a drug's pricing after taking into account
    discounts, rebates, and other price concessions--actually has increased
    since Inflectra's entry. As of September 2017, Remicade's ASP was more
    than 10 percent higher than Inflectra's ASP. Pfizer has offered to
    guarantee clients that Inflectra would be less expensive unit-for-unit
    than Remicade during a contract term. Despite Inflectra's lower per-
    unit prices, and J&J's escalating prices, Remicade has not lost any
    substantial volume or share of sales to Inflectra, even though FDA
    determined there to be no clinically meaningful differences between the
    two products.

        14. In July, J&J extolled the success of its scheme, noting that it
    had not ``seen much of an impact'' from Inflectra's entrance, and that
    J&J is ``especially well-
    prepared to manage through the Remicade biosimilars.'' \3\ J&J also
    said it was confident that it could fend off even subsequent biosimilar
    entrants this year because of its exclusionary contracts: ``[W]e have
    our contracting in place with all the managed care organizations [e.g.,
    health insurers].'' \4\ The net result is that patients (along with
    healthcare providers and the U.S. Government) have fewer choices and
    pay more than they should.
    ---------------------------------------------------------------------------
        \3\ Johnson & Johnson, Q2 2017 Results Earnings Call Transcript
    (July 18, 2017), available at https://seekingalpha.com/search/
    transcripts?term=johnson+$26+Johnson+biosimilar.
        \4\ Id.

        15. Major stakeholders at every level of the healthcare marketplace
    ---------------------------------------------------------------------------
    are suffering as a result of J&J's competition-reducing actions:

          Most importantly, consumers suffer in the form of artificially
    inflated prices (including higher coinsurance payments, insurance
    premiums, and taxes), as well as reduced choice.

          Government programs, including Medicare--and ultimately
    taxpayers--suffer by having to pay artificially higher prices for the
    vast majority of their infliximab utilization.

          Pfizer, of course, suffers loss of sales, investment, and
    reputation as a result of J&J's success in securing commitments to
    disadvantage Inflectra.

        16. Pfizer brings this action under the antitrust laws of the
    United States to challenge J&J's anticompetitive conduct. If J&J's
    conduct is allowed to continue, its ``Biosimilar Readiness Plan'' will
    become the playbook for biologic originator firms seeking to preserve
    their dominance in the face of biosimilar competition--thus subverting
    the competition-enhancing objectives of the BPCIA.

        17. Allegations relating to Pfizer's conduct are based on personal
    knowledge; other allegations are based on Pfizer's research, publicly
    available sources, feedback from customers, and information and belief.

                                  THE PARTIES

        18. Plaintiff Pfizer is a corporation organized and existing under
    the laws of Delaware. Pfizer's principal place of business in the
    United States is located at 235 East 42nd Street, New York, New York
    10017. Pfizer is a research-based international pharmaceutical company
    which researches, develops, manufactures, and sells pharmaceutical
    products across the spectrum, from branded innovator products to
    generics and over-the-counter medications. Pfizer is also committed to
    developing biosimilar medications to bring competition, lower prices,
    and choice to patients.

        19. Pfizer has commercialized Inflectra, a biosimilar to J&J's
    Remicade, through its partnership with Celltrion, the holder of the
    drug product's Biologics License Application. The FDA approved
    Inflectraas a biosimilar to Remicade on April 5, 2016.

        20. Defendant Johnson & Johnson is a corporation organized and
    existing under the laws of New Jersey. Johnson & Johnson's principal
    place of business in the United States is located at One J&J Plaza, New
    Brunswick, New Jersey 08933. Johnson & Johnson is an international
    pharmaceutical company--one of the largest in the world--and was the
    sole supplier of infliximab, marketed as Remicade, between 1998 and
    2016, when Inflectra came to market.

        21. Defendant Janssen Biotech, Inc. (``Janssen'') is a wholly owned
    subsidiary of Johnson & Johnson. Janssen is a corporation organized and
    existing under the laws of Pennsylvania. Janssen's corporate
    headquarters are located at 800 Ridgeview Drive, Horsham, Pennsylvania
    19044. Janssen co-owns or has licenses to the Remicade patents and
    performs the marketing for Remicade in the United States.

                  JURISDICTION, VENUE, AND INTERSTATE COMMERCE

        22. This action arises under the antitrust laws of the United
    States, including Section 1 of the Sherman Act, 15 U.S.C. Sec. 1,
    Section 2 of the Sherman Act, 15 U.S.C. Sec. 2, Section 3 of the
    Clayton Act, 15 U.S.C. Sec. 14, and Sections 4 and 16 of the Clayton
    Act, 15 U.S.C. Sec. Sec. 15 and 26.

        23. Subject matter jurisdiction is founded on 28 U.S.C.
    Sec. Sec. 1331 and 1337(a).

        24. Johnson & Johnson may be found, transacts business, and is
    subject to personal jurisdiction in this judicial district.

        25. Janssen maybe found, transacts business, and is subject to
    personal jurisdiction in this judicial district.

        26. The violations of law alleged in this Complaint took place, in
    part, in this judicial district and have injured Pfizer in this
    district. Venue is therefore appropriate in the Eastern District of
    Pennsylvania under Section 12 of the Clayton Act, 15 U.S.C. Sec. 22,
    and under 28 U.S.C. Sec. Sec. 1391(b) and (c).

        27. The creation, marketing, sale, and distribution of Remicade and
    Inflectra, and the actions complained of in this Complaint, occur in
    and substantially affect interstate commerce.

                       FACTUAL AND REGULATORY BACKGROUND

              A. Biologics

        28. Biologics are treatments derived from living systems such as
    microorganisms or plant or animal cells. As the FDA explains:
    ``Biological products include a wide range of products such as
    vaccines, blood and blood components, allergenics, somatic cells, gene
    therapy, tissues, and recombinant therapeutic proteins. Biologics can
    be composed of sugars, proteins, or nucleic acids or complex
    combinations of these substances, or maybe living entities such as
    cells and tissues. Biologics are isolated from a variety of natural
    sources--human, animal, or microorganism--and may be produced by
    biotechnology methods and other cutting-edge technologies. Gene-based
    and cellular biologics, for example, often are at the forefront of
    biomedical research, and may be used to treat a variety of medical
    conditions for which no other treatments are available.'' \5\ In
    contrast to most drugs, which are chemically synthesized and whose
    structure is known, most biologics are complex mixtures that are not
    easily identified or characterized.\6\
    ---------------------------------------------------------------------------
        \5\ See U.S. Food & Drug Administration, What Are ``Biologics''
    Questions and Answers, https://www.fda.gov/aboutfda/centersoffices/
    officeofmedicalproductsandtobacco/cber/ucm133077.htm (last visited
    Sept. 18, 2017).
        \6\ Id.

              B.  Congress Enacts the Biologics Price Competition and
    ---------------------------------------------------------------------------
    Innovation Act to Spur Price Competition for Biologic Medications

        29. Congress has made clear that competition in pharmaceuticals is
    to be encouraged, and, to that end, in 1984 enacted the Hatch-Waxman
    Act (``Hatch-Waxman''), which established an abbreviated pathway for
    approval of generic counterparts to non-biologic branded drug products.
    Before Hatch-Waxman, a generic applicant had to conduct the same kinds
    of safety and efficacy studies (including large clinical trials and the
    like) as the originating drug manufacturer. Such a process, which can
    cost hundreds of millions of dollars and take years to complete, was
    prohibitive for would-be generic entrants and led to the near absence
    of generic competition to branded drug products. Hatch-Waxman
    eliminated this hurdle; it allowed generic firms to rely upon the
    originator's safety and efficacy studies. Generic applicants need only
    show that their products use the same active pharmaceutical ingredient
    as the originator, and that their products are bioequivalent (e.g.,
    that the generic product's uptake into the body is equivalent to the
    branded drug). A principal goal of Hatch-Waxman was to trigger price
    competition with originator products, many of which had enjoyed
    longstanding exclusivity. That goal has been achieved: According to the
    FDA, the competition spurred by Hatch-Waxman has saved more than $1.6
    trillion for patients and the healthcare system.\7\
    ---------------------------------------------------------------------------
        \7\ See Kathleen ``Cook'' Uhl, 2016: A Record-Setting Year for
    Generic Drugs, U.S. Food & Drug Administration (Feb. 24, 2017),
    available at https://blogs.fda.gov/fdavoice/index.php/2017/02/2016-a-
    record-setting-year-for-generic-drugs/ (noting that ``2016 was a
    record-setting year for FDA's generic drug program,'' and that ``[o]ver
    the last 10 years, generic drugs have saved the U.S. healthcare system
    about $1.68 trillion'').

        30. However, for a number of reasons, biologic products generally
    are not covered by the Hatch-Waxman procedures. Nevertheless, given the
    success of Hatch-
    Waxman in spurring competition for non-biologic medicines, Congress and
    nearly all stakeholders in the healthcare system have recognized the
    great desirability of having an analogous system for biologics.\8\
    ---------------------------------------------------------------------------
        \8\ See U.S. Food & Drug Administration, Implementation of the
    Biologics Price Competition and Innovation Act of 2009 (Feb. 12, 2016),
    available at https://www.fda.gov/drugs/
    guidancecomplianceregulatoryinformation/ucm215089.htm (``The goal of
    the BPCI Act is similar, in concept, to that of the Drug Price
    Competition and Patent Term Restoration Act of 1984 (a.k.a. the `Hatch-
    Waxman Act') which created abbreviated pathways for the approval of
    drug products under Federal Food, Drug, and Cosmetic Act (FFD&C
    Act).'').

        31. In 2009, Congress addressed the need for competition in the
    biologics marketplace by introducing the BPCIA, which was signed into
    law in 2010. The Act furthers the ``FDA's longstanding policy of
    permitting appropriate reliance on what is already known about a drug,
    thereby saving time and resources and avoiding unnecessary duplication
    of . . . testing.'' \9\
    ---------------------------------------------------------------------------
        \9\ U.S. Food & Drug Administration, Implementation of the
    Biologics Competition and Innovation Act of 2009, https://www.fda.gov/
    Drugs/GuidanceComplianceRegulatoryInformation/ucm215089.htm (last
    visited Sept. 18, 2017).

        32. A principal purpose of the Act--as reflected in its very name
    (i.e., the Biologics Price Competition and Innovation Act)--was to spur
    ---------------------------------------------------------------------------
    price competition in biologic drug products:

              ``We have to find a way to introduce competition into [the
            biosimilar] market,'' including balancing ``giving incentives
            for development of new products but bringing about the benefits
            of competition in the marketplace.'' (Hon. Henry Waxman, United
            States Representative from California)

              ``Legislation to facilitate the development of biosimilars
            should promote competition and lower prices[.]'' (Hon. Anna G.
            Eshoo, United States Representative from California)

              ``We want to foster a robust biosimilar market.'' (Hon. Joe
            Barton, United States Representative from Texas)

              ``[C]ompetition [from biosimilars] is good for patient
            safety, consumer choice, and drive[s] savings for consumers and
            the healthcare system at large.'' (Hon. Gene Green, United
            States Representative from Texas)

        33. The BPCIA provides an abbreviated regulatory approval pathway
    for the introduction of biosimilars. A biosimilar applicant may rely on
    the clinical studies of the reference listed drug if it can show: (a)
    that the proposed biosimilar is ``highly similar to the [originator
    product, or RLD] notwithstanding minor differences in clinically
    inactive components''; and (b) that ``there are no clinically
    meaningful differences between the [proposed biosimilar] and the [RLD]
    in terms of safety, purity, and potency'' (42 U.S.C. Sec. 262(i)(2)).

        34. Although biosimilars have no clinically meaningful differences
    in safety, purity, and potency from the RLD, they are not automatically
    substitutable with the RLD (unlike Hatch-Waxman generics). Thus, if a
    doctor prescribes the RLD, a pharmacist cannot substitute a biosimilar
    unless that product has been designated as interchangeable by FDA and
    the relevant state law permits substitution of interchangeable
    biologics.\10\ This allows originator firms to retain the bulk of their
    existing patient bases, which typically is not possible for a branded
    firm to do when a Hatch-Waxman generic enters (because state
    substitution laws permit prescriptions for the brand to be
    automatically substituted with the Hatch-Waxman generic by the
    pharmacist without the need for physician intervention). This
    difference enables biologic originator firms to leverage their
    monopolies over existing patients to extract anticompetitive
    commitments from insurers and providers.
    ---------------------------------------------------------------------------
        \10\ The BPCIA does provide for an ``interchangeable'' designation,
    but FDA published draft guidelines for establishing interchangeability
    only this year. U.S. Food and Drug Administration, Considerations in
    Demonstrating Interchangeability With a Reference Product (Draft
    Guidance) (Jan. 17, 2017). And while Pfizer believes that Inflectra can
    be safely and effectively substituted for Remicade (indeed, studies
    have shown that switching patients can be done safely and effectively,
    and Pfizer has supported and/or taken part in some of these studies),
    it will be years before Inflectra or any other biologic receives a
    formal ``interchangeability'' designation from FDA in the United
    States. Nonetheless, neither the BPCIA nor FDA contemplates that
    biosimilars should be prevented from competing in themarketplace--i.e.,
    that consumers should be denied access to them--until they are
    designated interchangeable.

    ---------------------------------------------------------------------------
              C. Infliximab

        35. Infliximab is a tumor necrosis factor (``TNF'')-inhibiting
    biologic drug used to treat a range of immune-mediated diseases,
    including Crohn's disease, ulcerative colitis, rheumatoid arthritis,
    psoriatic arthritis, ankylosingspondylitis, and plaque psoriasis.

        36. As a biologic, infliximab is not synthesized in a laboratory,
    but rather derived from a living organism. Infliximab is a chimeric
    IgG1k monoclonal antibody (composed of human constant and murine
    variable regions) specific for human tumor necrosis factor-alpha.
    Infliximab is produced by a recombinant cell line cultured by
    continuous perfusion and is purified by a series of steps that includes
    measures to inactivate and remove viruses.

        37. Infliximab is an infusion therapy, meaning it is administered
    intravenously. Thus, infliximab patients must (in most cases) visit
    clinics, hospitals, or other medical facilities to receive the therapy
    from healthcare professionals. As a result, patients rarely purchase
    infliximab themselves at retail pharmacies. Instead, infusion centers,
    clinics, and hospitals purchase infliximab, and after administration,
    seek reimbursement from the patient's insurer or a government payer
    (e.g., Medicare). Infliximab is an important medicine that has provided
    life-changing benefits to millions of patients.

              D. J&J's Remicade

        38. J&J introduced the first infliximab product in the United
    States in 1998, under the brand name Remicade.

        39. Remicade is widely used: An estimated 475,000 patients in the
    U.S. receive at least one dose of Remicade annually. This fact,
    combined with the cost (approximately $4,000 per infused dose at list
    price), makes administering Remicade a major expense item for insurers
    and healthcare providers.

        40. J&J's list price increases for Remicade and other pricing
    actions have resulted in consistent increases in Remicade's ASP. J&J
    has increased the price of Remicade without experiencing a loss of
    sales to other therapies. Instead, Remicade sales have increased
    steadily since it was introduced. Indeed, J&J has been able to continue
    raising the price of Remicade notwithstanding the arrival of Inflectra.

        41. Since 1998, J&J has made billions of dollars in profit on
    Remicade.

              E. Pfizer's Inflectra

        42. Beginning in 2008, Celltrion undertook to develop a biosimilar
    to Remicade and move it through the intensive FDA review process. The
    Biologics License Application for Inflectra was filed with FDA in 2014.
    After rigorous scientific review, FDA approved infliximab-dyybon April
    5, 2016. In the FDA news release announcing its approval of Inflectra,
    the director of FDA's Center for Drug Evaluation and Research
    reiterated that approval as a biosimilar reflects a determination of
    ``no clinically meaningful differences'' from the originator, and
    stated that ``[p]atients and the health care community can be confident
    that biosimilar products are high quality and meet the agency's
    rigorous scientific standards.'' \11\
    ---------------------------------------------------------------------------
        \11\ See U.S. Food and Drug Administration, FDA Approves Inflectra,
    A Biosimilar to Remicade (Apr. 5, 2016), https://www.fda.gov/
    newsevents/newsroom/pressannouncements/ucm494227.
    htm.

        43. J&J claimed patent protection over Remicade--as noted, making
    it the sole provider of infliximab for nearly two decades--and thus
    Pfizer and Celltrion were forced to defend against J&J's patent suit in
    parallel with FDA's regulatory review of the Inflectra application. On
    August 17, 2016, J&J's patent covering the infliximab antibody was
    ruled invalid by the United States District Court for the District of
    Massachusetts, a ruling which confirmed that J&J had no valid right to
    exclude Pfizer (or other potential biosimilar entrants). The Court held
    that the antibodies covered by J&J's Remicade patent had been disclosed
    and claimed in an earlier patent.\12\ Just a few months after the
    district court ruling, the U.S. Patent and Trademark Office issued a
    final decision in a re-examination of the same patent, holding that the
    patent was invalid.\13\
    ---------------------------------------------------------------------------
        \12\ Janelle Lawrence, J&J Remicade Patent Found Invalid in U.S.
    Victory for Pfizer, Bloomberg (Aug. 17, 2016), https://
    www.bloomberg.com/news/articles/2016-08-17/j-j-patent-on-remicade-
    expiring-in-2018-invalid-judge-rules.
        \13\ Id.

        44. After overcoming these hurdles, and after a 180-day notice
    period required by the BPCIA, Pfizer began selling Inflectra in
    ---------------------------------------------------------------------------
    November 2016.

        45. Inflectra is approved for all the same indications as Remicade,
    except pediatric ulcerative colitis, as to which J&J continues to enjoy
    an FDA-granted period of exclusivity because of the indication's status
    as an ``orphan'' indication (established on proof that the number of
    people affected by the disease or condition for which the drug is to be
    developed is fewer than 200,000 persons), which is scheduled to end in
    2018. On that date, Inflectra will be eligible to seek approval for
    pediatric ulcerative colitis. In any event, this indication accounted
    for less than 5 percent of overall infliximab utilization in 2016.

        46. Pfizer introduced Inflectra with a list price 15 percent lower
    than Remicade's, and, in negotiations with insurers and providers,
    offered substantial additional pricing concessions in the form of
    discounts and/or rebates that in some instances were more than 40
    percent below Inflectra's list price. The goal and effect was to offer
    Inflectra for less than J&J was offering Remicade; indeed, for many
    customers, Pfizer committed to ensure that Inflectra would have a lower
    net per-unit price than Remicade.

        47. Given that it was charging a lower price for Inflectra than J&J
    was charging for Remicade, Pfizer was optimistic that it would have an
    opportunity to compete, to secure a reasonable share of the business,
    particularly for new patients, and to bring the benefits of price
    competition to consumers, providers, insurers, and the U.S. government.
    However, due to J&J's exclusionary conduct, competition has been
    foreclosed. J&J maintains its monopoly and has continued to capture
    over 96 percent of infliximab sales even while maintaining prices far
    above competitive levels.

              F.  The Importance of Insurance Coverage for Infliximab

        48. Most patients who are prescribed Remicade have some form of
    insurance coverage or qualify for patient assistance. The sources of
    insurance coverage are (a) private insurance, accounting for about 60
    percent of patients nationally, and (b) government insurance programs
    (principally Medicare and Medicaid), accounting for the remaining 40
    percent. Insurance coverage and reimbursement are therefore key to the
    adoption of the product by patients and healthcare providers alike. If
    a product as expensive as Remicade is not widely reimbursed, it will
    not be significantly utilized.

        49. Because Remicade is not dispensed in a retail pharmacy but
    rather administered intravenously in a clinic or other institutional
    setting, it generally is not included under the ``pharmacy benefit'' of
    most health plans. In the pharmacy benefit setting, physicians
    prescribe a drug and the patient procures the medication him or herself
    at the pharmacy, paying for it with a combination of insurance coverage
    (either private or government-sponsored) and out-of-pocket payment
    (usually, a co-pay). In the pharmacy benefit context, neither the
    prescribing physician nor the institution with which the physician is
    affiliated bears financial risk with respect to the drug selected,
    i.e., the drug is not purchased and stocked in advance by providers at
    their own cost. The pharmacy buys the drug, dispenses it, and is
    reimbursed.

        50. In contrast, ``medical benefit'' products such as Remicade are
    administered at a clinic or other healthcare provider site, and the
    provider itself first purchases the drug product for use in the
    infusion treatment of patients, and then later seeks reimbursement for
    the drug from a third party payer (a practice commonly referred to as
    ``buy and bill''). When a treatment is administered, the provider must
    secure payment for the service, including the cost of the product
    dispensed (which the provider had to pay up front with its own funds).
    In this context, the provider has a strong interest in utilizing drugs
    that are widely covered by insurance, particularly by the major
    national commercial health insurers and significant regional insurers
    active in its area. If a drug product is not widely covered, such that
    there is a risk that coverage might be denied, and providers thus would
    be burdened with a potential financial loss for what they paid for the
    product, providers are much less likely to purchase that product--a
    response that is in line with the providers' economic interests (to be
    reimbursed).

        51. Many of the facilities administering infusion services of the
    type at issue here are physician-owned. Thus, the physicians themselves
    have both prescribing authority and a strong financial incentive to
    avoid products that are not widely covered.

        52. Commercial insurers typically publish medical policies
    enumerating the drug products they will cover under the medical benefit
    and the terms under which they will do so. For example, medical
    policies may exclude drugs from coverage, or they may dictate
    restrictions on use. Drug manufacturers compete, usually with rebates
    or other price concessions, to obtain coverage under insurer medical
    policies and to have either fewer restrictions on reimbursement than
    their competitors--or, at a minimum, to achieve ``parity'' whereby the
    competing products have the same restrictions on reimbursement and the
    patient and/or doctor can choose between them. Securing at least parity
    placement is critical, especially for new products seeking to gain
    traction in the marketplace, and particularly with large insurers,
    which have tens of millions of covered patients.

              G. The Importance of Access at the Provider Level

        53. As discussed above, providers (hospitals, clinics, etc.) are
    the market actors that actually purchase infliximab for use with their
    infusion services for patients. J&J's agreements and conduct have the
    effect of foreclosing this essential source of distribution.

        54. Providers do not want to risk being unable to secure
    reimbursement for any drug used to treat a patient after having already
    paid for the product. Because it can be costly to monitor coverage
    status across myriad insurers and implement procedures to match product
    use to a patient's coverage, gaps in reimbursement policies give ``buy
    and bill'' provider accounts reasons to stock only products with
    universal (or near-universal) coverage. Here, due to J&J's
    anticompetitive contracts at the insurer level, J&J has succeeded in
    preventing biosimilar competitors from achieving the same status.

                           J&J'S EXCLUSIONARY SCHEME

        55. Not content with its nearly 2 full decades of exclusivity with
    Remicade, and the billions of dollars of profits that such exclusivity
    enabled, J&J hatched a multifaceted scheme to ensure that biosimilars
    would never become viable competitors--a scheme embodied, at least in
    part, in its ``Biosimilar Readiness Plan.'' J&J revealed the existence
    of the plan, and at least some specifics thereof, during a recent
    investor call and presentation.\14\ And a J&J consultant bragged at a
    recent health conference that his firm helped design the plan to
    realize J&J's goal of ensuring that biosimilars never gain a foothold.
    ---------------------------------------------------------------------------
        \14\ Johnson & Johnson, Q3 2016 Results Earnings Call Transcript
    (Oct. 14, 2016), available at https://seekingalpha.com/search/
    transcripts?term=johnson+%26+Johnson+biosimilar.

        56. J&J's conduct has not gone unnoticed in the industry. For
    example, an analyst at a prominent securities firm (Bernstein Research)
    recently summarized key aspects of J&J's scheme, observing that J&J
    has: (a) ``negotiated with [insurers]'' and set up ``exclusive
    contracts . . . in nearly half the market,'' thereby making providers
    unwilling to purchase Inflectra; (b) ``offered up deeper discounts to
    large independent infusion centers [i.e., major providers], which are
    more economically sensitive''; and (c) ``bundled several drugs and
    medical devices [together] for larger hospitals.'' \15\ The analyst
    also noted that a key to J&J's strategy was the ``long `tail' of
    [patients] remaining on the brand'' \16\--the incontestable demand--
    which gives J&J leverage to extract commitments from insurers not to
    cover Inflectra.\17\ Another industry observer, commenting on the
    Bernstein survey, noted that J&J's ``fail first'' requirements with
    insurers ``force hospitals and clinics to buy Remicade.'' The observer
    also noted that:
    ---------------------------------------------------------------------------
        \15\ Aaron Gal, Biosimilars: So, Why Has Remicade Biosimilar Not
    Gotten Much Traction in the U.S., Bernstein Research, at 1 (July 20,
    2017).
        \16\ Id.
        \17\  While the Bernstein survey suggests that Pfizer has offered
    only a `` `low single digit' discount off of the ASP'' of Inflectra,
    that is not accurate. As set forth herein, Pfizer has offered Inflectra
    at a significantdiscount (to list price as well as ASP), but continues
    to be foreclosed by J&J's anticompetitive contracts. J&J, meanwhile,
    has raised the price of Remicade since Inflectra's entry. The Bernstein
    survey also speculates that with the entry of a third biosimilar in
    mid-2019, ``we would likely [sic] see one of the biosimilars crossing
    the Rubicon and offering the required discounts.'' Gal, supra note 15,
    at 1. However, as set forth herein, J&J's exclusive contracts and
    bundling practices foreclose all new biosimilar entrants, including
    Pfizer, from competing with Remicade on price and, if not stopped, will
    allow J&J to continue to maintain the monopoly power it currently
    exercises with Remicade.

            J&J has had yet another advantage--an ability and willingness
            to bundle different medicines as part of a package deal. By
            offering discounts and rebates for several drugs, J&J can
            secure contracts and crowd out rivals. And discounts are also
            appealing to physicians who run their own infusion centers.\18\
    ---------------------------------------------------------------------------
        \18\ Ed Silverman, J&J Now Has Two Competitors for A Pricey
    Blockbuster. Will That Finally Drive Down Prices?, Stat News (July 25,
    2017), https://www.statnews.com/pharmalot/2017/07/25/merck-samsung-
    biosimilar-pfizer-johnson/.

    ---------------------------------------------------------------------------
        57. J&J's scheme is set forth in more detail below:

              A.  J&J Bars Access to Insurer Reimbursement Through Improper
    Exclusive Contracts and Anticompetitive Bundling Practices

                    1.  J&J's Exclusive Contracts with Health Insurers

        58. A centerpiece of J&J's strategy to block competition from
    biosimilars has been to secure contractual commitments from commercial
    insurance companies to exclude biosimilars from coverage under their
    plans, making Remicade the exclusive infliximab available to patients
    covered by those plans. Such contractual commitments have taken various
    forms. Some insurers have entered into contracts with J&J that required
    them simply to exclude biosimilars from their medical policies and/or
    drug formularies altogether. Other J&J contracts have imposed a
    spurious requirement that the biosimilar could be reimbursed only after
    a patient first tried and failed on Remicade (the ``fail first''
    requirement), which virtually ensures that the biosimilar will never be
    prescribed and never be reimbursed. If a patient fails on Remicade, it
    would defy sound medical judgment for a physician to switch to the
    therapeutically equivalent biosimilar, which works in exactly the same
    way, rather than another therapy, to which a patient may potentially
    respond differently.\19\ Regardless of their specific form, these
    contracts all had the same effect--to exclude biosimilars from coverage
    and (as one analyst recently confirmed) grant an ``exclusive'' to
    Remicade.\20\
    ---------------------------------------------------------------------------
        \19\ The notion that attempting treatment with a biosimilar after
    its reference listed drug has first failed would defy medical judgment
    recently has been reinforced in the European League Against Rheumatism
    rheumatoid arthritis management recommendations. In those
    recommendations, ``[t]he Task Force reiterated its position that if a
    TNF-inhibitor fails, another TNF-inhibitor--but not a biosimilar of the
    same molecule!--can be as effective as changing the mode of action.''
    Smolen, J.S., et al., EULAR Recommendations for the Management of
    Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying
    Antirheumatic Drugs: 2016 Update, Annals of the Rheumatic Diseases
    2017:0:1-18 (Mar. 6, 2017).
        \20\ Gal, supra note 15, at 1.

        59. J&J has induced most major health insurers, covering at least
    70 percent of commercially insured patients in the United States, to
    adopt these improper contractual exclusivity restrictions and to impose
    outright bans on Inflectra's coverage or so-called ``fail first''
    requirements. These insurers include (in decreasing order of patients
    ---------------------------------------------------------------------------
    covered):

        National insurers:

        (a)  UnitedHealthcare: UnitedHealthcare adopted the ``fail first''
    requirement. United Healthcare has approximately 30.6 million covered
    commercial medical patients across all 50 states.

        (b)  Anthem: Anthem excluded Inflectra from coverage altogether.
    Anthem has approximately 30.4 million covered commercial medical
    patients concentrated in 14 states.

        (c)  Aetna: Aetna adopted a complex set of indication specific
    conditions which operate in practice as ``fail first'' requirements.
    Aetna has approximately 17.9 million covered commercial medical
    patients in all or nearly all states and territories in the United
    States.

        (d)  Cigna: Cigna adopted the ``fail first'' requirement. Cigna has
    approximately 13 million covered commercial medical patients across all
    50 states.

        Regional insurers:

        (a)  HealthNet (Centene): HealthNet adopted a complex set of
    indication specific conditions which operate in practice as ``fail
    first'' requirements. HealthNet (as part of its acquisition by Centene)
    has approximately 12 million covered commercial medical patients
    concentrated in 28 states.

        (b)  CareFirst/Blue Cross Blue Shield: CareFirst adopted the ``fail
    first'' requirement. Indeed, CareFirst agreed with J&J that Inflectra
    would be non-preferred, meaning it cannot be reimbursed unless there
    are ``clinical circumstances that would exclude the use of . . .
    preferred products,'' including Remicade. CareFirst has approximately
    3.2 million covered commercial medical patients principally found in
    Maryland, Virginia, and the District of Columbia.

        (c)  Blue Cross Blue Shield of North Carolina: BCBS of North
    Carolina adopted the ``fail first'' requirement. BCBS of North Carolina
    has approximately 2.7 million covered commercial medical patients
    concentrated in North Carolina.

        (d)  Blue Cross Blue Shield of Tennessee: BCBS of Tennessee adopted
    the ``fail first'' requirement. BCBS of Tennessee has approximately 1.6
    million covered commercial medical patients concentrated in Tennessee.

        (e)  Blue Cross Blue Shield of Louisiana: BCBS of Louisiana adopted
    the ``fail first'' requirement. BCBS of Louisiana has approximately 1.6
    million covered commercial medical patients principally concentrated in
    Louisiana.

        (f)  Excellus Blue Cross Blue Shield: Excellus BCBS adopted the
    ``fail first'' requirement. Excellus has approximately 1.2 million
    covered commercial medical patients concentrated in New York.

        (g)  Independence Blue Cross: Independence Blue Cross adopted the
    ``fail first'' requirement. Independence Blue Cross is the leading
    health insurer in Philadelphia.

    These contracts alone affect approximately 114 million covered
    commercial medical patients of the over approximately 214 million
    patients covered by commercial medical insurance in the United States.
    Pfizer has reason to believe there are more.

        60. While exclusive contracts can--in certain circumstances--be
    perfectly appropriate, the exclusivity provisions described in
    Paragraphs 8, 9, and 58 serve no legitimate or procompetitive purpose
    and were not earned through simple price competition. After Inflectra's
    FDA approval in April 2016, and before J&J implemented its exclusionary
    contracts, health insurers undertook reviews to determine whether there
    was a medical reason not to reimburse Inflectra or to disfavor it
    relative to other therapies. Following these reviews, several major
    health insurance companies--including at least Aetna, Anthem, and
    UnitedHealthcare-- classified Inflectra at parity with Remicade. This
    confirmed that there was no medical reason justifying a restrictive
    reimbursement policy toward Inflectra. It also meant that, for the time
    being, Inflectra would be reimbursed without restriction. As a result,
    the stage was set for Inflectra to begin competing head-to-head with
    Remicade on a level playing field--and for patients to begin receiving
    the benefits of greater choice and lower prices.

        61. But this initial state of affairs was short lived. As a result
    of J&J's anticompetitive conduct, insurers began to reverse course and
    restrict coverage of Inflectra.

        62. For example, in October 2016, UnitedHealthcare, the nation's
    largest health insurer, with over 30 million covered commercial medical
    patients, published an update to its medical and site of care policies
    classifying Inflectra at parity with Remicade for the approved
    indications (with an effective date of November 1, 2016). This meant
    that, for UnitedHealthcare, Inflectra would be reimbursed freely and
    would not be disfavored relative to Remicade. Just weeks later,
    however, UnitedHealthcare reversed course. UnitedHealthcare classified
    Remicade as its ``preferred'' product, and instructed that Inflectra
    would be eligible for reimbursement only in circumstances so limited as
    to be practically non-existent. Under UnitedHealthcare's new policy,
    Inflectra could be reimbursed only where the following conditions are
    met: (a) the patient must show a minimal clinical response, or an
    intolerance or adverse reaction, to Remicade; (b) the physician must
    attest that Inflectra would not lead to the same adverse responses; and
    (c) the patient must show no loss of favorable response in established
    maintenance therapy with Remicade, and must not have developed
    neutralizing antibodies to any infliximab biosimilar product that has
    made the therapy less effective. As a practical matter, this meant that
    Inflectra would not be reimbursed for UnitedHealthcare's more than 30
    million commercial medical members, and that Remicade would be the
    exclusive infliximab with UnitedHealthcare--despite the lack of any
    medical basis for denying those members access to a lower-priced
    alternative to Remicade.

        63. UnitedHealthcare's reversal, of course, did not happen by
    chance. J&J induced UnitedHealthcare to enter into an exclusive deal by
    threatening to penalize UnitedHealthcare with the loss of significant
    rebates unless UnitedHealthcare agreed to deny coverage of Inflectra.

        64. J&J has employed the same approach to secure exclusive deals
    with most or all of the major insurers identified above. In most cases
    these coercive biosimilar-exclusion contracts were the only
    economically viable option for insurers--as adopting any alternative
    would require the insurer to incur a substantial penalty (i.e.,
    foregone rebates to existing Remicade patients) that could not be
    offset by the per-unit cost savings available on the number of patients
    likely to use the biosimilar, at least in the near term.

                 2. J&J's Bundling Tactics with Health Insurers

        65. J&J's threatened penalties are effective because they leverage
    the large base of existing patients already stabilized on Remicade.
    Given that J&J has offered the only infliximab option in the United
    States for nearly two decades, its base of existing Remicade patients
    is substantial, amounting to hundreds of thousands of patients across
    the country. And, in part driven by J&J's marketing efforts to secure
    this outcome, existing Remicade patients are likely to stay on
    Remicade. Thus, the demand for Remicade associated with this existing
    base of patients is, as a practical and economic matter, incontestable.
    This is so despite the fact that switching is within the scope of FDA's
    approval for use of biosimilars and thus appropriate when medically
    directed--something Pfizer discusses with clients. The situation is
    different for new patients who may be candidates for infliximab. In
    light of this, Pfizer has focused, among other things, on competing for
    a substantial share of new patient starts (the ``contestable'' demand)
    by pricing Inflectra competitively with both insurers and providers on
    a unit-for-unit basis. The fact that Inflectra's ASP is lower than
    Remicade's underscores the cost savings it offers.

        66. By threatening to withhold attractive rebates on all Remicade
    prescriptions-- including those for existing patients as well as new
    ones--unless an insurer agrees to exclusivity, J&J is able to leverage
    the incontestable demand for Remicade to exclude competition for the
    contestable demand, i.e., it bundles the contestable and incontestable
    demand. Even if Pfizer offers a significantly lower price for Inflectra
    unit-for-unit, as it has done, insurers will agree to J&J's exclusive
    deals to avoid losing rebates on the substantial base of existing
    Remicade patients who are not likely to switch to Inflectra despite the
    presence of the lower-priced biosimilar. A recent article by two Yale
    Medical School professors in the Journal of the American Medical
    Association illustrates how the kind of leverage J&J has over existing,
    stable Remicade patients allows it to extract commitments to exclude
    the biosimilar:

            If a biosimilar manufacturer intends to upend the preferred
            position of the brand by offering a substantial price discount
            to the [insurer], the branded manufacturer can respond by
            withdrawing the rebate on the [branded] biologic, creating a
            ``rebate trap.'' For any patient continuing the [branded]
            biologic, a payer's cost for that patient will double once the
            rebate is withdrawn. . . . Even in [an] optimistic scenario, in
            which the price of the biosimilar is 60 percent less than the
            price of the brand after rebates and discounts, if the payer is
            only able to convert 50 percent of its patient users to the
            biosimilar [because existing patients will tend to stay on the
            original branded product], the rebate trap ensures that payer
            total costs actually increase relative to costs prior to
            biosimilar availability.

                                  *    *    *

            To avoid the rebate trap, any strategy to reduce spending on
            biologics through adoption of biosimilars requires a near-
            complete switch of patient users from the branded biologic to
            the biosimilar. However, for many chronic diseases, the
            proportion of patients new to a given biological therapy is
            less than 20 percent of the total patients taking that drug in
            a given year. The remainder represents a stable base of
            patients whose disease is well-maintained while they are using
            current therapy and thus are unlikely to switch [to the
            biosimilar].\21\
    ---------------------------------------------------------------------------
        \21\ Aaron Hakim and Joseph S. Ross, ``Obstacles to the Adoption of
    Biosimilars for Chronic Diseases,'' Journal of the American Medical
    Association (May 1, 2017), available at http://jamanetwork.com/
    journals/jama/article-abstract/2625049 (emphasis added).

        67. J&J has further insulated its contracts with insurers from
    competition by bundling rebates for Remicade with rebates on other
    products in return for commitments not to cover Inflectra. J&J made it
    no secret that it would leverage other products as part of its
    ``Biosimilar Readiness Plan.'' As J&J's Worldwide Chair for
    Pharmaceuticals made clear on a recent earnings call, ``We are fully
    prepared to execute our focused biosimilar readiness plan,'' including
    ``developing innovative contracts . . . [to] utilize the full breadth
    of our portfolio.'' \22\ The ``full breadth of [J&J's] portfolio''
    includes several drugs for which Pfizer does not offer any directly
    competing alternative. These include drugs such as Simponi (used for
    rheumatoid arthritis, psoriatic arthritis, ankylosingspondylitis, and
    ulcerative colitis), Simponi Aria (used for rheumatoid arthritis), and
    Stelara (used for plaque psoriasis, psoriatic arthritis, and Crohn's
    disease). These products are widely used, with Simponi/Simponi Aria
    generating for J&J approximately $1.7 billion in 2016 and Stelara
    generating for J&J approximately $3.2 billion in 2016. J&J has
    threatened insurers with the loss of rebates on these other drugs, as
    well as Remicade, if they do not agree to exclude Inflectra from
    coverage.
    ---------------------------------------------------------------------------
        \22\ Johnson & Johnson, Q3 2016 Results Earnings Call Transcript
    (Oct. 14, 2016), available at https://seekingalpha.com/search/
    transcripts?term=johnson+%26+Johnson+biosimilar.

        68. J&J's multi-product bundling, along with its bundling of
    contestable demand (i.e., new patients) and incontestable demand (i.e.,
    existing Remicade patients), have amplified the anticompetitive effects
    of J&J's exclusive contracts, and made the exclusivity provided by
    those contracts even more durable. Insurers have made it clear to
    Pfizer that its net cost for Inflectra would need to be low enough to
    offset the loss of J&J rebates. But, because of the combined effect of
    these bundles, Pfizer cannot offset the financial penalties that J&J
    threatens to impose on insurers who do not agree to exclusivity. As a
    result, Pfizer is economically prohibited from competing for coverage
    by the major insurers--even when their exclusive contracts with J&J
    expire. J&J can use the same bundling strategies to ensure continuation
    ---------------------------------------------------------------------------
    of the exclusionary pattern.

              B.  J&J's Improper Insurer-Level Contracts Deter Hospitals
    and Clinics from Purchasing Inflectra, Thus Amplifying Foreclosure

        69. Providers are unwilling to stock a drug product where there is
    significant uncertainty about whether it will be reimbursed by health
    insurers; because they administer infliximab onsite, providers must
    expend funds for the product in the first instance, then seek
    reimbursement after providing treatment. The provider has theoretical
    recourse against the patient where coverage is denied, but the prospect
    of securing payment in full from the patient is bleak, especially for
    drugs as costly as Remicade. As a result, where a significant portion
    of a provider's patients are insured by plans that have agreed to
    exclude Inflectra--pursuant to the types of contracts described above--
    the provider is unlikely to offer Inflectra for any of its patients, to
    avoid being caught with no reimbursement.

        70. As a recent article in Bloomberg stated:

            Ascension Health, a nearly 23,000-bed nonprofit hospital system
            based in St. Louis, spends $55 million a year on Remicade, more
            than any other drug. Using Inflectra, part of a new class of
            medicines called biosimilars, would save it at least $10
            million annually, according to Ascension's chief pharmacist,
            Roy Guharoy. He met with Pfizer and planned to integrate
            Inflectra into care more often until learning that insurers
            preferred to stay with Remicade. ``This we did not expect,''
            Guharoy said. ``If the insurance companies force us to use the
            branded product, of course our hands are tied.'' \23\
    ---------------------------------------------------------------------------
        \23\ Jared S. Hopkins, What's Harder Than Making Copycat Biotech
    Drugs? Selling Them, Bloomberg (Aug. 15, 2017).

    In short, provider purchases are driven by the coverage stated by
    ---------------------------------------------------------------------------
    commercial insurers.

        71. Having created reimbursement concerns through its exclusionary
    contracts with health insurers, J&J touts the excluded status of
    Inflectra in its marketing communications, knowing that doing so will
    discourage providers from stocking the new biosimilar. As this brochure
    shows, J&J markets the ``fail first'' requirement as a selling point
    despite the fact that such a provision is medically inappropriate and
    despite FDA's determination that there are no clinically meaningful
    differences between the two products. Thus the brochure touts that
    Remicade is ``Preferred Over Inflectra . . . Inflectra requires trial
    and failure on Remicade prior to [Inflectra] utilization.''

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        72. Given the widespread gaps in Inflectra's insurance coverage--
    caused by J&J--providers using infliximab have overwhelmingly chosen to
    stock only Remicade (which is essentially universally covered given its
    long tenure and dominant position) rather than deal with the risk of
    possible denials of coverage for Inflectra. Thus, providers have
    declined to purchase Inflectra across the board, even for patients
    covered by commercial or government insurance plans that do cover the
    product. The effective foreclosure of biosimilars thereby is expanded
    well beyond the 70 percent of commercially insured patients directly
    foreclosed by J&J's insurer contracts. Indeed, as of September 1, 2017,
    about 90 percent of healthcare provider accounts using infliximab had
    purchased no Inflectra at all.

              C.  J&J Has Further Barred Access Through Exclusionary
    Contracts with Providers

        73. To further amplify Inflectra's foreclosure--even beyond the
    population of patients covered by insurance plans that have agreed to
    J&J's exclusivity terms, and the spillover effect on providers
    discussed above--J&J has imposed exclusionary contracts on providers
    themselves (e.g., clinics, hospitals, etc.).

        74. After Inflectra's introduction, J&J began offering certain
    large providers additional rebates and/or discounts on Remicade, but
    only if the provider committed to buy Remicade for nearly all of its
    infliximab needs. To be eligible for rebates, J&J required providers to
    maintain purchase levels for Remicade at very close to the levels of
    the year before Inflectra's launch--when Remicade was the only
    infliximab option. With about 30 percent of prescriptions in any year
    representing new patients (and a certain percentage of existing
    patients exiting therapy each year), this condition also requires
    providers to use Remicade for new patients if they wish to secure
    payment from J&J, thus bundling contestable and incontestable demand
    for Remicade. Like its insurer-level contracts, these contracts as a
    practical matter make Remicade the exclusive infliximab with the
    participating providers.

        75. J&J has also used multi-product bundling in its provider-level
    contracts. As one analyst reported, ``J&J bundled several drugs and
    medical devices for larger hospitals, making Inflectra less
    economical.'' \24\ Conditioning rebates linked to other J&J products
    upon a promise not to do business with Inflectra only exacerbates the
    exclusionary nature of J&J's contracts.
    ---------------------------------------------------------------------------
        \24\ Gal, supra note 15, at 1.

        76. Pfizer was and is prepared to negotiate with providers to make
    Inflectra the lower-priced infliximab option on a per-unit basis, and
    has even offered to guarantee that Inflectra would be less expensive
    unit-for-unit than Remicade. But as with insurer contracts, to secure
    the right to deal freely as to Inflectra (i.e., principally as to new
    patients), the providers would lose significant J&J rebates on their
    ---------------------------------------------------------------------------
    existing Remicade patient bases.

        77. For Pfizer to make up the J&J rebates/discounts that insurers
    and providers would lose on their existing Remicade patients, Pfizer
    would have to price Inflectra below its own average variable cost. This
    is because the lost J&J rebates/discounts are based on the much larger
    base of existing Remicade patients, whereas Pfizer would be serving a
    much smaller group of new patients, at least in the near term.

        78. When the total amount of discounts and rebates that J&J offers
    to insurers and providers under the contracts described herein,
    including multi-product bundle contracts, is attributed to the portion
    of Remicade sales that is contestable by a biosimilar like Inflectra,
    J&J is pricing Remicade below its own average variable cost. As a
    result, biosimilar competition to Remicade is foreclosed.

        79. The combined effect of J&J's multifaceted exclusionary scheme
    has been to foreclose Inflectra from approximately 90 percent of the
    provider account distribution channel essential to connecting Inflectra
    with patients of any kind.

                 J&J HAS MONOPOLY POWER IN THE RELEVANT MARKETS

        80. Monopoly power is the ability of a single seller to raise
    prices above the competitive price level without losing significant
    business.

        81. For years before Inflectra's entry, J&J's ASP for Remicade
    increased, yet Remicade did not lose business. Between 2007 and 2017,
    Remicade's ASP increased more than 62 percent. Despite Remicade's price
    hikes, unit sales of Remicade have actually grown 15 percent during the
    period from 2012 to 2016.

        82. Inflectra's introduction has done nothing to erode Remicade's
    monopoly power: Since Inflectra was launched, Remicade's ASP has
    continued to increase without impacting Remicade's market position. Ten
    months after Inflectra was introduced, Remicade still accounts for over
    96 percent of all infliximab sales. Indeed, J&J has confirmed that
    ``biosimilar competition'' has had ``very little impact'' on
    Remicade.\25\
    ---------------------------------------------------------------------------
        \25\ Johnson & Johnson, Q1 2017 Results Earnings Call Transcript
    (Apr. 18, 2017), available at https://seekingalpha.com/search/
    transcripts?term=johnson+%26+Johnson+biosimilar.

        83. As noted, infliximab is an infusion-administered TNF-inhibiting
    immunosuppressant with FDA approved indications for rheumatoid
    arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative
    colitis, Crohn's disease, and plaque psoriasis (together, the
    ---------------------------------------------------------------------------
    ``Relevant Indications'').

        84. The broadest appropriate relevant product market is infusion-
    administered drugs whose approved labeling from the FDA (a) encompasses
    one or more of the Relevant Indications, and (b) is without restriction
    for the applicable Relevant Indication, that is to say, the labeling
    does not specify that the drug may be used for the applicable Relevant
    Indication only after the patient has not responded to another therapy
    (the ``Relevant Product Market'').\26\ Remicade enjoys a share of over
    60 percent in the Relevant Product Market, nearly the same share it had
    before Inflectra entered.
    ---------------------------------------------------------------------------
        \26\ For example, the FDA approved Rituxan for the treatment of
    moderate to severe active rheumatoid arthritis in adults only after
    treatment with at least one other TNF antagonist has been used and did
    not work well enough.

        85. The following infusion-administered therapies have been
    ---------------------------------------------------------------------------
    approved as unrestricted therapies for the Relevant Indications:

              Rheumatoid Arthritis:

                  Remicade (infliximab) (J&J) (TNF-
            inhibitingimmuno-suppressant)

                  Simponi Aria (golimumab) (J&J) (TNF-
            inhibiting immuno-suppressant)

                  Inflectra (infliximab) (Pfizer) (TNF-
            inhibitingimmuno-suppressant)

                  Renflexis (infliximab) (Merck) (TNF-
            inhibitingimmuno-suppressant)

                  Orencia IV (abatacept) (Bristol-Myers Squibb)
            (synthetic recombinant DNA technology immune-suppressant)

                  Actemra IV (tocilizumab) (Roche)
            (interleukin-6 blocker) (IL-6 blocker)

              Psoriatic Arthritis:

                  Remicade (infliximab) (J&J) (TNF-
            inhibitingimmuno-suppressant)

                  Stelara IV (ustekinumab) (J&J) (human
            interleukin-12 and -23 antagonist)

                  Inflectra (infliximab) (Pfizer) (TNF-
            inhibitingimmuno-suppressant)

                  Renflexis (infliximab) (Merck) (TNF-
            inhibitingimmuno-suppressant)

                  Orencia IV (abatacept) (Bristol-Myers Squibb)
            (synthetic recombinant DNA technology immuno-suppressant)

              Ankylosing Spondylitis:

                  Remicade (infliximab) (J&J) (TNF-
            inhibitingimmuno-suppressant)

                  Inflectra (infliximab) (Pfizer) (TNF-
            inhibitingimmuno-suppressant)

                  Renflexis (infliximab) (Merck) (TNF-
            inhibitingimmuno-suppressant)

              Plaque Psoriasis:

                  Remicade (infliximab) (J&J) (TNF-
            inhibitingimmuno-suppressant)

                  Stelara IV (ustekinumab)(J&J) (human
            interleukin-12 and -23 antagonist)

                  Inflectra (infliximab) (Pfizer) (TNF-
            inhibitingimmuno-suppressant)

                  Renflexis (infliximab) (Merck) (TNF-
            inhibitingimmuno-suppressant)

              Crohn's Disease:

                  Remicade (infliximab) (J&J) (TNF-
            inhibitingimmuno-suppressant)

                  Stelara IV (ustekinumab) (J&J) (human
            interleukin-12 and -23 antagonist)

                  Inflectra (infliximab) (Pfizer) (TNF-
            inhibitingimmuno-suppressant)

                  Renflexis (infliximab) (Merck) (TNF-
            inhibitingimmuno-suppressant)

                  Entyvio (vedolizumab) (Takeda) (integrin
            receptor antagonist monoclonal antibody)

              Ulcerative Colitis:

                  Remicade (infliximab) (J&J) (TNF-
            inhibitingimmuno-suppressant)

                  Inflectra (infliximab) (Pfizer) (TNF-
            inhibitingimmuno-suppressant)

                  Renflexis (infliximab) (Merck) (TNF-
            inhibitingimmuno-suppressant)

                  Entyvio (vedolizumab) (Takeda) (integrin
            receptor antagonist monoclonal antibody)

    These infusion therapies are referred to collectively as the ``Relevant
    Products.''

        86. Certain non-infusion drugs are also indicated to treat the
    Relevant Indications. None of those drugs, however, is a reasonable
    substitute for the infusion-
    administered products. None significantly constrains the prices J&J is
    able to charge for Remicade.

        87. The non-infusion products approved for the Relevant Indications
    include oral medications (e.g., Xeljanz) and self-injectables (e.g.,
    Humira, Enbrel). These products are patient-administered. Infusion
    drugs, by contrast, must be delivered by healthcare professionals in a
    clinical setting (e.g., hospitals or infusion centers) during infusion
    sessions that take upwards of two hours.

        88. Physicians are not likely to switch from prescribing their
    patients infliximab to prescribing those non-infusion products in
    response to a small but significant non-transitory change in the price
    of infliximab.

        89. Not only are the infusion and non-infusion treatments different
    kinds of therapies, but they are most often sold to different buyers,
    on different contracts, and are distributed by different means:

              Infliximab is, as described above, sold primarily to
            hospitals and clinics and is almost never stocked by retail
            pharmacies (only rarely being stocked by certain specialty
            pharmacies). After administering the infusion treatments to
            their patients, the hospitals and clinics seek reimbursement
            from the patients' insurers or government payers.

              By contrast, non-infusion drugs such as Xeljanz, Humira, and
            Enbrel are primarily sold to and distributed in the pharmacy
            channels. Physicians who prescribe these non-infusion drugs
            generally do not administer the treatments and do not bear
            financial risk with respect to the drug selected.

              Non-infusion drugs are also typically covered by insurance
            through a pharmacy benefit plan. These are products that
            insured patients obtain using their ``pharmacy'' cards. Such
            drugs are put out for bid periodically by insurers and/or
            pharmacybenefit managers. The bidding process generally does
            not even include infusion and other therapies not stocked in a
            retail pharmacy.

              By contrast, infusion therapies generally are treated as
            part of the basic medical coverage provided by health insurers.
            Infusion therapies are thus generally put out for bid
            separately from self-administered therapies.

        90. Beyond the medical reasons physicians may have for prescribing
    an infusion therapy as opposed to a non-infusion therapy, patients
    exhibit strong preferences for one form of therapy over another.
    Patients with active lifestyles often prefer self-administered
    treatments. Infusion therapy, on the other hand, is often preferred by
    patients with needle aversions, or by patients who prefer to have their
    treatments administered by medical professionals.

        91. In addition, infusion and non-infusion therapies are offered at
    very different price points: On an annual basis, Enbrel and Humira
    (which are self-administered therapies) at list price are at least
    twice as expensive as Remicade (which is an infusion therapy) for
    patients stabilized on them.

        92. Because of these various factors, a small but significant non-
    transitory increase in price of infusion therapies would not have a
    meaningful impact on the demand for non-infusion therapies, and vice-
    versa.

        93. As noted, the Relevant Product Market includes certain segments
    that qualify themselves as Relevant Markets, in which J&J also
    possesses monopolypower. For example:

        94. Specific-use product markets. Specific-use product markets are
    predicated on infusion-administered therapies for the Relevant
    Indications. A small but significant nontransitory increase in price
    for an infusion product in each of these specific-use product markets
    would not cause substitution to non-infusion medicines approved for the
    same indication. In each category, Remicade has been the dominant
    infusion-administered therapy. The categories are as follows:

              Infusion-administered therapies for Crohn's disease.
            Remicade accounts for over 70 percent of prescriptions to
            patients of infusion-based drugs indicated for Crohn's disease.

              Infusion-administered therapies for rheumatoid arthritis.
            Remicade accounts for nearly 55 percent of prescriptions to
            patients of infusion-based drugs indicated for rheumatoid
            arthritis. When combined with the share of its product Simponi
            Aria, J&J commands an aggregate of nearly 65 percent of
            prescriptions to patients in this category.

              Infusion-administered therapies for ulcerative colitis.
            Remicade accounts for nearly 70 percent of prescriptions to
            patients of infusion-based drugs indicated for ulcerative
            colitis.

              Infusion-administered therapies for psoriatic arthritis.
            Remicade accounts for over 95 percent of prescriptions to
            patients of infusion-based drugs indicated for psoriatic
            arthritis.

              Infusion-administered therapies for ankylosing spondylitis.
            Remicade accounts for over 95 percent of prescriptions to
            patients of infusion-based drugs indicated for ankylosing
            spondylitis.

              Infusion-administered therapies for plaque psoriasis.
            Remicade accounts for over 95 percent of prescriptions to
            patients of infusion-based drugs for plaque psoriasis.

        95. Clinic-based product market. The Relevant Product Market
    encompasses a submarket consisting of sales of the Relevant Products to
    non-hospital clinics (including freestanding clinics and physician
    offices with infusion chairs) that administer infusion therapies to
    patients. Such a submarket is properly treated as a relevant submarket
    among other reasons because J&J is able to price discriminate between
    hospitals and non-hospital clinics. The U.S. antitrust enforcement
    agencies and economists recognize that relevant antitrust product
    markets can be based on categories of customers against whom sellers
    can exercise price discrimination, i.e., differential pricing.\27\ Non-
    hospital clinics are subject to successful price discrimination by J&J.
    J&J can and does identify and target clinics for differential pricing.
    There are significant differences in the rebates and discounts J&J
    makes available to non-hospital clinics as compared to hospital
    customers. Moreover, a small but significant non-transitory increase in
    the price of Remicade or other Relevant Products will not induce
    infusion clinics to switch to self-administered therapies. A very
    substantial percentage of provider accounts that purchase infliximab
    are non-hospital clinics.
    ---------------------------------------------------------------------------
        \27\  See, e.g., U.S. Department of Justice and Federal Trade
    Commission Horizontal Merger Guidelines (2010), Sec. 3.

        96. Product markets for new and existing patients. As described
    above, J&J has a substantial base of existing Remicade patients, the
    substantial majority of whom are not likely to switch to another
    therapy, even a biosimilar, if they have achieved relief with
    Remicade--even in response to a small but significant non-
    transitory increase in price for Remicade. By contrast, for new
    patients who are candidates for infusion-administered therapies for the
    Relevant Indications, Inflectra is a reasonable substitute for
    Remicade. Thus, there is a distinct product market for sales of
    Relevant Products to new patients in need of infusion-administered
    therapies for the Relevant Indications. There is also a distinct
    product market for patients already stabilized on Remicade--a market
    dominated by Remicade. As described above, J&J's scheme has bundled its
    control over the latter market (for patients stabilized on Remicade) to
    thwart competition in the former market (for new patients in need of
    ---------------------------------------------------------------------------
    infusion therapy).

        97. Infliximab product market. After discovery, the data may also
    support an infliximab-only product market. Among other things, J&J has
    been able to raise prices for Remicade consistently without losing
    significant sales to other branded drug products. Both J&J and Pfizer
    consider Remicade and Inflectra to be particularly close substitutes.
    For example, J&J's marketing materials focus on comparisons of price
    and clinical effectiveness between Remicade and infliximab biosimilars,
    and do not reference any other therapies, and its ``Biosimilar
    Readiness Plan'' similarly ignores other therapies, focusing instead on
    the unique competitive threat posed by biosimilars. Inflectra's
    marketing materials likewise focus on Remicade, not on other therapies.

        98. Barriers to entry. Substantial barriers to entry exist to
    developing other infusion-administered drug therapies for the Relevant
    Indications generally, and infusion-administered TNF inhibitors
    specifically. The development of a new therapy requires tens if not
    hundreds of millions of dollars and substantial risk, as any new
    product must survive years of research and development, clinical
    trials, and FDA approval. If left unchecked, J&J's conduct will serve
    as an additional barrier to entry, as potential new entrants will
    recognize that they will be unable to break J&J's ``rebate trap'' and
    thus to profitably enter the Relevant Markets--and consequently will
    not invest the resources necessary to develop biosimilars.

        99. While a second biosimilar to Remicade has been approved--called
    Renflexis, sponsored by Merck and Samsung--the sponsoring firms had to
    overcome just the kind of substantial burdens noted above, and began
    the effort long before J&J commenced its scheme to exclude biosimilar
    competition. J&J itself has expressed confidence in maintaining its
    Remicade dominance despite the potential entry of Renflexisbased on its
    exclusionary contracting strategy. Pfizer has received marketplace
    feedback that Renflexis will face the same access challenges from J&J's
    scheme as Inflectra.

        100. J&J's scheme--including coercive contracts bundling the
    incontestable demand (existing patients) with contestable demand (new
    patients), and promoting the results of its exclusionary insurer-level
    contracts to create uncertainty about Inflectra among providers--has
    led directly, with J&J's active encouragement, to nearly all provider
    accounts that use infliximab declining to purchase Inflectra at all.
    Even if some portion of a provider's patient base may be covered,
    providers are unwilling to risk using Inflectra only to ultimately be
    denied coverage. A single denied claim can cost a provider in excess of
    $4,000, whereas the typical provider savings in product acquisition
    cost for a covered Inflectra claim is $200-300. Because Remicade is
    nearly universally covered, providers have taken the ``safe'' option
    and stocked Remicade over Inflectra, thus increasing the already-
    substantial foreclosure caused by J&J's exclusionary contracts. Thus,
    as a practical matter, J&J's scheme has foreclosed Inflectra from
    approximately 90 percent of provider accounts using infliximab, the
    essential channel of distribution for infliximab. And, as noted, in
    terms of sales, Remicade continues to control over 96 percent of
    infliximab unit sales.

        101. Geographic market. The relevant geographic market for the
    Relevant Markets alleged herein is the United States of America and its
    possessions and territories, as these products are marketed and sold on
    a national basis.

    J&J's CONDUCT HAS STIFLED COMPETITION IN THE RELEVANT MARKETS, THEREBY
       MAINTAINING AND ENHANCING ITS MONOPOLY POWER AND INJURING PFIZER

        102. J&J's scheme has led to the near total foreclosure of
    Inflectra with patients across the country. First, its exclusionary
    contracts with health insurers alone--including with most of the
    largest health insurers in the country--have foreclosed Pfizer's
    ability to compete for at least 70 percent of patients covered by
    commercial health insurance plans in the United States. Second, J&J's
    exclusionary contracts with certain providers have foreclosed Pfizer's
    ability to compete even for patients covered by plans that do provide
    reimbursement for Inflectra. And, as discussed, the reimbursement
    challenges (created by J&J) have led most provider accounts to decline
    to purchase Inflectra at all, with approximately 90 percent of provider
    accounts that use infliximab across the country not stocking Inflectra
    at all. As of September 2017, J&J maintained over 96 percent share of
    infliximab unit sales in the U.S.

        103. Despite vigorous efforts to compete--including offering
    guarantees that Inflectra would be less expensive unit-for-unit than
    Remicade--Pfizer has been foreclosed from gaining a competitive
    foothold as a direct result of J&J's scheme. In the absence of
    Remicade's exclusionary practices, Inflectra's growth in the Relevant
    Markets would be substantially greater than it has been, and would be
    substantially larger in the future. J&J's conduct has deprived Pfizer
    of (a) past profits; (b) future profits; and (c) the value of invested
    capital from unrealized efforts to enter and expand in the Relevant
    Markets. Further, Pfizer's current and prospective customer
    relationships and goodwill have been, and will continue to be,
    impaired. J&J's conduct, if allowed to continue, will also dampen the
    incentives of Pfizer and other biosimilar developers to invest the
    substantial resources needed to bring biosimilars to the market. Thus,
    the aims of the BPCIA will have been thwarted.

        104. J&J's activities have not only harmed Pfizer, they have caused
    substantial harm to the competitive process as well as to government
    payers and to consumers, who have been deprived of the principal
    benefits of competition--more choices and lower prices. The
    anticompetitive effects of J&J's conduct are evident in its pricing of
    Remicade since Inflectra's entry. Despite the fact that Pfizer has
    offered substantial discounts and a lower ASP to compete for business
    with insurers and healthcare providers, J&J has been able to increase
    the price of Remicade without losing any significant share or volume of
    sales to Pfizer (or any other competitor). J&J's prices for Remicade
    have been increasing by every measure. J&J has increased Remicade list
    prices twice since FDA approval of Inflectra. These increases alone
    raised Remicade's list price nearly 9 percent. Remicade's actual ASP
    (which, as noted above, is net of discounts, rebates, and other price
    concessions) has also increased since Inflectra's entry-- negating any
    claim that J&J's rebates qualify as meaningful price competition.

        105. There is no efficiency or cost-reducing justification for
    J&J's coercive and exclusionary insurer- or provider-level contract
    terms. J&J has not achieved improved production costs, or economies of
    scale or scope through its contracting strategies. J&J also has
    achieved no improvements in the Remicade treatment through its
    contracting strategies.

        106. If J&J's conduct is not prohibited, it will be adopted by
    other originator biologics firms aiming to preserve their dominant
    positions. As the first major biosimilar approval, this case will be a
    bellwether for the success of Congress's biosimilars initiative, as
    embodied in the BPCIA.

                               CLAIMS FOR RELIEF

                             FIRST CLAIM FOR RELIEF

                         Violation of 15 U.S.C. Sec. 2

                     Monopolization of All Relevant Markets

        107. Pfizer repeats and realleges Paragraphs 1 through 106 as set
    forth herein.

        108. J&J has monopolized the Relevant Markets in violation of
    Section 2 of the Sherman Act.

        109. J&J has monopoly power in the Relevant Markets.

        110. Through the scheme described above, and other conduct likely
    to be revealed in discovery, J&J has willfully and unlawfully
    maintained and enhanced its monopoly power in violation of Section 2 of
    the Sherman Act. J&J's scheme constitutes exclusionary conduct within
    the meaning of Section 2 of the Sherman Act.

        111. J&J's scheme has stifled competition in the Relevant Markets
    and thwarted Congress's purpose in enacting the BPCIA.

        112. Among other things, given that (a) J&J imposed explicit
    conditions that insurers and providers eliminate (or almost completely
    curtail) their dealings with infliximab biosimilars, and (b) J&J's ASP
    for Remicade has actually increased since the biosimilar entered, J&J's
    pricing is not the clearly predominant means by which competition has
    been foreclosed in the Relevant Markets.

        113. Even if price were deemed to be the clearly predominant means
    by which competition has been foreclosed, when the total amount of
    discounts and rebates that J&J offers to insurers and providers under
    the contracts described herein, including multi-product bundle
    contracts, is attributed to the portion of Remicade sales that is
    contestable by a biosimilar like Inflectra, J&J is pricing Remicade
    below its own average variable cost.

        114. As a result of J&J's conduct, and the harm to competition
    caused by that conduct, Pfizer has suffered substantial and continuing
    injuries.

                            SECOND CLAIM FOR RELIEF

                         Violation of 15 U.S.C. Sec. 2

                Attempted Monopolization of All Relevant Markets

        115. Pfizer repeats and realleges Paragraphs 1 through 114 as set
    forth herein.

        116. J&J has attempted to monopolize the Relevant Markets in
    violation of Section 2 of the Sherman Act.

        117. J&J is violating Section 2 of the Sherman Act by attempting to
    implement the anticompetitive scheme set forth above with the specific
    intent to monopolize the Relevant Markets. J&J's scheme constitutes
    exclusionary conduct within the meaning of Section 2 of the Sherman
    Act.

        118. There is a dangerous probability that J&J will succeed in
    monopolizing the Relevant Markets through its anticompetitive scheme.

    119. J&J's scheme has stifled competition in the Relevant Markets and
    thwarted Congress's purpose in enacting the BPCIA.

        120. Among other things, given that (a) J&J imposed explicit
    conditions that insurers and providers eliminate (or almost completely
    curtail) their dealings with infliximab biosimilars, and (b) J&J's ASP
    for Remicade has actually increased since the biosimilar entered, J&J's
    pricing is not the clearly predominant means by which competition is
    dangerously likely to be foreclosed in the Relevant Markets.

        121. Even if price were deemed to be the clearly predominant means
    by which competition is dangerously likely to be foreclosed, when the
    total amount of discounts and rebates that J&J offers to insurers and
    providers under the contracts described herein, including multi-product
    bundle contracts, is attributed to the portion of Remicade sales that
    is contestable by a biosimilar like Inflectra, J&J is pricing Remicade
    below its own average variable cost.

        122. As a result of J&J's conduct, and the harm to competition
    caused by that conduct, Pfizer has suffered substantial and continuing
    injuries.

                             THIRD CLAIM FOR RELIEF

                         Violation of 15 U.S.C. Sec. 14

    Sale on Condition to Exclude Inflectra and Other Infliximab Biosimilars
    or Impose a Fail First Requirement and to Force Use of Remicade in All
                                Relevant Markets

        123. Pfizer repeats and realleges Paragraphs 1 through 122 as set
    forth herein.

        124. J&J has entered into agreements with insurers (which reimburse
    Remicade) and providers (which purchase Remicade), whereby it has
    conditioned the availability of discounts, rebates, and/or other price
    concessions on insurers and/or providers eliminating or drastically
    curtailing their dealings with Inflectra (or any other infliximab
    biosimilar).

        125. J&J's agreements function as exclusive agreements, what are
    for all practical purposes sole-source agreements, the effect of which
    is to foreclose substantially competition from rivals, such as Pfizer,
    in the sale of the infliximab to medical providers, in violation of
    Section 3 of the Clayton Act.

        126. The essence of the J&J-insurer contracts is to pay the
    insurers to exclude biosimilar alternatives from their prescription
    drug or medical benefits coverage, whereby the insurers either deny
    coverage altogether or restrict coverage to only the rarest of
    circumstances. The insurers, as the payers for the treatment, have the
    ability to exclude selected drugs from coverage and as a result,
    patients and providers do not have a practical ability to choose
    Inflectra or other infliximab biosimilars over Remicade where coverage
    is not available. Moreover, because insurers wield power over providers
    with the ability to grant or withhold coverage for treatment, and
    because providers are risk-averse when it comes to buying and stocking
    medications such as infliximab, the providers are effectively compelled
    to stock Remicade exclusively.

        127. The intent and effect of the insurers' performance of these
    contracts is to cause providers to forgo alternatives and to drive all
    treatment sales to J&J. The result of the J&J insurer contracts thus is
    the amplification of foreclosure, such that Inflectra and other
    biosimilars are denied access to approximately 90 percent of provider
    accounts and foreclosed from competition in the Relevant Markets.

        128. Because providers and insurers are the gateway for the
    distribution and sale of the Relevant Products, there are no viable
    alternative means of distribution or sale and substantial foreclosure
    exists. Biosimilar competitors to J&J have no practical alternative
    means of selling infliximab to patients.

        129. These de facto exclusive arrangements are in effect durable
    long-term agreements because the incentives J&J has exploited are not
    likely to change. So long as J&J's contracts remain in place,
    biosimilars will not be able to dent J&J's base of existing patients,
    and the incentives underlying J&J's contracts will remain. No insurer
    can practically walk away from and not continue to perform under the
    J&J agreement due to the above-discussed penalties.

        130. The effect of each such agreement is and has been to
    substantially lessen competition in the Relevant Markets. The aggregate
    impact of such agreements is and has been to substantially lessen
    competition or tend to create a monopoly in the Relevant Markets.

        131. By imposing such conditional contracts, J&J is directly and
    proximately foreclosing Pfizer and other competitors from a substantial
    portion of the Relevant Markets.

        132. J&J's conduct has had anticompetitive effects in the Relevant
    Markets, including, without limitation, the effects described above in
    Paragraphs 102 through 106.

        133. As a result of J&J's conduct, and the harm to competition
    caused by that conduct, Pfizer has suffered substantial and continuing
    injuries.

                            FOURTH CLAIM FOR RELIEF

                         Violation of 15 U.S.C. Sec. 1

            Agreements in Restraint of Trade in All Relevant Markets

        134. Pfizer repeats and realleges Paragraphs 1 through 133 as set
    forth herein.

        135. J&J has entered into agreements with insurers and providers of
    Remicade with the purpose and effect of unreasonably restraining trade
    and commerce in the Relevant Markets.

        136. J&J's solicitation and enforcement of the exclusionary
    contracts described above constitute unlawful agreements, contracts,
    and concerted activity that unreasonably restrain trade in the Relevant
    Markets in violation of Section 1 of the Sherman Act.

        137. J&J's conduct has had anticompetitive effects in the Relevant
    Markets, including, without limitation, the effects described above in
    Paragraphs 102 through 106.

        138. Among other things, given that (a) J&J imposed explicit
    conditions that insurers and providers eliminate (or almost completely
    curtail) their dealings with infliximab biosimilars, and (b) J&J's ASP
    for Remicade has actually increased since the biosimilar entered, J&J's
    pricing is not the clearly predominant means by which competition has
    been foreclosed in the Relevant Markets.

        139. Even if price were deemed to be the clearly predominant means
    by which competition has been foreclosed, when the total amount of
    discounts and rebates that J&J offers to insurers and providers under
    the contracts described herein, including multi-product bundle
    contracts, is attributed to the portion of Remicade sales that is
    contestable by a biosimilar like Inflectra, J&J is pricing Remicade
    below its own average variable cost.

        140. As a result of J&J's conduct, and the harm to competition
    caused by that conduct, Pfizer has suffered substantial and continuing
    injuries.

                               PRAYER FOR RELIEF

        141. WHEREFORE, Pfizer respectfully prays that the Court enter
    judgment against J&J and in favor of Pfizer, as follows:

                  a.  Awarding Pfizer money damages, trebled pursuant to
            law, in an amount in excess of $150,000.00 (exclusive of
            interest and costs);

                  b.  Awarding Pfizer the costs of the lawsuit, including
            its reasonable attorneys' fees and court costs;

                  c.  Declaring J&J's conduct unlawful and in violation of
            the above-
            referenced statutes;

                  d.  Entering appropriate preliminary and permanent
            injunctive relief barring J&J from continuing to undertake its
            anticompetitive scheme, including its exclusionary contracts;
            and

                  e.  Ordering such other and further relief as the Court
            may deem just, proper, and equitable.

                              JURY TRIAL DEMANDED

        142.  Pfizer demands a trial by jury for all issues triable by
    jury.

    Dated:  September 20, 2017 .        Respectfully submitted,
    Philadelphia, PA

                                        Robert Fiebach, Esq. (PA 02812)
                                        Peter M. Ryan, Esq. (PA 81816)
                                        Cozen O' Connor
                                        One Liberty Place
                                        1650 Market Street, Suite 2800
                                        Philadelphia, PA 19103
                                        Tel: +1 215 665 4166
                                        Fax: +1 215 665 2013
                                        rfiebach@cozen.com
                                        pryan@cozen.com

                                        Robert A. Milne, Esq. (Pro Hac Vice
                                        forthcoming)
                                        Michael J. Gallagher, Esq. (Pro Hac
                                        Vice forthcoming)
                                        Bryan D. Gant, Esq. (Pro Hac Vice
                                        forthcoming)
                                        White & Case LLP
                                        1221 Avenue of the Americas
                                        New York, NY 10025-1095
                                        Tel: (212) 819-8200
                                        Fax: (212) 354-8113
                                        rmilne@whitecase.com
                                        mgallagher@whitecase.com
                                        bgant@Whitecase.com

                                        Elliott E. Dionisio, Esq. (Pro Hac
                                        Vice forthcoming)
                                        White & Case LLP
                                        555 S. Flower Street, Suite 2700
                                        Los Angeles, CA 90071 2433
                                        Tel: (213) 620-7700
                                        Fax: (213) 452-2329
                                        elliott.dionisio@whitecase.com

                                        Counsel for Pfizer Inc.

                                     ______

               Prepared Statement of Olivier Brandicourt, M.D.,
                        Chief Executive Officer, Sanofi
        Chairman Grassley, Ranking Member Wyden, and members of the
    committee, thank you for the opportunity to appear before the Senate
    Committee on Finance to discuss pharmaceutical pricing, affordability,
    and patient access in the United States. I am Dr. Olivier Brandicourt,
    the chief executive officer of Sanofi.

        At Sanofi, we work passionately every day to understand and address
    the health care needs of patients around the world. We are dedicated to
    solving patients' most serious health challenges in numerous
    therapeutic areas, including diabetes, cardiovascular disease,
    immunology, oncology, multiple sclerosis (MS), rare diseases, and rare
    blood disorders. We are also devoted to preventing diseases through the
    research, development, and delivery of vaccines. And we contribute to
    improving the health of people around the world through our broad
    portfolio of consumer health products.

        Sanofi's U.S. subsidiaries have a rich history in the United States
    dating back over 100 years. We currently employ more than 13,000
    professionals across the United States in a broad range of critical
    roles, including business operations, research and development, and
    manufacturing, with our most significant presence in Massachusetts,
    where we are the largest employer in the life sciences industry, and
    major centers of operation in New Jersey, Pennsylvania, and Tennessee.

        Last year, Sanofi spent almost $7 billion on research and
    development, an increase of approximately 7 percent from 2017, which
    reflects our commitment to bringing better therapies to patients.
    Sanofi plans to maintain this level of R&D investment through 2021, and
    our R&D pipeline now contains 81 projects, including 33 new molecular
    entities in clinical development, and 35 projects that are in Phase III
    or have been submitted to regulatory authorities. This investment means
    that Sanofi potentially will seek approval for nine new medications in
    the next three years, primarily in therapeutic areas where Sanofi sees
    the greatest nexus between our expertise and patient need: diabetes,
    vaccines, oncology, immunology, rare diseases, and rare blood
    disorders.

        Our work in R&D includes more than a dozen compounds for the
    treatment of various kinds of cancers, and we are employing cutting-
    edge approaches in an effort to make significant advances for patients.
    Our research includes potential treatments to help the body's own
    immune system fight cancer, and antibody drug conjugates that we
    believe can deliver cytotoxic drugs to tumors while sparing normal
    tissue. Earlier this month, we announced successful results with one
    such candidate in a mid-stage trial in lung cancer, and we intend to
    initiate a pivotal study later this year.
                          i. rising costs for patients
        While the research and development landscape has fundamentally
    changed, the landscape in which patients access medications has also
    fundamentally changed, and not for the better. Affordability of
    medicines is a real and growing challenge for too many Americans. We
    understand the anger of patients who cannot afford the medicines they
    or their loved ones need due to rising out-of-pocket drug costs.

        There is no single root cause to the problem of rising patient out-
    of-pocket costs, and in order to develop meaningful solutions for
    patients, it is critical to take a comprehensive look at what is
    driving rising costs for patients. Given the number of factors that
    contribute to determining out-of-pocket costs for patients, every part
    of the supply chain, including manufacturers, has a role to play in
    solving this problem.

        We want everyone--including patients, providers, payers, pharmacy
    benefit managers (PBMs), policy makers, and regulators--to understand
    why we set prices as we do, and to reaffirm our commitment to our core
    principles of access, affordability and innovation. An important
    component of pricing includes the intersection between the list prices
    of our medicines, the net prices we actually receive after accounting
    for all rebates and other discounts, and out-of-pocket costs.

        While list prices often receive the most attention, they reflect
    the initial price we set for our medicines. They are not the amount
    Sanofi receives nor the prices typically paid by government and
    commercial insurers, employers, or PBMs. Under the current system,
    players within the supply chain--including PBMs, plans, wholesalers,
    distributors, and group purchasing organizations--receive either
    rebates and/or fees based on a percentage of the list price. Their
    economic incentives are therefore directly linked to the list price.
    And as long as the net price grows at a predictable rate, the greater
    the list price, the greater the economic returns for many players in
    the supply chain. Manufacturers, in turn, must account for anticipated
    rebates and other discounts when setting their list price.

        Thus, list price is the starting point for negotiations with
    payers, and it is often the basis for patient out-of-pocket costs. But
    focusing solely on the list price does not tell the whole story. In the
    current system, manufacturers pay significant rebates as a percentage
    of the list price to both government and private payers, as well as
    other intermediaries, in an effort to improve access for patients. In
    2018, 55 percent of Sanofi's gross sales were given back to payers as
    rebates, including $4.5 billion in mandatory rebates to government
    payers and $7.3 billion in discretionary rebates. As described later in
    my testimony, due to these rebates, the average aggregate net price of
    our products, including our insulin products, actually has declined
    over the last number of years.

        Sanofi provides rebates to PBMs and health plans to improve patient
    access to, and affordability for, Sanofi medicines. We want these
    rebates, which lower net prices, to benefit patients. Unfortunately,
    under the current system, savings from rebates are not consistently
    passed through to patients in the form of lower deductibles, co-
    payments or coinsurance amounts.

        For some patients, out-of-pocket costs are calculated based on a
    medicine's list price. However, based on variability in plan design,
    the list price alone does not explain patients' increasing
    affordability issues.

         Sanofi and Sanofi Genzyme U.S. Gross to Net 2018 Breakdown *

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    ------------------------------------------------------------------------

    -------------------------------------------------------------------------
    * Below are the summarized categories (by type) for various
     transactions:
    Mandatory Rebates: Medicaid, VA-DOD, Tricare, 340B, Medicare Coverage
     Gap
    Discretionary Rebates: Commercial, Medicare, Managed Medicaid, Medicaid
     Supplemental, GPO, Institutional Discounts
    Government Purchasing Organization (GPO) Fees & Coupons: Fees paid for
     administration of Sanofi's agreements with Group Purchasing
     Organizations on behalf of their members and various copay assistance
     programs
    DPA Fees: Performance based fees earned by wholesalers for providing
     complete sales information and maintaining targeting inventory rates
    Cash Discounts: Trade discounts offered to wholesalers for prompt
     payment of invoices
    Sales Returns: Netted with Clawback, Other Corrections/Credit Memos
    ------------------------------------------------------------------------

        For instance, in some cases, affordability issues are the result of
    changes in health plan designs, such as the increase in the number of
    high deductible health plans. Among those with private health
    insurance, enrollment in high deductible health plans (HDHPs) has
    generally increased since 2010. The design of these plans generally
    requires patients to pay the full list price of medicines during the
    deductible phase of the program, rather than the negotiated drug price
    available when the insurance portion kicks in.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        In other cases, affordability issues are caused by changes in
    insurance design which increasingly ask patients to pay higher cost-
    sharing for their medicines, even when the price of those medicines has
    stayed relatively flat or has declined for the health plan. For
    example, as noted later in my testimony, the average net price of
    Lantus, our most prescribed insulin, has declined by over 30 percent
    since 2012, while the average out-of-pocket burden for patients with
    commercial insurance and Medicare has increased by approximately 60
    percent over that same period. In this case, not only are discounts
    apparently not being passed on to patients, but patients are in fact
    being asked to pay more when PBMs and health plans are paying less for
    the medicine. This situation defies logic and should not happen.

        Increasing out-of-pocket costs also can result from changes to
    prescription drug formularies, which have a significant impact on the
    amount of out-of-pocket costs a patient will be asked to pay. A recent
    opinion piece in The New York Times \1\ powerfully highlights how
    changes to prescription drug formularies not only can create confusion
    and frustration for providers and patients, but also ultimately
    increase costs for patients when the medicines they need are not
    covered on a formulary's preferred tier.
    ---------------------------------------------------------------------------
        \1\ See https://www.nytimes.com/2019/01/18/opinion/cost-insurance-
    diabetes-insulin.html.

        The impact of the role each of these factors plays in out-of-pocket
    costs for any individual patient is highly variable, thus compounding
    the complexity of this issue. Out-of-pocket costs for a medicine for
    any particular patient depend on a number of factors in addition to
    list price, including: (1) what portion, if any, of a manufacturer's
    rebates a PBM or payer passes through to the patient, (2) the benefit
    design of the patient's health plan, and (3) the level of reimbursement
    negotiated between the patient's plan and the particular pharmacy. Each
    of these factors varies significantly among plans and pharmacies--even
    within the same health insurance company or PBM receiving the same
    ---------------------------------------------------------------------------
    manufacturer rebate--creating confusion and frustration for patients.

        Given the complexity in the system and number of factors that
    impact out-of-
    pocket costs, every part of the health-care system has an obligation to
    work to solve this problem. I am grateful that this Committee--and
    others--are taking a holistic approach to collecting information both
    on what is causing the problem for patients, and also on solutions to
    address patient access and affordability without undermining the
    incentives and rewards for scientific risk-taking and discovery that
    are the hallmark of the United States ecosystem and economy.

        I am here today to share Sanofi's story, the actions we have taken
    to improve patient access and affordability, and our ideas about what
    more can be done.
         ii. sanofi actions to improve patient access and affordability
        As a global health-care leader, Sanofi has a long-standing
    commitment to promoting health-care systems and policies that make our
    treatments accessible and affordable to patients in need. We believe we
    can play an important role in the development of constructive solutions
    that will benefit both patients and the health-care system as a whole.
    I will address some of our ongoing initiatives and recommendations for
    solutions in my testimony.

        Sanofi's ultimate goal, detailed below, is to encourage a
    transition to a value-
    driven health-care system that provides incentives for continued
    improvements in patient care while increasing access and affordability.
    Given the complexities of the current system, changes must be
    approached thoughtfully, with a focus on establishing processes that
    will both enable affordable access to treatment and protect innovation
    in an era of potentially transformative scientific advancements.

        Sanofi is--and will continue to be--an industry leader in helping
    to address this challenge. While many factors, including decisions
    affecting patient out-of-pocket spending and insurance coverage, are
    influenced or controlled by others in the health-care system, including
    other manufacturers, we recognize that there are actions we can take to
    help improve access and affordability for patients. For our part, we
    recognize that we must price our medicines transparently and according
    to their value, while at the same time contributing to broader
    solutions that improve patient outcomes and the financial
    sustainability of the U.S. health-care system.

        Policy changes are required across the entire health care system.
    But we are not waiting for systemic change to arrive before taking
    action. Sanofi has adopted a variety of approaches to work within the
    current system to improve access and affordability for patients.
    Whether it has been launching new medicines in multiple sclerosis and
    rheumatoid arthritis at disruptively low prices, limiting price
    increases to an external benchmark of overall medical spending, or
    lowering the net price of a medicine, Sanofi has approached the
    challenge of access and affordability not with words, but with actions.
                   iii. sanofi pricing principles and actions
        Two years ago, Sanofi announced our progressive and industry-
    leading pricing principles to help stakeholders understand our pricing
    decisions and to advance a more informed discussion of issues related
    to the pricing of medicines.\2\
    ---------------------------------------------------------------------------
        \2\ See https://www.sanofi.us/-/media/Project/One-Sanofi-Web/
    Websites/North-America/Sanofi-US/Home/corporateresponsibility/
    Prescription_Medicine_Pricing_2019.pdf.

        These principles include a pledge to keep annual list price
    increases at or below the projected U.S. National Health Expenditure
    (NHE) growth rate, an estimate of medical spending calculated by the
    Centers for Medicare and Medicaid Services (CMS) and often used as a
    measure of healthcare inflation. These principles apply to all of our
    prescription medicines if a pricing decision results in more than a $15
    annual increase in the price of the medication. In addition, we
    committed to making both our average aggregate list and net price
    changes across our portfolio transparent to help illustrate how revenue
    accrues to Sanofi versus other parts of the pharmaceutical supply
    ---------------------------------------------------------------------------
    chain.

        In 2018, all of our price increases were consistent with our
    policy, as are all pricing actions we have taken in 2019. Across our
    entire portfolio of medicines, the average aggregate list price
    increase was 4.6 percent while the average aggregate net price--that
    is, the actual price paid to Sanofi--declined by 8.0 percent.

        The declining average aggregate net price in 2018 represents the
    third consecutive year the amount that health plans and PBMs pay Sanofi
    for our medicines has declined.

             U.S. Portfolio Annual Average Aggregate Price Changes *
    ------------------------------------------------------------------------
                              Average Aggregate List   Average Aggregate Net
              Year                    Price                    Price
    ------------------------------------------------------------------------
    2016                     4.0% Increase            2.1% Decrease
    ------------------------------------------------------------------------
    2017                      1.6% Increase           8.4% Decrease
    ------------------------------------------------------------------------
    2018                      4.6% Increase            8.0% Decrease
    ------------------------------------------------------------------------
    * Average aggregate across Sanofi's prescription product portfolio.

        Specific to insulin, the average aggregate net price across all
    Sanofi insulin products has declined over the past four years. For our
    entire insulin portfolio, the average net price is 25 percent lower
    today than it was in 2012.\3\
    ---------------------------------------------------------------------------
        \3\ Based on internal review of pricing actions and payer
    contracting.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

        In addition to our pledge to limit price increases in the U.S.,
    Sanofi's pricing policy includes a commitment to transparency in how we
    price new medicines coming to the market for the first time. When we
    set the price of a new medicine, we hold ourselves to a rigorous and
    structured process that includes consultation with external
    ---------------------------------------------------------------------------
    stakeholders and considers four factors:

            (1)  A holistic assessment of value, including (a) clinical
            value and outcomes, or the benefit the medicine delivers to
            patients, and how well it works compared to a standard of care;
            (b) economic value, or how the medicine reduces the need--and
            therefore costs--of other health care interventions; and (c)
            social value, or how the medicine contributes to quality of
            life and productivity. Our assessments rely on a range of
            internal and external methodologies, including health
            technology assessment (HTA) approaches and other analyses that
            help define or quantify value and include patient perspectives
            and priorities.

            (2)  Similar treatment options available or anticipated at the
            time of launch in order to understand the competitive landscape
            within the disease areas in which the medicine may be used.

            (3)  Affordability, including the steps we must take to promote
            access for patients and contribute to a more sustainable system
            for payers and health-care delivery systems.

            (4)  Unique factors specific to the medicine at the time of
            launch. For example, we may need to support ongoing clinical
            trials to provide additional critical information on the value
            of the product (e.g., longer-term outcomes studies), implement
            important regulatory commitments, or develop sophisticated
            patient support tools that improve care management and help
            decrease the total cost of care.

        Using this approach, Sanofi has launched a number of highly
    innovative products at prices well below the competition, some even
    before our principles were officially adopted.

              In 2012, Sanofi launched Aubagio ', a medicine
            used to treat relapsing forms of MS, at a list price more than
            25 percent below the other approved oral MS medication on the
            market at the time.

              In 2017, we launched Kevzara ', a second line
            medication used to treat certain types of rheumatoid arthritis
            (RA), at a list price 30 percent below other leading treatments
            for RA. After completing a head to head study against the
            market-leading anti-TNF, Kevzara was found superior in RA
            patients.

              In 2017, we launched Dupixent ', the first drug
            of its kind for moderate to severe atopic dermatitis,
            specifically within the cost-effectiveness range provided by
            the Institute for Clinical and Economic Review (ICER) of
            $37,000, compelling the Chief Medical Officer for a leading PBM
            to say ``this is how pricing should work.'' While we have
            concerns about ICER's methodology in many of their drug
            reviews, our willingness to work with ICER is further
            demonstration to our commitment to price our medicines based on
            the value they provide with consideration of input from a
            third-party analysis.

              In 2018, we launched Admelog ' at the lowest list
            price of any mealtime insulin.

              In February 2019, Sanofi and Regeneron announced that
            Praluent ' will be made available at a new reduced
            U.S. list price. Beginning in early March, new U.S. National
            Drug Code (NDC) option will be available at approximately 60
            percent less than the original list price for the drug. This
            action follows our earlier announcement in March 2018, when
            Sanofi and Regeneron committed to lowering the U.S. net price
            for payers in return for reducing burdensome access barriers
            for appropriate patients.\4\ Sanofi and Regeneron took the
            additional step of announcing a new NDC to further assist
            patients, particularly in Part D, who still face cost-sharing
            linked to the list price, and who were thus not helped by the
            earlier net price reduction. With the new lower-priced
            Praluent, most Medicare Part D patients are expected to save as
            much as $345 per month, depending on their insurance plan.
    ---------------------------------------------------------------------------
        \4\ See http://www.news.sanofi.us/2018-03-10-Sanofi-and-Regeneron-
    announce-plans-to-make-Praluent-R-more-accessible-and-affordable-for-
    patients-with-the-greatest-health-risk-and-unmet-need.

        With the right incentives in the system, our approach to setting
    launch prices for these new medicines would have had the effect of
    ensuring affordable access for patients. Unfortunately, because of the
    way the U.S. health care system is currently constructed, our
    experience has shown that pricing medicines at lower list prices has
    failed to result in adequate access or affordability for most patients.
    For instance, since Dupixent was launched, rebates have been required
    in most cases to secure access for patients. Despite the responsible
    list price and subsequent rebates, 8 commercial and 2 Medicaid plans
    nevertheless implemented a step edit requiring patients to try
    immunosuppressant therapy first before using Dupixent. They implemented
    this step edit notwithstanding the fact that immunosuppressant therapy
    is not FDA approved for use in atopic dermatitis and is referenced as a
    worst-case scenario for patients in practice guidelines due to its
    questionable benefit-risk profile.
                  iv. sanofi's insulin products: a case study
        We feel a special obligation to address the pressing issues around
    access and affordability of insulin products. In my time as CEO, Sanofi
    has made a concerted effort to improve both system sustainability and
    patient affordability in our approach to our portfolio of insulin
    products, which includes six different products to meet individualized
    patient needs. And it is important to note the evolution and innovation
    of insulin, as we are often asked if anything has changed in the last
    100 years that warrants pricing action.

        Sanofi's groundbreaking discovery of insulin glargine, and its
    development of a novel pre-filled disposable injection pen to deliver
    insulin glargine, have profoundly improved the lives of millions of
    patients living with diabetes in the United States and worldwide.
    Sanofi's insulin glargine drug products are sold under the trade names
    Lantus ', Lantus SoloSTAR ', Toujeo SoloSTAR
    ', and Toujeo Max SoloSTAR ', each of which
    represents a significant leap forward in the treatment of diabetes.
    Sanofi has been awarded patents for its innovative technologies on each
    of these products.

        These novel drug products began with Sanofi's discovery of insulin
    glargine. Despite having ``insulin'' in its name, Sanofi's insulin
    glargine is markedly different from prior insulin products, which had a
    relatively short duration of action and required patients to inject
    themselves multiple times a day and wake up at night for injections in
    order to control blood glucose levels. Each injection of prior insulin
    products caused a sharp spike in the patient's insulin levels, which
    could cause symptoms of low blood sugar ranging from shakiness and
    confusion to, in the extreme, coma or death. Injections also had to be
    timed before every meal, disrupting patient's lives, sleep times, and
    ability to eat with friends and family. As such, the consistent goals
    of insulin therapy over the last century have included reducing the
    frequency of insulin administration and flattening the post-
    administration peak of insulin in the bloodstream. Prior attempts to
    achieve these goals included cumbersome mechanical pumps that had to be
    worn on the body for constant infusion, and NPH insulin, which had an
    intermediate duration of action but still caused a pronounced peak in
    insulin levels.

        Glargine changed all of that. Sanofi scientists, in a remarkable
    feat of protein engineering, succeeded in fundamentally altering the
    human insulin molecule at the amino acid level, changing its
    pharmacological characteristics to give patients a steady release of
    insulin with just a single daily administration. Unlike anything that
    came before it, glargine forms tiny solid crystals upon injection that
    dissipate over time to provide a flatter, stable, long-lasting effect
    that mimics the flat profile of insulin release from a healthy pancreas
    and reduces the risks caused by low blood sugar. The once-daily
    administration of glargine also proved a significant boon to patient
    lifestyles.

        Insulin is also an excellent example of list prices not reflecting
    the actual prices paid by insurance companies, and out-of-pocket costs
    that continue to rise despite lower net prices. The net price of our
    insulin product Lantus ', for example, has fallen over 30
    percent since 2012; yet, over this same period, average out-of-pocket
    costs for patients with commercial insurance and Medicare--before the
    benefit of any Sanofi financial assistance program--has risen 60
    percent.
                   v. sanofi's financial assistance programs
        Our commitment to affordability for patients extends beyond
    responsible launch pricing, limited price increases, and transparency.
    We offer a suite of traditional and innovative patient assistance
    programs to enable appropriate patient access and to help patients
    afford the Sanofi medicines prescribed to them. We publicize our
    programs in a number of ways to ensure patients and providers are aware
    of our offerings, including through advertising online, on television,
    as well as in provider office settings and at pharmacies.

        As noted previously in my testimony, rising out-of-pocket costs for
    patients is a complex problem with many causes. In some cases, access
    issues are linked to lack of insurance. But having insurance is no
    longer a guarantee of affordable care, and Sanofi believes it is also
    critical to address the needs of patients who may be exposed to
    excessive cost-sharing based on insurance plan design or other
    deficiencies in the system.

        Because patient situations are different, we have carefully
    tailored our assistance programs for insulin products to meet a variety
    of patient needs:

              Commercially insured patients qualify for our co-pay
            assistance program, which reduces the financial burden for
            insulin products. Through this program, over 90 percent of
            participating commercially insured patients pay either $10 or
            $0 per month for their Sanofi-manufactured insulin products.
            Last year, our co-pay assistance programs for commercially
            insured patients provided more than 400,000 eligible patients
            with $342 million in patient savings.

              For diabetes patients who do not qualify for one of our co-
            pay assistance programs, we created the Insulins ValYOU Savings
            Program in 2018. The purpose of this program is to provide
            relief for those patients who currently pay high variable
            retail prices for insulin and do not qualify for other
            assistance programs. Through this program, eligible individuals
            can access all Sanofi insulins for $99 per 10 mL vial or $149
            for a pack of SoloStar pens, approximately a one-month supply
            of insulin,\5\ at a discount of up to 60 percent discount below
            the list price, resulting in potential savings of up to $3,000
            per year. There are no income requirements and the program is
            available at U.S. pharmacies. Last year (its first year), the
            program resulted in $6.2 million in patient savings.
    ---------------------------------------------------------------------------
        \5\ Patients with type 1 diabetes require insulin replacement with
    both long-acting (basal) and mealtime (bolus) insulin. An average adult
    with type 1 diabetes who weighs 70 kg (155 pounds) should be taking
    anywhere from 0.5-1.0 u/kg/day--depending upon activity levels, and
    meal choices. Using the higher daily dose of 1.0 u/kg/day, this patient
    would need a total of 70 units/day of insulin, of which approximately
    half should be mealtime (bolus) insulin and half should be long-acting
    (basal) insulin. For this average patient, one vial of long-acting
    (basal) and one vial of mealtime (bolus) insulin could provide a
    monthly supple of insulin.
        Many patients with type 2 diabetes require long-acting (basal)
    insulin only. Our internal data shows the average daily dose is
    approximately 45 units per day, resulting in a monthly requirement of
    1350 units of long-acting (basal) insulin per month. Lantus SoloSTAR
    ' pack contains 1500 units of insulin (5 pens x 300 units
    per pen) and Toujeo SoloSTAR ' pack contains 1350 units of
    insulin (3 pens x 450 units per pen). For the average patient with type
    2 diabetes, the ValYOU Savings Program would meet the monthly insulin
    requirement with one payment of $149. Patients on lower doses of Lantus
    may opt for the 10ml vial, which would meet the monthly insulin
    requirement with one payment of $99.

              For eligible low-income patients, Sanofi offers many of our
            medicines, including our insulin products, at no charge through
            its Sanofi Patient Connection patient assistance program. We
            are proud that, in 2018, more than 93,000 patients participated
            in the Sanofi Patient Connection program, receiving free
    ---------------------------------------------------------------------------
            medicine valued at $508 million.

        While Sanofi alone cannot eliminate the issue of patient
    affordability, no matter how comprehensive or innovative our patient
    assistance programs, we believe that our efforts can make a meaningful
    difference for many patients. We are committed to maintaining these
    programs and raising awareness of these options to the patients who
    need them.
                              vi. policy proposals
        Over the past few years, we have led by example and made decisions
    to help improve access and affordability for patients. I am here today
    to tell you that I know our actions, while well-intentioned, have not
    been enough. I hope we can all agree on market-based policy solutions
    that will incentivize a high-value, sustainable health-care system that
    improves the affordability of innovative medicines in the U.S.

        Based on our experience, targeting list price controls alone will
    not be sufficient to address patient access and affordability. That is
    why the solution to drug pricing must include protections for patients,
    tying responsible pricing to both access and affordability for
    patients.

        There are obviously a variety of ways to accomplish this, and
    Sanofi could support any number of options that align to our core
    principles:

            (1)  The U.S. should continue to maintain a strong ecosystem
            for innovation. As such, any policy proposals should strictly
            avoid directly and artificially controlling the price of
            medicines, either through price controls set by the Federal
            Government, or worse, outsourcing that decision to foreign
            governments. Policy proposals that we believe would
            fundamentally undermine the unique innovation ecosystem of the
            United States include reference pricing, importation, or price
            controls set by CMS. Based on our experience, these approaches
            may be effective at controlling budgets for central payers but
            come at a steep cost for patients--namely limiting access to
            innovative treatments. Additionally, given that the U.S. is the
            world's leader in science and innovation--and the jobs that
            come with it--these approaches pose additional risks to the
            U.S. economy and future scientific discovery. Finally, and most
            importantly, given the differences between systems, these
            approaches may do little to improve access and affordability
            for patients.

                As we have experienced, within the current system,
            declining prices for payers or new treatments priced at
            responsibly lower list prices are no guarantee that those
            actions will translate to affordability or access for patients.

            (2)  Changes to the pricing system must be holistic, and the
            majority of benefits should accrue to patients. As noted
            previously, simply enacting price controls--either set by a
            State, Federal, or foreign government--will not solve the
            problem of access and affordability for patients. We believe
            system incentives need to change to encourage smaller list
            price increases, or even list price reductions, by requiring
            health plans to cover those medicines that meet these standards
            at an affordable co-pay level and only allow access
            restrictions consistent with the label and accepted evidence-
            based best clinical practice.

                If policies are enacted that solely target the list price
            of medicines without these common-sense patient protections,
            our shared goal of lowering drug costs--for both government and
            patients while maintaining the engine of innovation in the
            United States to bring new innovative medicines to patients
            will not be fully achieved. To appropriately accomplish this
            objective, Sanofi is willing to trade price for access and
            affordability and share accountability for offsetting the
            financial impact on the Medicare programs.

                Sanofi supports and recommends several policy solutions to
            incentivize responsible pricing behavior. To ensure that these
            changes do not create a windfall for manufacturers or health
            plans and PBMs, Sanofi recommends applying these policies only
            to medicines that satisfy certain limits on price increases.
            This approach will shift the current incentives in the system
            to reward ``good'' behavior in a manner that truly helps
            patients. Several of the solutions outlined below are also
            priorities for Chairman Grassley, Ranking Member Wyden and
            other members of this committee and I look forward to the
            opportunity to work with you on advancing these and other
            policy initiatives:

                First, reducing out-of-pocket costs for patients is our top
            priority. As we have experienced, limiting list price of
            medicines alone is not sufficient to fully solve this problem.
            Sanofi has identified a number of ways to effectively reduce
            out-of-pocket costs for consumers and broadly supports
            tradeoffs between price and access to help patients, including:

                 Implementation of the Anti-Kickback Safe Harbor rebate
            proposed rule in a manner that directly lowers out-of-pocket
            costs for patients without creating loopholes that would
            undermine the proposed rule's intent.

                 Requiring a portion of the discounts and rebates paid by
            manufacturers to reduce costs for patients at the pharmacy
            counter.

                 Changing government price reporting rules and the Anti-
            Kickback statute in a manner that would promote value-based
            contracting.

                 Implementing an annual out-of-pocket cap for Medicare
            beneficiaries.

                 Allowing manufacturers to offer co-pay assistance to
            Medicare beneficiaries.

                 Changing or clarifying government price reporting rules
            to make it easier to reduce list prices on medicines that have
            been on the market for a long time--namely by (1) making clear
            that the government pricing metrics for the new, lower list
            price drug do not have to be averaged with the metrics for
            older, higher list price drug and (2) permitting a company to
            treat the new lower price drug as a new product for purposes of
            Medicaid rebate calculations, which will help to link the
            rebate liability for the new drug to the new drug's lower price
            as opposed to the higher price for the old drug.

                Second, Sanofi supports policies that cultivate a highly
            competitive free market system and rewards the type of
            entrepreneurial risk-taking necessary to the discovery and
            development of life-saving new medicines. A key element of that
            system is a strong and predictable intellectual property
            system. However, after a reasonable period of time--which I
            believe is already reflected in U.S. law--generic and
            biosimilar medicines should quickly enter the market to offer
            long-term access at lower costs. To help accomplish these
            goals, Sanofi supports:

                 Legislation that promotes competition, such as the
            CREATES Act, and prohibitions on ``reverse payment''
            agreements. While some changes may be needed to avoid
            unintended consequences, we support moving forward with
            policies that limit manufacturers' ability to unfairly avoid
            competition. At Sanofi, we make product supply available to
            generic and biosimilar manufacturers developing data necessary
            for FDA applications for their products. We do this in a timely
            manner and on reasonable terms.

                 Increased system-wide transparency, which would improve
            competition across health care by making relevant information
            available to patients and policymakers. Providing more
            information about what is driving costs in the system and how
            money is flowing through the system will allow for increased
            competition and better-informed decision making. Policies like
            the SPIKE Act, which appropriately include a threshold for
            reporting to incentivize responsible pricing behavior and the
            C-THRU Act, are potential approaches.
                                vii. conclusion
        I look forward to having a productive conversation about the
    complexities of the current prescription drug pricing system and
    proposals to improve affordable patient access to high quality,
    innovative medications to drive optimal health outcomes.

        Thank you for the invitation to speak with you today and I look
    forward to working with you.

                                     ______

        Questions Submitted for the Record to Olivier Brandicourt, M.D.
                   Questions Submitted by Hon. Chuck Grassley
        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant. If the HHS proposed rule is finalized, can you assure the
    committee that your company will offer up-front discounts? If not, why?

        Answer. As the question notes, one of the practical implications of
    the Proposed Rule is to incentivize a shift from back-end rebate
    payments to up-front discounts that are passed through at the point-of-
    service to the patient (at least in part). We understand that some in
    the health care industry have raised concerns that the nation's
    antitrust laws, specifically the Robinson-Patman Act, and long-running
    antitrust litigation involving drug manufacturers, wholesalers, and
    pharmacies could prevent or reduce discounting under a pricing
    structure without rebates. But, the Robinson-Patman Act focuses on
    price discrimination--involving any dimension of price--and it does not
    distinguish between up-front discounts and rebates. In addition, the
    referenced litigation, In re Brand Name Prescription Drugs Antitrust
    Litigation, did not result in any change in the ability of a
    prescription drug manufacturer to offer an up-front discount.
    Consequently, because Sanofi's view is that the antitrust laws apply
    equally to up-front discounts and back-end rebates, we do not believe
    that they present any impediment to offering up-front discounts to
    patients at the point of sale. Sanofi is committed to working with
    other stakeholders to lower patient out-of-pocket costs, and the
    company will carefully review any final rule issued by HHS regarding
    the Anti-Kickback Statute and its safe harbor regulations--with the
    goal of providing point-of-sale discounts to patients in a compliant
    manner to help lower patient out-of-pocket costs.

        Question. Please describe how you expect your company to respond to
    the HHS proposed rule to eliminate safe harbor protection for back-end
    rebates in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. Sanofi is committed to working with other stakeholders to
    lower patient out-of-pocket costs, and the company will carefully
    review any final rule issued by HHS regarding the Anti-Kickback Statute
    and its safe harbor regulations--with the goal of providing point-of-
    sale discounts to patients in a compliant manner to help lower patient
    out-of-pocket costs.

        With respect to list price, if (1) the proposed changes to the
    anti-kickback statute safe harbors were codified, and (2) Congress
    implemented similar changes to the commercial insurance market, Sanofi
    would lower the list prices of its prescription medications for
    products in competitive categories for which there is currently a
    material difference between list price and net price on the assumption
    that patient access and affordability would be improved. Sanofi also
    supports policy changes that would de-link other payments in the
    pharmaceutical supply chain from list price.

        We support extending the intent behind the anti-kickback statute
    safe harbor proposed rule to the commercial market so that incentives
    are aligned across the marketplace. Together, we believe these changes
    would facilitate Sanofi's ability to lower our list prices. However, we
    recommend a step-wise approach, implementing changes to the commercial
    market after the safe harbor rule is implemented on January 1, 2020.
    Such an approach would provide an opportunity for stakeholders and the
    government to identify unintended consequences, and address them, prior
    to extending these policies to the commercial market.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

        Without a better understanding of how these policy changes
    ultimately would affect the competitive marketplace, patient access,
    and affordability, we are unable to quantify the amount of up-front
    discounts or any potential list price reduction.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. Sanofi negotiates rebates with PBMs and Part D plans to
    secure better formulary position for our products, which in turn
    provides the best possible access and cost sharing for the majority of
    Medicare Part D beneficiaries. When evaluating what level of rebates to
    offer, Sanofi considers the potential business impact of such
    arrangements.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

                             Primary Care Products

                                        Percentage of Sales by Payer Channel \1\
    ----------------------------------------------------------------------------------------------------------------
                                                                          Channel
    ----------------------------------------------------------------------------------------------------------------
                                                                                       FSS Others
                 Product              Commercial  Medicare  Medicaid  Tricare   340B      \2\      Institutional \3\
    ----------------------------------------------------------------------------------------------------------------
    Lantus                                   25%       36%       10%       0%     5%          19%                 4%
    ----------------------------------------------------------------------------------------------------------------
    Toujeo                                   47%       39%        7%       0%     4%           2%                 0%
    ----------------------------------------------------------------------------------------------------------------
    Soliqua 100/33                           77%       15%        3%       0%     3%           1%                 0%
    ----------------------------------------------------------------------------------------------------------------
    Apidra                                   16%        1%       66%       0%     8%           7%                 2%
    ----------------------------------------------------------------------------------------------------------------
    Admelog                                   0%        0%       91%       0%     9%           0%                 0%
    ----------------------------------------------------------------------------------------------------------------
    Multaq                                   24%       57%        2%       0%     3%          12%                 2%
    ----------------------------------------------------------------------------------------------------------------
    Praluent                                 22%       32%        1%       0%     2%           5%               38%
    ----------------------------------------------------------------------------------------------------------------
    \1\ Based on gross sales.
    \2\ This category includes the VA, DOD, and other purchases through Sanofi US's Federal Supply Schedule (FSS).
    \3\ This category includes Hospital/GPO, Long-Term Care, Outpatient, and Staff Model.

                                          Percentage by Volume by Payer Channel
    ----------------------------------------------------------------------------------------------------------------
                                                                          Channel
    ----------------------------------------------------------------------------------------------------------------
                 Product               Commercial  Medicare  Medicaid  Tricare   340B   FSS Others    Institutional
    ----------------------------------------------------------------------------------------------------------------
    Lantus                                    25%       36%       10%       0%     5%          19%                4%
    ----------------------------------------------------------------------------------------------------------------
    Toujeo                                    47%       39%        7%       0%     4%           2%                0%
    ----------------------------------------------------------------------------------------------------------------
    Soliqua 100/33                            77%       15%        3%       0%     3%           1%                0%
    ----------------------------------------------------------------------------------------------------------------
    Apidra                                    16%        1%       67%       0%     7%           7%                2%
    ----------------------------------------------------------------------------------------------------------------
    Admelog                                    0%        0%       91%       0%     9%           0%                0%
    ----------------------------------------------------------------------------------------------------------------
    Multaq                                    24%       57%        2%       0%     3%          12%                2%
    ----------------------------------------------------------------------------------------------------------------
    Praluent                                  22%       32%        1%       0%     2%           5%               38%
    ----------------------------------------------------------------------------------------------------------------

                            Specialty Care Products

                                        Percentage of Sales by Payer Channel \4\
    ----------------------------------------------------------------------------------------------------------------
                                                                               Channel
    ----------------------------------------------------------------------------------------------------------------
                                                  Commercial/               Medicaid/VA /             Non-Contracted
                      Product                    Managed Care    Medicare    DOD/Tricare    PHS/340B       Sales
    ----------------------------------------------------------------------------------------------------------------
    Cerdelga                                                0%        12%              6%         4%             78%
    ----------------------------------------------------------------------------------------------------------------
    Cerezyme                                                0%        15%             15%        22%             48%
    ----------------------------------------------------------------------------------------------------------------
    Aldurazyme                                              0%         6%             29%        23%             42%
    ----------------------------------------------------------------------------------------------------------------
    Fabrazyme                                               0%        13%             10%        26%             51%
    ----------------------------------------------------------------------------------------------------------------
    Myozyme                                                 0%        18%             15%        31%             36%
    ----------------------------------------------------------------------------------------------------------------
    Thyrogen                                                0%         4%              5%        25%             66%
    ----------------------------------------------------------------------------------------------------------------
    Caprelsa                                                0%         6%             10%         0%             84%
    ----------------------------------------------------------------------------------------------------------------
    Aubagio                                                47%        33%             11%         2%              7%
    ----------------------------------------------------------------------------------------------------------------
    Lemtrada                                                0%        35%             10%        41%             14%
    ----------------------------------------------------------------------------------------------------------------
    Kevzara                                                69%        15%              4%         3%              9%
    ----------------------------------------------------------------------------------------------------------------
    Dupixent                                               75%         9%              6%         3%              7%
    ----------------------------------------------------------------------------------------------------------------
    Eloctate                                                0%         5%             33%        37%             25%
    ----------------------------------------------------------------------------------------------------------------
    Alprolix                                                0%         5%             27%        39%             29%
    ----------------------------------------------------------------------------------------------------------------
    Jevtana                                                 0%        70%              1%        30%              0%
    ----------------------------------------------------------------------------------------------------------------
    Zaltrap                                                 0%         0%              0%         0%            100%
    ----------------------------------------------------------------------------------------------------------------
    Elitek                                                  0%        15%              1%         7%             77%
    ----------------------------------------------------------------------------------------------------------------
    Mozobil                                                 0%        25%              6%        45%             24%
    ----------------------------------------------------------------------------------------------------------------
    Thymoglobulin                                           0%         0%              0%         4%             96%
    ----------------------------------------------------------------------------------------------------------------
    \4\ The data used to derive this information is contracted sales data. Because many of these products are
      purchased through non-contracted sales, Sanofi has a limited view regarding through which channels these
      products are purchased. Percentage by volume by channel results in similar percentages to percentage by sales
      so a separate chart is not provided.

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees? To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. Sanofi does not hire external consultants or lobbyists to
    advocate for coverage of our products at State Medicaid Pharmacy and
    Therapeutics Committees. Sanofi employees do attend State Medicaid
    Pharmacy and Therapeutics Committees meetings. Relevant advocacy
    activities to support Medicaid access and coverage of our medicines, if
    any, are disclosed to States in accordance with individual State laws.

        Question. Please describe how the costs of patient assistance
    programs are accounted for within your company's financial statements.
    Please also describe the types of market information, such as
    prescribing and use patterns, that your company collects from different
    types of patient assistance programs and patient hub services.

        Answer. Within Sanofi's financial statements, Sanofi includes the
    administrative costs of the company's co-pay assistance programs, other
    point-of-sale programs, and free drug patient assistance program
    (Sanofi Patient Connection) in the ``Selling and general expenses''
    line item. For co-pay assistance and other point-of-sale programs,
    Sanofi records the pharmacy reimbursement amount paid by the company as
    a reduction in sales. Sanofi records free product provided through
    Sanofi Patient Connection within ``Cost of Sales.'' Sanofi Care North
    America, the 501(c)(3) operating foundation that donates free product
    to Sanofi Patient Connect, records the free goods as a ``Contribution''
    when received from Sanofi and as a ``Donation'' when donated to Sanofi
    Patient Connection.

        With regard to market information associated with its patient
    assistance programs and hub services, Sanofi generally collects data
    that aids in the efficient administration and operation of these
    programs. For example, the vendors operating Sanofi Patient Connection
    and the hubs collect information provided by patients on enrollment
    forms, including patient and provider demographic information, patient
    insurance information, patient diagnosis, and prescription information
    necessary to evaluate patient program eligibility and/or administer the
    program. (Sanofi does not itself receive patient protected health
    information except in very limited circumstances, such as when a
    patient reaches out to Sanofi directly when they do not agree with
    their patient assistance eligibility determination or when Sanofi
    monitors vendor calls for compliance with company policies and
    procedures.) With respect to Sanofi Patient Connection, Sanofi does not
    use this information for purposes other than administering the patient
    assistance program. With respect to hub services, in addition to using
    this information to administer hub programs, Sanofi may use this data
    to develop market and business insights.

        With respect to Sanofi's point-of-sale patient assistance programs,
    Sanofi also receives anonymized program utilization data, including
    information about patient out-of-pocket costs, the average amounts that
    Sanofi reimburses pharmacies through the program, abandonment rates,
    dispensing pharmacies, and the prescribers writing the prescriptions
    associated with program utilization. This information is used to
    administer the program. Sanofi may also use this data to develop market
    and business insights.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. For each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. In the attached documents, we have provided information for
    the period January 1, 2015 through December 31, 2018 regarding payments
    made by Sanofi US to tax-exempt organizations.\5\ The information is
    provided in a number of documents consistent with how Sanofi maintains
    this information. In some cases, this information may be over-inclusive
    and include non-tax exempt organizations (e.g., contributions for
    independent medical education into both non-profit and other entities).
    The information includes contributions and sponsorships to various tax-
    exempt health-care-oriented organizations, including patient groups.
    The information also includes contributions made for independent
    medical education grants, and to teaching hospitals for investigator-
    sponsored trials and for physician fellowship payments. On March 8,
    2018, Sanofi acquired Bioverativ, Inc., a biopharmaceutical company
    focused on therapies for hemophilia and other rare blood disorders. The
    attached documents also describe the monetary contributions to tax
    exempt organizations made by Bioverativ since March 8, 2018.
    ---------------------------------------------------------------------------
        \5\ These contributions may not relate to particular drug products.
    Sanofi US supports programs and initiatives of external, independent,
    not-for-profit organizations that align with Sanofi US's corporate
    vision and values. These organizations are generally healthcare-
    oriented and focus on one or more therapeutic areas in which Sanofi US
    is actively involved. The attached information focuses on Sanofi US
    entities that manufacture and sell drug products and does not include
    entities that manufacturer and sell consumer health products or
    vaccines. Contribution information prior to 2015 is archived in
    databases and systems that Sanofi does not currently maintain and which
    are not easily accessible. The information available does not
    distinguish between restricted and unrestricted grants.

        With respect to any foundations or charitable arms of Sanofi, from
    January 1, 2014 through the end of 2017, Sanofi maintained an entity
    called Sanofi Foundation of North America, a 501(c)(3) nonprofit
    operating foundation that was closed at the end of 2017. Donations made
    from that entity are included in the attachments described above.
    Currently, Sanofi maintains an entity called Sanofi Cares North
    America, which is a 501(c)(3) nonprofit operating foundation that makes
    donations of Sanofi products free of charge to eligible financially-
    needy uninsured and underinsured patients through a program known as
    the Sanofi Patient Connection. Sanofi Cares North America also donates
    product to five non-governmental organization partners for the purpose
    of emergency disaster relief--Americares, DirectRelief, Heart to Heart
    International, MAP International, and Project Hope, and to
    approximately one hundred summer camps with 501(c)(3) status for
    ---------------------------------------------------------------------------
    children with diabetes.

        Question. Pay for delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the ``Preserve Access to
    Affordable Generics and Biosimilars Act,'' which would help put an end
    to these deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Answer. With respect to patent litigation, Sanofi believes it is
    inappropriate to presume that any settlement of patent litigations
    related to pharmaceutical products is anticompetitive. Patent
    settlements are often the most efficient and effective way to resolve
    disputes regarding patented drugs, and they often lead to the earliest
    appropriate entry of generic products into the market, which benefits
    patients. In fact, settlements permit entry of a generic alternative
    into the market earlier than expiration of the relevant branded
    product's patent. Each patent litigation and potential settlement
    presents unique factors and must be considered individually and in
    light of the relevant circumstances.

        Question. Has your company ever entered into these kinds of
    settlements with a generic company?

        Answer. No, Sanofi does not enter into ``pay for delay'' or
    ``reverse payment'' agreements that prohibit generic drug or biosimilar
    development after the expiration of a patent. Sanofi has reached
    settlements in patent infringement cases, and these agreements have
    allowed the generic company to commercialize its product before the
    expiration of the branded product's patent(s).

        Question. Do you support the pay for delay bill?

        Answer. We support the intent behind this legislation to promote
    competition, including prohibitions on ``reverse payment'' agreements.
    However, we have significant concerns with the way that this bill is
    drafted, and therefore we do not support this particular legislation.

        We believe that it is inappropriate to make settlements of patent
    litigations presumptively illegal or to classify such settlements as
    anticompetitive. Such settlements can be the most efficient and
    effective way to resolve legitimate disputes regarding patented drugs,
    and they often lead to the earliest appropriate entry of generic
    products into the market, which in turn benefits patients. As stated
    above, each patent litigation and potential settlement presents unique
    factors and must be considered individually and in light of the
    relevant circumstances.

        Additionally, we have concerns that this bill could apply
    retroactively to agreements entered into after June 17, 2013. For
    clarity and certainty in the marketplace, any new legislation governing
    the settlement of patent litigation should apply prospectively only.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Answer. Sanofi offers discounts in bundled sales arrangements only
    in limited circumstances. For example, Sanofi may offer bundled
    discounts on its products Toujeo' and Lantus' to
    ensure that both products attain a formulary position that benefits
    patients. This is especially important because the products may serve
    patients with different medical needs.

        Question. Does your company view these practices as anticompetitive
    or harmful to patients' access to quality, lower cost medicine?

        Answer. Sanofi prioritizes patient access to medications at a
    reasonable cost. Sanofi's arrangements with individual PBMs or insurers
    promote this goal by maintaining stability of supply at affordable
    prices. In competitive drug markets, Sanofi may enter into arrangements
    with particular PBMs or insurers that permit Sanofi to further reduce
    its prices on one or more medications in exchange for greater certainty
    regarding the amount of those medications it will sell over a specified
    term. These arrangements promote patient access to quality, affordable
    medications, are procompetitive, and comply with the antitrust laws.

        Moreover, in competitive drug markets Sanofi's ability to ensure
    patient access to affordable medications is affected both by PBMs and
    insurers (who may have considerable negotiating leverage over
    manufacturers) and by other manufacturers (who may respond to
    competition from Sanofi in a variety of ways). While some manufacturers
    may respond by building ``rebate walls'' or ``rebate traps'' around
    their products, Sanofi shares the Committee's concern about practices
    that are harmful to patients' access to quality, affordable medication.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. The elimination of safe harbor protection for rebates would
    remove incentives for manufacturers to attempt to influence formulary
    placement through such discounts. It is also possible that competitive
    products would be launched at lower list prices and more readily
    incorporated into formularies on the basis of their clinical benefits
    in a world without rebates. This would benefit the system overall,
    including consumers.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        Answer. The primary factors that Sanofi considers in setting list
    price include the value of the product, the competitive environment,
    patient affordability and access, investment in further product
    development or needs to reinvest in R&D more generally. In certain
    limited cases, Sanofi also will consider regulatory costs when setting
    the list price of a product. These factors may be considered, for
    example, where ongoing clinical trials are needed for a particular
    therapy or when the FDA mandates a Risk Evaluation and Mitigation
    Strategy (``REMS'') for a product--such as with Sanofi's drug
    Lemtrada. Sanofi does not, however, consider our routine and ongoing
    regulatory compliance efforts within the cost of our products. Rather,
    those efforts are considered part of Sanofi's operating costs.

        Question. When setting the list price of a drug, does your company
    consider the risk of liability or litigation? If so, how specifically
    do those factors affect the list price of a drug? Please provide at
    least one specific example, if applicable, from your current product
    portfolio.

        Answer. When conducting its pricing analysis for a new drug, Sanofi
    does not specifically consider the risk of liability or litigation
    associated with such product.

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see Value Based Arrangements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        How can VBAs help lower what patients pay out-of-pocket?

        Can Congress do more to allow for and encourage the use of VBAs?

        Answer. Sanofi believes that encouraging an environment that is
    supportive of value-based arrangements would help promote drug
    affordability, increase patient access to medicines, and improve
    patient adherence and outcomes. Although there are different types of
    these agreements, value-based contracts generally tie prices and
    payments to the value of a particular prescription drug product--while
    potentially reducing patient out-of-pocket costs and providing patients
    with better access to the most innovative drug products. A manufacturer
    could, for example, condition payment for a product on its success in
    meeting a predefined clinical outcome, and this type of arrangement
    could make drugs more affordable and lower healthcare costs throughout
    the system.

        Facilitating value-based arrangements also could encourage new drug
    innovation, control costs for such new products, and recognize the full
    value of complex and personalized treatments. Nevertheless, despite the
    promise of these arrangements, industry stakeholders--including
    manufacturers and payers--need better legal and regulatory clarity. For
    example, we support the creation of a safe harbor from Anti-Kickback
    Statute liability to protect value-based agreements. We also are
    supportive of any legislation that would facilitate value-based
    arrangements and protect them from legal enforcement, such as the
    Patient Affordability, Value, and Efficiency Act (PAVE Act).

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad.

        Pharmacy benefit managers and plans have argued that rebates are
    used to lower premiums across the board and that it is the best way to
    seek a price concession on otherwise expensive drugs.

        Your industry argues that these payers are insisting on higher
    rebates that can only be achieved by raising list prices.

        But patients often lose under this system, with out of pocket costs
    being tied to list price. Insulin patients appear to be routinely
    impacted by this perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        What assurance can you provide that you would in fact lower your
    prices?

        What actions should be taken to ensure that patients are actually
    seeing the benefits of lower out of pocket costs?

        Answer. If (1) the proposed changes to the anti-kickback statute
    safe harbors were codified, and (2) Congress implemented similar
    changes to the commercial insurance market, Sanofi would lower the list
    prices of its prescription medications for products in competitive
    categories for which there is currently a material difference between
    list price and net price on the assumption that patient access and
    affordability would be improved. Sanofi also supports policy changes
    that would de-link other payments in the pharmaceutical supply chain
    from list price.

        We support extending the intent behind the anti-kickback statute
    safe harbor proposed rule to the commercial market so that incentives
    are aligned across the marketplace. Together, we believe these changes
    would facilitate Sanofi's ability to lower its list prices. However, we
    recommend a step-wise approach, implementing changes to the commercial
    market after the safe harbor rule is implemented on January 1, 2020.
    Such an approach would provide an opportunity for stakeholders and the
    government to identify unintended consequences, and address them, prior
    to extending these policies to the commercial market.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

        Without a better understanding of how these policy changes
    ultimately would affect the competitive marketplace, patient access,
    and affordability, we are unable to quantify the amount of any
    potential list price reduction.

        With respect to actions that should be taken to ensure patients are
    seeing the benefit of lower out-of-costs, we support legislation that
    would incentivize manufacturers to lower list prices by connecting
    better patient access and affordability to such pricing actions.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        Answer. Sanofi considers a variety of factors when setting or
    raising its list prices. These factors include the value of the
    product, the competitive environment, patient affordability and access,
    investment in further product development or needs to reinvest in R&D
    more generally. Within this framework, any list price increase is made
    consistent with our pricing principles, including our commitment to
    limit the total annual increase to a level at or below the NHE
    projected growth rate, as estimated by CMS.

        Although we agree that one factor in price increases across the
    industry may be the increased demand for rebates at the PBM and health
    plan level, that is not the only factor. In fact, Sanofi believes that
    reducing incentives for high prices throughout the supply chain by
    delinking payments from list price would have a meaningful impact on
    price and patient costs. This is true, for example, with group
    purchasing organizations (GPOs) that negotiate pricing for Part B
    providers. As with PBMs, these GPOs negotiate rebates and
    administrative fees that are linked to the list price of the product.
    These structures thus create the same misalignment of interests as in
    the PBM setting. It is important to note, as well, that the current
    average sales price (ASP)-based system for Medicare Part B works to
    moderate price growth because reimbursement reflects the weighted
    average of discounts given to providers, payers, and other commercial
    purchasers. This means that the Medicare program and its beneficiaries
    benefit from the discounts health plans and providers negotiate on
    these drugs. Due to this market-based competition, ASP reimbursement
    rates often are substantially lower than list prices.
                         biosimilar competition/insulin
        Question. Biosimilars have been much anticipated as a solution to
    the drug pricing crisis. In particular, the FDA is moving to make
    insulin a biologic that would be subject to biosimilar competition in
    the future.

        But we are hearing from all of you that the biosimilar market
    doesn't work and the benefit of these cheaper but equally effective
    alternatives are really not available to U.S. patients.

        Can a biosimilar version of insulin be part of the solution for
    diabetes patients?

        If so, what changes need to be made to the system so that patients
    and the taxpayer can realize the benefit of biosimilars? (Merck gave up
    on pursuing a biosimilar to Sanofi's Lantus.) \6\
    ---------------------------------------------------------------------------
        \6\ https://www.fiercepharma.com/pharma/merck-ditches-biosimilar-
    lantus-but-will-ease-path-for-mylan-s-rival-insulin-product.

        Answer. Sanofi believes that biosimilars currently--and will
    continue to--result in increased competition. In fact, this type of
    competition has grown among insulin manufacturers in recent years, and
    we expect that it will continue to lower prices for patients with
    diabetes. For example, in 2016, Eli Lilly introduced a follow-on
    biologic to Sanofi's drug Lantus. Additionally, in 2018, Sanofi
    introduced Admelog, a follow-on biologic of Humalog, at a list price
    that was 15% lower than the reference product. Mylan also is developing
    a second follow-on insulin glargine that references Lantus, and Sanofi
    is developing a biosimilar insulin aspart, a rapid-acting insulin,
    which we expect to introduce in 2021. Sanofi expects that the already
    highly competitive diabetes drug market will become increasingly robust
    over time--including with the anticipated introduction of
    ---------------------------------------------------------------------------
    interchangeable biosimilar basal and rapid acting insulins.

        There are changes already in place that will help patients and
    taxpayers realize the benefit of biosimilars. Specifically, in March
    2020, certain biologics that are currently regulated as drugs,
    including long acting insulins, will be regulated as biologics and
    therefore will be subject to the existing biosimilars pathway. We
    expect the change in insulin regulation to spur the continued
    development of substitutable or interchangeable insulin products, and
    to increase competition in this space generally.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices.

        With the increased scrutiny of the industry and of the drug supply
    chain as a whole in the United States, have any of your companies re-
    evaluated your business strategy in foreign countries? If not, then
    why?

        Answer. No, Sanofi has not reevaluated its business strategy in
    foreign countries. Other countries have implemented systems, such as
    price controls or reference price regimes, to directly and artificially
    regulate the price of medicines. In our experience, there is not an
    opportunity for Sanofi to negotiate prices with these foreign
    government payers. Sanofi's only choice is to accept the government-
    mandated price, or to not sell the pharmaceutical in that country,
    which not only hurts a company financially, but more importantly harms
    patients.

        We note that, although these systems may be effective at
    controlling budgets for central payers, they come at a steep cost for
    patients, including severe access restrictions and rationing. For
    instance, one analysis of the report released to justify the
    International Pricing Index found that 96 percent of new cancer
    medicines are available in the U.S. compared to 71 percent in the
    United Kingdom and 65 percent in France.\7\
    ---------------------------------------------------------------------------
        \7\ http://phrma-docs.phrma.org/download.cfm?objectid=0C19E240-
    19C7-11E9-87D20050569A4
    B6C.

        As a Sanofi specific example, Dupixent is the first drug to be
    approved for moderate to severe atopic dermatitis (eczema) in the US.
    FDA granted Breakthrough Therapy designation to Dupixent as preliminary
    clinical evidence indicated that ``the drug may demonstrate substantial
    improvement over available therapy on clinically significant
    endpoint(s).'' Dupixent was approved by FDA in March 2017 under
    Priority Review, which means that FDA's goal is to take action on this
    application within 6 months (compared to 10 months under standard
    review). Within 24 hours of FDA approval, Sanofi shipped orders for
    Dupixent to be made available to U.S. patients. In contrast, Health
    Canada approved Dupixent in November 2017. However, Dupixent is still
    ---------------------------------------------------------------------------
    not publicly reimbursed in Canada.

        Question. If a proposal, like IPI, were implemented, would it force
    your companies to potentially ``walk away from the negotiating table
    when other countries demand low prices subsidized by America's
    seniors,'' as HHS Senior Advisor for Drug Pricing Reform John O'Brien
    has said?

        Answer. In our experience, there is not an opportunity for
    manufacturers to negotiate with a government. Sanofi's only choice is
    to accept the government-mandated price, or to not sell the product in
    that country, which, as noted above, not only hurts Sanofi financially,
    but more importantly harms patients.

        Question. What are some of your ideas on how we can ensure
    Americans aren't shouldering the full cost of pharmaceuticals?

        Answer. While we understand the concern that Americans are
    shouldering more than their fair share of the cost of innovation in the
    pharmaceutical sector, the list price discrepancy between the U.S. and
    other countries is due, in primary part, to the different health care
    systems. Because Sanofi pays significant rebates to payers and PBMs,
    the difference between the price in other developed countries and the
    net price in the U.S. is not nearly as large.

        Sanofi's top priority is reducing out-of-pocket costs for patients.
    We believe that there need to be reforms to the current system to
    better align incentives, including market-based approaches to pricing
    that promote competition and ensure patients have affordable and
    sustainable access to innovative medicines. Currently, payers and PBMs
    inconsistently pass through the growing savings that they receive from
    increased negotiated rebates. Accordingly, despite increasing rebates
    and lower net prices, out-of-pocket costs for many patients have
    continued to grow. Sanofi supports policies that pass PBM and payer
    rebate savings to patients at the pharmacy counter through lower copays
    and coinsurance. Sanofi would also support policies that would
    incentivize responsible pricing by tying smaller list price increases,
    or even list price reductions, to both access and affordability for
    patients.
                  foreign countries' pricing and reimbursement
        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year.

        ``When foreign governments extort unreasonably low prices from U.S.
    drug makers, Americans have to pay more to subsidize the enormous cost
    of research and development. . . . It's unfair and it's ridiculous, and
    it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing medical advances?

        Answer. It is true that the U.S. is the main engine in
    pharmaceutical and biotechnology innovation in the world. Although
    U.S.-based manufacturers manage clinical trials globally, there are
    substantially more research and development dollars invested in the
    U.S. than in any other country. To illustrate, in 2015, PhRMA member
    companies spent over $47 billion in domestic R&D and only $12 billion
    in R&D abroad. For Sanofi, in 2018, we spent nearly $7 billion on R&D
    globally--a substantial portion of which in the U.S.--and we expect
    that our annual R&D spend will be consistent through 2021. These
    investments in research, in turn, create significant and important job
    opportunities in the United States.

        However, it is important to note that while other countries'
    pricing and reimbursement systems may help to contain costs in those
    countries, they come at a steep cost for patients, including severe
    access restrictions and rationing. For instance, one analysis of the
    report released to justify the International Pricing Index found that
    96 percent of new cancer medicines are available in the U.S. compared
    to 71 percent in the United Kingdom and 65 percent in France.\8\
    Moreover, the list price discrepancy between the U.S. and other
    countries is due, in part, to the different health-care systems.
    Because Sanofi pays significant rebates to payers and PBMs, the
    difference between the price in other developed countries and the net
    price in the U.S. is not nearly as large.
    ---------------------------------------------------------------------------
        \8\ http://phrma-docs.phrma.org/download.cfm?objectid=0C19E240-
    19C7-11E9-87D20050569A4
    B6C.

        Question. How do foreign countries' pricing and reimbursement
    ---------------------------------------------------------------------------
    systems affect our prescription drug costs?

        Answer. Pricing and reimbursement systems in other countries do not
    affect how Sanofi prices its medicines in the United States. Consistent
    with our pricing principles, when Sanofi sets the price of a new
    medicine in the U.S., we hold ourselves to a rigorous and structured
    process that includes consultation with external stakeholders. In our
    view, an objective measure of a new product's value considers the
    benefit to patients, compared to a standard of care; the reduced need--
    and therefore costs--of other health-care interventions; and any
    increase in quality of life and productivity. We believe our pricing
    reflects these factors. We also consider factors such as the
    affordability for patients and any unique factors specific to the
    medicine, like the need to support ongoing clinical trials, implement
    important regulatory commitments, or develop sophisticated patient
    support tools that improve care management and help decrease the total
    cost of care. Additionally, under our pricing principles, we have
    pledged to limit price increases at or below the National Health
    Expenditure (NHE), which is the projected annual health-care spending
    growth rate as estimated by CMS.

        Question. Are foreign governments taking note of the concerns being
    raised by the Trump administration and have they responded in any way?

        Answer. Sanofi is not aware of any responses by foreign governments
    to U.S. drug pricing policy proposals advanced by the Trump
    administration.

        Question. Has there been any noticeable change in any of our trade
    agreements since these concerns have been raised by the Trump
    administration?

        Answer. Sanofi is not aware of any such changes.

                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various States
    have been exploring whether to exclude certain drugs from their
    Medicaid program. For example, the State of Massachusetts recently
    asked CMS for permission to create a closed formulary where the State
    Medicaid program would pick at least one drug per therapeutic class.
    CMS denied their waiver request citing violation of Federal law, but
    this proposal does bring up important questions on how to contain drug
    prices in State Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to State Medicaid programs,
    do you think it would lower drugs costs while ensuring access to
    patients?

        Answer. The Part D program encourages strong competition in the
    marketplace, including by providing beneficiaries with choice of
    different plans and encouraging drug manufacturers to compete for
    formulary position to support broad access to their medicines (in part
    by securing lower cost-sharing obligations for patients in preferred
    formulary tiers). By contrast, State Medicaid programs are obligated,
    as a condition of a manufacturer's participation in the Medicaid Drug
    Rebate Program, to cover company's products (subject to certain narrow
    exceptions). Consequently, although we believe that increased
    competition in the Medicaid program could help to lower drug prices,
    including if Medicaid implemented certain of the Part D program's
    principles, it is not immediately clear how these changes would further
    enhance patient access.
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        Answer. The Medicaid Rebate Act, and CMS's corresponding rules,
    require drug manufacturers to pay rebates to the State Medicaid
    Programs for units of drug dispensed to their beneficiaries. Medicaid
    ``Best Price'' generally is defined as the lowest price offered to
    commercial purchasers in the United States, and it is one of two key
    metrics used for setting the level of rebates that manufacturers must
    pay to each state Medicaid program for Medicaid beneficiary
    utilization. Best Price does not, therefore, reflect a price point at
    which manufacturers sell products to Medicaid, and Sanofi does not view
    the Medicaid Best Price requirements as encouraging manufacturers to
    set higher initial prices. However, Medicaid Best Price considerations
    are a factor in assessing whether to offer higher rebate amounts to our
    commercial (Best Price-eligible) customers.

        Question. What, if any, changes would you suggest we make to the
    program?

        Answer. With regard to the Medicaid Drug Rebate Program and the
    determination of Best Price, the Trump administration's Pricing
    Blueprint highlights the impediments that exist under current rules
    with regard to value-based discounting arrangements. Sanofi would like
    to pursue more innovative product discounting strategies--including
    arrangements in which we would stand behind the value or outcomes that
    our products provide to patients and to the healthcare system
    generally. But, current Medicaid rebate calculation rules regarding
    bundled discount arrangements, and the manner in which manufacturers
    must account for discounts that are incurred over long periods of time,
    present significant obstacles to adopting these arrangements. If the
    rules for the Medicaid Drug Rebate Program were amended to permit
    manufacturers to exclude certain appropriately-structured value-based
    discounts from their Best Price calculation, it is likely that Sanofi
    could adopt more innovative value-based discount contracts, and that
    these arrangements in turn could result in significant savings for
    patients and the system.
                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        How will they lower overall health-care costs for our Federal
    programs?

        What have the preliminary results looked like so far?

        Answer. Sanofi believes that encouraging an environment that is
    supportive of value-based arrangements would help promote drug
    affordability, increase patient access to medicines, and improve
    patient adherence and outcomes. Specifically, value-based arrangements
    tie prices and payments to value while reducing patient out-of-pocket
    costs and providing patients with better access to the most innovative
    drug products. For example, value-based arrangements can be premised
    upon the effectiveness of a manufacturer's product, which may help to
    secure payer coverage for new and innovative therapies. Where payment
    to a manufacturer is conditioned on the value or clinical outcomes of a
    product, value-based arrangements also may help to improve patient
    cost-sharing challenges. Additionally, value-based arrangements could
    encourage new drug innovation while controlling costs for such new
    products by aligning the price of the drug to the value the drug brings
    to the patient.

        Recently, Sanofi has executed value-based contracts related to
    Soliqua 100/33, Praluent, and Kevzara. These arrangements are in their
    nascent stages, and we do not have sufficient information to assess the
    results.

        Despite the promise of these and similar arrangements, Sanofi
    strongly believes that better legal and regulatory clarity would
    facilitate greater proliferation of value-based contracts. For example,
    we support the creation of a safe harbor from Anti-Kickback Statute
    liability to expressly protect value-based agreements. We also are
    supportive of legislation that would remove Best Price-barriers to
    value-based contracts, such as the Patient Affordability, Value, and
    Efficiency Act (PAVE Act).
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump Administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point-of-sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        If so, would this transparency bring down drug costs--overall and
    for specialty drugs?

        Answer. Because the proposed rule would require manufacturer
    discounts to be provided at the pharmacy counter, the proposal will
    facilitate increased transparency with respect to the arrangements
    between manufacturers and PBMs, and with respect to the discounts
    manufacturers offer on their medicines. We believe such increased
    transparency would result in lower patient costs.

        However, Sanofi believes that HHS's proposal does not go far enough
    in creating the kind of systemic change needed to create a more
    transparent drug supply chain throughout the entire U.S. health-care
    system. We believe that increased, system-wide transparency, that
    appropriately protects competitively sensitive information, would
    improve competition by making relevant information available to
    patients and policymakers. Providing more information about what is
    driving costs in the system, and taking steps to curtail misaligned
    incentives related to the flow of money through the system, for
    instance through legislation like the C-THRU Act, would allow for
    increased competition and better-informed decision making.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the Pharmacy Benefit Manager. But there's
    another side of the equation that I'd like to ask about.

        How do wholesalers negotiate pricing with manufacturers?

        What impact does this have on drug costs?

        What incentives or disincentives do they have to contain price
    increases?

        Answer. Wholesalers do not typically negotiate pricing with
    manufacturers. Wholesalers are merchant-middlemen in the supply chain,
    and they generally facilitate the efficient distribution of drugs and
    biologicals to end customers (such as pharmacies or clinics). While
    Sanofi may offer a prompt pay discount to wholesalers, wholesalers
    generally purchase product at Wholesale Acquisition Cost (i.e., list
    price) and they facilitate the acquisition of products by end
    purchases--frequently at prices that are negotiated between Sanofi and
    the end purchaser. If wholesalers sell to end purchasers at a loss
    based on the negotiated price, wholesalers will issue a ``chargeback''
    to the manufacturer for the difference. In addition, Sanofi pays
    service fees to wholesalers to operationalize this distribution and
    chargeback process, and those fees typically are based on a percent of
    WAC. As with fees paid to PBMs, Sanofi's view is that flat pricing for
    wholesaler administrative services could exert downward pressure on
    drug prices by delinking list price from fee payments.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price.

        Like many Oregonians, I am skeptical drug manufacturers would
    voluntarily lower their prices. Therefore, would you support
    legislation that would (1) make similar changes the administration has
    put forward related to Part D and Medicaid managed care, (2) change the
    rebate system in a similar way to the proposal for the commercial
    market, and (3) require drug makers to lower the list price of their
    drugs equal to the amount of rebates provided today?

        Answer. If (1) the proposed changes to the anti-kickback statute
    safe harbors were codified, and (2) Congress implemented similar
    changes to the commercial insurance market, Sanofi would lower the list
    prices of its prescription medications for products in competitive
    categories for which there is currently a material difference between
    list price and net price on the assumption that patient access and
    affordability would be improved. Sanofi also supports policy changes
    that would de-link other payments in the pharmaceutical supply chain
    from list price.

        We support extending the intent behind the anti-kickback statute
    safe harbor proposed rule to the commercial market so that incentives
    are aligned across the marketplace. Together, we believe these changes
    would facilitate Sanofi's ability to lower our list prices. However, we
    recommend a step-wise approach, implementing changes to the commercial
    market after the safe harbor rule is implemented on January 1, 2020.
    Such an approach would provide an opportunity for stakeholders and the
    government to identify unintended consequences, and address them, prior
    to extending these policies to the commercial market.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

        Without a better understanding of how these policy changes
    ultimately would affect the competitive marketplace, patient access,
    and affordability, we are unable to quantify the amount of any
    potential list price reduction.

        We support legislation that would incentivize manufacturers to
    lower list prices by connecting better patient access and affordability
    to such pricing actions. The U.S. market-based approach to drug pricing
    has been successful in reducing net prices, but in the current system,
    that value is not being passed on to patients. We expect that the
    reforms we note above would address that issue while preserving a
    market-based approach that promotes competition and ensures patients
    have affordable and sustainable access to innovative medicines.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        For each drug listed in response to question 1, please also provide
    a list of which quarters and years each drug hit the cap.

        Answer. Sanofi takes steps to ensure that it complies with all
    applicable laws related to the Medicaid Drug Rebate Program, including
    that it is paying rebates to the state Medicaid programs in accordance
    with law. Sanofi sells NDCs in 29 product families for which it pays
    Medicaid rebates at 100 percent of AMP. Respectfully, Sanofi's view is
    that the detailed information requested by this question is
    confidential and proprietary. We would be happy to work with the
    Committee to provide this information in a way that mitigates against
    competitive harms that could arise from public disclosure of this
    information.
                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. For example, an analysis by the U.S.
    Department of Health and Human Services Office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.
    Accordingly, please describe the following:

        Your company's current compliance plan and procedures used to
    ensure compliance with the requirements of the Medicaid Drug Rebate
    Program including internal audits or other checks you use to identify
    compliance vulnerabilities.

        Answer. Sanofi takes steps to ensure that it complies with all
    applicable laws related to its participation in the Medicaid Drug
    Rebate Program (MDRP). These steps include, for example, documenting
    Medicaid rebate calculation methodologies, processes, and reasonable
    assumptions as appropriate. Sanofi's government price reporting
    personnel also hold weekly meetings with the Sanofi legal department,
    including with support from outside counsel as needed, to ensure that
    compliance questions are discussed and addressed in a timely manner.
    Sanofi's MDRP compliance is tested through several audits, including
    biannual Sarbanes-Oxley Act audits, biannual external audits,
    conversations with an external consultant government pricing advisory
    team, and annual calculation audits of Average Manufacturer Price and
    Best Price.

        Question. Any past or ongoing issues of non-compliance.

        Answer. Given the complexity of the MDRP and applicable law and
    guidance, Sanofi routinely reviews its calculation methodologies and
    reasonable assumptions. In the normal course of business, questions may
    arise as to specific Sanofi compliance processes for the MDRP. When
    such questions arise, Sanofi takes prompt steps to engage with CMS
    about appropriate next steps, including a restatement of any of the
    components of the Medicaid rebate calculation if needed. Such
    restatements are administrative in nature and expressly contemplated by
    the CMS regulations.

        Question. Any corrective actions taken to address identified
    problems or issues of noncompliance with the MDRP and how such steps
    were communicated to the Centers for Medicare & Medicaid Services.

        Answer. As noted above, in the event that Sanofi identifies any
    compliance questions that it believes warrant review by CMS, Sanofi
    promptly engages with CMS. This may occur, for example, in the event of
    statutory or regulatory changes, or if CMS releases new sub-regulatory
    guidance.

        Question. Any steps taken to improve compliance and ensure that all
    Medicaid drug rebates owed to the federal government and the states are
    paid in full.

        Answer. Sanofi's government price reporting team routinely works
    with in-house and outside counsel regarding compliance with the
    Medicaid Drug Rebate Act and CMS rules. As part of this continuing
    compliance, the company assesses its calculation processes and
    reasonable assumptions for purposes of calculating Average Manufacturer
    Price, Best Price, and Unit Rebate Amount. In certain cases, moreover,
    Sanofi engages directly with CMS to seek the agency's view of Sanofi's
    reasonable assumptions or compliance processes. In any instance in
    which Sanofi would determine that the State Medicaid Programs were
    underpaid rebates, Sanofi would engage with CMS to determine the
    appropriate way forward, including restating pricing metrics and paying
    additional rebates to the States.
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus or other compensation was tied.

        Is your salary, bonus or other compensation tied to either revenue
    or net income of the company as a whole? Has it ever been? If yes,
    please explain what assumptions about price increases are used when the
    compensation committee sets revenue or net income goals. Does the
    compensation committee provide any guidance to executives in regards to
    the amount of revenue that the company will generate from price
    increases versus volume growth?

        Answer. The Sanofi board of directors, acting on the recommendation
    of the Compensation Committee, sets the compensation for the chief
    executive officer (CEO). That compensation structure includes fixed
    compensation, variable compensation, options, performance shares, and
    benefits in kind.

        Sanofi's overall compensation policy is designed to motivate and
    reward performance by ensuring that a significant portion of
    compensation is contingent on the attainment of financial, operational,
    and extra-financial criteria aligned with the corporate interest and
    with the creation of shareholder value. Therefore, in 2017 (the most
    current year in which public information is available), as Sanofi's
    CEO, Dr. Brandicourt was eligible for up to 250 percent of his target
    fixed compensation in variable compensation. Several factors are
    considered in determining his variable compensation; 40 percent is
    based on financial indicators, and 60 percent is based on specific
    individual objectives, including external growth, product launches,
    operational transformation, organization and staff relations, and new
    product pipeline.

        Dr. Brandicourt's compensation package also includes equity-based
    compensation, which is medium-term and aims to align the interests of
    the CEO with those of the shareholders and other stakeholders. In 2017,
    he received a set number of options to subscribe for shares, based on
    performance conditions measured over a 3-year period, as well as
    performance shares based on business net income, return on assets, and
    total shareholder return.
                                   net prices
        Question. In your testimony, you stated, ``we have increased
    transparency by providing, each year, information about our list and
    net prices across all of our medicines,'' and that ``in 2018, the
    average aggregate list price increase across all Sanofi medicines in
    the U.S. was 4.6 percent . . . the price actually paid to Sanofi,
    declined by 8 percent. So declining average aggregate net price in
    [2018] represents the third consecutive year in which the amount paid
    by payers across all of our medicines went down.'' Please describe how
    the company's year-over-year aggregate net price is calculated. Please
    also specifically address the following questions.

        Answer. Sanofi calculates the aggregate net price as follows: Brand
    net sales are divided by common units for the appropriate period. This
    amount--``net price per unit''--is then compared to the prior period.
    This amount establishes any increase or decrease for the brand for the
    period being calculated. Once this is done for all brands, the
    increase/decrease is weighted by gross sales (i.e., volume) to show the
    aggregate net price impacts for Sanofi's portfolio of medicines.

        Question. How many products are included in the calculation of the
    average net price change? What was the median net price change?

        Answer. This analysis is done on 79 separate products, covering 76
    brands. Some brands have multiple product forms with different prices;
    Sanofi separates these product forms when calculating average net
    price.

        The median net price change in 2018 was zero percent across all
    products. Removing products with no net price change, the median net
    price change in 2018 is -1.0%. This calculation is not weighted by
    gross sales.

        Question. Is net price weighted? If so, how? For example, in
    determining the aggregate net price does the company assign different
    weights to different products based on volume or other factors? Are
    ``on patent'' and ``off patent'' drugs weighted identically? Are other
    statistical weights used or are all products treated equally?

        Answer. All products are weighted by gross sales (i.e., volume),
    irrespective of whether Sanofi has any current patents related to the
    product. No other statistical weights were used.

        Question. Does the figure that you provided during your testimony
    account for U.S. prices, international prices, or both? Generally
    speaking, when your company reports net price changes, does it
    differentiate between U.S. and international prices?

        Answer. The data Dr. Brandicourt provided regarding average
    aggregate list price and average aggregate net price accounted for U.S.
    prices. Sanofi's annual pricing report \9\ and related reporting on net
    price consider U.S. prices only.
    ---------------------------------------------------------------------------
        \9\ https://mediaroom.sanofi.com/-/media/Project/One-Sanofi-Web/
    Websites/Global/Sanofi-COM/mediaroom/pdf/2019/
    Prescription_Medicine_Pricing_2019.pdf.

        Question. Please list the five drugs your company sold in the U.S.
    that had the greatest year-over-year net price increase in 2018, noting
    the increase for each drug by dollar figure and percentage. Please list
    the five drugs your company sold in the U.S. that had the lowest year-
    over-year net price increase (and/or the greatest decrease) in 2018,
    noting the increase (or decrease) for each drug by dollar figure and
    ---------------------------------------------------------------------------
    percentage.

         Products with Greatest Average Net Price Increases in 2018 \10\
    ------------------------------------------------------------------------
                                           YOY Percentage    YOY U.S. Dollar
                   Product                     Change        Change by Unit
    ------------------------------------------------------------------------
    Renvela \11\                                      40%             $1.00
    ------------------------------------------------------------------------
    Imovax \12\                                       15%             30.10
    ------------------------------------------------------------------------
    Caprelsa \13\                                     12%          1,536.60
    ------------------------------------------------------------------------
    Hectorol \14\                                     11%              0.03
    ------------------------------------------------------------------------
    Zaltrap \15\                                       9%              0.60
    ------------------------------------------------------------------------
    \10\ We have excluded products that were discontinued/divested in 2018,
      have no sales in 2018, or if the reason for net price increase was due
      to changes in prior accounting estimates or assumptions (as opposed to
      changes in rebates and discounts).
    \11\ Sanofi did not take any list price increases on Renvela in 2018.
      The net price increase is due to (1) changes in prior accounting
      estimates/assumptions, and (2) increasing use of generics in class,
      resulting in (i) change in the mix of business, and (ii) a reduction
      in rebate payments.
    \12\ Sanofi took a 5-percent list price increase on Imovax in 2018.
    \13\ Sanofi took a 5-percent list price increase on Caprelsa in 2018.
    \14\ Sanofi reduced the list price of Hectorol by 47 percent in October
      2018. The net price increase was due to a reduction in rebate
      payments.
    \15\ Sanofi did not take any list price increases on Zeltrap in 2018.

         Products with Greatest Average Net Price Decreases in 2018 \16\
    ------------------------------------------------------------------------
                                           YOY Percentage    YOY U.S. Dollar
                   Product                     Change        Change by Unit
    ------------------------------------------------------------------------
    Renvela AG                                       -74%             -1.57
    ------------------------------------------------------------------------
    Zolpidem CR                                      -68%             -0.26
    ------------------------------------------------------------------------
    Leflunomide                                      -63%             -0.59
    ------------------------------------------------------------------------
    Clolar                                           -48%           -894.26
    ------------------------------------------------------------------------
    Priftin                                          -26%             -0.54
    ------------------------------------------------------------------------
    \16\ We have excluded products that were discontinued/divested, have no
      sales in 2018, or if the reason for net price decline was due to
      changes in prior accounting estimates or assumptions (as opposed to
      changes in rebates and discounts).

        Question. For 2018, what was the average net price change in the
    U.S. market for (1) drugs with no competition, (2) drugs with only
    branded competition, and (3) drugs with generic competition?

        Answer. (1) Drugs with no competition:\17\ 0.0%.
    ---------------------------------------------------------------------------
        \17\ We define a product as having no competition if there are no
    other products in the therapeutic class.

        (2) Drugs with only branded competition:\18\ -2.1%.
    ---------------------------------------------------------------------------
        \18\ We define a product as having only branded competition if
    there is no generic, follow-on biologic, or biosimilar product in the
    therapeutic class.

        (3) Drugs with AB-rated generic/follow-on biologic/biosimilar
    ---------------------------------------------------------------------------
    competition: -13.5%.

        Question. In its most recent pricing report, Sanofi states that it
    ``increased the price of 35 of our 76 prescription medicines'' in the
    United States. This statement appears to be in regards to list price.
    How many of these medicines had their net price increase?

        Answer. Seventeen of the 35 prescription medicines with list price
    increases also had average net price increases.

        Question. In its most recent pricing report, Sanofi states that
    ``in 2018, 55 percent of our gross sales were given back to payers as
    rebates, including $4.5 billion in mandatory rebates to government
    payers and $7.3 billion in discretionary rebates.'' For each product,
    please disclose the gross sales and the amount of rebates paid.

        Answer. Product-level rebate information is confidential and
    proprietary information for competitive reasons and falls within the
    definition of ``trade secret'' under the Trade Secrets Act, 18 U.S.C.
    Sec. 1905, Exemption 4 of the Freedom of Information Act, 5 U.S.C.
    Sec. 552(b)(4), and the Defend Trade Secrets Act of 2016, 18 U.S.C.
    Sec. 1836. Public disclosure of this information would cause
    significant harm to Sanofi and Sanofi's customers, and competitors
    would gain unfair competitive advantage if they were to obtain this
    information through public disclosure.

        We note that congressional and executive agencies have historically
    expressed concern that disclosure of such information could inhibit
    competition. For example, in 2007 when then-chairman Waxman asked
    several Medicare Part D prescription drug plans (``PDPs'') to submit to
    the House Oversight and Government Reform Committee information on the
    negotiated price discounts, rebates and other price concessions that
    they obtained from drug manufacturers, the CBO issued a report
    concluding that public disclosure of that information could reduce the
    rebates that PDPs received and thus raise Medicare costs.\19\
    Specifically, the CBO found that the disclosure of rebate data could
    cause the variation in rebates among purchasers to decline. Because
    PDPs generally secure rebates that are somewhat larger than the average
    rebates observed in commercial health plans, the disclosure of Part D
    rebates to competitors could create pressure to reduce those rebate
    amounts, which in turn could increase costs for the Medicare program
    and, on average, the costs for Medicare beneficiaries.\20\
    Specifically, the CBO found that the disclosure of rebate data could
    cause the variation in rebates among purchasers to decline. Second, CBO
    concluded that disclosure of rebates could facilitate tacit collusion
    among the manufacturers of competing brand-name drugs, reducing the
    rebates to PDPs and thus increasing net drug prices.\21\ Similarly, the
    Federal Trade Commission (``FTC'') has cited concerns regarding the
    anti-competitive effects of disclosing net pricing and other price-
    sensitive information. In the context of the healthcare industry
    generally, the FTC noted:
    ---------------------------------------------------------------------------
        \19\  CBO, Letter to the Hon. Joe Barton and the Hon. Jim McCrery
    (March 12, 2007), available at https://www.cbo.gov/system/
    files?file=2018-10/03-12-drug-rebates.pdf; see also CBO, ``Increasing
    Transparency in the Pricing of Health Care Services and
    Pharmaceuticals'' (June 5, 2008), available at https://www.cbo.gov/
    sites/default/files/110th-congress-2007-2008/reports/06-05-
    pricetransparency.pdf.
        \20\ Id., at 3.
        \21\ Id., at 4.

            [Price transparency] can actually harm competition and
            consumers. Some types of information are not particularly
            useful to consumers, but are of great interest to competitors.
            We are especially concerned when information disclosures allow
            competitors to figure out what their rivals are charging, which
            dampens each competitor's incentive to offer a low price, or
            increases the likelihood that they can coordinate on higher
            prices.\22\
    ---------------------------------------------------------------------------
        \22\ FTC, Office of Policy Planning, ``Price Transparency or TMI?''
    (July 2, 2015), available at https://www.ftc.gov/news-events/blogs/
    competition-matters/2015/07/price-transparency-or-tmi.

        Moreover, in describing its concerns about a New York state bill
    that would have required pharmacy benefit managers (``PBMs'') to
    disclose their rebate arrangements with drug manufacturers, the FTC
    explained that disclosure of this information could ``facilitate
    collusion, raise prices, and harm the patients the Bill is supposed to
    protect.'' \23\ The FTC further explained that, without knowledge of
    such competitor rebate information:
    ---------------------------------------------------------------------------
        \23\ FTC, Office of Policy Planning, Bureau of Competition and
    Bureau of Economics, Letter to Hon. James L. Seward re: New York Senate
    Bill 58, at 5 (March 31, 2009), available at https://www.ftc.gov/sites/
    default/files/documents/advocacy--documents/ftc-staff-comment-
    honorable-james-l.seward-concerning-new-york-senate-bill-58-pharmacy-
    benefit-managers-pbms/v090006newyorkpbm.pdf.

            [M]anufacturers have powerful incentives to bid aggressively
            for formulary position, because preferential formulary
            treatment may yield increased sales. Unprotected disclosures
            thus may raise the price that New York consumers pay for
            pharmaceutical coverage by undermining competition among
            pharmaceutical companies for preferred formulary treatment.\24\
    ---------------------------------------------------------------------------
        \24\ Id. See, also, FTC, Office of Policy Planning, Bureau of
    Competition, and Bureau of Economics, to Assemblyman Greg Aghazarian
    re: California Assembly Bill No. 1960 (September 7, 2004) (concluding
    that, if manufacturers learn the exact amount of the rebates offered by
    their competitors through required PBM disclosures, then tacit
    collusion among manufacturers is more feasible, which may lead to
    higher prices for PBM services and drugs), available at https://
    www.ftc.gov/sites/default/files/documents/advocacy_documents/ftc-
    comment-hon.greg-aghazarian-concerning-ca.b.1960-requiring-pharmacy-
    benefit-managers-make-disclosures-purchasers-and-prospective-
    purchasers/v040027.pdf.

        For these reasons, in public settings, we have provided rebate
    information at an aggregate level only, to prevent reverse engineering
    by competitors to learn our net pricing information for specific
    products. We would be happy to work with the committee to provide this
    information in a way that mitigates against competitive harms that
    ---------------------------------------------------------------------------
    could arise from public disclosure of this information.

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. When new products enter the market, do drug companies set
    high initial prices and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. We can only speak for Sanofi. Consistent with our pricing
    principles, when Sanofi sets the price of a new medicine, we hold
    ourselves to a transparent, rigorous, and structured process that
    includes consultation with external stakeholders. In our view, an
    objective measure of a new product's value considers the benefit to
    patients, compared to a standard of care; the reduced need--and
    therefore costs--of other health care interventions; and any increase
    in quality of life and productivity. We believe our pricing reflects
    these factors. We also consider factors such as the affordability for
    patients and any unique factors specific to the medicine, like the need
    to support ongoing clinical trials, implement important regulatory
    commitments, or develop sophisticated patient support tools that
    improve care management and help decrease the total cost of care.
    Additionally, under our pricing principles, we limit annual list price
    increases to the National Health Expenditure, which is CMS's projected
    annual health-care spending growth rate. Since we established our
    pricing principles in 2017, all price increases for our insulin
    products have been at or below NHE.

        Sanofi offers rebates to health plans and PBMs in order to help
    secure and maintain favorable formulary positions. Our aim in these
    negotiations is to establish affordable access to patients. Currently,
    however, payers and PBMs inconsistently pass through to patients the
    growing savings they receive from increased negotiated rebates and
    discounts. Accordingly, despite increasing rebates and lower net
    prices, out-of-pocket costs for many patients have continued to grow.
    Sanofi supports policies that would pass through PBM rebate savings to
    patients at the pharmacy counter in the form of lower cost-sharing.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. We can only speak for Sanofi. If (1) the proposed changes
    to the anti-kickback statute safe harbors were codified, and (2)
    Congress implemented similar changes to the commercial insurance
    market, Sanofi would lower the list prices of its prescription
    medications for products in competitive categories for which there is
    currently a material difference between list price and net price on the
    assumption that patient access and affordability would be improved.
    Sanofi also supports policy changes that would de-link other payments
    in the pharmaceutical supply chain from list price.

        We support extending the intent behind the anti-kickback statute
    safe harbor proposed rule to the commercial market so that incentives
    are aligned across the marketplace. Together, we believe these changes
    would facilitate Sanofi's ability to lower our list prices. However, we
    recommend a step-wise approach, implementing changes to the commercial
    market after the safe harbor rule is implemented on January 1, 2020.
    Such an approach would provide an opportunity for stakeholders and the
    government to identify unintended consequences, and address them, prior
    to extending these policies to the commercial market.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which would simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

        Without a better understanding of how these policy changes
    ultimately would affect the competitive marketplace, patient access,
    and affordability, we are unable to quantify the amount of any
    potential list price reduction. When setting the price of a new
    medicine, Sanofi's decision making will continue to be guided by our
    pricing principles framework, which are discussed in Part 1 of this
    response.

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D? In
    the health insurance plans that you offer your employees, do you ask
    your insurers to pass through the full manufacturer rebates to the
    beneficiaries?

        Answer. To address prices of drugs that are not subject to rebates
    in Medicare Part D, Sanofi supports policies that would incentivize
    responsible pricing by tying smaller list price increases, or even list
    price reductions, to both access and affordability for patients. Sanofi
    also believes that value-based discounting arrangements could drive
    down the price of prescription drugs in all contexts, regardless of the
    existence of rebates, including for Medicare Part D. Sanofi favors
    reforms in applicable statutes and regulations to permit manufacturers
    and payers to adopt these arrangements more broadly than is the case
    today.

        The Sanofi medical plan is self-insured; as such, the company pays
    the majority (approximately 80 percent) of the health-care claims that
    are incurred by our employees and their dependents. Sanofi does not,
    therefore, pass rebates through to members. Importantly, the Sanofi PPO
    medical/Rx plan, which covers 90 percent of our employees who elect
    medical coverage, maintains very low member cost-sharing for
    prescriptions. For example, members incur no cost ($0 co-pays) for
    Sanofi and partner prescription drugs. For non-Sanofi prescriptions,
    the out-ofpocket expense varies for generic ($15/prescription),
    preferred brand ($25/prescription) and non-
    preferred brand ($40/prescription).

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand. What are your recommendations for
    increasing transparency in how your companies set the list prices for
    drugs, and for improving transparency in the supply chain for
    prescription drugs? Would you support federal standards for
    transparency in setting the list prices for drugs?

        Answer. Sanofi supports increased system-wide transparency, which
    would improve competition by making relevant information available to
    patients and policymakers. Two years ago, Sanofi announced our
    progressive and industry-leading pricing principles to help
    stakeholders understand our pricing decisions and to advance a more
    informed discussion of issues related to the pricing of medicines.\25\
    ---------------------------------------------------------------------------
        \25\ https://mediaroom.sanofi.com/en/articles/2017/sanofi-pricing-
    principles-for-the-u-s/.

        Sanofi's pricing policy includes a commitment to transparency in
    how we price new medicines coming to the market for the first time.
    When Sanofi sets the price of a new medicine, we hold ourselves to a
    transparent, rigorous, and structured process that includes
    consultation with external stakeholders. In our view, an objective
    measure of a new product's value considers the benefit to patients,
    compared to a standard of care; the reduced need--and therefore costs--
    of other health care interventions; and any increase in quality of life
    and productivity. We believe our pricing reflects these factors. We
    also consider factors such as the affordability for patients and any
    unique factors specific to the medicine, like the need to support
    ongoing clinical trials, implement important regulatory commitments, or
    develop sophisticated patient support tools that improve care
    ---------------------------------------------------------------------------
    management and help decrease the total cost of care.

        Tied to our pledge to keep annual list price increases at or below
    the projected U.S. National Health Expenditure growth rate, Sanofi has
    committed to providing its rationale should Sanofi increase any list
    price above the NHE growth rate, highlighting clinical value, real
    world evidence, regulatory change, new data, or other circumstances
    that support our decision. Sanofi also has committed to disclose
    annually our aggregate U.S. gross and net price changes from the prior
    calendar year. These data may help illustrate how pricing changes
    accrue to manufacturers versus others in the value chain, highlighting
    our discrete role in the broader U.S. health care system.

        We support Federal standards for transparency in the rationale for
    price increases above a certain threshold, provided that there are
    appropriate guardrails. Sanofi believes that increased transparency
    should accomplish three goals:

            (1)  Preempt similar state laws, as was done with the Sunshine
            Act, to create a consistent reporting process.

            (2)  Ensure information that if released publically could be
            anti-competitive is kept confidential.

            (3)  Take a holistic approach to transparency, such as
            requiring PBMs to disclose when the net price of a medicine has
            declined and whether the increased rebates are used to lower
            costs for patients or for other reasons.

        We would be willing to work with this Committee on appropriate
    policy solutions.

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently. How many of your drugs are included in
    value-based contracts and how many patients are benefiting from them?
    How do these value-based contracts work to lower drug prices for both
    patients and taxpayers?

        Answer. At this time, Sanofi has entered into value-based
    arrangements involving three Sanofi products: Soliqua 100/33, Praluent,
    and Kevzara. At present, we are not able to identify the specific
    number of patients who benefit from these arrangements.

        Sanofi believes that encouraging an environment that is supportive
    of value-based arrangements would help promote drug affordability,
    increase patient access to medicines, and improve patient adherence and
    outcomes. Specifically, although there are different types of these
    agreements, value-based contracts generally tie prices and payments to
    the value of a particular prescription drug product--while potentially
    reducing patient out-of-pocket costs and providing patients with better
    access to the most innovative drug products. A manufacturer could, for
    example, condition payment for a product on its success in meeting a
    predefined clinical outcome, and this type of arrangement could make
    drugs more affordable and lower costs throughout the system.

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    Federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack. Are any of your
    companies providing medical necessity paperwork to doctors in order to
    get your drugs covered by Medicare?

        Answer. No. Sanofi does not provide patient-specific clinical or
    medical necessity information to physicians in furtherance of the
    Medicare coverage of any of Sanofi's products for particular patients.
    Consistent with guidance from the Department of Health and Human
    Services Office of Inspector General (OIG), Sanofi typically provides
    physicians with a copy of an applicable blank prior authorization form,
    or in some cases, the form with only the physician's demographic
    information filled out, along with separate instructions for filling
    out the form. Also, in keeping with OIG guidance, Sanofi provides
    physicians with template appeals letter for instances in which a
    physician needs to appeal non-coverage for a Sanofi product. These
    template letters do not include any patient medical information, and
    instead are provided only as a guide for physicians to describe the
    reasons that the patient requires his or her prescribed Sanofi
    product.\26\ Similarly, Sanofi provides physicians with template
    letters of medical necessity, which do not offer medical information on
    specific patients. Instead, these documents provide a general framework
    pursuant to which physicians may prepare their own, patient-specific
    letters of medical necessity.\27\ These measures comply with the OIG
    guidance in that they provide ``limited support'' in connection with a
    purchase or prescribing decision for a Sanofi product.
    ---------------------------------------------------------------------------
        \26\ See, e.g., https://www.visitspconline.com/servlet/
    servlet.FileDownload?file=00P3600000Q1T
    boEAF.
        \27\ See, e.g., https://www.visitspconline.com/servlet/
    servlet.FileDownload?file=00P3600000Q1T
    byEAF.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers. What is delaying the
    uptake of biosimilar drugs in the United States? What policies do you
    ---------------------------------------------------------------------------
    recommend to increase the development of biosimilar drugs?

        Answer. Sanofi supports the entry of biosimilar medicines in the
    market after a reasonable period of time after the innovator biologic
    is developed, which we believe is already reflected in U.S. law. There
    are changes already in place that will help patients and taxpayers
    realize the benefit of biosimilars. Specifically, in March 2020,
    certain biologics that are currently regulated as drugs, including long
    acting insulins, will be regulated as biologics and therefore will be
    subject to the existing biosimilars pathway. We expect the change in
    regulation to spur the continued development of substitutable or
    interchangeable products, and to increase competition in this space
    generally. Further, we believe that as health-care providers become
    more familiar with biosimilars, the uptake of biosimilar drugs will
    increase. Findings from a recent review show that there is an overall
    lack of biosimilar familiarity among U.S. and European health-care
    providers, leading to low prescribing comfort as well as safety and
    efficacy concerns.\28\ The study concludes that, to realize the full
    cost-saving potential of biosimilar medicines, clinician-directed
    biosimilar education is necessary to address the gaps in biosimilar
    knowledge, facilitate prescribing changes, and ultimately increase
    biosimilar use.
    ---------------------------------------------------------------------------
        \28\ See ``Factors Affecting Health Care Provider Knowledge and
    Acceptance of Biosimilar Medicines: A Systematic Review,'' 25 J.
    Managed Care & Specialty Pharm. 102-112 (Jan. 2019), available at
    https://www.jmcp.org/doi/10.18553/jmcp.2019.25.1.102.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach.

        Researchers say that this type of imagery, combined with viewing
    hours of drug commercials each month, leads consumers to underestimate
    the risks associated with medications. For the past decade, studies
    have shown that aggressive direct-toconsumer advertising is associated
    with rising drug prices and an increase in inappropriate drug
    prescriptions.

        Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. Sanofi believes DTC advertisements can play an important
    role in both raising awareness about a disease and educating patients
    about their treatment options. The benefits of DTC advertisements are
    reflected in the results of a recent survey conducted by Princeton
    Survey Research Associates International, which found that DTC
    advertisements often prompt conversations about alternatives such as
    generics or lifestyle changes, and prompt positive behaviors, such as
    information-seeking and medicine adherence.\29\
    ---------------------------------------------------------------------------
        \29\ https://www.phrma.org/report/2017-direct-to-consumer-
    advertising-survey-results.

        When DTC advertisements solely discuss a particular disease or
    condition without mentioning or alluding to a specific drug, FDA
    considers the advertisements disease awareness communications. Disease
    awareness communications are not considered promotional labeling or
    advertising, and thus such communications are not subject to the
    requirements of the Federal, Food, Drug and Cosmetic Act (FDCA) or FDA
    regulations. In contrast, DTC advertisements that make claims about a
    drug are subject to requirements governing disclosure of risk and other
    information, including a statutory requirement to include a brief
    summary relating to side effects, contraindications, and effectiveness.
    FDA's prescription drug advertising regulations distinguish between
    print and broadcast advertisements, which require a ``brief summary''
    for print advertisements and what is referred to as a ``major
    statement'' of risks for broadcast advertisements. FDA regulations also
    set forth additional requirements for information to be included in
    both print and broadcast advertisements. Certain broadcast
    advertisements, including the initial television advertisement for a
    prescription drug and all television advertisements for prescription
    drugs subject to a Risk Evaluation Mitigation Strategy with elements to
    assure safe use, are subject to pre-dissemination review by FDA. Even
    where a television advertisement is not subject to mandatory review,
    sponsors may elect to voluntarily submit the advertisement to FDA for
    ---------------------------------------------------------------------------
    advisory review.

        While the time-limited nature of broadcast DTC advertisements can
    present challenges in ensuring a drug advertisement presents all
    information required by the FDCA and FDA regulations in a manner easily
    digestible to a consumer, or even HCP, audience, Sanofi strives to
    disseminate balanced DTC advertisements that clearly and effectively
    communicate a product's benefits and risks. To that end, prior to
    airing any DTC television advertisement, Sanofi submits each
    advertisement to FDA for pre-dissemination review and incorporates
    FDA's comments, even when such review is not required for the
    advertisement in question. To further the objective of ensuring that
    DTC advertisements educate consumers about potential treatment options
    in a non-misleading manner, we believe industry would benefit from a
    regulatory framework that allows for greater flexibility in the risk
    and other information required to be included in broadcast
    advertisements, including, for example, the flexibility to focus on
    select significant risks in the advertisement itself while directing
    consumers to a website for a more fulsome discussion of a product's
    risks. FDA has acknowledged that its regulations provide ``only limited
    flexibility'' for risk disclosure in broadcast advertisements. Thus,
    allowing for greater flexibility in content control in DTC
    advertisements would likely require amending existing FDA regulations,
    as well as potentially the underlying statutory provisions governing
    the information required to be disclosed in advertisements.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organization for Economic Cooperation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price.

        One of the most well-known examples is Mylan's increase of the
    price of EpiPen from less than $100 in 2007 to more than $600 in 2016.
    Another example, is the ever-increasing price of insulin. Sanofi
    increased the price of a vial of Lantus from $88.20 in 2007 to $307.20
    in 2017. And those are just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. Current regulations, including price reporting
    requirements, create uncertainty about the implications of lowering a
    list price. We are working with CMS on alternatives that could enable
    us to put lower list price versions of our products on the market.
    Until such system changes are implemented, we are working to improve
    the affordability of our products for those who are uninsured or
    underinsured through our many patient support programs.

        It is important to note, as well, that revenues from existing
    therapies are used to fund future R&D across therapeutic areas.
    Sanofi's R&D strategy is to allocate resources to priority therapeutic
    areas based both on scientific opportunity and unmet medical need,
    leveraging multiple therapeutic modalities and accelerating early
    development. Our R&D pipeline currently contains 81 projects, including
    33 new molecular entities in clinical development, and 35 projects are
    in Phase III or have been submitted to regulatory authorities. From
    2008 to 2017, Sanofi invested over $55 billion dollars globally in R&D.
    Last year we invested almost $7 billion globally, or approximately 24%
    of our gross profits, in our research and development activities. We
    expect to continue to spend around the same on R&D in the coming years.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market.

        These ``pay-for-delay'' patent settlements benefit both brand-name
    pharmaceutical companies by helping them avoid costly patent litigation
    and general manufacturers by rewarding them a hefty sum to delay
    entering the market with a cheaper drug alternative. However, these
    deals do not benefit consumers. According to an FTC study, these
    anticompetitive deals cost consumers and taxpayers $3.5 billion in
    higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Answer. No, Sanofi does not enter into ``pay for delay'' agreements
    that prohibit generic drug or biosimilar development after the
    expiration of a patent. Sanofi has reached settlements in patent
    infringement cases, and these agreements have allowed the generic
    company to commercialize its product before the expiration of the
    applicable patent covering Sanofi's innovator product.

        Question. Why would a pharmaceutical company enter into a pay-for
    delay agreement?

        Answer. We can only speak for Sanofi, and we do not enter into
    ``pay-for-delay'' settlement agreements.

        Question. Do you think these agreements stifle competition and
    prevent generic alternatives to your branded medications?

        Answer. With respect to patent litigation, generally, Sanofi
    believes it is inappropriate to presume that any settlement of patent
    litigations related to pharmaceutical products is anticompetitive. Such
    settlements are often the most efficient and effective way to resolve
    disputes regarding patented drugs. Additionally, they often lead to the
    earliest appropriate entry of generic products into the market thereby
    benefiting patients--earlier than expiration of the relevant patents.
    Each patent litigation and potential settlement presents unique factors
    and must be considered individually and in light of the relevant
    circumstances.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) Office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections.

        The rule is predicted to increase net drug costs in its early
    years. The CMS actuaries estimate it would cost $196 billion over 10
    years. Despite this high price tag, the beneficiary benefits are
    limited. The proposed rule notes that under the CMS Actuary's analysis,
    the majority of beneficiaries would see an increase in their total out-
    of-pocket payments and premium costs; reductions in total cost sharing
    will exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. At this time, it is difficult to predict the effect of the
    administration's proposed rule. It is our expectation that it will
    result in lower out-of-pocket costs for patients by protecting only
    manufacturer rebates to Medicare Part D and Medicaid MCO plans and
    their PBMs that are reflected in the point-of-sale price. Without a
    better understanding of how these policy changes ultimately would
    affect the competitive marketplace, patient access, and affordability,
    however, we are unable to provide assurances regarding how prices might
    change.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spent nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9% of all medical marketing, in 1997 to $9.6
    billion, or 32% of total spending, in 2016.

        Can each of you please provide what your ratio of spending on sales
    and marketing to research and development is today?

        Answer. In 2018, Sanofi's global ratio of spending on sales and
    marketing \30\ to research and development was approximately 117
    percent.
    ---------------------------------------------------------------------------
        \30\ ``Sales and marketing'' includes, but is not limited to: sales
    force, promotion, and marketing management.
    ---------------------------------------------------------------------------
                                 price-gouging
        Question. Sanofi, as I understand it, has made a pledge to the
    public to limit its price increases to the national health expenditures
    growth projection.

        As the chair of the board of directors at PhRMA would you support
    membership requirements that would cap annual price increases for drugs
    sold as part of Medicare, similar to what Sanofi has pledged?

        Given that PhRMA members are considering creating higher standards
    for themselves, would you support an industry-wide standard on annual
    price increases that applies to all pharmaceutical corporations,
    whether or not they are members of PhRMA?

        Answer. Dr. Brandicourt appeared before the committee on behalf of
    Sanofi; we cannot speak on behalf of PhRMA or any other company. We
    note that pricing discussions among PhRMA members, or pharmaceutical
    manufacturers more generally, could implicate federal antitrust laws
    and therefore would be inappropriate.

        Two years ago, Sanofi announced our progressive and industry-
    leading pricing principles, which include a pledge to keep annual list
    price increases at or below the projected U.S. National Health
    Expenditure (NHE) growth rate, as calculated by CMS. In 2018, all of
    Sanofi's price increases across its medicines were consistent with
    those pricing principles, as are all pricing actions taken in 2019.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. For Sanofi, the key requirement for any policy solution is
    that it should result in improved access and lower prescription out-of-
    pocket drug costs for patients, while maintaining incentives for
    innovations. To reform the current misaligned incentives in the current
    system, Sanofi supports de-linking payments to PBMs, payers and others
    in the supply chain from the list price. Additionally, we support
    policies that would incentivize lower launch prices, smaller list price
    increases, or even list price reductions, by requiring health plans to
    cover those medicines at an affordable co-pay level and only allow
    access restrictions consistent with the label and accepted best
    clinical practice.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates do
    not rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The Administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. Yes. Sanofi supports policies, such as those proposed in
    the C-THRU Act, that would encourage or require PBMs and payers to be
    transparent regarding how they use manufacturer rebates and pass
    through manufacturer rebates to patient at point of sale in the form of
    lower out-of-pocket costs.

        As part of our pricing principles, Sanofi voluntarily discloses
    annually our aggregate U.S. gross and net price changes from the prior
    calendar year. These data help illustrate how pricing changes accrue to
    manufacturers versus others in the value chain, highlighting our
    discrete role in the broader U.S. health care system.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health-care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        Answer. Yes, we do.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, how do you utilize the
    rebates your PBM negotiates to lower health-care costs or drug costs
    for your employee plans and what does your company do with that
    savings? Specifically, do the savings go toward lowing premiums?

        Answer. The Sanofi medical plan is self-insured; as such, the
    company pays the majority (approximately 80 percent) of the health-care
    claims that are incurred by our employees and their dependents.
    Therefore, Sanofi uses rebates to defray the overall cost of its health
    plan, which allows us to keep plan costs stable for all participants.

        We offer our employees generous healthcare coverage and have been
    able to keep the deductibles of our PPO, which covers 90% of our
    employees who elect medical coverage, at $200 for single coverage and
    $400 for family coverage over the past few years. With respect to our
    PPO prescription drug benefit, members incur no cost ($0 co-pays) for
    Sanofi and partner prescription drugs. For non-Sanofi prescriptions,
    the out-of-pocket expense varies for generic ($15/prescription),
    preferred brand ($25/prescription) and non-preferred brand ($40/
    prescription). The Sanofi plan's actuarial value is around 90%, which
    puts it at the ``platinum'' level.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, does your PBM offer
    point-of-sale rebates to your employees?

        Answer. Yes, our PBM does offer point-of-sale rebates, however only
    around 8 percent of its clients currently are enrolled in point-of-sale
    rebates.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. For Sanofi, the key requirement for any policy solution is
    that it should result in improved access and lower prescription out-of-
    pocket drug costs for patients, while maintaining incentives for
    innovations. To reform the current misaligned incentives in the current
    system, Sanofi supports de-linking payments to PBMs, payers and others
    in the supply chain from the list price. Additionally, we support
    policies that would incentivize lower launch prices, smaller list price
    increases, or even list price reductions, by requiring health plans to
    cover those medicines at an affordable co-pay level and only allow
    access restrictions consistent with the label and accepted best
    clinical practice.

        Sanofi also supports the intent behind legislation like the SPIKE
    Act, which would impose price transparency requirements on companies
    that increase the list price of a particular drug over a certain
    threshold. We believe that increased transparency should accomplish
    three goals: (1) preempt similar state laws, as was done with the
    Sunshine Act, to create a consistent reporting process; (2) ensure
    information that if released publically could be anti-competitive is
    kept confidential; and (3) take a holistic approach to transparency,
    such as requiring PBMs to disclose when the net price of a medicine has
    declined and whether the increased rebates are used to lower costs for
    patients or for other reasons.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)? How many of your company's products are
    based, at least in part, on NIH research, and how many are the result
    of research funded solely by your company?

        Answer. In identifying targets for new drugs, Sanofi relies on
    global science, which often includes NIH-funded research. Sanofi has
    collaborated with NIH on various research and development (R&D)
    initiatives on projects related to HIV,
    Epstein-Barr virus, influenza, and respiratory syncytial virus.

        While there is no question that NIH plays a vital role in basic
    research and early discovery, the majority of Sanofi's current
    portfolio of products in the pre-development to development phases do
    not rely on NIH funding. Sanofi reinvests a significant portion of its
    revenue into the R&D of new or improved medicines and vaccines. Last
    year, Sanofi globally spent almost $7 billion on R&D globally, an
    increase of approximately 7 percent from 2017, which reflects our
    commitment to bringing better therapies to patients. Sanofi plans to
    maintain this level of R&D investment through 2021, and our R&D
    pipeline now contains 81 projects, including 33 new molecular entities
    in clinical development, and 35 projects that are in Phase III or have
    been submitted to regulatory authorities. This investment means that
    Sanofi potentially will seek approval for nine new medications in the
    next three years, primarily in therapeutic areas where Sanofi sees the
    greatest nexus between our expertise and patient need: diabetes,
    vaccines, oncology, immunology, rare diseases, and rare blood
    disorders.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer.

    ------------------------------------------------------------------------
                                            Research and     Advertising and
                  USD \31\                   Development     Marketing \32\
    ------------------------------------------------------------------------
    2018                                    $6,954,920,000    $4,519,400,000
    ------------------------------------------------------------------------
    2017                                    $6,238,080,000    $3,764,280,000
    ------------------------------------------------------------------------
    2016                                    $5,689,200,000    $3,006,300,000
    ------------------------------------------------------------------------
    2015                                    $5,590,200,000    $2,773,100,000
    ------------------------------------------------------------------------
    2014                                    $6,160,440,000    $2,673,000,000
    ------------------------------------------------------------------------
    \31\ Sanofi reports its financials in Euros. All financial figures
      reported in this document have been converted from Euros into U.S.
      dollars. These are Sanofi global financial figures.
    \32\ Includes global spending on ``promotion'' and ``marketing
      management.''

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. If (1) the proposed changes to the anti-kickback statute
    safe harbors were codified, and (2) Congress implemented similar
    changes to the commercial insurance market, Sanofi would lower the list
    prices of its prescription medications for products in competitive
    categories for which there is currently a material difference between
    list price and net price on the assumption that patient access and
    affordability would be improved. Sanofi also supports policy changes
    that would de-link other payments in the pharmaceutical supply chain
    from list price.

        We support extending the intent behind the anti-kickback statute
    safe harbor proposed rule to the commercial market so that incentives
    are aligned across the marketplace. Together, we believe these changes
    would facilitate Sanofi's ability to lower its list prices. However, we
    recommend a step-wise approach, implementing changes to the commercial
    market after the safe harbor rule is implemented on January 1, 2020.
    Such an approach would provide an opportunity for stakeholders and the
    government to identify unintended consequences, and address them, prior
    to extending these policies to the commercial market.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

        Without a better understanding of how these policy changes
    ultimately would affect the competitive marketplace, patient access,
    and affordability, we are unable to quantify the amount of any
    potential list price reduction.

        Question. How will this proposal affect how your company sets the
    list prices for new drug products?

        Answer. When setting the price of a new medicine, Sanofi's decision
    making will continue to be guided by our pricing principles framework.
    When Sanofi sets the price of a new medicine in the U.S., we hold
    ourselves to a rigorous and structured process that includes
    consultation with external stakeholders. In our view, an objective
    measure of a new product's value considers the benefit to patients,
    compared to a standard of care; the reduced need--and therefore costs--
    of other health-care interventions; and any increase in quality of life
    and productivity. We believe our pricing reflects these factors. We
    also consider factors such as the affordability for patients and any
    unique factors specific to the medicine, like the need to support
    ongoing clinical trials, implement important regulatory commitments, or
    develop sophisticated patient support tools that improve care
    management and help decrease the total cost of care.

        To the extent reform of the anti-kickback statute safe harbors
    results in changes in the competitive marketplace, patient access, and
    affordability, the rule is likely to affect our pricing of new
    medicines.

        Question. If the proposal is finalized and not extended to the
    private market, will your company make any list price reductions? If
    so, how large would the reductions be relative to the size of the
    rebates your company is currently providing?

        Answer. Sanofi is committed to working with other stakeholders to
    lower patient out-of-pocket costs, and the company will carefully
    review any final rule issued by HHS regarding the Anti-Kickback Statute
    and its safe harbor regulations--with the goal of providing point-of-
    sale discounts to patients, in accordance with law, to lower their out-
    of-pocket costs.

        Without addressing the currently misaligned incentives across all
    payer channels, it is unclear the extent to which Sanofi would be able
    to lower list prices. We would need a better understanding of how the
    rule ultimately would affect the competitive marketplace, patient
    access, and affordability in both the government and commercial
    insurance markets in order to quantify the amount of any potential list
    price reduction.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\33\
    ---------------------------------------------------------------------------
        \33\ MACPAC, ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wp-content/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        This requirement created an unintended loophole. Rather than use
    the price of the authorized generic, drug companies can sell its
    authorized generic to a corporate subsidiary at an artificially lower
    price, and use that lower price to bring down the AMP, which in turn
    ---------------------------------------------------------------------------
    lowers the rebate obligation.

        Does your company engage in this practice? Has your company ever
    engaged in this practice in the past?

        Answer. Sanofi currently markets authorized generic versions of
    certain of its products, through corporate affiliates, under separate
    National Drug Codes (``NDC''). Sanofi's general approach for these
    products has been that if two products share the same drug, dosage
    form, and strength, and both are sold by the same corporate entity or
    Sanofi business unit, then their sales are blended for the calculation
    of AMP and Best Price.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. In October you were asked by a reporter whether you would
    lower the price of insulin if point-of-sale rebates were enacted. Your
    response was, ``We realize that some medicines remain economically out
    of reach for some patients. We take this issue seriously and will
    continue to seek innovative solutions to help make insulins more
    affordable for patients.'' Please answer that question more
    specifically: will you lower your list price in response to the rebate
    rule?

        Answer. If (1) the proposed changes to the anti-kickback statute
    safe harbors were codified, and (2) Congress implemented similar
    changes to the commercial insurance market, Sanofi would lower the list
    prices of its prescription medications for products in competitive
    categories for which there is currently a material difference between
    list price and net price on the assumption that patient access and
    affordability would be improved. Sanofi also supports policy changes
    that would de-link other payments in the pharmaceutical supply chain
    from list price.

        We support extending the intent behind the anti-kickback statute
    safe harbor proposed rule to the commercial market so that incentives
    are aligned across the marketplace. Together, we believe these changes
    would facilitate Sanofi's ability to lower its list prices. However, we
    recommend a step-wise approach, implementing changes to the commercial
    market after the safe harbor rule is implemented on January 1, 2020.
    Such an approach would provide an opportunity for stakeholders and the
    government to identify unintended consequences, and address them, prior
    to extending these policies to the commercial market.

        We want to ensure that the new system achieves its goal of
    improving affordability for patients. For instance, CMS should monitor
    and evaluate how the new system affects formulary access, utilization
    management, and patient cost-sharing, particularly with respect to
    medicines with a lower list price. We also have concerns that changes
    to the rebate system may lead to new fees, which simply require
    manufacturers to pay previous rebate values in new ways, rather than
    creating savings for patients.

        Without a better understanding of how these policy changes
    ultimately would affect the competitive marketplace, patient access,
    and affordability, we are unable to quantify the amount of any
    potential list price reduction.

        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? For those drugs is
    your list price equal to your net price?

        Answer. When considering rebates paid by Sanofi in any form,
    including those that are government-mandated, Sanofi offers rebates on
    all of its products at some point in the distribution channel. We do
    not expect that this will change based on the company's pipeline.

        Question. Do you invest more in R&D than you generate in U.S. sales
    revenue? Please include specific figures.

        Answer. In 2018, Sanofi spent $6,954,920,000 globally on R&D, a 7-
    percent increase over 2017 and approximately 24 percent of its global
    gross profits. In 2018, Sanofi's U.S. net sales were $13,617,200,000.

        Answer. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. Yes. In 2018, Sanofi spent $6,954,920,000 globally on R&D,
    and $6,921, 880,000 globally on marketing and administration.
    ``Administration'' includes, but is not limited to: finance, human
    resources, external affairs, legal, business services, business
    development, and internal audit.

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. In 2018, Sanofi spent $6,954,920,000 globally on R&D, and
    $8,154,980,000 globally on marketing and sales. The primary function
    included in ``sales'' is the sales force.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. Sanofi believes that advertising is an important tool to
    inform and educate the public about its medicines, while raising
    general awareness of diseases that are frequently surrounded by stigma.
    We are committed to ensuring that our advertisements provide accurate,
    accessible, and useful health information to patients and consumers.
    Our communications are designed to educate patients and consumers about
    serious health conditions and the availability of treatments, and to
    encourage them to seek guidance from their healthcare professionals
    about appropriate treatment. We consider a variety of factors in
    determining whether and how to advertise a product, including patient
    needs and the unique aspects of an individual product or disease state.

                                     ______

                                          Independent Medical Education Grants
                                               1st Jan 2015-30th June 2015
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                             \2\
    ----------------------------------------------------------------------------------------------------------------
    Academic CME, LLC Postgraduate         Incorporating Advancements in Monoclonal Antibody            $298,600.04
     Institute for Medicine                 Therapeutics into Patient Management Strategies                        Collaboration \3\
                                            within Dyslipidemia

    Academy of Managed Care Pharmacy       The unmet needs of multiple sclerosis, and the                    $6,500
                                            principles and current evidence in the use of DMTs

    Admin of the Tulane Educational Fund   7th Annual Tulane Symposium on Thyroid And Parathyroid        $10,000.00
     on behalf of TUHSC CCE                 Diseases                                                               Collaboration \3\
    AKH Inc. Advancing Knowledge and       American Society for Preventive Cardiology: Annual            $10,000.00
     Healthcare                             Cardiovascular Disease Prevention Conference

    American Academy of Physician          AAPA Conference 2015--Neurology Track                          $5,000.00
     Assistants

    American Academy of Physician          AAPA Conference 2015--Endocrinology Track                      $5,000.00
     Assistants

    American Academy of Physician          AAPA Conference 2015--Nephrology Track                         $3,500.00
     Assistants

    American Association of Clinical       Georgia-AACE 2015 Annual Meeting                               $7,500.00
     Endocrinologists

    American Association of Clinical       Lipids Sessions at Endocrine University: Disease               $5,000.00
     Endocrinologists                       Management and Technology Skills for Endocrinology
                                            Fellows In Training

    American Association of Clinical       Southern States--AACE 2015 Annual Meeting                      $7,500.00
     Endocrinologists

    American Association of Clinical       Diabetes Sessions At Endocrine University: Disease            $25,000.00
     Endocrinologists                       Management and Technology for Endocrinology Fellows
                                            in Training

    American Association of Clinical       AACE 24th Annual Scientific & Clinical Congress               $47,350.00
     Endocrinologists                       (Thyroid Sessions)

    American Association of Clinical       AACE 24th Annual Scientific & Clinical Congress               $47,350.00
     Endocrinologists                       (Diabetes Session)

    American Association of Clinical       Diabetes Sessions at AACE 24th Annual Scientific And          $47,350.00
     Endocrinologists                       Clinical Congress

    American Association of Clinical       Mid Atlantic Chapter of The American Association of            $7,500.00
     Endocrinologists                       Clinical Endocrinologists 13th Annual Meeting &
                                            Symposium

    American Association of Clinical       Mid Atlantic Chapter of the American Association of            $7,500.00
     Endocrinologists                       Clinical Endocrinologists 13th Annual Meeting 7
                                            Symposium

    American Association of Clinical       California Chapter of The American Association of             $20,000.00
     Endocrinologists                       Clinical Endocrinologists Presents: Hot Topics in
                                            Diabetes and Endocrinology for Primary Care

    American Association of Clinical        LDL-C Reduction in the High-Risk Patient: How Low           $261,057.00
     Endocrinologists Medtelligence, LLC    Should We Go?                                                          Collaboration \3\

    Association of Diabetes Educators      Diabetes Education and People with Diabetes: Partners         $15,000.00
                                            in the Winners Circle, New York American State
                                            Regional Conference

    American Association of Diabetes       AADE 2015--Rumor has It? Demystifying the Use of Basal       $321,895.00
     Educators                              Insulin in Type 2 Diabetes Management

    American College of Cardiology         ACC Rise and Shine Series: Just The Facts--An                 $55,000.00
     Foundation                             Objective Overview of PCSK9 Inhibitors                                 Collaboration \3\

    American College of Cardiology          Lipid Management Today: Unanswered Questions and            $125,000.00
     Foundation Med-IQ, LLC                 Unquestioned Answers                                                   Collaboration \3\

    American College of Surgeons American  36th Annual Meeting of the American Association of             $5,000.00
     Association of Endocrine Surgeons      Endocrine Surgeons

    American Diabetes Association          2015 Professional Educator Conference                          $5,000.00

    American Diabetes Association          ADA Inside: The Intelligent Use of Insulin Inspiring         $387,602.00
                                            System Improvement with Diabetes Education

    American Diabetes Association          Diabetes is Primary                                          $166,545.00

    American Health Resources, Inc.        Focus on the Patient with Diabetes: Managing Co-               $6,000.00
                                            Morbidities and Improving Outcomes

    American Health Resources, Inc.        Identification and Resolution of Injection Technique          $12,600.00
                                            Barriers in Patients with Diabetes

    American Nephrology Nurses'            The Questions, Myths, and Facts Regarding the                $160,000.00
     Association Rockpointe Corporation     Management Of CKD-MBD

    American Neurological Association      2015 American Neurological Association 140th Annual           $25,000.00
                                            Meeting

    American Society of Nephrology         ASN Highlights 2015                                           $15,000.00

    American Society of Nephrology         AST/ASN Transplant Nephrology Core Curriculum                 $15,000.00

    Ann & Robert H. Lurie Children's       Lysosomal Storage Disease Training Program for Genetic        $75,000.00
     Hospital of Chicago                    Counselors

    Annenberg Center for Health Sciences   Diabetes Monitor Conference Coverage (ADA 2015)               $50,000.00
     at Eisenhower

    Association of Black Cardiologists,    Lipid Management and Cardiovascular Risk Reduction:          $380,000.00
     Inc. National Association for          The Evolving Treatment Paradigm                                        Collaboration \3\
     Continuing Education

    Association of Family Practice         Chronic Kidney Disease                                         $4,000.00
     Physician Assistants

    Association of Family Practice         Joint Injection                                                $6,100.00
     Physician Assistants

    Association of Family Practice         Diabetes--What Do I Prescribe After Metformin?                 $3,150.00
     Physician Assistants

    Baylor University Medical Center dba   New Treatment Paradigms for Castrate Resistant                $15,330.00
     A. Webb Roberts Center CancerNet,      Prostate Cancer
     LLC

    Baylor University Medical Center dba   New Treatment Paradigms for Castrate Resistant                $15,330.00
     A. Webb Roberts Center CancerNet,      Prostate Cancer
     LLC

    BIDDM                                  Beth Israel Deaconess Medical Center Renal Division            $5,500.00
                                            Grand Rounds and Renal Biology Conference Series

    Board of Regents of the University of  18th Annual Primary Care Update                                $6,000.00
     Oklahoma Health Science

    Brigham and Women's Hospital Workshop  Kidney Disease Screening And Awareness Program (KDSAP)        $29,000.00
                                            New Chapters Training Workshop

    California Academy of Family           The Family Medicine Clinical Forum                            $20,000.00
     Physicians

    Cardiovascular Institute of Sarasota   11th Annual Cardiovascular Symposium Cardiology Update        $10,000.00
     Foundation for Education Florida       2015: Time to Focus on Early Cardiovascular Disease                    Collaboration \3\
     Medical Association                    Prevention

    Children Health and Research           Fellowship in Inherited Metabolic Disorders and               $75,000.00
     Foundation, Inc.                       Lysosomal Storage Disorders

    Children's Hospital of Philadelphia    Genetic Counselor Fellowship in lysosomal storage             $75,000.00
     Foundation                             disorders

    Cincinnati Children's Hospital         Genetic Counseling Fellowship in the Lysosomal Storage        $74,987.00
     Medical Center                         Disorders

    Cleveland Clinic Educational           Nephrology Update2015                                         $10,000.00
     Foundation

    Cleveland Clinic Educational           Diabetes and Thyroid Update--A Multidisciplinary              $10,000.00
     Foundation                             Symposium on Diabetes and Thyroid Diseases

    Cleveland Clinic Educational           2015 Diabetes Day 20th Annual Symposium: Diabetes             $10,000.00
     Foundation                             Through The Ages

    Cleveland Clinic Educational           18th Annual Intensive Review of Endocrinology and             $20,000.00
     Foundation                             Metabolism

    Cleveland Clinic Educational           Mellen Center Update In Multiple Sclerosis                     $5,000.00
     Foundation

    Colorado Foundation for Medical Care   3rd Annual Convention of The Cardio Renal Society of          $30,000.00
     Cardio Renal Society of America        America

    CME Outfitters, LLC                    Risky Business: Understanding and Attenuating Risk           $207,090.00
                                            Associated with Disease-Modifying Therapy in
                                            Relapsing-Remitting Multiple Sclerosis

    Consortium of Multiple Sclerosis       Expert Debates in Multiple Sclerosis: Opposing Views         $125,000.00
     Centers                                in Management

    Consortium of Multiple Sclerosis       PatientGPS TM: Clinical Paths to Explore Treatment           $100,000.00
     Centers                                Options and Individualize Therapy in Multiple
                                            Sclerosis

    Consortium of Multiple Sclerosis       A Practical Guide to Rehabilitation in MS (an AIMS           $190,765.00
     Centers                                Primer)

    Creative Educational Concepts, Inc.    Achieving Equilibrium in Diabetes with GLP-1 Receptor        $142,875.00
                                            Agonists: Avoiding Hypoglycemia When Treating
                                            Postprandial Hyperglycemia

    Duke University                        Residency in Medical Genetics                                 $70,853.52

    Educational Concepts Group, LLC        Advances in The Management Of GU Cancers: Highlights          $22,000.00
                                            From the 2015 Genitourinary Cancers Symposium

    Educational Review Systems National    Effective Management of Gaucher Disease? A Primer for         $35,000.00
     Home Infusion Association              Home and Specialty Infusion Clinicians

    Emory Genetics Laboratory              Multidisciplinary Extramural LSD Educational Talks on         $24,200.00
                                            Lysosomal Storage Diseases

    Emory Genetics Laboratory              The Paul M. Fernhoff Genetic Counseling Fellowship in         $75,000.00
                                            the Lysosomal Storage Disorders

    Emory University                       Emory Latino Diabetes Education Program                      $241,455.00

    Endometriosis Association Inc.         Adhesion Awareness for Doctors and Patients:                  $54,591.48
                                            Communicating the Significance of Adhesion Disease

    Fabry Support & Information Group      Eyes On Fabry-Illinois College of Optometry--Chicago           $2,550.00

    Fabry Support & Information Group      Eyes on Fabry Southern College of Optometry Memphis,           $2,500.00
                                            TN

    Florida Academy of Physician           The Good, the Bad, and the Latrogenic: Renal                   $9,000.00
     Assistants                             Medication Dosing?

    Foundation for Care Management         Diabetes Mellitus: Detecting and Treating Type I & II         $50,000.00
                                            Patients in a Type II Global Epidemic

    Glens Falls Association for the Blind  Interesting Cases - Lessons Learned the Hard Way              $23,352.24

    Horizon CME, Inc.                      PCSK9 Inhibitors: Where Do They Fit in The Treatment         $163,300.00
                                            of Dyslipidemia?                                                       Collaboration \3\

    Hospital for Special Surgery           Neurological Directions 2015: Update in Neuromuscular          $5,000.00
                                            Medicine

    Humboldt-Del Norte Consortium for      Multiple Sclerosis                                             $4,100.00
     Continuing Medical Education

    Icahn School of Medicine at Mount      Multiple Sclerosis and its Mimics                              $1,920.00
     Sinai

    Imedex, LLC                            Unraveling The Complexities of Treating Metastatic           $198,856.00
                                            Colorectal Cancer with Anti-Angiogenesis Agents                        Collaboration \3\
                                            Across Multiple Lines of Therapy

    Institute for Medical and Nursing      New Developments in Insulin Therapy: Expert Answers To       $222,519.33
     Education                              Your Clinical Questions--A Regional Meeting Series

    Johns Hopkins University               The 11th Annual Johns Hopkins Multiple Sclerosis             $210,000.00
                                            Symposium Series

    Johns Hopkins University Advanced      The Future of Lipid Management: New Perspectives &           $174,400.00
     Studies in Medicine                    Targets For LOWERING LDL-C

    Johns Hopkins University Medical       Innovations in Prandial Glucose Control for Patients         $133,000.00
     Logix, LLC                             with Type 2 Diabetes

    Kidneys for Life Fund Raising for      4th Update on Fabry Nephropathy; Manchester UK, June 1-       $75,000.00
     MINT                                   2, 2015

    Joslin Diabetes Center, Inc.           Complementary Treatments To Enhance Insulin Efficacy:        $392,463.00
     Integrated Learning Partners, LLC      Theory And Strategies

    Letters & Sciences University of       MS Leadership Summit 2015-2016                               $205,000.00
     North Texas Health Science Center at
     Fort Worth

    Medical Education Resources CMEology,  Shifting the Treatment Paradigm for Multiple                 $100,000.00
     LLC                                    Sclerosis: Advances in Pathophysiology and Emergence
                                            of Novel Disease Modifying Therapies

    Medical Education Resources Tarsus     Best of the Cardiometabolic Health Congress: Regional         $80,000.00
     Cardio Inc. dba Health Science Media   Conference Series and Virtual Highlights Activity
                                            with Extended Distribution on Medscape Education

    Medical Education Resources Tarsus     Best of the Cardiometabolic Health Congress: Regional         $65,000.00
     Cardio Inc. dba Health Science Media   Conference Series and Virtual Highlights Activity
                                            with Extended Distribution on Medscape Education

    Medical Education Resources Tarsus     Novel Therapies for LDL-C Lowering in the Fight              $250,000.00
     Cardio Inc. dba Health Science Media   Against Residual ASCVD Risk

    Medical Learning Institute, Inc.       Understanding the Evolution of MS Care: Optimizing            $43,186.00
                                            Therapeutic Decision Making

    Medical University of South Carolina   10th Annual Symposium on the Nephrology Update for             $2,500.00
                                            Primary Care and Hospital Medicine

    Med-IQ, LLC                            The Top 10 Challenges in Managing High Risk Prostate         $192,276.00
                                            Cancer

    Med-IQ, LLC                            Advancing the Management of Gaucher's Disease                $200,957.00

    Med-IQ, LLC                            The Evolving Therapeutic Landscape In Gaucher's              $147,963.00
                                            Disease

    Med-IQ, LLC                            The Evolution of Science, Medicine and Patient               $315,090.00
                                            Centered Care in CKD-MBD

    Med-IQ, LLC                            Medical Insiders: Emerging Science for the Management        $100,000.00
                                            of Metastatic Castration-Resistant Prostate Cancer

    Med-IQ, LLC                            Moving Beyond the Guidelines in the Management of            $135,207.00
                                            Castration-Resistant Prostate Cancer

    Med-IQ, LLC                            New Horizons In Dyslipidemia Management: An                  $121,862.00
                                            Interactive Digital Publication                                        Collaboration \3\

    Med-IQ, LLC Taking Control of Your     New and Emerging Insulins: The Top 10 Things You Need        $568,909.00
     Diabetes                               to Know About Biosimilars and Other Novel Insulins on
                                            the Therapeutic Horizon

    Med-IQ, LLC Taking Control of Your     Practical Strategies to Address Postprandial                 $722,362.00
     Diabetes                               Hyperglycemia in Type 1 and Type 2 Diabetes: An                        Collaboration \3\
                                            Important Aspect of Overall Diabetes Care

    Med-IQ, LLC Taking Control of Your     Making the Connection: Advancing Clinical Care and           $200,000.00
     Diabetes                               Improving Adherence for Patients with Diabetes

    Medscape, LLC                          Advances in Ultra Rapid-Acting Insulin                       $732,600.00

    Medscape, LLC                          A Balancing Act in CKD-MBD: Managing Hyperphosphatemia       $377,300.00
                                            and Cardiovascular Disease

    Medscape, LLC                          Anti-Vegf Therapy in Metastatic Colorectal Cancer:            $99,000.00
                                            Where Are We and What Do We Know?                                      Collaboration \3\

    Medscape, LLC                          The Future of Basal Insulin: Improving Patient               $200,000.00
                                            Outcomes by Addressing Unmet Needs

    Medscape, LLC                          Combination Therapy in The Modern T2D Era                    $170,000.00

    Medscape, LLC                          Long-Term Efficacy and Safety of Phosphate Binders for       $209,500.00
                                            Hyperphosphatemia in CKD-MBD

    Medscape, LLC                          Comprehensive Management of CKD-MBD: Hands-on Case           $192,000.00
                                            Studies

    Medscape, LLC                          An Update on LDL-C Management: Current Guidelines,           $450,000.00
                                            Treatment, and Future Recommendations

    Medscape, LLC                          Highlights on Multiple Sclerosis Management From AAN         $100,000.00
                                            2015

    Michigan Council of Nurse              Update in Arthritis Medication: Clearing Up the                $1,600.00
     Practitioners                          Confusion Michigan Council of Nurse Practitioners
                                            Annual Conference

    Michigan State Medical Society         2015 Diabetes and Lipid Updates                                $5,000.00

    Minnesota Optometric Association        Eyes on Fabry Minnesota Optometric Association's              $5,100.00
     Fabry Support & Information Group      Metro Society

    Montefiore Medical Center              Multiple Sclerosis: Exploring Treatment Options and           $85,000.00
                                            Individualizing Therapy

    National Association of Managed Care   Individualizing Treatment Strategies to Improve               $57,000.00
     Physicians, Inc.                       Patient Outcomes in the Management of Type 2 Diabetes
                                            (T2DM)

    National Committee for Quality         Strategies for Success As A Patient-Centered Medical         $100,000.00
     Assurance (NCQA) Med-IQ, LLC           Home--Diabetes

    National Committee for Quality         Strategies for Success As A Patient-Centered Medical         $250,000.00
     Assurance (NCQA) Med-IQ, LLC           Home--Dyslipidemia                                                     Collaboration \3\

    National Comprehensive Cancer          NCCN 20th Annual Conference General Session: Advancing        $50,000.00
     Network, Inc.                          the Standard of Cancer CareTM

    National Kidney Foundation             Getting Ahead of Metabolic and Mineral Disturbances in       $350,850.00
                                            the Management of CKD-MBD: A Focus on Management
                                            Strategies

    National Kidney Foundation             Kidney Disease Outcomes Quality Initiative (KDOQI)            $10,000.00
                                            2015

    National Kidney Foundation, Inc.       24th Annual Fellows Research Forum                             $5,000.00

    National Kidney Foundation, Inc.       Charlotte Patient Empowerment Workshop                         $3,500.00

    National Lipid Association             Lipid Academy Course Series of 3                              $15,000.00

    National Lipid Association             Masters in Lipidology Course Series of 3                      $15,000.00

    National Lipid Association             National Lipid Association's 2015 Scientific Meeting          $55,000.00
                                            Series

    National Lipid Association             National Lipid Association's 2015 Scientific Meeting          $70,000.00
                                            Series                                                                 Collaboration \3\

    National Lipid Association             2015 National Lipid Association's Masters in                  $30,000.00
                                            Lipidology and Lipid Academy Course Series                             Collaboration \3\

    National Lipid Association Continuing  Dyslipidemia: New Challenges and Emerging Options in         $248,160.00
     Education Alliance, LLC                Lowering CVD RISK                                                      Collaboration \3\

    National Tay-Sachs & Allied Diseases   NTSAD Science Symposium & Workshop For Researchers &          $10,000.00
     Association, Inc.                      Healthcare Professionals

    Nebraska Academy of Physician          Renal Medication Dosing: The Good, the Bad and the             $4,000.00
     Assistants                             Latrogenic

    New Jersey Academy of Family           The Future of Basal Insulin: Improving Patient               $399,550.00
     Physicians Medscape, LLC               Outcomes by Addressing Unmet Needs

    New Mexico Optometric Association      Genetics, Gene Therapy and Stem Cell Therapy in Eye            $2,500.00
     Inc.                                   Care--The Future is Here

    North American Center for Continuing   (CRS 2015) Therapeutic Advances in                           $310,100.00
     Medical Education, LLC Horizon CME,    Hypercholesterolemia: Examining the Role of PCSK-9                     Collaboration \3\
     Inc.                                   Inhibitors in Addressing Unmet Needs

    North American Center for Continuing   Overcoming Systemic Barriers To Optimized                    $274,805.00
     Medical Education, LLC Horizon CME,    Hematopoeitic Stem Cell Transplants
     Inc.

    Nurse Practitioner Alternatives        Caring for the Patient 2015                                  $118,400.00
     International Organization of
     Multiple Sclerosis Nurses

    Oakstone Publishing, LLC PeerVoice     When Statins Are Not Enough: State of the Science in         $256,350.00
     America Limited                        Targeting Residual CV Risk                                             Collaboration \3\

    Ohio State University                  Neuromuscular Fellowship Program                              $75,000.00

    Penn State University Antidote         15th Annual Diabetes Symposium                                $18,000.00
     Education Company

    Penn State University PeerView         Peerview Inplay: ``A Game-Based Approach to Patient-         $199,300.00
     Institute for Medical Education,       Centered Hypercholesterolemia Management''                             Collaboration \3\
     Inc.

    Penn State University PeerView         Peerview Video In session, ``Approved Disease-               $139,375.00
     Institute for Medical Education,       Modifying Therapies For Multiple Sclerosis
     Inc.                                   Management: What Can We Learn From Recently Presented
                                            Data?''

    Penn State University PeerView         Peerview Select-A-Scenario Live, ``Applying The Latest        $74,210.00
     Institute for Medical Education,       Evidence To Guide Treatment Decision-Making in CRPC:
     Inc.                                   Real Cases, Difficult Choices--You Make the Call''

    Pharmacy Times Office of Continuing    Overcoming Challenges and Optimizing Insulin Therapy         $216,040.00
     Professional Education                 in Type 2 Diabetes

    Pharmacy Times Office of Continuing    A Guide to Optimizing Insulin Therapy in Type 2              $175,730.00
     Professional Education                 Diabetes in the Managed Care Setting: Guidelines, New
                                            and Emerging Insulin Analogs, and Challenges in
                                            Management a Satellite Symposium at the 2015 AMCP
                                            Annual Meeting

    Pharmacy Times Office of Continuing    Overcoming Challenges of Insulin Therapy in Type 2           $128,495.00
     Professional Education                 Diabetes: Exploring Emerging Options

    Physicians' Education Resource, LLC    8th Annual Interdisciplinary Prostate Cancer Congress        $15,000.00
                                            and Other Genitourinary Malignancies

    Postgraduate Institute for Medicine C- New Frontiers and Treatment Advances for Atopic              $350,000.00
     MEducation Resources, LLC              Dermatitis: Focus on the Role of Established and                       Collaboration \3\
                                            Evolving Biologic Therapies for Patients with
                                            Moderate-to-Severe and Treatment-Resistant Atopic
                                            Dermatitis

    Postgraduate Institute for Medicine    20th Anniversary Scottsdale Prostate Cancer Symposium         $15,000.00
     Diversified Conference Management,
     Inc.

    Postgraduate Institute for Medicine    Differentiating Therapeutic Approaches for Relapsing          $50,000.00
     Enquiring Minds LLC                    Multiple Sclerosis

    Primary Care Education Consortium      Managing Postprandial Hyperglycemia in Type 2                $230,465.30
                                            Diabetes: Combining Basal Insulin and Glucagon-Like
                                            Peptide-1 Receptor Agonists

    Primary Care Education Consortium      Strategies for Intensifying Insulin Management in Type       $275,955.15
                                            2 Diabetes

    PRIME Education Inc. (PRIME)           Shifting Paradigms in Lipid Management                       $215,850.00
                                                                                                                   Collaboration \3\

    PRIME Education Inc. (PRIME)           New Therapies and Evidence for Patient-Centered              $205,000.00
                                            Hypercholesterolemia Care--Evolving Roles for                          Collaboration \3\
                                            Pharmacists

    PRIME Education Inc. (PRIME)           Evidence-Based Decisions and a Mock P&T: The Role of         $161,020.00
                                            New LDL-C Reduction Therapy

    Pri-Med Institute, LLC (d/b/a pmiCME)  Optimizing Insulin Therapy for Patients with Type 2          $805,275.00
                                            Diabetes: Existing Challenges and New Opportunities
                                            for Improved Care

    Pri-Med Institute, LLC (d/b/a pmiCME)  Evolving Insulin Therapy: Optimizing Care Through            $812,950.00
     Horizon CME, Inc.                      Proper Selection & Use

    Pri-Med Institute, LLC (d/b/a pmiCME)  Combining GLP-1 Receptor Agonists With Basal Insulin:        $797,090.00
     Horizon CME, Inc.                      Realizing the Potential in Type 2 Diabetes

    ProCE, Inc.                            Safe Use of Concentrated Insulin: Helping Patients to         $87,575.00
                                            Get It Right

    Purdue University Medikinetics LLC     Addressing Postprandial Glucose Excursions in Type 2         $363,648.00
                                            Diabetes with Inhaled Insulin

    Purdue University PeerView Institute   Peerview Video Inexchange, ``Contemporary Multiple            $38,000.00
     for Medical Education, Inc.            Sclerosis Management: Identifying and Overcoming
                                            Challenges in the Managed Care Setting''

    Regents of the University of           5th Annual UC Irvine Health Neuromuscular Colloquium          $20,000.00
     California

    Regents of the University of Colorado  Practical Ways to Achieve Targets in Diabetes Care           $200,000.00

    Regents of the University of Colorado  Aspen Lung Conference Asthma 2015: Mechanisms to               $5,000.00
                                            Personalized Medicine/Thomas Petty Aspen Lung                          Collaboration \3\
                                            Conference

    Regents of the University of           Pharmacotherapy of Inherited Metabolic Diseases PharmD        $75,000.00
     Minnesota                              Post-Doctoral Fellowship

    Regents of the University of           Transplant Immunosuppression 2015: Improving Outcomes         $50,000.00
     Minnesota

    Research To Practice                   Data + Perspectives: Clinical Investigators Review Key       $100,000.00
                                            Publications And Current Cases in Advanced Prostate
                                            Cancer? An Independent Satellite Symposium (ISS)
                                            Series Held as Ancillary Events During The 2015
                                            Genitourinary Cancers Symposium

    Rush University Medical Center         Rush University Medical Center Thyroid Cancer                 $20,000.00
                                            Symposium

    Saint Joseph's Regional Medical        Chronic Kidney Disease for the Excellent Internist             $2,700.00
     Center

    Saint Louis University School of       Role of Inflammation in Neurologic & Psychiatric               $5,850.00
     Medicine                               Diseases: Implications for Clinical Practice

    Scripps Health                         Type 2 DM-Emerging Therapeutic Trends in OADS and            $330,257.00
                                            Insulin Combinations 2015: ADA Symposium

    Scripps Health                         Scripps' 35th Annual Conference: Clinical Hematology          $15,000.00
                                            and Oncology 2015

    Scripps Health                         Advanced Therapeutic Interventions to Optimize Obesity        $50,000.00
                                            and DM Care

    Scripps Health                         Emerging Therapeutic Trends to Optimize Diabetes Care         $50,000.00

    Society for Urologic Nurses and        Expert Perspectives in Advanced Prostate Cancer:              $30,000.00
     Associates (SUNA) Plexus               Practical Issues And Considerations for Nurses
     Communications

    Southeastern Regional Genetics         Lysosomal Storage Disease Workgroup Meeting                    $2,000.00
     Groups, Inc. (SERGG)

    Southern Alliance for Physician        Comprehensive Management of Thyroid and Parathyroid            $8,500.00
     Specialties CME                        Diseases

    St. Dominic-Jackson Memorial Hospital  Managing the Diabetes Spectrum in the Pediatric and           $10,000.00
                                            Adult Populations: Pre-Diabetes, Type 1 and Type 2

    Stony Brook University                 Hands on Cadaver Training in Colon And Rectal Diseases         $5,000.00
                                            Robotics, Laparoscopy, Endoscopy, Abdominal Wall
                                            Reconstruction

    Swedish Medical Center Foundation      Thyroid Cancer and Parathyroid Disease - A Practical           $8,000.00
                                            Approach

    Texas Academy of Family Physicians     Management of Chronic Kidney Disease in Primary Care           $3,000.00
                                            At The 2015 C. Frank Webber Lectureship

    The Board of Trustees of the           Fabry Nephrology Fellowship                                   $75,000.00
     University of Alabama for the
     University of Alabama at Birmingham

    The Board of Trustees of the UA for    Mini-Symposium on Fabry Disease: Prospects for                $17,536.00
     the UA at Birmingham                   Improved Care

    The Children's Mercy Hospital          12th Annual Great Plains Pediatric and Adult Endocrine         $3,000.00
                                            Symposium

    The Endocrine Society                  Overcoming Barriers in Diabetes Management with              $512,978.00
                                            Individualized Treatment Strategies

    The Endocrine Society                  PCSK9 Inhibition--A Revolution in Cholesterol Therapy        $272,029.00
                                                                                                                   Collaboration \3\

    The Endocrine Society                  Endo 2015 Thyroid Cancer Sessions                             $73,000.00
                                                                                                                   Collaboration \3\

    The Endocrine Society                  Endo 2015 Diabetes Sessions                                   $50,000.00

    The Endocrine Society                  Maximizing Benefits of Incretin-Based Therapy in Type        $135,056.00
                                            2 Diabetes

    The Endocrine Society American         Diabetes Masters Series 2015--Solving The Puzzle:            $235,867.00
     Association of Diabetes Educators      Current Approaches to Providing Quality T2DM Care

    The France Foundation American         Diabetes: Making the Right Choice in a Sea of                $121,080.00
     Academy of Physician Assistants        Treatment Options

    The France Foundation                  MS Clinical Dialogs: A Peer Discussion on Optimal             $76,547.00
                                            Treatment (Phase 2)

    The Medical College of Wisconsin,      The Eighth Annual Diabetes Symposium of Wisconsin              $5,000.00
     Inc.

    The Ohio State University,             Endocrine Update 2015                                         $10,000.00

    The University of Texas MD Anderson    6th Current Concepts in the Management of Thyroid &           $20,000.00
     Cancer Center                          Parathyroid Neoplasms

    The University of Texas Southwestern   37th Annual Carrell-Krusen Neuromuscular Symposium            $20,000.00
     Medical Center at Dallas

    The University of Texas Southwestern   Neuromuscular Medicine Fellowship                             $74,100.00
     Medical Center at Dallas

    The University of Toledo               Outcomes of Myeloma: The Optimizing Sequenxe of                $3,000.00
                                            Treatments Including Transplant

    Trustees of Columbia University in     Renal Biopsy in Medical Diseases of the Kidneys                $3,500.00
     the City of New York

    UC Regents                             Diabetes Update and Advances In Endocrinology And              $7,500.00
                                            Metabolism

    UC Regents                             LSD Genetic Counseling Fellowship                             $75,000.00

    Ultimate Medical Academy, LLC dba      Cutting Edge Of Transplantation 2015                          $30,000.00
     Global Education Group American
     Society of Transplantation

    University of California Irvine        Genetic Neuromuscular Diseases Fellowship                     $75,000.00

    University of California, San Diego    34th Annual Advanced Nephrology: Nephrology for the           $10,000.00
                                            Consultant

    University of California, San Diego    20th International Conference on Advances in Critical          $5,000.00
     CRRT Inc.                              Care Nephrology--AKI & CRRT 2015

    University of Cincinnati CORE Medical  Navigating the Evolving Therapeutic Landscape in              $65,500.00
     Education, LLC.                        Advanced Prostate Cancer

    University of Cincinnati Paradigm      Multidisciplinary Approach to Charting a Treatment            $94,650.00
     Medical Communications, LLC            Course for Men with Metastatic Castration-Resistant
                                            Prostate Cancer

    University of Cincinnati Paradigm      Advancing Treatment Strategies in Metastatic                  $95,000.00
     Medical Communications, LLC            Castration-Resistant Prostate Cancer: The Urologist's
                                            Role

    University of Florida                  Pediatric Neuromuscular Fellowship                            $75,000.00

    University of Florida Foundation       Southern Salt, Water, and Kidney Club 56th Annual              $5,000.00
                                            Scientific Meeting

    University of Kansas Endowment         Neuromuscular Review Course Series 2015                       $60,000.00
     Association

    University of Massachusetts Medical    MS Practice Update: Managing Walking Impairment,              $30,000.00
     School                                 Neurogenic Bladder, Bowel and Sexual Dysfunction in
                                            Multiple Sclerosis

    University of Massachusetts Medical    Understanding and Applying New Advances in Basal             $303,080.00
     School C-MEducation Resources, LLC     Insulin Therapy

    University of Massachusetts Medical    The IQ&A Interactive Diabetes Intelligence Zone: Focus       $152,000.00
     School C-MEducation Resources, LLC     on Inhaled Insulin, Combination Regimens, and
                                            Postprandial Hyperglycemia

    University of Massachusetts Medical    Novel Mechanisms and Advancing Therapeutic Paradigms         $336,000.00
     School C-MEducation Resources, LLC     for Optimizing LDL--Focused Management and                             Collaboration \3\
                                            Cardioprotection in the Diabetic Patient

    University of Massachusetts Medical    New Frontiers and Treatment Advances for Atopic              $366,000.00
     School C-MEducation Resources, LLC     Dermatitis: Focus on the Role of Established and                       Collaboration \3\
                                            Evolving Biologic Therapies for Patients with
                                            Moderate-to-Severe and Treatment-Resistant Atopic
                                            Dermatitis

    University of Massachusetts Medical    New Frontiers and Treatment Advances in Rheumatoid           $345,000.00
     School C-MEducation Resources, LLC     Arthritis: Focus on Mechanisms of Action, Cytokine-                    Collaboration \3\
                                            Mediated Inflammation and the Evidence for Safe and
                                            Effective Therapy for RA Through Inhibition of the IL-
                                            6 Cytokine and Other Signaling Systems

    University of Massachusetts Medical    Novel Mechanisms and Advancing Therapeutic Paradigms         $465,900.00
     School C-MEducation Resources, LLC     for Optimizing LDL-Focused Management of Primary and                   Collaboration \3\
                                            Familial Hypercholesterolemia

    University of Massachusetts Medical    Understanding and Applying New Advances in Basal             $971,000.00
     School C-M Education Resources, LLC    Insulin Therapy

    University of Massachusetts Medical    New Frontiers and Emerging Treatment Paradigms for           $347,000.00
     School C-MEducation Resources, LLC     Optimizing LDL-Targeted Cardiovascular Risk Reduction                  Collaboration \3\

    University of Miami                    Pediatric Nephrology Seminar XLII and Renal Pathology         $10,000.00
                                            Course

    University of Pittsburgh               Seventh Annual Multidisciplinary Thyroid Cancer                $3,250.00
                                            Symposium: Integrating the New ATA Guidelines into
                                            Clinical Practice

    University of Rochester, School of     2015 Society for Investigative Dermatology Annual             $10,000.00
     Medicine and Dentistry Society of      Meeting                                                                Collaboration \3\
     Investigative Dermatology

    University of Southern California      37th Thyroid Symposium 2015: Practical Solutions To           $10,000.00
                                            Complex Clinical Problems

    University of the Pacific Horizon      Basal Insulin Therapy in the Treatment of Insulin            $223,275.00
     CME, Inc.                              Resistant Type 2 Diabetes: The Role of the Pharmacist
                                            in Ensuring Their Safe and Effective Use

    University of Virginia                 The 39th Annual Fitz-Hugh Symposium: Contemporary             $10,000.00
                                            Management and Cutting Edge Advances in
                                            Otolaryngology--Head & Neck Surgery (Special Emphasis
                                            on Laryngology and Head & Neck Endocrine Surgery)

    USF Health Professions Conferencing    12th Annual Rocky Mountain Metabolic Syndrome                  $5,000.00
     Corporation CEConsultants, LLC         Symposium

    VHA Inc.                               Treating Elevated LDL-C: Beyond Statins                       $85,000.00
                                                                                                                   Collaboration \3\

    Wellmont Health System                 13th Annual Diabetes Symposium                                 $4,000.00

    Yale University                        Diabetes 2015                                                 $50,000.00

    Yale University                        2015 New England Thyroid Club Program                         $10,000.00
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q3, 2015 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Jul 2015-30th Sep 2015
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    Academic CME, LLC                      APPLYING ADVANCED TREATMENT STRATEGIES WITHIN                    326,430
                                            RHEUMATOID ARTHRITIS                                                   Collaboration \3\

    AKH Inc. Advancing Knowledge and       FLORIDA SOCIETY OF RHEUMATOLOGY 2015 ANNUAL CME                    5,000
     Healthcare Florida Society of          CONFERENCE
     Rheumatology

    American Academy of Continuing         TRANSLATING CLINICAL DATA INTO NEPHROLOGY PRACTICE IN            149,800
     Medical Education, Inc.                THE MANAGEMENT OF HYPERPHOSPHATEMIA

    American Association of Clinical       HEARTLAND-AACE 6TH ANNUAL MEETING                                  7,500
     Endocrinologists

    American Association of Clinical       ILLINOIS CHAPTER OF THE AMERICAN ASSOCIATION OF                    5,000
     Endocrinologists                       CLINICAL ENDOCRINOLOGISTS 5TH ANNUAL METING

    American Association of Diabetes       INHALED INSULIN A BREATH OF FRESH AIR FOR THE                     62,800
     Educators Horizon CME, Inc.            TREATMENT OF DIABETES

    American Diabetes Association          30TH ANNUAL CLINICAL CONFERENCE ON DIABETES: BEYOND               25,000
                                            THE NUMBERS

    American Diabetes Association          DIABETES AND ENDOCRINE DISORDERS FOR THE GENERALIST                5,000
                                            AND SPECIALIST

    American Diabetes Association          TRANSITIONS OF CARE THROUGH THE DIABETES LIFESPAN                  5,000

    American Society of Nephrology         ASN BOARD REVIEW COURSE AND UPDATE                                15,000

    American Society of Nephrology         CALCIUM OR NO CALCIUM: THAT IS THE QUESTION                      125,825

    American Urological Association        ESTABLISHING AN ADVANCED PROSTATE CANCER CLINIC: A                60,000
     Education & Research, Inc.             PRACTICAL GUIDE FOR THE UROLOGY CLINIC

    Association of Family Practice         JOINT ASPIRATION/INJECTION WORKSHOP                                5,300
     Physician Assistants

    Cardiovascular Society of Buffalo and  UNDERSTANDIJG FABRY DISEASE FROM A CARDIAC PERSPECTIVE             7,000
     Western NY SUNY AT BUFFALO CME
     OFFICE

    Cleveland Clinic Educational           CURRENT AND FUTURE THERAPEUTIC OPTIONS TARGETING                  80,000
     Foundation                             RESIDUAL CVD RISK: EMERGING THERAPIES FOR THE                          Collaboration \3\
                                            TREATMENT OF DYSLIPIDEMIA

    CME Outfitters, LLC                    RISKY BUSINESS: UNDERSTANDING AND ATTENUATING RISK               207,090
                                            ASSOCIATED WITH DISEASE-MODIFYING THERAPY IN
                                            RELAPSING-REMITTING MULTIPLE SCLEROSIS

    Consortium of Multiple Sclerosis       EXPERT DEBATES IN MULTIPLE SCLEROSIS: OPPOSING VIEWS             125,000
     Centers Nurse Practitioner             IN MANAGEMENT
     Alternatives

    Consortium of Multiple Sclerosis       PATIENTGPS?: CLINICAL PATHS TO EXPLORE TREATMENT                 100,000
     Centers Nurse Practitioner             OPTIONS AND INDIVIDUALIZE THERAPY IN MULTIPLE
     Alternatives                           SCLEROSIS

    Dignity Health MandatoryCE LLC         2ND ANNUAL NEW MEXICO REGIONAL DIABETES SYMPOSIUM                 45,000

    FORE                                   2015 ORTHOPAEDICS FOR THE PRIMARY CARE PRACTITIONER &              4,000
                                            REHABILITATION THERAPIST

    Humboldt-Del Norte Consortium for      MULTIPLE SCLEROSIS                                                 4,100
     Continuing Medical Education

    Icahn School of Medicine at Mount      MULTIPLE SCLEROSIS AND ITS MIMICS                                  1,920
     Sinai

    Icahn School of Medicine at Mount      ADVANCES IN PEDIATRIC FOOD ALLERGY                                15,000
     Sinai

    Institute for the Advancement of       LEARNER-DIRECTED CME: WHAT DO PRIMARY CARE PROVIDERS              49,500
     Human Behavior Answers in CME, Inc.    NEED TO KNOW ABOUT THE LATEST ADVANCES IN THE
                                            TREATMENT HYPERCHOLESTEROLEMIA

    Johns Hopkins University Advanced      THE 11TH ANNUAL JOHNS HOPKINS MULTIPLE SCLEROSIS                 210,000
     Studies in Medicine                    SYMPOSIUM SERIES

    Johns Hopkins University Advanced      COMPREHENSIVE CARE FOR PATIENTS WITH GAUCHER DISEASE:            195,100
     Studies in Medicine                    EMERGING CONCEPTS FOR IMPROVED OUTCOMES

    Johns Hopkins University Medical       MANAGEMENT OF PERSISTENT HYPERGLYCEMIA IN TYPE 2                  81,750
     Logix, LLC                             DIABETES: BEYOND STARTING DOSES OF BASAL INSULIN

    Medical Education Resources Tarsus     THE EVOLUTION OF INSULIN THERAPY: NEW DEVELOPMENTS IN            100,000
     Cardio Inc. dba Health Science Media   TREATMENT, TECHNOLOGY, AND METHODS OF ADMINISTRATION

    Medical Learning Institute, Inc.       PEERVIEW INREVIEW, RISING TO THE CHALLENGE: FOSTERING            100,000
     PeerView Institute for Medical         EFFECTIVE PATIENTPROVIDER COMMUNICATION THROUGHOUT
     Education, Inc.                        THE COURSE OF POMPE DISEASE

    Medical University of South Carolina   1ST ANNUAL NEPHROLOGY TRANSPLANT SYMPOSIUM FOR                     2,500
                                            NEPHROLOGISTS, PRIMARY CARE AND HOSPITALISTS

    Med-IQ, LLC                            TARGETING MODERATE-TO-SEVERE ATOPIC DERMATITIS:                   99,896
                                            EVOLVING TREATMENT STRATEGIES TO ADDRESS A KEY UNMET                   Collaboration \3\
                                            MEDICAL NEED

    Med-IQ, LLC                            CASE SIMULATIONS IN TUMOR LYSIS SYNDROME: AGGRESSIVE             100,000
                                            PROPHYLAXIS STRATEGIES TO PREVENT ADVERSE PATIENT
                                            OUTCOMES

    Med-IQ, LLC                            UPDATE FOR CLINICIANS: THE POTENTIAL OF IL-6                     104,578
                                            INHIBITORS TO REVOLUTIONIZE RHEUMATOID ARTHRITIS                       Collaboration \3\
                                            TREATMENT

    Medscape, LLC                          A PRACTICAL GUIDE TO THE PREVENTION OF SURGICAL                  160,000
                                            ADHESIONS

    Medscape, LLC                          IDENTIFYING AND ADDRESSING INADEQUATELY MANAGED                  138,500
                                            OSTEOARTHRITIS PAIN

    Medscape, LLC                          GLP-1 RECEPTOR AGONISTS IN T2D MANAGEMENT: THE MODERN            105,100
                                            INJECTABLE

    Missouri Academy of Physician          THE GOOD, THE BAD, AND THE IATROGENIC?                             3,500
     Assistants

    Missouri Academy of Physician          JOINT INJECTIONS                                                   5,000
     Assistants

    Montefiore Medical Center PlatformQ    A COMPREHENSIVE PERSPECTIVE ON INSULIN REPLACEMENT FOR           100,000
     Health Education, LLC                  TYPE 2 DIABETES

    Montefiore Medical Center PlatformQ    MULTIPLE SCLEROSIS: EXPLORING TREATMENT OPTIONS AND               85,000
     Health Education, LLC                  INDIVIDUALIZING THERAPY

    National Association of Managed Care   ADVANCES IN THE MANAGEMENT OF MULTIPLE SCLEROSIS: A               57,000
     Physicians, Inc.                       CLOSER LOOK AT NOVEL THERAPIES

    National Association of Managed Care   INDIVIDUALIZING TREATMENT STRATEGIES FOR EFFECTIVE A1C            57,000
     Physicians, Inc.                       REDUCTION AND IMPROVED OUTCOMES IN TYPE 2 DIABETES

    National Jewish Health California      CSAAI 23RD ANNUAL EDUCATIONAL MEETING                             10,000
     Society of Allergy, Asthma and                                                                                Collaboration \3\
     Immunology

    National Kidney Foundation, Inc.       GREENSBORO PATIENT EMPOWERMENT WORKSHOP                            3,500

    National Kidney Foundation, Inc.       CHRONIC KIDNEY DISEASE & THE PRIMARY CARE                         25,000
                                            PRACTITIONER: EARLY SCREENING AND PREVENTION FOR THE
                                            AT-RISK PATIENT

    National Kidney Foundation, Inc.       11TH ANNUAL JOINT MEETING OF THE UPSTATE AND WESTERN               5,000
                                            NEW YORK COUNCILS ON RENAL NUTRITION

    National Medical Association           NEW TYPE 2 DIABETES GUIDELINES AND THE TREND TOWARD              100,000
                                            NEWER PHARMACOLOGICAL TREATMENT

    North American Center for Continuing   IMPLEMENTING BEST PRACTICES FOR TUMOR LYSIS SYNDROME             100,000
     Medical Education, LLC Horizon CME,
     Inc.

    Not-For-Profit Hospital Corporation    CHRONIC KIDNEY DISEASE: STATE OF THE ART 2015                      1,900

    Pennsylvania Academy of Family         PA ACADEMY OF FAMILY PHYSICIANS FOUNDATION A1C                   150,000
     Physicians Foundation                  CHALLENGE

    Pennsylvania Society of Physician      THYROID MASSES                                                     8,400
     Assistants

    Pharmacy Times Office of Continuing    CONVENIENT CARE OPPORTUNITIES TO OPTIMIZING INSULIN               48,689
     Professional Education                 THERAPY IN TREATMENT OF TYPE 2 DIABETES

    Pharmacy Times Office of Continuing    AJPB QUALITY FORUM: IMPLEMENTATION OF QUALITY MEASURES            50,000
     Professional Education PQA, Inc.       TO IMPROVE OUTCOMES IN DYSLIPIDEMIA                                    Collaboration \3\

    Pharmacy Times Office of Continuing    AJPB QUALITY FORUM: AIMING FOR A FIVE-STAR RATING IN              50,000
     Professional Education PQA, Inc.       DIABETES CARE: MANAGED CARE PLANS AND COMMUNITY
                                            PHARMACIST COLLABORATION

    Postgraduate Healthcare Education,     ADDRESSING HYPOGLYCEMIA IN TYPE 2 DIABETES MELLITUS:              30,000
     LLC Medical Logix, LLC                 THE PHARMACISTS ROLE IN OPTIMIZING PATIENT OUTCOMES

    Postgraduate Institute for Medicine C- NOVEL MECHANISMS AND ADVANCING THERAPEUTIC PARADIGMS             379,000
     MEducation Resources, LLC              FOR OPTIMIZING LDL-FOCUSED MANAGEMENT AND                              Collaboration \3\
                                            CARDIOPROTECTION IN THE DIABETIC PATIENT

    Postgraduate Institute for Medicine C- THE IQ&A INTERACTIVE CARDIOVASCULAR INTELLIGENCE ZONE:           238,100
     MEducation Resources, LLC              NEW FRONTIERS IN LDL-TARGETED CV RISK REDUCTION                        Collaboration \3\

    Preventive Cardiovascular Nurses       2015 FALL LEARNING SERIES                                         35,000
     Association

    PRIME Education Inc. (PRIME)           CASE-BASED DEBATES ABOUT UTILITY OF PCSK9 INHIBITORS             123,000
                                            IN PATIENT POPULATIONS FOR LIPID REDUCTION                             Collaboration \3\

    PRIME Education Inc. (PRIME)           INTERNATIONAL INSIGHTS ON TREATMENT ADVANCES FOR                 166,077
                                            RHEUMATOID ARTHRITIS                                                   Collaboration \3\

    PRIME Education Inc. (PRIME)           NEW CHALLENGES IN THE PREVENTION AND MANAGEMENT OF                78,810
                                            TUMOR LYSIS SYNDROME IN PATIENTS WITH CHRONIC
                                            LYMPHOCYTIC LEUKEMIA

    Pri-Med Institute, LLC (d/b/a pmiCME)  DYSLIPIDEMIA IN PRIMARY CARE: NEW GUIDELINE                      250,000
     Horizon CME, Inc.                      RECOMMENDATIONS AND TREATMENT OPTIONS                                  Collaboration \3\

    ProCE, Inc. Institute for Safe         CONCENTRATED INSULIN: SAFE USE IN THE HOSPITAL AND               102,233
     Medication Practices                   TRANSITIONS OF CARE

    Projects In Knowledge, Inc.            MULTIPLE SCLEROSIS @ POINT OF CARE                               200,000

    Regents of the University of Colorado  RENAL DISEASE & ELECTROLYTE DISORDERS COURSE                       3,000

    Regents of the University of Colorado  PEDIATRIC AND ADULT DIFFERENTIATED THYROID CANCER, ARE            75,000
     American Thyroid Association           THEY DIFFERENT?

    Regents, University of California      THIRD ANNUAL UCLA REVIEW OF CLINICAL NEUROLOGY                    15,000

    Rush University Medical Center Plexus  DEVELOPING AN INTEGRATIVE APPROACH TO METASTATIC                  65,000
     Communications                         PROSTATE CANCER: MAKING IT PERSONAL TO IMPROVE
                                            CLINICAL OUTCOMES

    Rutgers, The State University of New   8TH ANNUAL PERSPECTIVES IN RHEUMATIC DISEASES,                    10,000
     Jersey Global Academy for Medical      PRESENTED BY RHEUMATOLOGY NEWS, INTERNAL MEDICINE                      Collaboration \3\
     Education, LLC                         NEWS, FAMILY PRACTICE NEWS

    South Dakota Academy of Physician      DIABETIC MANAGEMENT                                                3,500
     Assistants

    Tennessee Academy of Physician         FALLFEST 2015-RENAL DISEASE                                        2,500
     Assistants

    Texas A&M University System Health     11TH ANNUAL DIABETES CONFERENCE                                   10,000
     Science Center Coastal Be

    The Boston Home                        CARING FOR THE PATIENT WITH ADVANCED MULTIPLE                     10,000
                                            SCLEROSIS

    The Endocrine Society                  UPDATE IN BASAL INSULINS: YOUR QUESTIONS ANSWERED                129,040

    The Endocrine Society                  2015 CLINICAL ENDOCRINOLOGY UPDATE                                25,000

    The Endocrine Society                  2015 CLINICAL ENDOCRINOLOGY UPDATE                                25,000

    The France Foundation                  MS CLINICAL DIALOGS: A PEER DISCUSSION ON OPTIMAL                 76,547
                                            TREATMENT (PHASE 2)

    The France Foundation National         A MULTI-DISCIPLINARY APPROACH TO LIMB-GIRDLE MUSCLE              240,794
     Society of Genetic Counselors          WEAKNESS DYSTROPHY AND RELATED CONDITIONS MANAGEMENT

    The Medical College of Wisconsin,      INTERACTIVE UPDATES IN USE OF STEM CELL MOBILIZATION             120,000
     Inc. Carden Jennings Publishing Co.,   FOR THE TREATMENT OF BLOOD RELATED CANCERS
     Ltd.

    Ultimate Medical Academy, LLC dba      IMPROVING OUTCOMES IN RHEUMATOID ARTHRITIS: TREATING             162,588
     Global Education Group Integritas      TO TARGET, IL-6-DIRECTED THERAPIES, AND EVOLVING                       Collaboration \3\
     Communications, LLC                    MANAGEMENT ALGORITHMS

    UMA MLG, LLC                           THE CHANGING LANDSCAPE OF DYSLIPIDEMIA TREATMENT                 198,900
                                                                                                                   Collaboration \3\

    UMA MLG, LLC                           A 3-DIMENSIONAL VIEW INTO THE ROLE OF GLP1 IN TYPE-2              30,000
                                            DIABETES: EXPLORING EVIDENCE-BASED GUIDELINES AS
                                            PATIENT-CENTERED THERAPY

    University of California, San Diego    PROMOTING BEHAVIOR CHANGE IN DIABETES: A SKILL                    50,000
     Behavioral Diabetes Institute          BUILDING PROGRAM FOR HEALTH CARE PROFESSIONALS A

    University of Cincinnati Global        THE KNEE COURSE 2015                                              19,500
     Academy for Medical Education, LLC

    University of Virginia Renal           RENAL PHYSICIANS ASSOCIATION 2015 ADVANCED                        12,500
     Physicians Association                 PRACTITIONER CONFERENCE
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q3, 2015 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Oct 2015-31st Dec 2015
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    American Academy of Physician          2015 ADULT HOSPITAL MEDICINE BOOT CAMP                             2,500
     Assistants

    American Association of Clinical       NEW ENGLAND CHAPTER OF AACE 7TH ANNUAL MEETING                     5,000
     Endocrinologists

    American Association of Clinical       DIABETES DAY FOR PRIMARY CARE CLINICIANS EDUCATIONAL              50,000
     Endocrinologists                       SERIES

    American Neurological Association      2015 AMERICAN NEUROLOGICAL ASSOCIATION 140TH ANNUAL               25,000
                                            MEETING

    ANNA Chapter 125, 126, and 133         ANNA NJ COLLABORATIVE 2015                                         3,000

    Annenberg Center for Health Sciences   INITIATING AND ADVANCING MULTIPLE SCLEROSIS THERAPIES:           125,000
     at Eisenhower Postgraduate Institute   IMPROVING PATIENT CARE AND HEALTH OUTCOMES
     for Medicine

    Baylor University Medical Center dba   FOLLOWING THE EVIDENCE A PRACTICAL, CASE BASED                    45,975
     A. Webb Roberts Center MedNet, LLC     APPROACH TO PERSONALIZED TREATMENT OPTIONS FOR
                                            MULTIPLE SCLEROSIS

    California Optometric Association      2015 MONTEREY SYMPOSIUM                                            7,416

    Cedars-Sinai Medical Center            5TH ANNUAL SYMPOSIUM ON LYSOSOMAL STORAGE DISORDERS               26,010

    Consortium of Multiple Sclerosis       4TH CONFERENCE OF THE INTERNATIONAL MS COGNITION                  56,280
     Centers Nurse Practitioner             SOCIETY IN COLLABORATION WITH THE CONSORTIUM OF
     Alternatives                           MULTIPLE SCLEROSIS CENTERS

    Harris County Optometric Society       EYES ON FABRY HARRIS COUNTY OPTOMETRIC SOCIETY                     7,000
     Fabry Support & Information Group

    Horizon CME, Inc.                      STRATEGIES FOR SELECTION AND OPTIMAL SEQUENCING OF                85,000
                                            CURRENT TREATMENT OPTIONS FOR METASTATIC CASTRATION-
                                            RESISTANT PROSTATE CANCER

    Icahn School of Medicine at Mount      3RD NY MASTERS COURSE IN ENDOCRINOLOGY AND ENDOCRINE              15,000
     Sinai                                  SURGERY

    Indiana Academy of Physician           THE GOOD, THE BAD AND THE IATROGENIC (RENAL MEDICATION             3,250
     Assistants                             DOSING)

    Letters & Sciences                     ADVANCES IN MS RESEARCH & PRACTICE 2015 ANNUAL                    70,000
                                            CONFERENCE

    Medical Education Resources Tarsus     2015 CMHC SYMPOSIUM: NOVEL THERAPIES FOR LDL-C                    40,000
     Cardio Inc. dba Health Science Media   LOWERING IN THE FIGHT AGAINST RESIDUAL ASCVD RISK

    Medical Learning Institute, Inc.       PEERVIEW IN EXCHANGE, ESTABLISHING BEST PRACTICES FOR            140,325
     PeerView Institute for Medical         THE PERSONALIZED CARE OF PATIENTS WITH MULTIPLE
     Education, Inc.                        SCLEROSIS: A TIMELY DISCUSSION AMONG ADVANCED
                                            PRACTICE CLINICIANS?

    Medical Learning Institute, Inc.       PEERVIEW VIDEO IN SESSION, CLINICAL HIGHLIGHTS FROM              134,450
     PeerView Institute for Medical         BARCELONA: AN UP-TO-DATE REVIEW OF NEW DATA ON
     Education, Inc.                        APPROVED DISEASE-MODIFYING THERAPIES FOR MULTIPLE
                                            SCLEROSIS MANAGEMENT?

    Medical Learning Institute, Inc.       2016 ACMG--PEERVIEW LIVE, ENSURING THE RAPID                     239,950
     PeerView Institute for Medical         IDENTIFICATION AND INDIVIDUALIZED MANAGEMENT OF
     Education, Inc.                        GAUCHER DISEASE TYPE 1: KEY PRINCIPLES AND STRATEGIES

    Med-IQ,                                LLC NEW THERAPIES FOR GAUCHER'S DISEASE: TALK TO YOUR            147,396
                                            PHARMACIST

    Med-IQ, LLC                            EARLIER RECOGNITION AND TREATMENT OF GAUCHER'S DISEASE           135,728
                                            IN HEMATOLOGY CLINICS

    Med-IQ, LLC                            RECOGNIZING THE UNLIKELY: IMPROVING IDENTIFICATION AND           246,977
                                            CARE OF FABRY DISEASE

    Michigan State Medical Society         CARDIOVASCULAR DISEASE IN PATIENTS WITH RENAL DISEASE              2,500

    National Jewish Health                 38TH ANNUAL PULMONARY AND ALLERGY UPDATE                          10,000
                                                                                                                   Collaboration \3\

    National Jewish Health Western         WSAAI 54TH ANNUAL SCIENTIFIC SESSION                              10,000
     Society of Allergy, Asthma and                                                                                Collaboration \3\
     Immunology (WSAAI)

    National Kidney Foundation, Inc.       NATIONAL KIDNEY FOUNDATION'S 47TH ANNUAL MEDICAL                   2,500
                                            SYMPOSIUM

    National Multiple Sclerosis Society    Research Symposium 2015: MS Research Discoveries:                  3,000
     New York Chapter                       Wellness and Treatments for Living Your Best Life

    Pennsylvania Society of Physician      RENAL MEDICATION DOSING: THE GOOD, THE BAD, AND THE                4,000
     Assistants                             IATROGENIC

    PESI, Inc. Metabolic Endocrine         13TH ANNUAL WORLD CONGRESS ON INSULIN RESISTANCE,                 15,000
     Education Foundation                   DIABETES AND CARDIOVASCULAR DISEASE--WCIRDC                            Collaboration \3\

    Postgraduate Institute for Medicine    FAILURE IS NOT AN OPTION: SELECTING OPTIMAL STEM CELL            205,195
     AXIS Medical Education, Inc.           MOBILIZATION STRATEGIES FOR MULTIPLE MYELOMA AND NON-
                                            HODGKIN LYMPHOMA

    Postgraduate Institute for Medicine    1,800 SECONDS? IN DIABETES MANAGEMENT WITH A GLP-1                75,000
     Catamount Medical Education, LLC       RECEPTOR AGONIST AND BASAL INSULIN

    Projects In Knowledge, Inc. MedPage    CLINICAL CONTEXT: MULTIPLE SCLEROSIS                             131,000
     Today, LLC

    Rutgers, The State University of New   THE FOURTH EVIDENCE-BASED PEDIATRIC UPDATE SYMPOSIUM               5,000
     Jersey

    Rutgers, The State University of New   SKIN DISEASE EDUCATION FOUNDATION'S 16TH ANNUAL LAS                5,000
     Jersey Global Academy for Medical      VEGAS DERMATOLOGY SEMINAR, FEATURING THE 12TH ANNUAL                   Collaboration \3\
     Education, LLC                         PSORIASIS FORUM

    Society of Nuclear Medicine            SNMMI 2015-2016 THYROID IMAGING AND THERAPY                      108,730
                                            EDUCATIONAL OUTREACH FOR REFING PHYSICIANS AND
                                            IMAGING PHYSICIANS

    Swedish Medical Center Foundation      FIFTH ANNUAL INTENSIVE UPDATE IN NEUROLOGY                        10,000

    Swedish Medical Center Foundation      DIABETES MANAGEMENT UPDATE 2015                                    8,000

    The Board of Trustees of the UA for    SPECIAL NEPHROLOGY RESEARCH AND TRAINING CENTER                   15,000
     the UA at Birmingham                   SYMPOSIUM--11/9/15

    The University of Texas Southwestern   NEUROTHERAPEUTICS UPDATE                                           5,000
     Medical Center at Dallas

    Tufts University School of Medicine    IMPROVING CARE FOR HEART FAILURE PATIENTS: AN UPDATE               5,000
                                            FOR HEALTHCARE PROVIDERS - THE 8TH ANNUAL NEW ENGLAND
                                            HEART FAILURE AND TRANSPLANT NETWORK CONFERENCE

    University of Massachusetts Medical    NEW FRONTIERS AND EMERGING TREATMENT PARADIGMS FOR               347,000
     School C-MEducation Resources, LLC     OPTIMIZING LDLTARGETED CARDIOVASCULAR RISK REDUCTION                   Collaboration \3\

    University of Massachusetts Medical    THE IQ&A INTERACTIVE RHEUMATOID ARTHRITIS INTELLIGENCE           189,000
     School C-MEducation Resources, LLC     ZONE: FOCUS ON THE EVIDENCE BASIS FOR RA MANAGEMENT                    Collaboration \3\
                                            THROUGH INHIBITION OF THE IL-6 CYTOKINE AND OTHER
                                            FOUNDATION SIGNALING SYSTEMS

    University of Massachusetts Medical    NEW FRONTIERS AND TREATMENT ADVANCES FOR ATOPIC                  360,000
     School C-MEducation Resources, LLC     DERMATITIS: FOCUS ON THE ROLE OF ESTABLISHED AND                       Collaboration \3\
                                            EVOLVING BIOLOGIC THERAPIES FOR PEDIATRIC AND ADULT
                                            PATIENTS WITH MODERATE-TO-SEVERE AND TREATMENT-
                                            RESISTANT ATOPIC DERMATITIS

    University of Texas Health Science     AMDA INTERNATIONAL PATIENT AND SCIENTIFIC CONFERENCE--            60,000
     Center at San Antonio Acid Maltase     PAST, PRESENT, FUTURE
     Deficiency Association, Inc.

    Vindico Medical Education, LLC         IN SEARCH OF THE GUIDING LIGHT: RE-VISITING THE USE OF           372,524
                                            ORAL AND HIGHEFFICACY THERAPIES IN A MODERN ERA OF
                                            MULTIPLE SCLEROSIS TREATMENT

    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q4, 2015 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Jan 2016-31th Mar 2016
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    Admin of the Tulane Educa Fund on      8TH ANNUAL TULANE SYMPOSIUM ON THYROID AND PARATHYROID             7,500
     behalf of TUHSC CCE                    DISEASES

    AKH Inc Advancing Knowledge and        2016 SOUTH BEACH SYMPOSIUM: CLINICAL DERMATOLOGY                   5,000
     Healthcare                             SYMPOSIUM                                                              Collaboration \3\

    AKH Inc Advancing Knowledge and        NOVEL MECHANISMS AND ADVANCING THERAPEUTIC PARADIGMS             336,000
     Healthcare C-MEducation Resources,     FOR OPTIMIZING LDLFOCUSED MANAGEMENT AND CV RISK                       Collaboration \3\
     LLC                                    REDUCTION IN THE DIABETIC PATIENT

    American Academy of Continuing         INCREASING ACCESS TO KIDNEY TRANSPLANTATION: NOVEL               104,000
     Medical Education, Inc. Spire          STRATEGIES TO EXPAND LIVING DONATION
     Learning

    American Association of Clinical       THYROID SESSIONS AT ENDOCRINE UNIVERSITYr: DISEASE                30,000
     Endocrinologists                       MANAGEMENT & TECHNOLOGY SKILLS FOR ENDOCRINOLOGY
                                            FELLOWS IN TRAINING

    American Association of Clinical       NEVADA AACE THYROID CANCER SYMPOSIUM                               5,000
     Endocrinologists

    American Association of Clinical       LDL-C REDUCTION IN THE PATIENT WITH DIABETES: HOW LOW            267,758
     Endocrinologists Medtelligence, LLC    SHOULD WE GO AND HOW SHOULD WE GET THERE?                              Collaboration\3\

    American College of Cardiology         DYSLIPIDEMIA COMBO-THERAPY: A FRAMEWORK FOR CLINICAL              75,000
     Foundation                             DECISION-MAKING                                                        Collaboration\3\

    American College of Rheumatology       2016 ACR RHEUMATOLOGY COURSES                                    150,000
                                                                                                                   Collaboration \3\

    American Health Resources, Inc.        EXAMINING THE ROLE OF PCSK9 INHIBITORS IN DYSLIPIDEMIA             4,200
                                            MANAGEMENT                                                             Collaboration \3\

    American Kidney Fund                   AMERICAN KIDNEY FUND 2016 CLINICAL SCIENTIST IN                   75,000
                                            NEPHROLOGY PROGRAM

    American Society of Transplant         ASTS 16TH ANNUAL STATE OF THE ART WINTER SYMPOSIUM:               50,000
     Surgeons                               LIMITED SUPPLY, INCREASING DEMAND: EXPANDING ORGAN
                                            DONATION

    Annenberg Center for Health Sciences   EXPERTS IN RESIDENCE: BRIDGING THE GAP FROM KNOWLEDGE            110,000
     at Eisenhower                          TO PRACTICE IN CASTRATION-RESISTANT PROSTATE CANCER

    Association of Black Cardiologists,    EVOLVING STRATEGIES FOR CARDIOVASCULAR RISK REDUCTION:           350,000
     Inc. National Association for          BEYOND STATIN THERAPY                                                  Collaboration \3\
     Continuing Education

    Cardiovascular Center of Sarasota      12TH ANNUAL CARDIOVASCULAR SYMPOSIUM CARDIOLOGY UPDATE             5,000
     Foundation for Research and Florida    2016: FROM INTERVENTION TO PREVENTION TIME TO FOCUS                    Collaboration \3\
     Medical Association                    ON EARLY CARDIOVASCULAR HEALTH

    Cardio Renal Society of America        4th ANNUAL CARDIO-RENAL METABOLIC CONFERENCE                       6,000

    CME Outfitters, LLC                    IMPLEMENTING PERSONALIZED ACTION PLANS FOR PATIENTS             99,867.5
                                            WITH ATOPIC DERMATITIS                                                 Collaboration \3\

    Consortium of Multiple Sclerosis       CLINICIAN-PATIENT SHARED DECISION MAKING IN MS: AN               100,860
     Centers Nurse Practitioner             ESSENTIAL STEP TOWARD BETTER OUTCOMES
     Alternatives

    Emory University                       EVALUATION OF THE LGMD DIAGNOSTIC TESTING PROGRAM:                 5,850
                                            PROGRAM UPDATES, OPPORTUNITIES AND FUTURE WORK

    Forefront Collaborative National       CURRENT CONTROVERSIES IN DYSLIPIDEMIA MANAGEMENT: A               85,000
     Lipid Association                      POINT-COUNTERPOINT DISCUSSION                                          Collaboration \3\

    Medical Learning Institute, Inc.       UNDERSTANDING THE EVOLUTION OF MS CARE: OPTIMIZING                43,186
                                            THERAPEUTIC DECISION MAKING

    Medical Learning Institute, Inc.       PEERVIEW INCLINIC, ``MAXIMIZING CARE FOR INDIVIDUALS             145,000
     PeerView Institute for Medical         WITH MULTIPLE SCLEROSIS: THE ROLE OF
     Education, Inc.                        INTERPROFESSIONAL EDUCATION''

    Medical Learning Institute, Inc.       PEERVIEW LIVE, "DISRUPTING DISEASE WORSENING IN                  296,820
     PeerView Institute for Medical         PATIENTS WITH MS: HOW CAN WE HARNESS THE FULL
     Education, Inc                         POTENTIAL OF AVAILABLE DISEASE-MODIFYING

    Med-IQ, LLC                            WHEN INSULIN ALONE ISN'T THE ANSWER: A FOCUSED LOOK AT           257,768
                                            COMBINING BASAL INSULIN AND GLP-1 RECEPTOR AGONISTS

    Med-IQ, LLC                            HOW EARLY IS EARLY? WHEN TO START ERT AND OTHER                  160,522
                                            CONSIDERATIONS FOR OPTIMIZING TREATMENT OF FABRY
                                            DISEASE

    National Association of Managed Care   EFFECTIVE A1C REDUCTION IN TYPE 2 DIABETES: A CLOSER              75,000
     Physicians, Inc.                       LOOK AT COMBINATION INSULIN THERAPY

    National Kidney Foundation, Inc.       CKD-MBD: STATE-OF-THE-ART CONSIDERATIONS FOR OPTIMAL             253,850
     University of Illinois at Chicago      OUTCOMES

    National Lipid Association             NATIONAL LIPID ASSOCIATION 2016 MASTERS IN LIPIDOLOGY             20,000
                                            COURSE SERIES                                                          Collaboration \3\

    National Lipid Association             NATIONAL LIPID ASSOCIATION 2016 LIPID ACADEMY COURSE              20,000
                                            SERIES                                                                 Collaboration \3\

    Nebraska Academy of Physician          JOINT INJECTION WORKSHOP                                           5,100
     Assistants

    Nevada System of Higher Education      2016 WINTER CLINICAL DERMATOLOGY CONFERENCE--HAWAII               50,000
     Foundation for Research and                                                                                   Collaboration \3\
     Education in Dermatology

    North American Center for Continuing   MEETING THE UNMET NEEDS OF PATIENTS WITH                         415,000
     Medical Education, LLC Horizon CME,    HYPERCHOLESTEROLEMIA: A FOCUS ON PCSK9 INHIBITORS                      Collaboration \3\
     Inc.

    NYU School of Medicine                 SEMINAR IN ADVANCED RHEUMATOLOGY                                  20,000
                                                                                                                   Collaboration \3\

    NYU School of Medicine                 41ST ANNUAL COMPREHENSIVE REVIEW OF PHYSICAL MEDICINE              5,000
                                            AND REHABILITATION

    Pharmacy Times Office of Continuing    COST-EFFECTIVENESS OF DISEASE-MODIFYING THERAPIES IN              89,160
     Professional Education                 MULTIPLE SCLEROSIS: A MANAGED CARE PERSPECTIVE

    Pharmacy Times Office of Continuing    INNOVATION AND CLINICAL ADVANCES IN ACHIEVING GLYCEMIC           240,728
     Professional Education                 CONTROL: EVALUATING THE EFFICACY OF COMPLIMENTARY
                                            AGENTS

    Pharmacy Times Office of Continuing    THE ROLE OF THE PHARMACIST IN ACHIEVING TIGHT GLYCEMIC            53,346
     Professional Education                 CONTROL IN TYPE 2 DIABETES: PROMOTING PATIENT SELF-
                                            MONITORING AND AGGRESSIVE TREATMENT

    Physicians' Education Resource, LLC    2016 NEW YORK GUTM: 9TH ANNUAL INTERDISCIPLINARY                  75,000
                                            PROSTATE CANCER CONGRES

    Postgraduate Healthcare Education,     OPTIMIZED APPROACHES TO INSULIN THERAPY AND GLUCOSE              301,000
     LLC                                    CONTROL IN TYPE 2 DIABETES

    Postgraduate Institute for Medicine C- NEW THERAPEUTIC ADVANCES AND PRACTICAL STRATEGIES FOR            309,500
     MEducation Resources, LLC              COMPLEMENTARY BASAL INSULIN PLUS INCRETIN SYSTEM-
                                            TARGETED THERAPY TO OPTIMIZE GLUCOSE CONTROL

    Postgraduate Institute for Medicine C- NEW THERAPEUTIC ADVANCES AND PRACTICAL STRATEGIES FOR            331,000
     MEducation Resources, LLC              COMPLEMENTARY BASAL INSULIN PLUS INCRETIN SYSTEM-
                                            TARGETED THERAPY IN COMPLEX PATIENTS WITH

    Primary Care Education Consortium      COMBINING A GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST             309,985
                                            WITH BASAL INSULIN: THE WHY AND HOW

    PRIME Education Inc (PRIME)            NEW TREATMENT GUIDELINES, EVIDENCE, AND AGENTS IN                249,505
                                            RHEUMATOID ARTHRITIS                                                   Collaboration \3\

    Pri-Med Institute, LLC (d/b/a pmiCME)  HOW TO SELECT AND INITIATE INSULIN THERAPY IN THE TYPE           998,500
     Horizon CME, Inc.                      2 DIABETES PATIENT

    Pri-Med Institute, LLC (d/b/a pmiCME)  GLP-1 RECEPTOR AGONISTS AND BASAL INSULIN COMBINATION:           977,000
     Horizon CME, Inc.                      AN COMPLEMENTARY STRATEGY FOR TYPE 2 DIABETES
                                            TREATMENT INTENSIFICATION

    Projects In Knowledge, Inc.            MEDIMAGE CASES: MULTIPLE SCLEROSIS                               125,000

    Rhode Island Hospital, CME             ENDOCRINE GRAND ROUNDS                                            10,000

    Rutgers, The State University of New   SKIN DISEASE EDUCATION FOUNDATION'S 40TH ANNUAL HAWAII            10,000
     Jersey Global Academy for Medical      DERMATOLOGY SEMINAR                                                    Collaboration \3\
     Education, LLC

    ScientiaCME, LLC Specialty Pharma      PROSTATE CANCER: ADVANCES IN PATIENT MANAGEMENT &                 14,875
     Education Center                       TREATMENT OPTIONS

    Scripps Health                         SCRIPPS WHITTIER DIABETES INSTITUTE'S PROJECT DULCE               50,000

    The Endocrine Society Advanced         THE EFFECTIVE USE OF INSULIN IN TYPE 2 DIABETES: A               329,613
     Studies in Medicine                    FOCUS ON TREATMENT ADVANCES

    The Endocrine Society Institute for    DIABETES MASTERS SERIES 2016: INITIATING THE                   237,055.5
     Medical and Nursing Education          CONVERSATION: SHARING PERSPECTIVES ON ADVANCES IN
                                            T2DM TREATMENT TO IMPROVE PATIENT-CENTERED CARE

    The Endocrine Society Scripps Health   NEW COMPLEMENTARY INSULIN COMBINATIONS TO ACHIEVE                361,515
                                            HBA1C TARGETS: 2016 ENDOCRINE SOCIETY ANNUAL
                                            CONVENTION SATELLITE SYMPOSIUM

    The Massachusetts General Hospital     CLINICAL ENDOCRINOLOGY 2016                                        5,000

    The Medical College of Wisconsin,      NEW TITORY FOR THE UROLOGIST: OPTIMAL MONITORING AND             150,000
     Inc. Paradigm Medical                  TREATMENT SELECTION FOR MCRPC
     Communications, LLC

    The Medical College of Wisconsin,      OPTIMIZING STEM CELL MOBILIZATION STRATEGIES TO                  299,980
     Inc. PeerView Institute for Medical    ENHANCE SUCCESS OF AUTOLOGOUS HEMATOPOIETIC STEM CELL
     Education, Inc.                        TRANSPLANTATION

    The Vitamin D Workshop Inc.            THE 19TH WORKSHOP ON VITAMIN D                                     5,000

    Trustees of Boston University          PCE DIRECTED LEARNING ECOURSE: A MULTIMODAL APPROACH             152,105
     Continuing Education Alliance, LLC     TO MANAGING KNEE OSTEOARTHRITIS

    Trustees of the University of          2016 THYROID MASTER CLASS: MANAGEMENT OF ADVANCED                 10,000
     Pennsylvania/CME                       (PROGRESSIVE MEDULLARY AND RAI-REFRACTORY
                                            DIFFERENTIATED) THYROID CANCER AND UPDATE IN THYROID/
                                            PARATHYROID ULTRASOUND IMAGING

    University of Cincinnati PeerView      PEERVIEW INREVIEW, ``ACHIEVING RAPID CONTROL OF                   68,700
     Institute for Medical Education,       DISEASE ACTIVITY IN PATIENTS WITH MULTIPLE SCLEROSIS:
     Inc.                                   THE INCREASINGLY IMPORTANT ROLE OF DISEASEMODIFYING''

    University of Massachusetts Medical    THE PHYSIOLOGIC BASIS FOR OPTIMIZING GLYCEMIC CONTROL            331,000
     School C-MEducation Resources, LLC     WITH BASAL INSULIN IN COMPLEX PATIENTS WITH DIABETES

    University of Massachusetts Medical    THE FOUNDATIONAL ROLE AND PHYSIOLOGIC BASIS FOR                  305,600
     School C-MEducation Resources, LLC     OPTIMIZING GLYCEMIC CONTROL WITH LONG-ACTING
                                            INSULINS: FOCUS ON THE SAFETY-EFFICACY PROFILES OF
                                            NEW

    University of Massachusetts Medical    NEW FRONTIERS AND CLINICAL ADVANCES IN IMMUNOTHERAPY             389,000
     School C-MEducation Resources, LLC     FOR ASTHMA: FOCUS ON BIOLOGICS-BASED MANAGEMENT OF                     Collaboration \3\
                                            MODERATE-TO-SEVERE ASTHMA IN PATIENTS

    University of Virginia                 RENAL PHYSICIANS ASSOCIATION 2016 ANNUAL MEETING                  25,000

    University of Virginia                 RENAL PHYSICIANS ASSOCIATION ADVANCED PRACTITIONER                 7,500
                                            CONFERENCE

    Yale University Research To Practice   CURRENT STRATEGIES AND ONGOING RESEARCH IN THE                    80,000
                                            MANAGEMENT OF ADVANCED PROSTATE CANCER--AN
                                            INDEPENDENT SATELLITE SYMPOSIUM (ISS) HELD AS AN

    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q1, 2016 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Apr 2016-30th Jun 2016
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    Academic CME, LLC                      STRATEGIES FOR IMPROVING OUTCOMES IN PATIENTS WITH                20,000
                                            MULTIPLE SCLEROSIS

    AKH Inc., Advancing Knowledge and      NOVEL MECHANISMS AND ADVANCING THERAPEUTIC PARADIGMS             350,000
     Healthcare C-MEducation Resources,     FOR OPTIMIZING REAL WORLD MANAGEMENT OF                                Collaboration \3\
     LLC                                    HYPERCHOLESTEROLEMIA: APPLYING LDLTARGETED THERAPIES
                                            FOR CV RISK REDUCTION TO THE FRONT LINES OF
                                            CARDIOVASCULAR, DIABETES, AND INTERNAL MEDICINE
                                            PRACTICE

    AKH Inc Advancing Knowledge and        NAVIGATING THE COMPLEX MAZE OF LDL-LOWERING THERAPIES:           378,700
     Healthcare C-MEducation Resources,     A REAL WORLD ROADMAP FOR THE CARDIOVASCULAR                            Collaboration \3\
     LLC                                    SPECIALIST

    American Academy of Physician          AAPA CONFERENCE 2016--ENDOCRINOLOGY TRACK                         12,500
     Assistants

    American Academy of Physician          AAPA CONFERENCE 2016--NEPHROLOGY TRACK                             6,000
     Assistants

    American Academy of Physician          AAPA CONFERENCE 2016--ORTHOPAEDICS TRACK                           7,500
     Assistants

    American Association of Clinical       AACE 25TH ANNUAL MEETING AND CLINICAL CONGRESS--                  5,0000
     Endocrinologists                       DIABETES SESSIONS

    American Association of Clinical       CALIFORNIA CHAPTER OF THE AMERICAN ASSOCIATION OF                 20,000
     Endocrinologists                       CLINICAL ENDOCRINOLOGISTS PRESENTS: HOT TOPICS IN
                                            DIABETES AND ENDOCRINOLOGY FOR PRIMARY CARE 2016

    American Association of Diabetes       AADE 2016: DOES THE SHOE FIT? MATCHING THE RIGHT                 321,194
     Educators Institute for Medical and    INSULIN COMBINATION TO INDIVIDUAL PATIENTS WITH T2DM
     Nursing Education

    American Association of Nurse          SECONDARY PREVENTION OF ASCVD: NOVEL THERAPIES TO                 75,000
     Practitioners (AANP) Medical           IMPROVE OUTCOMES IN PATIENTS WITH                                      Collaboration \3\
     Communications Media, Inc.             HYPERCHOLESTEROLEMIA

    American College of Allergy, Asthma &  EAC 2016 - UPDATE IN ALLERGY, ASTHMA & IMMUNOLOGY                 10,000
     Immunology Eastern Allergy                                                                                    Collaboration \3\
     Conference

    American Diabetes Association          DIABETES IS PRIMARY                                              133,595

    American Diabetes Association          31ST ANNUAL CLINICAL CONFERENCE ON DIABETES                       32,000

    American Society of Gene Therapy       ASGCT 19TH ANNUAL MEETING                                         26,000

    American Society of Health-System      THE CHANGING LANDSCAPE OF HYPERCHOLESTEROLEMIA: THE              117,215
     Pharmacists                            EMERGING ROLE OF NON-STATIN THERAPIES                                  Collaboration \3\

    American Thoracic Society              ATS 2016 INTERNATIONAL CONFERENCE--SELECTED SESSIONS              20,178
                                            IN ASTHMA                                                              Collaboration \3\

    Baylor University Medical Center dba   UPDATE ON GLP-1 RECEPTOR AGONISTS IN THE MANAGEMENT OF            20,000
     A. Webb Roberts Center MedNet, LLC     TYPE 2 DIABETES MELLITUS

    Carolinas Healthcare System/Charlotte  30TH ANNUAL MEETING OF THE GLOMERULAR DISEASE                      3,000
     AHEC                                   COLLABORATIVE NETWORK

    Children's Hospital Corporation        BOSTON CHILDREN'S HOSPITAL, DIVISION OF NEPHROLOGY                 5,500
                                            WEEKLY SEMINAR SERIES

    Consortium of Multiple Sclerosis       2016 SCIENCE OF MS MANAGEMENT                                     69,225
     Centers Nurse Practitioner
     Alternatives

    Foundation of the Consortium of MS     2016 MS MENTORSHIP FORUM                                          25,000
     Centers

    Horizon CME, Inc.                      GLP-1 RECEPTOR AGONISTS: AN ALTERNATIVE TO PRANDIAL              265,190
                                            INSULIN

    Horizon CME, Inc.                      ACHIEVING LDL GOALS IN PATIENTS WITH                             187,395
                                            HYPERCHOLESTEROLEMIA: APPLYING PCSK9 INHIBITORS IN                     Collaboration \3\
                                            PRACTICE

    Horizon CME, Inc.                      CURRENT THERAPIES FOR PROSTATE CANCER                             24,000

    Johns Hopkins University Medical       PATIENT-CENTERED CARE IN ADVANCED PROSTATE CANCER                 60,000
     Communications Media, Inc.

    Johns Hopkins University Medical       MULTIPLE SCLEROSIS IN THE AGE OF ENHANCED THERAPEUTIC            100,000
     Logix, LLC                             OPTIONS

    Johns Hopkins University Medscape,     REAL-LIFE SCENARIOS: SIMULATION IN MCRPC                          50,000
     LLC

    Medical Education Resources Tarsus     PATIENT-FOCUSED LDL-C MANAGEMENT AND RISK REDUCTION IN           200,000
     Cardio Inc. dba Cardiometabolic        CLINICAL PRACTICE: THE UTILITY OF PCSK9 INHIBITORS                     Collaboration \3\
     Health Congress

    Med-IQ, LLC                            RECENT UPDATES IN CKD-MBD: MERGING SCIENCE AND PATIENT-           84,883
                                            CENTERED CARE

    Med-IQ, LLC Taking Control of Your     PRACTICAL STRATEGIES FOR ADVANCING INSULIN THERAPY:            995,246.5
     Diabetes                               FROM TIMELY INITIATION AND APPROPRIATE TITRATION OF
                                            BASAL INSULIN TO ADDRESSING POST PRANDIAL GLUCOSE
                                            CONTROL

    Medscape, LLC                          KEY CONCEPTS IN CKD-MBD: ESSENTIALS FOR IMPROVING                199,500
                                            OUTCOMES

    Medscape, LLC                          ADVANCES IN BASAL INSULIN                                        829,075

    Medscape, LLC                          CME-TV: INDIVIDUALIZING T2D INSULIN THERAPY UTILZIING            816,000
                                            COMPLIMENTARY MECHANISMS OF ACTION

    Medscape, LLC                          CASE CONSIDERATIONS: HOW TO REDUCE CV RISK IN                    225,100
                                            DYSLIPIDEMIA?                                                          Collaboration \3\

    Medscape, LLC                          2016 UPDATE: CLINICAL ADVANCEMENTS IN MODERATE TO                640,000
                                            SEVERE ATOPIC DERMATITIS                                               Collaboration \3\

    Medscape, LLC                          WHAT DO WE KNOW ABOUT LDL-C?: A 2016 UPDATE                      242,190
                                                                                                                   Collaboration\3\

    Medscape, LLC                          A PATIENT JOURNEY THROUGH STATIN INTOLERANCE: WHAT               249,215
                                            HAVE WE LEARNED?                                                       Collaboration \3\

    Medscape, LLC                          AN ENDOCRINOLOGY CLINIC IN DYSLIPIDEMIA: SOLVING                 237,915
                                            CHALLENGING CASES                                                      Collaboration \3\

    Medscape, LLC                          RHEUMATOID ARTHRITIS: FOUNDATIONS IN PATHOPHYSIOLOGY,            249,825
                                            TARGETS, AND TREATMENT                                                 Collaboration \3\

    Medscape, LLC                          WATERSHEDS IN RHEUMATOID ARTHRITIS: A CONCISE GUIDE TO            99,500
                                            MAJOR CONFERENCES IN 2016                                              Collaboration \3\

    Michigan State Medical Society         DIABETES AND LIPID UPDATES                                         5,000

    MidEastern Chapter of the Society of   46TH ANNUAL SPRING MEETING AND EXHIBITION OF THE                   7,500
     Nuclear Medicine                       MIDEASTERN CHAPTER OF THE SOCIETY OF NUCLEAR MEDICINE
                                            AND MOLECULAR IMAGING

    Missouri Academy of Physician          DIABETES UPDATE FOR THE PRIMARY CARE PROVIDER                      5,000
     Assistants

    Montefiore Medical Center PlatformQ    EVOLVING TREATMENT PARADIGMS IN METASTATIC CASTRATION-            75,000
     Health Education, LLC                  RESISTANT PROSTATE CANCER

    National Association of Managed Care   BEST PRACTICES IN THE TREATMENT AND MANAGEMENT OF                 57,000
     Physicians, Inc.                       RELAPSING MULTIPLE SCLEROSIS

    National Association of Managed Care   ADVANCES IN LDL-C REDUCTION: A STRATEGIC LOOK AT THE              25,000
     Physicians, Inc.                       EFFECTIVENESS OF PCSK9 INHIBITORS                                      Collaboration \3\

    National Comprehensive Cancer          NCCN 2016 ONCOLOGY CASE MANAGER AND MEDICAL DIRECTOR              25,000
     Network, Inc.                          PROGRAM

    National Comprehensive Cancer          2016-2017 MONTHLY ONCOLOGY TUMOR BOARDS: A                        25,000
     Network, Inc.                          MULTIDISCIPLINARY APPROACH TO INDIVIDUALIZED PATIENT
                                            CARE

    National Jewish Health                 EVALUATION AND TREATMENT OF SEVERE ASTHMA: THE ROLE OF          94,011.5
                                            BIOLOGIC AND DIRECTED THERAPIES                                        Collaboration \3\

    National Jewish Health Prova           ATOPIC DERMATITIS: DEFINING ITS PATHOGENESIS,                    224,850
     Education, Inc.                        TARGETING ITS TREATMENT                                                Collaboration \3\

    National Kidney Foundation, Inc.       PATHOGENESIS AND MANAGEMENT OF FABRY DISEASE                     166,485

    National MS Society Greater New        NEW HAMPSHIRE LIVING WELL WITH MS CONFERENCE                       1,500
     England Chapter

    National Lipid Association             TRANSLATION OF THE LDL RECEPTOR: A NATIONAL LIPID                125,000
                                            ASSOCIATION CORE CURRICULUM INTENSIVE PROGRAM                          Collaboration \3\

    New Jersey Academy of Family           MANAGING T2DM IN SPECIAL POPULATIONS                               6,000
     Physicians

    North American Center for Continuing   GRAND ROUNDS IN CARDIOLOGY: PCSK9 INHIBITORS WITHIN              499,838
     Medical Education, LLC                 THE TARGETED TREATMENT APPROACH TO                                     Collaboration \3\
                                            HYPERCHOLESTEROLEMIA

    Nurse Practitioner Alternatives        IMPROVING CARE IN MULTIPLE SCLEROSIS: A NURSING                  100,000
     International Organization of          PERSPECTIVE
     Multiple Sclerosis Nurses

    Nurse Practitioner Alternatives        MULTIPLE SCLEROSIS 2016: WHAT NURSES NEED TO KNOW                 57,900
     International Organization of
     Multiple Sclerosis Nurses

    Nurse Practitioner Alternatives        2016 MS COUNSELING POINTS:HIGHLIGHTING THE ROLE OF                35,625
     International Organization of          NURSES IN MULTIDISCIPLINARY MANAGEMENT OF MS
     Multiple Sclerosis Nurses

    Oakstone Publishing, LLC PeerVoice     ADVANCEMENTS IN CARE FOR PATIENTS WITH                            29,725
     America Limited                        HYPERCHOLESTEROLEMIA AND RESIDUAL CV RISK: EMERGING                    Collaboration \3\
                                            DATA, EVOLVING STRATEGIES

    Oregon Health & Science University     ON THE HORIZON: UPDATES IN MULTIPLE SCLEROSIS                      9,930
     Foundation

    Penn State University i3 Health        GUIDELINE UPDATES AND EVOLVING CLINICAL PARADIGMS IN              23,500
                                            DIFFERENTIATED THYROID CANCER

    Penn State University PeerView         PEERVIEW SELECT-A-SCENARIO LIVE: TRANSFORMING PROSTATE           120,510
     Institute for Medical Education,       CANCER CARE IN A RAPIDLY EVOLVING TREATMENT LANDSCAPE
     Inc.

    Penn State University PeerView         PEERVIEW SELECT-A-SCENARIO LIVE: ``CRITICAL                      150,000
     Institute for Medical Education,       DISCUSSIONS IN PROSTATE CANCER: HOW TO SELECT AND
     Inc.                                   SEQUENCE THERAPIES THROUGHOUT THE DISEASE CONTINUUM''

    Pharmacy Times Office of Continuing    ACHIEVING GLYCEMIC CONTROL: PROMOTING PATIENT SELF-               57,000
     Professional Education                 MONITORING AND EXPLORING INNOVATIVE TREATMENT
                                            STRATEGIES IN THE CONVENIENT CARE SETTING

    Pharmacy Times Office of Continuing    MANAGING HYPERLIPIDEMIA: A NEW CHARGE FOR SPECIALTY               32,000
     Professional Education                 PHARMACY WITH THE ADVENT OF PCSK9 INHIBITORS                           Collaboration \3\

    Pharmacy Times Office of Continuing    OPTIMIZING TREATMENT REGIMENS FOR MS: THE PHARMACIST?S            35,000
     Professional Education                 ROLE IN ADVANCING PATIENT CARE

    Pharmacy Times Office of Continuing    MANAGING ATOPIC DERMATITIS: A PHARMACIST'S OPPORTUNITY            86,450
     Professional Education                 TO INTERVENE                                                           Collaboration \3\

    Physicians' Education Resource, LLC    CANCER SUMMARIES AND COMMENTARIE: UPDATE FROM CHICAGO:            40,000
                                            ADVANCES IN THE TREATMENT OF GENITOURINARY CANCERS

    Pna Centers For Neurological Research  RRNMF COURSE ON POMPE'S DISEASE RECOGNITION AND                   25,000
                                            THERAPY

    Postgraduate Healthcare Education,     THE CHANGING LANDSCAPE IN THE TREATMENT OF RHEUMATOID             52,500
     LLC                                    ARTHRITIS: AN UPDATE FOR PHARMACISTS                                   Collaboration \3\

    Postgraduate Institute for Medicine C- IQ&A INTERACTIVE DIABETES INTELLIGENCE ZONE: GLYCEMIC            191,000
     MEducation Resources, LLC              REGULATION THROUGH COMBINATION THERAPY--FOCUS ON
                                            SAFETY, CONVENIENCE, METABOLIC EFFECTS, HA1C CONTROL,
                                            AND EFFICACY OF COMBINATION BASAL INSULIN-GLP-1 RA
                                            REGIMENS FOR FPG AND PPG CONTROL

    Postgraduate Institute for Medicine    WHY AREN'T THEY TAKING THEIR MEDS? PATIENT-CENTERED               33,000
     Enquiring Minds LLC                    APPROACHES TO NON-ADHERENCE IN MS

    Primary Care Education Consortium      REMOVING THE COMPLEXITY AND CONCERNS OF INSULIN                   78,595
                                            MANAGEMENT IN TYPE 2 DIABETES, 4-HOUR WORKSHOPS TO BE
                                            HELD DURING THE METABOLIC AND ENDOCRINE DISEASE
                                            SUMMITS 2016

    PRIME Education Inc (PRIME)            PRACTICAL SKILLS IN MEDICATION MANAGEMENT WITH NEWER             415,000
                                            CHOLESTEROL THERAPIES: CAN WE ACHIEVE PATIENT AND                      Collaboration \3\
                                            MANAGED CARE HOMEOSTASIS?

    PRIME Education Inc (PRIME)            GME-CME ADVANCED PRACTICE SEMINAR IN MULTIPLE                    150,329
                                            SCLEROSIS: FOCUSED TRAINING FOR EFFECTIVE
                                            INDIVIDUALIZED TREATMENT DECISION-MAKING

    PRIME Education Inc (PRIME)            RHEUMATOLOGY HOUSE CALLS--ENGAGING PATIENTS AND                  172,845
                                            PROVIDERS IN RHEUMATOID ARTHRITIS COLLABORATIVE                        Collaboration \3\
                                            LEARNING

    PRIME Education Inc (PRIME)            NEW TARGETS IN THE THERAPEUTIC LANDSCAPE FOR ADULTS              291,095
                                            WITH ATOPIC DERMATITIS                                                 Collaboration \3\

    Pri-Med Institute, LLC (d/b/a pmiCME)  OSTEOARTHRITIS OF THE KNEE: A MULTI-MODAL APPROACH TO            160,000
                                            PAIN MANAGEMENT

    Pri-Med Institute, LLC (d/b/a pmiCME)  HOW LOW DO YOU GO? CLINICAL UPDATES IN LOW-DENSITY               490,479
                                            LIPOPROTEINCHOLESTEROL MANAGEMENT                                      Collaboration \3\

    Purdue University Focus Medical        2016 ARTHROS CITY ROUNDS SERIES                                   10,000
     Communications, LLC                                                                                           Collaboration \3\

    Research Foundation of SUNY            MEASURING QUALITY OF LIFE (QOL) IN ESRD                            5,000

    Research To Practice                   YEAR IN REVIEW--A FOUR-PART MULTI-TUMOR REGIONAL CME              60,000
                                            SYMPOSIA SERIES FOCUSED ON THE APPLICATION OF
                                            EMERGING RESEARCH INFORMATION TO THE CARE OF PATIENTS
                                            WITH COMMON CANCERS: GENITOURINARY CANCERS MODULE

    San Francisco Neurological Society     CALIFORNIA NEUROLOGY SOCIETY - UPDATES IN NEUROLOGY                3,000
     Association of California              2016
     Neurologists Foundation

    Scripps Health                         ANNUAL NEW APPROACHES TO OPTIMIZE REAL-WORLD DIABETES             50,000
                                            CARE: SPRING CONFERENCE

    Society for Urologic Nurses and        COMPETENCE IN ADVANCED PROSTATE CANCER REGIONAL ONS               30,000
     Associates (SUNA)                      CHAPTER NURSING FORUMS. DEVELOPING STRATEGIES FOR
                                            SEQUENCING AND COMBINING THERAPIES: NURSING
                                            CONSIDERATIONS FOR IMPLEMENTING A TAILORED TREATMENT
                                            APPROACH

    Society of Nuclear Medicine            61ST ANNUAL MEETING OF THE SOUTHWESTERN CHAPTER, SNMMI             2,000
     Southwestern Chapter of the Society
     of Nuclear Medicine

    Swedish Medical Center Foundation      SIXTH ANNUAL INTENSIVE UPDATE IN NEUROLOGY                         3,000

    Texas A&M University System Health     12TH ANNUAL DIABETES CONFERENCE: 'DIABETES HEAD TO                10,000
     Science Center Coastal Be              TOE'

    The Endocrine Society                  ENDO 2016 GENYZME THYROID SESSIONS                               100,000

    The Omnia-Prova Education              MANAGEMENT OF RA: GLOBAL OUTLOOK AND LATIN AMERICAN              311,067
     Collaborative, Inc. Prova Education,   IMPLICATIONS                                                           Collaboration \3\
     Inc.

    Trustees of Boston University          KEYS TO ACHIEVING OPTIMAL GLUCOSE CONTROL: EARLY                 375,000
     Continuing Education Alliance, LLC     INSULIN INITIATION AND CONTROL OF POSTPRANDIAL
                                            GLUCOSE

    Trustees of Boston University          IMPLEMENTING NEW THERAPIES FOR REFRACTORY                        350,000
     Continuing Education Alliance, LLC     DYSLIPIDEMIA: PRACTICAL CONSIDERATIONS FOR CLINICAL                    Collaboration \3\
                                            PRACTICE

    Ultimate Medical Academy, LLC dba      IMPROVING OUTCOMES IN SEVERE ASTHMA: A NEW ERA IN                185,333
     Global Education Group Integritas      PRECISION MEDICINE                                                     Collaboration \3\
     Communications, LLC

    UMA MLG, LLC                           COMPREHENSIVE DYSLIPIDEMIA MANAGEMENT: A VIRTUAL                 249,825
                                            REALITY TOUR BEYOND STATIN MONOTHERAPY                                 Collaboration\3\

    University of Chicago Intelligent      INSIDE DYSLIPIDEMIA MANAGEMENT: IMPROVING RISK                   285,734
     Medical Decisions, Inc.                ASSESSMENT, REFERRALS AND LIPID GOAL ATTAINMENT FOR                    Collaboration \3\
                                            HIGH-RISK CV PATIENTS INSPIRING SYSTEM IMPROVEMENT
                                            WITH DATA-DRIVEN EDUCATION

    University of Cincinnati Advances in   MAUIDERM NP+PA SUMMER 2016                                        25,000
     Cosmetic and Medical Dermatology                                                                              Collaboration \3\

    University of Kansas Endowment         NEUROMUSCULAR REVIEW COURSE SERIES 2016                           15,000
     Association

    University of Massachusetts Medical    PIVOTAL TREATMENT ADVANCES IN BIOLOGIC THERAPY FOR               376,000
     School C-MEducation Resources, LLC     ATOPIC DERMATITIS (AD): FOCUS ON THE                                   Collaboration \3\
                                            IMMUNOPATHOBIOLOGY OF AD AND ROLE OF EVOLVING
                                            BIOLOGIC THERAPIES FOR OPTIMIZING OUTCOMES IN
                                            PATIENTS WITH MODERATE-TO-SEVERE AND TREATMENT-
                                            RESISTANT AD

    University of Rochester Society of     2016 SOCIETY FOR INVESTIGATIVE DERMATOLOGY ANNUAL                 50,000
     Investigative Dermatology              MEETING                                                                Collaboration \3\

    University of Southern California      VAN DER MEULEN SYMPOSIUM: MULTIPLE SCLEROSIS UPDATE               20,000

    University of Tennessee Advanced       ONCOLOGY PHARMACY CONSULTS: UPDATES ON THE MANAGEMENT             45,000
     Studies in Medicine                    OF PROSTATE CANCER

    University of Texas Health Science     AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO) 2016                  3,500
     Center at San Antonio                  REVIEW

    University of Vermont and State        NEW ENGLAND THYROID CONFERENCE                                    10,000
     Agricultural College

    USF Health Professions Conferencing    13TH ANNUAL ROCKY MOUNTAIN METABOLIC SYNDROME                      5,000
     Corporation CEConsultants, LLC         SYMPOSIUM

    Wellmont Health System                 14TH ANNUAL DIABETES SYMPOSIUM                                     4,000

    Yale University                        INAUGURAL 1-95 INFILTRATIVE CARDIOMYOPATHY CONFERENCE              5,000
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q2, 2016 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st July 2016-30th Sep 2016
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    American Association of Clinical       ORR-AACE 18TH ANNUAL MEETING                                       5,000
     Endocrinologists

    American Association of Clinical       MID ATLANTIC-AACE 14TH ANNUAL MEETING                              2,500
     Endocrinologists

    American Association of Clinical       TEXAS-AACE ANNUAL MEETING & TEXAS ENDOCRINE SURGICAL               5,000
     Endocrinologists                       SYMPOSIUM

    American Association of Clinical       NEVADA AACE ENDOCRINOLOGY FOR THE NON ENDOCRINOLOGISTS             5,000
     Endocrinologists                       AND ANNUAL MEETING

    American Association of Clinical       NEVADA-AACE ENDOCRINOLOGY FOR THE NON ENDOCRINOLOGISTS             7,500
     Endocrinologists                       AND ANNUAL MEETING

    American Association of Nurse          BEST PRACTICES IN ACHIEVING OPTIMAL A1C TARGETS AND              141,980
     Practitioners (AANP)                   POST PRANDIAL GLYCEMIC CONTROL

    American Diabetes Association          14TH ANNUAL PROFESSIONAL EDUCATION SYMPOSIUM, AN                  10,000
                                            AFTERNOON WITH DIABETES EXPERTS: DIABETES DISTRESS,
                                            PHYSICAL ACTIVITY, MEDICATIONS, AND UPDATES TO THE
                                            STANDARDS

    American Health Resources, Inc.        EXAMINING NEW OPTIONS IN THE MANAGEMENT OF INSULIN                 4,600
                                            RESISTANT TYPE 2 DIABETES: A FOCUS ON BASAL INSULIN
                                            THERAPY

    American Society for Blood and Marrow  2017 ASBMT/SANOFI NEW INVESTIGATOR AWARD                          65,000
     Transplantation

    Antidote Education Company             MANAGING DIABETES IN OLDER POPULATIONS                            50,000

    California Academy of Physician        MANAGEMENT OF OSTEOARTHRITIS IN THE PRIMARY SETTING                4,000
     Assistants

    California Academy of Physician        2016 ANNUAL MEETING OF THE CALIFORNIA ACADEMY OF                   4,000
     Assistants                             PHYSICIAN ASSISTANTS (CAPA): UPDATES IN TYPE 2
                                            DIABETES CARE

    Cardiovascular Research Foundation     BEST MANAGEMENT FOR COMPLEX PATIENTS WITH COMPLEX                 58,100
                                            DISEASE: THE NEXT FRONTIER BEYOND REVASCULARIZATION

    Consortium of Multiple Sclerosis       2016 CMSC ANNUAL MEETING SCIENTIFIC PROGRAM                       25,000
     Centers Nurse Practitioner
     Alternatives

    Consortium of Multiple Sclerosis       MS AT THE CUTTING EDGE: A 5-PART WEBINAR SERIES                   56,700
     Centers Nurse Practitioner
     Alternatives

    Dignity Health MandatoryCE LLC         5TH ANNUAL ARIZONA DIABETES SYMPOSIUM                             50,000

    Dignity Health MandatoryCE LLC         2016 ARKANSAS DIABETES SYMPOSIUM: FOCUS ON PREVENTION,            35,000
                                            CURRENT TREATMENTS, AND COMORBIDITIES

    Elsevier Office of Continuing Medical  ECTRIMS 2016: OPTIMALLY MANAGING PATIENTS WITH                    85,000
     Education Academic CME, LLC            MULTIPLE SCLEROSIS THROUGH INDIVIDUALIZED TREATMENT
                                            OPTIONS

    Emory University                       9TH WORLD CONGRESS ON PREVENTION OF DIABETES AND ITS              50,000
                                            COMPLICATIONS

    Florida Academy of Physician           EVALUATING KIDNEY DISEASE: KIDNEY KASES                            5,000
     Assistants

    Florida Academy of Physician           JOINT INJECTIONS                                                   5,500
     Assistants

    Foundation for Orthopaedic Research    ORTHOPAEDICS FOR THE PRIMARY CARE PRACTITIONER &                   5,000
     and Education, Inc.                    REHABILITATION THERAPIST

    Horizon CME, Inc.                      GLP-1 RECEPTOR AGONIST AND BASAL INSULIN: AN EMERGING             53,253
                                            STANDARD FOR TYPE DIABETES TREATMENT

    Horizon CME, Inc.                      ULTRALONG-ACTING BASAL INSULINS: WHERE DO THEY FIT?               53,253

    Integritas Communications, LLC         CLINICAL UPDATES IN THE MANAGEMENT OF SEVERE ASTHMA:               5,000
     Ultimate Medical Academy, LLC dba      NEW STRATEGIES TO INDIVIDUALIZE LONG-TERM CARE                         Collaboration \3\
     Global Education Group

    LeBonheur Children's Hospital          BACK TO SCHOOL DIABETES CONFERENCE                                 3,828

    Medical Education Resources Tarsus     COMBINING GLP-1RAS WITH INSULIN TO IMPROVE GLUCOSE               159,650
     Cardio Inc. dba Cardiometabolic        CONTROL
     Health Congress

    Medical Learning Institute, Inc.       PEERVIEW VIDEO INSESSION AT AAN 2016, ``STAYING                  131,530
     PeerView Institute for Medical         CURRENT WITH THE LATEST UPDATES ON APPROVED DISEASE-
     Education, Inc.                        MODIFYING THERAPIES FOR MULTIPLE SCLEROSIS
                                            MANAGEMENT: CLINICAL HIGHLIGHTS FROM VANCOUVER''

    Med-IQ, LLC                            SEQUENCING TREATMENT FOR METASTATIC CASTRATION-                  158,565
                                            RESISTANT PROSTATE CANCER: HOW TO MATCH PATIENTS TO
                                            THE RIGHT THERAPY

    Med-IQ, LLC                            THE EVOLVING THERAPEUTIC LANDSCAPE FOR MODERATE-TO-               88,759
                                            SEVERE ATOPIC DERMATITIS                                               Collaboration \3\

    National Association for Continuing    POSTPRANDIAL HYPERGLYCEMIA AND GLP-1 RECEPTOR                    150,000
     Education                              AGONISTS: EFFECTIVE STRATEGIES TO ACHIEVE GOALS

    National Association of Managed Care   NEW PERSPECTIVES AND EMERGING TREATMENT PARADIGMS IN              57,000
     Physicians, Inc.                       THE MANAGEMENT OF RELAPSING MULTIPLE SCLEROSIS

    National Association of Managed Care   CLINICAL ADVANCES IN ATOPIC DERMATITIS: NOVEL                     57,000
     Physicians, Inc.                       THERAPIES FOR IMPROVED PATIENT OUTCOMES

    National Association of Managed Care   IMPROVING PATIENT OUTCOMES WITH INDIVIDUALIZED THERAPY            57,000
     Physicians, Inc.                       IN THE MANAGEMENT OF TYPE 2 DIABETES

    National Kidney Foundation, Inc.       25TH ANNUAL FELLOWS RESEARCH FORUM                                 3,500

    National Kidney Foundation, Inc.       CHRONIC KIDNEY DISEASE-MINERAL BONE DISORDER:                    149,420
     University of Illinois at Chicago      IMPLICATIONS FOR CARDIAC OUTCOMES

    National Medical Association           STRATEGIES TO ACHIEVE BETTER CLINICAL OUTCOMES IN TYPE           200,000
                                            2 DIABETES AND ITS THERAPEUTIC COMPLICATIONS

    Penn State University Antidote         16TH ANNUAL DIABETES SYMPOSIUM                                    15,000
     Education Company

    Penn State University Medical          STRATEGIES FOR IMPROVING OUTCOMES IN PATIENTS WITH MS             15,000
     Communications Media, Inc.

    Pennsylvania Society of Physician      NEW TREATMENT OPTIONS IN DIABETES MELLITUS                         8,000
     Assistants

    Potomac Center for Medical Education   EXPANDING DMD TREATMENT OPTIONS FOR PATIENTS WITH MS             205,000
     Rockpointe Corporation

    Primary Care Network, Inc. PlatformQ   THE EVOLUTION OF BASAL INSULINS: ONE SMALL STEP OR A             100,000
     Health Education, LLC                  GIANT LEAP?

    Projects In Knowledge MedPage Today,   NEUROLOGY MASTERY IN MULTIPLE SCLEROSIS                          120,000
     LLC

    Regents of the University of           6TH ANNUAL UC IRVINE HEALTH NEUROMUSCULAR COLLOQUIUM              20,000
     California

    Regents of the University of Colorado  PRACTICAL WAYS TO ACHIEVE TARGETS IN DIABETES CARE               200,000

    Regents, University of California      THE 4TH ANNUAL UCLA DIABETES SYMPOSIUM                            10,000

    Scripps Health                         ANNUAL NEW APPROACHES TO OPTIMIZE REAL-WORLD DIABETES             70,000
                                            CARE: FALL CONFERENCE AND ENDURING MATERIALS

    The Board of Trustees of the UA for    SPECIAL NEPHROLOGY RESEARCH AND TRAINING CENTER                   15,000
     the UA at Birmingham                   SYMPOSIUM--11/9/15

    The Medical College of Wisconsin,      2016 ASBMT CLINICAL RESEARCH TRAINING COURSE                      25,000
     Inc. American Society for Blood and
     Marrow Transplantation

    University of California, San Diego--  PROMOTING BEHAVIOR CHANGE IN DIABETES: A SKILL                    50,000
     Behavioral Diabetes Institute          BUILDING PROGRAM FOR HEALTH CARE PROFESSIONALS

    University of California, San Diego    ADDRESSING THE NATURAL HISTORY OF TYPE 2 DIABETES:               142,899
     Taking Control of Your Diabetes        PRACTICAL APPROACHES TO CONTROLLING FASTING AND POST-
                                            PRANDIAL GLUCOSE LEVELS

    University of Cincinnati Global        HE METABOLIC & ENDOCRINE DISEASE SUMMIT (MEDS) 2016               25,000
     Academy for Medical Education, LLC T

    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q3, 2016 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Oct 2016-31th Dec 2016
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    American Academy of Pas                2016 ADULT HOSPITAL MEDICINE BOOT CAMP                             5,000

    American Association of Clinical       CALIFORNIA CHAPTER OF THE AMERICAN ASSOCIATION OF                  5,000
     Endocrinologists                       CLINICAL ENDOCRINOLOGISTS (CA AACE) 16TH ANNUAL
                                            MEETING & SYMPOSIUM

    American Association of Clinical       DIABETES DAY FOR PRIMARY CARE CLINICIANS ADVANCES IN              75,000
     Endocrinologists                       DIABETES CARE

    American College of Allergy, Asthma &  PLENARY SESSION: MODERN THERAPIES FOR ALLERGIC SKIN               35,000
     Immunology                             DISEASES                                                               Collaboration \3\

    American Health Resources, Inc.        NEW COMPLEMENTARY COMBINATION THERAPY FOR DIABETES:               21,800
                                            FIXED DOSE BASAL INSULINS AND GLP-1 RECEPTOR AGONISTS

    American Nephrology Nurses'            IMPROVING PATIENT OUTCOMES IN CKD-MBD: INDIVIDUALIZED            139,250
     Association                            MANAGEMENT AND ENHANCED PATIENT ENGAGEMENT

    American Society of Nephrology         CKD-MBD GUIDELINES: A CRITICAL APPRAISAL OF RECENT               181,790
                                            STUDIES

    American Society of Transplantation    AST FELLOWS SYMPOSIUM ON TRANSPLANTATION (2016)                   35,000

    American Thyroid Association, Inc.     3RD ANNUAL E. CHESTER RIDGWAY TRAINEE CONFERENCE                  25,000
     University of Colorado School of
     Medicine

    American Thyroid Association, Inc.     86TH ANNUAL MEETING OF THE AMERICAN THYROID                       50,000
     University of Colorado School of       ASSOCIATION
     Medicine

    American Urological Association        ADVANCEMENTS IN UROLOGY 2017, AN AUA/JUA SYMPOSIUM                15,000

    American Urological Association        ADVANCED PROSTATE CANCER: MANAGING THE SPECTRUM OF THE            60,000
     Education & Research, Inc.             DISEASE

    Annenberg Center for Health Sciences   EXPERTPERSPECTIVES: SHIFTING PARADIGMS, EMERGING                 224,355
     at Eisenhower                          TREATMENTS IN MODERATE TO SEVERE ATOPIC DERMATITIS                     Collaboration \3\

    Annenberg Center for Health Sciences   DEVELOPMENT OF SPANISH LANGUAGE VERSION OF: ANIMATED              75,000
     at Eisenhower Postgraduate Institute   MULTIPLE SCLEROSIS (MS) PATIENT AN ANIMATED PATIENTS
     for Medicine Prime Medic               GUIDE TO MS/ANIMADAS DE ESCLEROSIS MULTIPLE (EM)
                                            PACIENTE GUIA DEL PACIENTES ANIMADA A EM

    Augusta University                     NEUROLOGY FOR THE NON-NEUROLOGIST                                  5,000

    AXIS Medical Education, Inc.           AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION AND            74,580
                                            MOBILIZATION IN MULTIPLE MYELOMA: CURRENT DEBATE AND
                                            DEVELOPMENTS

    Baylor Scott & White Health Baylor     3RD ANNUAL SYMPOSIUM ON INDIVIDUALIZED NOVEL DISEASE-             40,000
     University Medical Center dba A.       MODIFYING TREATMENT OPTIONS FOR MULTIPLE SCLEROSIS
     Webb Roberts Center MedNet, LLC

    Baylor Scott & White Health MedNet     EMERGING BIOLOGICAL THERAPIES FOR ATOPIC DERMATITIS IN            35,000
                                            CHILDREN AND ADULTS                                                    Collaboration \3\

    California Optometric Association      FABRY DISEASE--OPHTHALMIC MANIFESTATIONS AND RECENT                9,650
                                            ADVANCES

    Cleveland Clinic Educational           MULTIPLE SCLEROSIS CASE-BASED ONLINE MONOGRAPH                    25,000
     Foundation

    Clinical Care Options, LLC             NEW DIRECTIONS IN GU CANCERS: HIGHLIGHTS FROM THE 2017            25,000
     Postgraduate Institute for Medicine    GENITOURINARY CANCERS SYMPOSIUM

    C-MEducation Resources, LLC AKH Inc    NEW FRONTIERS AND PIVOTAL CLINICAL ADVANCES IN                   297,000
     Advancing Knowledge and Healthcare     PATHOIMMUNOBIOLOGY OF ATOPIC DERMATITIS: THE                           Collaboration \3\
                                            TRANSLATIONAL PATH IN ATOPIC DERMATITIS AND
                                            IMPLICATIONS FOR DERMATOLOGY PRACTICE

    Consortium of Multiple Sclerosis       ADDRESSING COMORBIDITIES IN THE DIAGNOSIS AND                     85,000
     Centers Nurse Practitioner             MANAGEMENT OF PATIENTS WITH MULTIPLE SCLEROSIS: A
     Alternatives                           RESOURCE GUIDE FOR CLINICIANS

    Consortium of Multiple Sclerosis       CLINICAL CONSULT: CASES AND COMPREHENSIVE CARE IN MS             115,200
     Centers Nurse Practitioner
     Alternatives

    Consortium of Multiple Sclerosis       MONITORING AND FOLLOW-UP IN MULTIPLE SCLEROSIS                    60,725
     Centers Nurse Practitioner             COMPREHENSIVE CARE
     Alternatives

    Continuing Education Alliance, LLC     TARGETED THERAPIES IN MODERATE TO SEVERE ATOPIC                   92,550
     Board of Regents for University of     DERMATITIS: EMERGING OPTIONS                                           Collaboration \3\
     Nebraska

    Creative Educational Concepts, Inc.    ADVANCED PROSTATE CANCER: SEARCHING FOR OPTIMAL                   15,000
                                            THERAPY SEQUENCE AND ASSESSING EMERGING TREATMENT
                                            OPTIONS

    Delaware Academy of Physician          MULTIPLE SCLEROSIS                                                 2,200
     Assistants Inc.

    Elsevier Office of Continuing Medical  CLINICAL ADVANCES IN RHEUMATOID ARTHRITIS: A FOCUS ON            350,000
     Education Advanced Studies in          IMPROVING PATIENT OUTCOMES
     Medicine

    Elsevier Office of Continuing Medical  SPOTLIGHT ON FABRY DISEASE: DIAGNOSIS, GENOTYPE-                 200,000
     Education Excerpta Medica              PHENOTYPE CORRELATION, AND MULTIDISCIPLINARY PATIENT
                                            CARE

    Elsevier Office of Continuing Medical  ESMO2016: A THERAPEUTIC UPDATE ON THE MANAGEMENT OF               90,000
     Education Excerpta Medica BV           PATIENTS WITH PROSTATE CANCER

    Excel Continuing Education             MULTIPLE SCLEROSIS: MANAGING THE DISEASE, ITS SYMPTOMS             7,000
                                            AND QUALITY OF LIFE (PART OF THE SOUTH FLORIDA
                                            NEUROLOGY SYMPOSIUM: IMPROVING PATIENT OUTCOMES)

    Excel Continuing Education             NEW DIRECTIONS IN THE MANAGEMENT OF POMPE DISEASE                 64,120

    Florida Academy of Physician           MULTIPLE SCLEROSIS                                                 5,000
     Assistants Inc.

    Foundation of the Consortium of MS     2016-2017 ROBERT LISAK, MD MEDICAL STUDENT RESEARCH                8,000
     Centers                                SCHOLARSHIP

    Global Academy for Medical Education   SKIN DISEASE EDUCATION FOUNDATION'S 17TH ANNUAL LAS               25,000
     Postgraduate Institute for Medicine    VEGAS DERMATOLOGY SEMINAR FEATURING THE 13TH ANNUAL                    Collaboration \3\
     Rutgers, the State University          PSORIASIS FORUM

    Global Academy for Medical Education   16TH ANNUAL CARIBBEAN DERMATOLOGY SYMPOSIUM                       20,000
     Rutgers Biomedical and Health                                                                                 Collaboration \3\
     Sciences

    Global Academy for Medical Education   SKIN DISEASE EDUCATION FOUNDATION'S 41ST ANNUAL HAWAII            50,000
     University of Louisville Research      DERMATOLOGY SEMINAR                                                    Collaboration \3\
     Foundation

    Haymarket Medical Education            BASAL INSULIN PLUS GLP-1 RAS: THERAPEUTIC SYNERGIES TO           146,788
                                            OPTIMIZE PATIENT OUTCOMES: 4 VIDEO ``HOUSE CALLS''
                                            DISCUSSIONS AMONG EXPERTS

    Illinois Academy of Physician          JOINT INJECTABLES                                                  4,000
     Assistants

    Illinois Academy of Physician          CHRONIC KIDNEY DISEASE                                             5,000
     Assistants

    Indiana Academy of Physician           ``WHAT IS CHRONIC KIDNEY DISEASE (CKD) AND END STAGE               6,500
     Assistants                             RENAL DISEASE (ESRD)?''

    Indiana Neurological Society Indiana   DEMYELINATING DISEASES: WHAT TO DO WHEN THE INSULATION             5,000
     State Medical Association              BEGINS TO FRAY

    Integritas Communications Global       LOOKING BENEATH THE SURFACE IN ATOPIC DERMATITIS:                361,807
     Education Group                        TARGETING IMMUNE DYSREGULATION AND DELIVERING                          Collaboration \3\
                                            COMPREHENSIVE CARE

    Integritas Communications, LLC UMA      ATOPIC DERMATITIS: NEW PERSPECTIVES ON MANAGING A               267,480
     Education, Inc. dba Global Education   CHRONIC INFLAMMATORY DISEASE                                           Collaboration \3\
     Group

    Integritas Communications, LLC UMA     CLINICAL ADVANCES IN ATOPIC DERMATITIS: EXPERT                   202,218
     Education, Inc. dba Global Education   INSIGHTS INTO NEW AND EMERGING THERAPIES                               Collaboration \3\
     Group

    Integritas Communications, LLC UMA     CLINICAL UPDATES IN RHEUMATOID ARTHRITIS: NEW                    249,900
     Education, Inc. dba Global Education   STRATEGIES TO TARGET REMISSION AND INDIVIDUALIZE                       Collaboration \3\
     Group                                  COMPREHENSIVE CARE

    International Eczema Council           PSORIASIS AND ATOPIC DERMATITIS: TWO DISEASES OR ONE             100,000
     International Psoriasis Council        SPECTRUM?                                                              Collaboration \3\

    International Organization of MS       NP CONNECTIONS: THE ROLE OF THE NURSE PRACTITIONER IN             75,000
     Nurses Nurse Practitioner              MULTIPLE SCLEROSIS CARE
     Alternatives

    Kentucky Academy of Physician          JOINT INJECTION WORKSHOP                                           5,000
     Assistants

    Medical Learning Institute Inc. PVI    PEERVIEW LIVE AT CMSC 2017, GUIDING PATIENTS THROUGH             345,810
     Peerview Institute for Medical         THE RISKS AND BENEFITS OF DISEASE-MODIFYING THERAPY:
     Education Inc.                         PATIENT STORIES OF SHARED DECISION-MAKING THROUGHOUT
                                            THE COURSE OF MULTIPLE SCLEROSIS

    Medical Learning Institute Inc. PVI     PEERVIEW LIVE AT ACMG 2017 STRENGTHENING THE GENETICS-          219,430
     Peerview Institute for Medical         HEMATOLOGY PARTNERSHIP TO SHORTEN THE PATH TO
     Education Inc.                         DIAGNOSIS & TREATMENT OF GAUCHER DISEASE TYPE 1: A
                                            PATIENT STORY

    Medical Learning Institute Inc. PVI,   PEERVIEW VIDEO INPLAY NOVEL OPTIONS AND PATIENT                  169,480
     PeerView for Medical Education Inc.    PERSPECTIVES IN RHEUMATOID ARTHRITIS: INDIVIDUALIZING                  Collaboration \3\
                                            CARE FOR THERAPEUTIC SUCCESS

    Medical Learning Institute Inc. PVI,   PEERVIEW VIDEO INREVIEW: ASSESSING THE COMPARATIVE                60,000
     PeerView Institute for Medical         EFFECTIVENESS OF DISEASE-MODIFYING THERAPIES: WHAT
     Education                              CAN BE LEARNED FROM HEAD-TO-HEAD CLINICAL TRIALS AND
                                            RECENT NUMBER-NEEDED-TO-TREAT ANALYSES?

    Medical Learning Institute, Inc.       PEERVIEW IN REVIEW, ``DELAYING DISABILITY PROGRESSION            106,800
     PeerView Institute for Medical         IN THE MULTIPLE SCLEROSIS PATIENT: WHAT CAN WE LEARN
     Education, Inc.                        FROM AVAILABLE DATA ON APPROVED DISEASE-MODIFYING
                                            THERAPY?''

    Medical Learning Institute, Inc.       PEERVIEW TALKS: HIGHLY EFFECTIVE DISEASE-MODIFYING                65,000
     PeerView Institute for Medical         THERAPIES FOR MULTIPLE SCLEROSIS: WHEN AND IN WHOM
     Education, Inc.                        SHOULD THEY BE USED?

    Medical Learning Institute, Inc.       NEW DEVELOPMENTS IN THE TREATMENT OF ATOPIC                      156,480
     PeerView Institute for Medical         DERMATITIS: CLINICAL HIGHLIGHTS FROM VIENNA                            Collaboration \3\
     Education, Inc.

    Med-IQ, LLC                            DIFFERENTIATING GAUCHER DISEASE FROM OTHER HEMATOLOGIC           290,043
                                            CONDITIONS: EVERY DAY COUNTS

    Med-IQ, LLC                            LYSOSOMAL STORAGE DISEASES: NEWBORN SCREENING UPDATES            261,483
                                            AND IMPLICATIONS FOR LONG-TERM CARE

    Med-IQ, LLC                            FABRY DISEASE : WHEN TO TREAT                                    100,000

    Michigan State Medical Society         CARING FOR PATIENTS WITH A FOCUS ON THE KIDNEYS                    5,000

    MS Views And News Inc.                 2016 NEUROLOGICAL ASPECTS OF MS AND BEYOND--SYMPOSIUM             17,500

    MSWorld Inc.                           2016 MSWORLD-HOSTED TALKS SERIES                                  35,000

    National Association of Managed Care   NEW HORIZONS IN THE TREATMENT AND MANAGEMENT OF                   70,000
     Physicians, Inc.                       MULTIPLE SCLEROSIS: BEST PRACTICES FOR IMPROVED
                                            PATIENT OUTCOMES

    National Association of Managed Care   NEW HORIZONS IN THE TREATMENT AND MANAGEMENT OF ATOPIC            90,000
     Physicians, Inc.                       DERMATITIS (AD): HOW NOVEL THERAPIES ARE CHANGING THE                  Collaboration \3\
                                            TREATMENT PARADIGM

    National Jewish Health                 THE 39TH ANNUAL NATIONAL JEWISH HEALTH PULMONARY &                20,000
                                            ALLERGY UPDATE                                                         Collaboration \3\

    National Kidney Foundation             12TH ANNUAL JOINT MEETING OF THE UPSTATE AND WESTERN               7,500
                                            NEW YORK COUNCILS ON RENAL NUTRITION

    National Kidney Foundation             STRATEGIES TO IMPROVE PATIENT OUTCOMES IN CKD-MBD                243,260
                                            MANAGEMENT

    Neurologic Disease Foundation          21ST FALL MS SEMINAR--OPTIMIZING MANAGEMENT OF MS                  5,995

    New England Section American           85TH ANNUAL MEETING NEW ENGLAND SECTION OF THE                    10,000
     Urological Assn American Urological    AMERICAN UROLOGICAL ASSOCIATION
     Association Education and Research,
     Inc.

    Not-For-Profit Hospital Corporation    THYROID CANCER MANAGEMENT? AN OVERVIEW AND UPDATE OF               2,750
                                            NEW TREATMENT OPTIONS

    Not-For-Profit Hospital Corporation    END STAGE RENAL DISEASE FOR THE NON-NEPHROLOGIST                   1,910

    PeerVoice America Limited Oakstone     EMERGING PARADIGMS IN ATOPIC DERMATITIS: TARGETING THE           492,850
     Publishing, LLC.                       UNDERLYING PATHOLOGY                                                   Collaboration \3\

    Penn State College of Medicine         CASES FROM THE COMMUNITY: CLINICAL INVESTIGATORS                  80,000
     Research To Practice                   PROVIDE THEIR PERSPECTIVES ON EMERGING RESEARCH AND
                                            ACTUAL PATIENTS WITH ADVANCED PROSTATE CANCER]AN
                                            INDEPENDENT SATELLITE SYMPOSIUM (ISS) HELD AS A
                                            PREMIUM ANCILLARY EVENT DURING THE 2017 GENITOURINARY
                                            CANCERS SYMPOSIUM

    Penn State University                  PENN STATE HERSHEY CANCER INSTITUTE: CONTEMPORARY                  3,500
                                            TOPICS IN THYROID CANCER

    Pennsylvania Society of Physician      MULTIPLE SCLEROSIS: A PRIMARY CARE PERSPECTIVE                     4,500
     Assistants

    Pharmacy Times Continuing Education    AN AMERICAN JOURNAL OF MANAGED CARE SYMPOSIUM:                    92,358
                                            APPLYING MANAGED CARE STRATEGIES TO THE ADVANCING
                                            LANDSCAPE OF MULTIPLE SCLEROSIS

    Pharmacy Times Office of Continuing    MANAGING ATOPIC DERMATITIS: A PHARMACIST'S OPPORTUNITY            23,200
     Professional Education                 TO INTERVENE                                                           Collaboration \3\

    Postgraduate Institute for Medicine    BEST PRACTICES FOR MANAGING ADVERSE EVENTS ASSOCIATED             40,000
     Clinical Care Options, LLC             WITH NOVEL THERAPIES FOR PATIENTS WITH HEMATOLOGIC
                                            MALIGNANCIES

    Potomac Center for Medical Education   NOVEL INSIGHTS IN ATOPIC DERMATITIS: PATHWAYS,                   469,900
     Rockpointe Corporation                 BIOMARKERS, AND PHENOTYPES FOR A TARGETED APPROACH

    President and Fellows of Harvard       DIABETES AND CARDIOMETABOLIC SYNDROME IN PRIMARY CARE             10,000
     College Beth Israel Deaconess
     Department of Medicine

    President and Fellows of Harvard       18TH BIENNIAL HARVARD UROLOGIC CANCER COURSE                      50,000
     College Dana Farber Cancer Institute

    President and Fellows of Harvard       SURGERY OF THE THYROID AND PARATHYROID GLANDS                     10,000
     College Massachusetts Eye and Ear
     Infirmary Depart of Otolaryngology

    PRIME Education Inc. (PRIME)           ADVANCING OUR UNDERSTANDING OF THE IMMUNOLOGY AND                289,785
                                            TREATMENT CONSIDERATIONS IN ATOPIC DERMATITIS

    ProCE, Inc. Wild Iris Medical          EVOLUTION OF MULTIPLE SCLEROSIS MANAGEMENT: PHARMACY'S           119,975
     Education, Inc.                        ROLE

    Purdue University CiME LLC             APPLYING EVIDENCE BASED MANAGEMENT STRATEGIES FOR                 62,792
                                            PATIENTS WITH MS: AN EDUCATIONAL DATA CONTINUUM

    Regents, University of California      FOURTH ANNUAL UCLA REVIEW OF CLINICAL NEUROLOGY                    5,000

    Rheumatology Nurses Society American   RHEUMATOLOGY NURSES SOCIETY 2016 ANNUAL CONFERENCE                25,000
     Academy of Continuing Medical
     Education, Inc.

    RMEI Postgraduate Institute for        A LEARNING PATHWAY IN ATOPIC DERMATITIS: ACHIEVING               989,750
     Medicine                               SUCCESS IN ASSESSMENT AND MANAGEMENT TO IMPROVE                        Collaboration \3\
                                            PATIENT OUTCOMES

    RMEI The Omnia-Prova Education         TARGETING THE CYTOKINE PATHWAY IN RA MANAGEMENT:                 199,610
     Collaborative (TOPEC)                  IMPLICATIONS FOR NOVEL AND EMERGING IL-6 AGENTS                        Collaboration \3\

    Robert Michael Educational Institute,  THE FUTURE OF ASTHMA MANAGEMENT: PRECISION THERAPY               212,340
     LLC                                    WITH EMERGING CYTOKINE INHIBITORS                                      Collaboration \3\

    Sanford Medical Center Fargo           2016 SANFORD HEALTH NEPHROLOGY, DIALYSIS, TRANSPLANT               3,000
                                            SYMPOSIUM

    Sidney Kimmel Medical College at       5TH ANNUAL DIABETES SYMPOSIUM: NEW ADVANCES & TRENDS              10,000
     Thomas Jefferson University

    Society of Urologic Nurses and         EMERGING PRACTICE PATTERNS FOR THE UROLOGY NURSE IN               50,000
     Associates Plexus Communications       MANAGING PATIENTS WITH ADVANCED PROSTATE CANCER:
                                            CHALLENGES AND BEST PRACTICES WITH SYSTEMIC THERAPY

    Southern Alliance for Physician        40TH ANNUAL SOUTHEASTERN CONSORTIUM FOR DERMATOLOGY               10,000
     Specialties CME                        UPDATES IN PSORIASIS AND INFLAMMATORY DISORDERS                        Collaboration \3\

    Southern Salt, Water, and Kidney Club  57TH ANNUAL SCIENTIFIC MEETING                                     2,500

    The Medical College of Wisconsin,      25TH ANNUAL PERSPECTIVES IN UROLOGY: POINT                        15,000
     Inc. Carden Jennings Publishing Co.,   COUNTERPOINT (PCP 25)
     Ltd.

    Trustees of Boston University          2016 PCE ONCOLOGY SYMPOSIA SERIES FOR ADVANCED                   150,000
     Continuing Education Alliance          PRACTICE PROVIDERS SPECIALIZED IN ONCOLOGY: CHOOSING
                                            INITIAL THERAPY FOR METASTATIC PROSTATE CANCER: A NEW
                                            DIRECTION

    Trustees of Boston University          PRACTICING CLINICIANS EXCHANGE (PCE) 2016 PRIMARY CARE            50,000
     Continuing Education Alliance, LLC     SYMPOSIA SERIES 3 FOR NURSE PRACTITIONERS & PHYSICIAN                  Collaboration \3\
                                            ASSISTANTS: RHEUMATOID ARTHRITIS: TREATING TO TARGET
                                            IN PRIMARY CARE

    UMA Education, Inc. dba Global         SCRATCHING BENEATH THE SURFACE OF ATOPIC DERMATITIS               25,000
     Education Group                                                                                               Collaboration \3\

    UMA Education, Inc. dba Global         METASTATIC PROSTATE CANCER: CURRENT TRENDS AND FUTURE             53,000
     Education Group Applied Clinical       LANDSCAPE
     Education

    UMA MLG, LLC                           MANAGING MODERATE-TO-SEVERE ATOPIC DERMATITIS IN                 169,430
                                            ADULTS: PATHOLOGY-BASED, TARGETED THERAPIES                            Collaboration \3\

    University of Cincinnati               INNOVATIVE TECHNIQUES: THE KNEE COURSE 2016                        5,000

    University of Cincinnati CORE Medical  PRACTICE CHANGING ADVANCES: EXPANDING THE ATOPIC                 112,825
     Education, LLC                         DERMATITIS ARMAMENTARIUM                                               Collaboration\3\

    University of Cincinnati CORE Medical  TYPE 2 DIABETES: MASTERING COMBINATION THERAPIES TO               42,825
     Education, LLC                         INDIVIDUALIZE AND OPTIMIZE OUTCOMES

    University of Cincinnati Robert        TAILORING APPROACHES TO MANAGEMENT IN PATIENTS WITH              247,170
     Michael Educational Institute, LLC     RHEUMATOID ARTHRITIS: WHAT'S NEW?                                      Collaboration \3\

    University of Nevada, Reno School of   2016 FALL CLINICAL DERMATOLOGY CONFERENCE                        125,000
     Medicine Foundation for Research and                                                                          Collaboration \3\
     Education in Dermatology

    University of Tennessee Advanced       LYSIS CRISIS: PHARMACIST'S ROLE AND RESPONSIBILITY IN             70,000
     Studies in Medicine                    THE MANAGEMENT OF TUMOR LYSIS SYNDROME

    University of Vermont and State        NORTHERN NEW ENGLAND NEUROLOGICAL SOCIETY ANNUAL                   5,000
     Agricultural College                   MEETING

    WebMD Global LLC                       2016 CLINICAL COURSE ON NEW DEVELOPMENTS IN ATOPIC               144,200
                                            DERMATITIS                                                             Collaboration \3\

    World Allergy Organization             WAO INTERNATIONAL SCIENTIFIC CONFERENCE 2016                      30,000
                                                                                                                   Collaboration \3\
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q4, 2016 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Jan 2017-31th Mar 2017
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    AcademicCME, LLC.                      Applying Newer Biologic Therapies to Improve Outcomes         324,370.00
                                            in Patients with Atopic Dermatitis                                     Collaboration \3\

    Academy for Continued Healthcare       Current and Emerging Approaches to Customize Prostate          50,000.00
     Learning                               Cancer Treatment: an eNewsletter Series

    Academy of Managed Care Pharmacy       Management of Rare and Orphan Diseases for Improved            34,500.00
     (AMCP)                                 Patient and Payer Outcomes

    Advanced Studies in Medicine Elsevier  Hawaii Dermatology Seminar: A Therapeutic Update on           131,590.00
     Office of Continuing Medical           the Management of Patients with Atopic Dermatitis                      Collaboration \3\
     Education

    Advancing Knowledge in Healthcare      Overcoming the Clinical Challenges of Basal Insulin           167,340.00
     Medtelligence                          Usage in Type 2 Diabetes

    American Academy of PAs                AAPA 2017--Rheumatology Track                                   5,000.00
                                                                                                                   Collaboration \3\

    American Association of Clinical       Using Insulin When, Where, and How It's Needed: Type 2        204,570.00
     Endocrinologists                       Diabetes Treatment in the Modern Age

    American Association of Clinical       AACE 2017--Treatment Advances for Challenging Patients        329,620.00
     Endocrinologists ASiM                  with Type 2 Diabetes: The Role of Emerging Insulin
                                            Combinations

    American Association of Clinical       Endocrine University--Thyroid Sessions                         10,000.00
     Endocrinologists

    American Association of Diabetes       Improving Adherence with New Fixed-Dose Insulin               864,525.00
     Educators Medscape                     Combination Therapy

    American College of Cardiology         Recent Trends in Combination Therapy: Managing                 50,000.00
     Foundation                             Cholesterol Even in the Most Resistant                                 Collaboration \3\

    American College of Medical Genetics   Genzyme/ACMG Foundation Clinical Genetics Fellowships          75,000.00
     Foundation                             in Medical Biochemical Genetics

    American College of Rheumatology       2017 ACR Rheumatology Courses                                 150,000.00
                                                                                                                   Collaboration \3\

    American Society of Transplantation    2017 AST Cutting Edge of Transplantation: One                  38,000.00
                                            Transplant for Life, Many Pathways to Success

    American Urological Association        2017 CRPC Live Forum for Urology Residents and Fellows         60,000.00

    American Urological Association        2017 AUA Annual Meeting: Highlights in Advanced                75,000.00
                                            Prostate Cancer

    Annenberg Center for Health Sciences   Chronic Kidney Disease-Mineral and Bone Disorder-              67,905.00
     at Eisenhower                          Translating Evidence Into Practice

    Annenberg Center for Health Sciences   Expert Discussions: Recent Advances in Metastatic             100,000.00
     at Eisenhower Clinical Care Options,   Prostate Cancer Treatment
     LLC

    Annenberg Center for Health Sciences   Dana Farber Master Class for Oncologists--                     25,000.00
     at Eisenhower                          Genitourinary Cancers Track

    AXIS Medical Education                 Integrating Shared Decision Making and Guideline               40,000.00
                                            Recommendations for Prostate Cancer Treatment

    AXIS Medical Education ReachMD         Advancing Interdisciplinary Care in Prostate Cancer:          143,090.00
                                            Clinical Updates for Urology and Oncology Healthcare
                                            Professionals

    Boston University School of Medicine-- PCE Series 2: Decision Points--Considerations for             399,897.00
     Office of CME Continung Education      Using New Complementary GLP-1 Receptor Agonist-
     Alliance, LLC Institute for Medical    Insulin Combinations in Patients with T2DM
     and Nursing Education, Inc.

    Boston University School of Medicine   PCE 2017 Primary Care Symposia Series 3: Joint                100,000.00
     Practicing Clinicians Exchange         Management: The Role of Primary Care in Rheumatoid                     Collaboration \3\
                                            Arthritis

    Catamount Medical Education, LLC       MS4: Sequencing, Switching, Escalation, and Symptom           150,000.00
     Postgraduate Institute for Medicine    Management

    Cedars-Sinai Medical Center            6th Annual Symposium on Lysosomal Storage Disorders            15,000.00

    Children's Hospital of Philadelphia    Genetic Counselor Fellowship in Lysosomal Storage              75,000.00
     Foundation                             Disorders

    Conquer Cancer Foundation of the       2017 Genitourinary (GU) Cancers Symposium: Translating         28,000.00
     American Society of Clinical           Research to Value-Based and Patient-Centric Care
     Oncology American Society of
     Clinical Oncology, Inc.

    Consortium of Multiple Sclerosis       The Science of MS Management: 2017                             70,775.00
     Centers Nurse Practitioner
     Alternatives

    Consortium of Multiple Sclerosis       Advances In Multiple Sclerosis (AIMS) 2016: A 360             125,000.00
     Centers Nurse Practitioner             Approach to Translating Data into Optimal Practice
     Alternatives The France Foundation

    Duke University                        Fellowship in Medical Biochemical Genetics                     75,000.00

    Elesevier Office of Continuing         Clinical Issues in Severe Asthma: Consensus and               271,605.00
     Education Integritas Communications    Controversies on the Road to Precision Medicine                        Collaboration \3\

    Elsevier Office of Continuing Medical  Perspectives from the American Academy of Dermatology         131,590.00
     Education ASiM                         2017 Meeting: Clinical Strategies and Scientific                       Collaboration3
                                            Advances in Atopic Dermatitis

    Emory Genetics Laboratory              Paul M. Fernhoff Genetic Counselor Fellowship in               75,000.00
                                            Lysosomal Storage Diseases

    Endocrine Society                      ENDO 2017 Thyroid Sessions                                     75,000.00

    Enquiring Minds, LLC Postgraduate      Multiple Sclerosis in Pediatric Patients: Expert               60,000.00
     Institute for Medicine                 Guidance on Overcoming Challenges in Diagnosis and
                                            Treatment

    Evolve Medical Education, LLC          From Symptom Control to Target Treatment: The Shifting        201,325.00
                                            Paradigm of Atopic Dermatitis                                          Collaboration \3\

    Excerpta Medica BV Elsevier Office of  2017 Genitourinary Cancers Symposium: A Therapeutic            65,795.00
     Continuing Medical Education           Update on the Management of Patients with Prostate
                                            Cancer

    Foundation of the Consortium of MS     2017 FCMSC Medical Resident Annual Meeting (CMSC)              24,700.00
     Centers                                Scientific Scholarships

    Foundation of the Consortium of MS     2017-2018 Medical Student Research Scholarships                34,000.00
     Centers

    Haymarket Medical Education            Physiologic Approaches to Optimizing Glycemic Control:        309,519.00
                                            A Pecha Kucha-Inspired CME Symposium on Long-Acting
                                            Insulins

    Horizon CME                            Fixed-Ratio GLP-1RA and Basal Insulin Formulations:           182,100.00
                                            How and When to Use Them?

    Horizon CME                            GLP-1 RA and Basal Insulin Combinations: New Options          212,645.00
                                            for Treatment Intensification

    Integrity Continuing Education, Inc.   Overcoming Barriers to the Early Recognition and              149,000.00
                                            Diagnosis of Rheumatoid Arthritis in Real-World                        Collaboration \3\
                                            Practice: Strategies to Expedite Treatment to
                                            Remission

    Integrity Continuing Education, Inc.   2017 AAFP State Society CME Meetings and Publication          198,500.00
                                            in Action Enduring Material Initiative--Evaluating                     Collaboration \3\
                                            Newer Targeted Therapies for Patients with Rheumatoid
                                            Arthritis: Addressing Unmet Needs in the Primary Care
                                            Practice

    International Psoriasis Council        Evolving Perspectives on Psoriasis and Atopic                 100,000.00
                                            Dermatitis: Are They Two Diseases or One Spectrum?                     Collaboration \3\

    Lysosomal and Rare Disorders Research  Genetic, Rare and Immune Disorders Symposium (GRIDS)           30,000.00
     and Treatment Center Professional      2016
     Education Services Group

    Med Learning Group                     Actionable Pathologic Targets in Rheumatoid Arthritis:        169,700.00
                                            Modifying the Dysregulation of the Immune Response to                  Collaboration \3\
                                            Self to Optimize Patient Outcomes

    Medical Learning Institute Inc. PVI    ``Insights Into the Pathophysiology of Atopic                 290,600.00
     Peerview Institute for Medical         Dermatitis: Setting the Stage for Novel Treatment                      Collaboration \3\
     Education Inc.                         Options''

    Medical Learning Institute Inc. PVI    ``Addressing Unmet Needs in Rheumatoid Arthritis              156,730.00
     Peerview Institute for Medical         Through Novel Treatment Options and Enhanced                           Collaboration \3\
     Education Inc.                         Physician-Patient Collaboration''

    Medical Learning Institute Inc. PVI,   PeerView Video in Exchange, ``Establishing a                   98,750.00
     PeerView Institute for Medical         Therapeutic Alliance in the Management of Multiple
     Education                              Sclerosis: How Can We Better Align Treatment
                                            Preferences and Goals among Patients and
                                            Practitioners?''

    Med-IQ, LLC                            Newborn Screening for Lysosomal Storage Disorders:            197,866.00
                                            Recent Progress and Unanswered Questions

    Med-IQ, LLC                            Medical Insiders: Targeting IL-6 Signaling in the             125,000.00
                                            Treatment of Rheumatoid Arthritis                                      Collaboration3

    Med-IQ, LLC                            Tumor Lysis Syndrome in a Rapidly Evolving Treatment          142,099.00
                                            Landscape

    Med-IQ, LLC                            Insulin Intensification with GLP-1 Receptor Agonists:         251,110.00
                                            Clinical Evidence and Real World Perspectives

    Med-IQ, LLC                            Viewpoints on Atopic Dermatitis: How Emerging                 169,995.00
                                            Treatments May Change the Management of Moderate to                    Collaboration \3\
                                            Severe Disease

    Medscape                               Osteoarthritis of the Knee: A Patient-Simulation              250,000.00
                                            Approach to Assessment and Management

    Medscape LLC                           Managing Patients With Rheumatoid Arthritis in the            250,000.00
                                            Virtual Clinic Setting                                                 Collaboration \3\

    Medscape LLC                           A Lipid Clinic in Action: How Would You Treat?                225,000.00
                                                                                                                   Collaboration \3\

    Medscape LLC Close Concerns            Improving Outcomes in Diabetes: Glucose Monitoring,            75,000.00
                                            Adherence, and Individualized Treatment

    Medscape, LLC                          Autologous Stem Cell Transplantation in Multiple              182,500.00
                                            Myeloma: Who, When, and How?

    Mount Sinai School of Medicine         International Center for Fabry Disease                        150,000.00

    MS Cure Fund, Inc.                     1st Quarter 2017 Multiple Sclerosis Lifestyle                  19,750.00
                                            Management Patient Education Programs

    National Association of Managed Care   Managing Castration-Resistant Prostate Cancer:                 45,000.00
     Physicians                             Understanding the Therapeutic Landscape

    National Association of Managed Care   What's New in the Evolving Treatment Landscape for             57,000.00
     Physicians, Inc.                       Moderate-to-Severe Atopic Dermatitis (AD)                              Collaboration \3\

    National Jewish Health                 Personalized Medicine in Severe Asthma: Applying              120,044.00
                                            Emerging Data and Treatments to Everyday Clinical                      Collaboration \3\
                                            Practice

    National Jewish Health Western         WSAAI 55th Annual Scientific Session                           15,000.00
     Society of Allergy, Asthma and                                                                                Collaboration \3\
     Immunology (WSAAI)

    National Lipid Association Robert      Navigating the Challenges of Prescribing PCSK9                249,835.00
     Michael Educational Institute (RMEI)   Inhibitors in Persistent Elevated LDL-C                                Collaboration \3\

    National Society of Genetic            New Lysosomal Storage Disease Healthcare Advocate              28,000.00
     Counselors (NSGC) Emory University     Workshop

    New York University--Langone School    Department of Neurology, Division of Neurogenetics             75,000.00
     of Medicine

    North American Center for Continuing   Fixed-Ratio GLP-1 RA and Basal Insulin Combinations: A        173,365.00
     Medical Education Horizon CME          Complementary Approach to Treatment Intensification

    Norton Healthcare Foundation           Celebrating MS Innovations 2017                                10,000.00

    NYU Post-Graduate Medical School       NYU Seminar In Advanced Rheumatology                           10,000.00
                                                                                                                   Collaboration \3\

    Organ Donation and Transplantation     2017 National Donor Management Summit                           5,000.00
     Alliance

    Penn State College of Medicine MCM     Evolving Standards of Care in Metastatic Prostate             138,400.00
     Education                              Cancer

    Penn State College of Medicine PVI     ``PeerView Master Class and Practicum Live--Urologists        150,000.00
     Peerview Institute for Medical         at the Intersection of Evidence-Based and Patient-
     Education Inc.                         Centric Prostate Cancer Care: Practical Guidance for
                                            Everyday Practice''

    Penn State College of Medicine, MCM    Rheumatoid Arthritis: Improving Quality of Care               100,000.00
     Education                                                                                                     Collaboration \3\

    Pharmacy Times Continuing Education    Managing Diabetes with Insulin/ GLP-1 Receptor Agonist        251,500.00
                                            Combinations: A Clinical Discussion of Safety and
                                            Efficacy Data

    Pharmacy Times Continuing Education    Information for Pharmacists: Counseling on                     36,000.00
                                            Dermatologic Conditions                                                Collaboration \3\

    Pharmacy Times Continuing Education    Advances in the Treatment of Moderate to Severe Atopic         59,867.00
                                            Dermatitis: Practice and Management Essentials for                     Collaboration \3\
                                            Specialty Pharmacists

    Pharmacy Times Continuing Education    Medical Crossfirer: Value-Based Diabetes: Managing            187,400.00
                                            Costs Yet Improving Outcomes

    Pharmacy Times Continuing Education    Treatment Advances in Diabetes: Evaluating the Safety          68,000.00
                                            and Efficacy of Insulin/GLP-1 Receptor Agonist
                                            Combinations

    Pharmacy Times Continuing Education    Atopic Dermatitis: Focusing on the Patient Care                74,000.00
                                            Strategy in the Managed Care Setting                                   Collaboration \3\

    Ponce Medical School Foundation, Inc.  The Role of the Primary Care Providers with Chronic            10,000.00
                                            Kidney Disease Patients.

    Postgraduate Healthcare Education,     Working Together Against Clinical Inertia: Using              126,075.00
     LLC                                    Combination Injectable Therapies in Type 2 Diabetes

    Postgraduate Institute for Medicine    Best Practice Roadmaps and Clinical Rationale for Use         968,000.00
     CMEducation Resources                  of Complementary Insulin plus GLP-1 Receptor Agonist
                                            Combination Therapy To Optimize PAN-Glycemic HA1c
                                            Target Goal Attainment in T2D: The Physiologic and
                                            Mechanistic Basis for New Basal Insulin plus Short-
                                            Acting GLP-1 RA Fixed-Ratio, Combination Formulations
                                            for Controlling FPG and Postprandial Hyperglycemia
                                            (PPG): Optimizing Glucose Control and Reducing Risks
                                            of Hypoglycemia and Weight Gain

    Postgraduate Institute for Medicine    Best Practice Roadmaps and Clinical Rationale for Use         319,000.00
     CMEducation Resources                  of Complementary Insulin plus GLP-1 Receptor Agonist
                                            Combination Therapy To Optimize PAN-Glycemic HA1c
                                            Target Goal Attainment in T2D: The Physiologic and
                                            Mechanistic Basis for New Basal Insulin plus Short-
                                            Acting GLP-1 RA Fixed-Ratio, Combination Formulations
                                            for Controlling FPG and Postprandial Hyperglycemia
                                            (PPG): Optimizing Glucose Control and Reducing Risks
                                            of Hypoglycemia and Weight Gain

    Postgraduate Institute for Medicine    New Fixed-Ratio Combination Insulin Regimens for              341,000.00
     CMEducation Resources                  Optimizing Comprehensive Glycemic Management In
                                            Challenging Patients with T2D: The Rationale,
                                            Evidence, and Mechanistic Basis for Fixed Ratio,
                                            Complementary Insulin plus GLP-1 RA Combinations for
                                            Achieving FPG and PPG Target Goals-Focus on Pan-
                                            Glycemic Control While Mitigating Risks of
                                            Hypoglycemia and Weight Gain

    Practicing Clinicians Exchange         Practicing Clinicians Exchange (PCE) Directed Learning        138,800.00
     Continuing Education Alliance          eCourse: Updates on the Management of Knee
                                            Osteoarthritis in Primary Care: The Role of
                                            Viscosupplementation

    President and Fellows of Harvard       New England Thyroid Club                                        1,500.00
     College acting through Harvard
     Medical School Depart. of Contin Edu
     Beth Israel Deaconess Medical Center

    President and Fellows of Harvard       Clinical Endocrinology 2017                                     5,000.00
     College acting through the Harvard
     Medical School Department of Con The
     Massachusetts General Hospital

    PRIME Education, LLC                   GME-CME Today Advanced Practice in Multiple Sclerosis:         92,938.00
                                            Focused Training for Effective Individualized
                                            Treatment Decision-Making

    PRIME Education, LLC                   Implications of Cardiovascular Outcomes Trials on             228,145.00
                                            Lipid-Lowering Therapies                                               Collaboration \3\

    PRIME Education, LLC                   Applying Evidence and Lessons Learned in the                  295,270.00
                                            Management of Moderate-to-Severe Atopic Dermatitis                     Collaboration \3\

    Pri-Med Institute, LLC Horizon CME     Practical Strategies to Using Novel GLP-1 RA and Basal        972,120.00
                                            Insulin Combinations in Clinical Practice

    Pri-Med Institute, LLC Horizon CME     Integrating Newer Basal Insulins in Primary Care: A           956,499.91
                                            Case-based Review

    Projects In Knowledge @Point of Care   Rheumatologic Diseases @Point of Care                         150,000.00
                                                                                                                   Collaboration \3\

    Projects In Knowledge @Point of Care   Multiple Sclerosis @Point of Care                             133,225.00

    Prostate Cancer Foundation              MARS2 Retreat (Mission: Androgen Receptor Splice              10,000.00
                                            Variant)

    PVI Peerview Institute for Medical     PeerView Video inSession, ``Examining the Clinical             66,240.00
     Education Inc. Medical Learning        Implications of Late-Breaking Data on Approved and
     Institute Inc.                         Emerging Disease Modifying Therapies for Multiple
                                            Sclerosis Management: What Are the Key Learnings From
                                            Boston?''

    Regents of the University of           5th Annual UC San Diego Essentials and Advances in              5,000.00
     California                             Apheresis

    Regents of the University of           Transplant Immunosuppression 2017: Achieving Long-Term         35,000.00
     Minnesota                              Success

    Research To Practice                   What Urologists Want to Know: Addressing Current               85,000.00
                                            Questions and Controversies in the Management of
                                            Early and Advanced Prostate Cancer--An Independent
                                            Satellite Symposium (ISS) Held in Conjunction with
                                            the 2017 American Urological Association (AUA) Annual
                                            Meeting

    Rocky Mountain MS Center               MS 101 2017 Programs                                           10,000.00

    Rush University Medical Center Plexus  Realizing Improved Outcomes in Advanced Prostate               80,000.00
     Communications                         Cancer through Evolving Research and Emerging
                                            Treatment Paradigms: Challenges and Opportunities

    Rush University Medical Center Plexus  VHA Oncology Clinical Forums: ``Current Treatment             100,000.00
     Communications                         Strategies for Advanced Prostate Cancer: Sequencing
                                            Therapies and Incorporating Novel Approaches''

    Society for Inherited Metabolic        2016 North American Metabolic Academy                          20,000.00
     Disorders

    St. Joseph's Regional Medical Center   Introduction to Clinical Transplantation; Renal                 1,500.00
                                            Transplantation--An Overview

    The France Foundation                  State Chapter Meetings: A Physiological Approach to           357,120.00
                                            Combination Therapies: Improving Glycemic Control in
                                            T2DM

    The France Foundation                  A Bright Outlook on New and Emerging RA Management            145,330.00
                                            Options: What Would You Do?                                            Collaboration \3\

    The France Foundation Calibre          Famous People with Diabetes: A Case Study Exploring           552,210.00
     Institute for Quality Medical          the Use of New and Emerging Basal Insulins
     Education

    The Medical College of Wisconsin,      27th International Prostate Cancer Update                      20,000.00
     Inc. Carden Jennings Publishing Co.,
     Ltd.

    The Medical College of Wisconsin,      Optimizing Stem Cell Mobilization for Autologous              223,000.00
     Inc. Carden Jennings Publishing Co.,   Transplantation in Myeloma
     Ltd.

    The National Multiple Sclerosis        The Living Well with MS Conference (North Florida)              3,500.00
     Society, North Florida Chapter

    The Trustees of the University of      Lysosomal Storage Disease Fellowship                           75,000.00
     Pennsylvania

    The University of Chicago              22nd Annual University of Chicago Developmental                 5,000.00
                                            Therapeutics Symposium

    The University of Texas MD Anderson    7th Current Concepts in the Management of Thyroid &            25,000.00
     Cancer Center                          Parathyroid Neoplasms

    Tufts Medical Center                   Hypertrophic Cardiomyopathy--A Contemporary and                20,000.00
                                            Treatable Disease: Diagnosis, Heart Failure
                                            Management, and Prevention of Sudden Death

    UC Irvine                              University of California, Irvine Lysosomal Storage             56,857.68
                                            Diseases Patient and Family Educational Grant

    UCI Office of Continuing Medical       Nephrology Grand Rounds                                         2,000.00
     Education University of California
     Irvine

    UMA Education Inc., dba Global         Optimizing Outcomes in Atopic Dermatitis                      106,250.00
     Education Group, Physicians'                                                                                  Collaboration \3\
     Education Resource

    University of Alabama at Birmingham    2017 Fabry Fellowship                                          75,000.00

    UMA Education, Inc.: dba Global        Going Deeper on Atopic Dermatitis: Pathophysiology to         239,640.92
     Education Integritas Communications    the Management of Moderate-to-Severe Disease                           Collaboration \3\

    University of Arkansas for Medical     Tackling Type 2 Diabetes at the Community Level: A             90,000.00
     Sciences MedIQ                         Focused QI Initiative to Overcome Local Challenges to
                                            Patient Health

    University of Cincinnati Advances in   MauiDerm 2017                                                  45,000.00
     Cosmetic and Medical Dermatology                                                                              Collaboration \3\

    University of Kansas Medical Center/   Neuromuscular Review Course 2017                               20,000.00
     Kansas Endowment Association

    University of Kansas School of         Neuromuscular Medicine Fellowship                              75,000.00
     Medicine

    University of Massachusetts Medical    The Physiologic and Mechanistic Rationale for                 341,000.00
     School CMEducation Resources           Achieving HA1c Target Goals with Basal Insulin In
                                            Vulnerable Patients with Type 2 Diabetes: Focus on
                                            the Safety-Efficacy Equation, Patient Selection,
                                            Switching, Dosing and Physiologic, PK/PD Profiles of
                                            Long-Acting Basal Insulin Formulations

    University of Massachusetts Medical    The iQ&A Case-By-Case interactive Diabetes                    178,000.00
     School CMEducation Resources           Intelligence Zone: Practical, Real World Strategies
                                            for Deploying Fixed-Ratio Insulin Combinations in T2D-
                                            National Experts in Diabetes Focus on Patient
                                            Identification, Dose Titration, Pan-Glycemic (FPG and
                                            PPG) Control, Mechanistic Complementarity, and
                                            Optimizing the Safety-Weight-Efficacy Equation in
                                            Patients with Diabetes

    University of Massachusetts Medical    The iQ&A Case-By-Case Interactive Diabetes                    178,000.00
     School CMEducation Resources           Intelligence Zone: Focus on Practical Aspects of
                                            Using Physiologic, Long-Acting Basal Insulin to
                                            Optimize Glycemic Management in T2D

    University of Rochester School of      2017 Society for Investigative Dermatology Annual              50,000.00
     Medicine and Dentistry Society for     Meeting                                                                Collaboration \3\
     Investigative Dermatology

    University of Massachusetts Medical    The iQ&A Case-By-Case Interactive Diabetes                    178,000.00
     School CMEducation Resources           Intelligence Zone: Focus on Practical Aspects of
                                            Using Physiologic, Long-Acting Basal Insulin to
                                            Optimize Glycemic Management in T2D

    University of Rochester School of      2017 Society for Investigative Dermatology Annual              50,000.00
     Medicine and Dentistry Society for     Meeting                                                                Collaboration3
     Investigative Dermatology

    University of Vermont and State        The 28th Annual Eastern Winter Dermatology Conference                   Collaboration \3\
     Agricultural Colle                     10,000.00

    UT Southwestern Medical Center         39th Annual Carrell-Krusen Neuromuscular Symposium              5,000.00
                                                                                                                   Collaboration \3\

    World Allergy Organization             Collaboration on Severe Asthma (COSA)                          35,000.00
                                                                                                                   Collaboration \3\
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q1, 2017 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                              1st April 2017-30th June 2017
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    AKH Inc., Advancing Knowledge in       A Multidisciplinary Approach to the Treatment of              149,125.00
     Healthcare Center of Excellence        Prostate Cancer: Providing Therapies that Improve
     Media, LLC--An affiliate of The Lynx   Overall Survival and Quality of Life
     Group

    AKH Inc., Advancing Knowledge in       Endocrine Nurses Society Symposium 2017 Thyroid                 5,000.00
     Healthcare Endocrine Nurses Society    Sessions

    American Academy of Dermatology The    The Future is Finally Here--Targets of the New Atopic          75,000.00
     France Foundation                      Dermatitis Drugs                                                       Collaboration \3\

    American Academy of PAs                AAPA 2017--Orthopaedics Track                                  10,000.00

    American Association of Clinical       Current Landscape in Medullary Thyroid Cancer: Updates        198,425.00
     Endocrinologists                       for Clinicians

    American Association of Clinical       Georgia-AACE April Dinner Program: New Developments in          3,276.00
     Endocrinologists                       Thyroid Cancer

    American College of Allergy, Asthma &  EAC 2017 Update in Allergy, Asthma & Immunology                10,000.00
     Immunology Eastern Allergy                                                                                    Collaboration \3\
     Conference

    American College of Allergy, Asthma &  Society of Allergy, Asthma & Immunology CSAAI 2017 A           10,000.00
     Immunology; California                 Midsummer Night's Wheeze

    American College of Medical Genetics   Genzyme/ACMG Foundation Clinical Genetics Fellowships          75,000.00
     Foundation                             in Biochemical Genetics

    American Society of Clinical           Oncology 2017 ASCO Annual Meeting Genitourinary Cancer         28,000.00
     Oncology, Inc. Conquer Cancer          Tracks Bundle--Prostate and Nonprostate
     Foundation of the American Society
     of Clinical

    American Thoracic Society              ATS 2017 International Conference--Selected Sessions           20,000.00
                                            in Asthma                                                              Collaboration \3\

    Ann & Robert H. Lurie Children's       Lysosomal Storage Disease Training Program for Genetic         75,000.00
     Hospital of Chicago                    Counselors

    Med Learning Group                     Novel Formulations of Basal Insulins for Patients with        249,050.00
                                            Diabetes: A New Opportunity to Optimize Outcomes

    Med Learning Group                     A Virtual Reality View of Biologic Agents: Targeted           375,000.00
                                            Therapies for the Management of Moderate-to-Severe                     Collaboration \3\
                                            Atopic Dermatitis in Adults

    Medical Learning Institute Inc. PVI     Enhancing Autologous Hematopoietic Stem Cell                 108,050.00
     Peerview Institute for Medical         Transplantation Through Individualized Stem Cell
     Education Inc.                         Mobilization Strategies

    Medical Learning Institute Inc. PVI     PeerView Video in Session ``New Developments in              154,980.00
     Peerview Institute for Medical         Inflammatory Dermatologic and Respiratory Diseases:                    Collaboration \3\
     Education Inc.                         Clinical Highlights From Helsinki''

    Medscape LLC                           Basal Insulin in Today's Clinical Practice                    500,000.00
                                            Environment: Improving Use for Better Patient
                                            Outcomes

    Medscape LLC                           Clinical Advances in Atopic Dermatitis                        950,000.00
                                                                                                                   Collaboration \3\

    Medscape LLC                           A Medscape Studio Series on Modern Approaches for             125,000.00
                                            Optimizing Care in MS

    Michigan State Medical Society         Rheumatology Update                                             5,000.00
                                                                                                                   Collaboration \3\

    MSWorld Inc.                           Comprehensive Proposal for 2017 MS World Conference            50,000.00
                                            Coverage

    MSWorld Inc.                           2017 ``MSWorld Talks'' Series                                  55,000.00

    Muscular Dystrophy Association         MDA Care Center Open House at Nemours Children's                  500.00
                                            Hospital

    National Association of Managed Care   Individualizing Treatment in the Management of Type 2          57,000.00
     Physicians, Inc.                       Diabetes: Novel Therapies for Improved Patient
                                            Outcomes

    National Comprehensive Cancer Network  Prostate Cancer Patient Management Simulator                   35,000.00

    National Lipid Association Vindico     Back to the Future: Clinical Experience with and               50,000.00
     Medical Education                      Access to Lipid-Lowering Agents of the Past, Present,                  Collaboration \3\
                                            and Future--A National Lipid Association Expert
                                            Discussion and Town Hall

    National Medical Association           Endocrinology, Diabetes, and Metabolism Symposium             250,000.00
                                            Current and Emerging Interventions: Saving Lives and
                                            Limbs by Improving Diabetes Care

    National Medical Association           MODERN ERA DIAGNOSIS, TREATMENT AND MANAGEMENT OF              15,000.00
                                            PATIENTS WITH PROSTATE CANCER

    National Multiple Sclerosis Society    National MS Society Monthly Email Newsletter                   75,000.00

    National Society for Cutaneous         2017 Real World Dermatology for Residents                      40,000.00
     Medicine                                                                                                      Collaboration \3\

    OhioHealth                             OhioHealth Multiple Sclerosis Symposium                         5,000.00

    Oncology Nursing Society               42nd ONS Annual Congress and two Oncology Updates              25,000.00
                                            Regional Programs

    Oregon Health & Science University     7th International Symposium on Gait & Balance in               13,108.00
                                            Multiple Sclerosis: Neuroplasticity and
                                            Rehabilitation in MS

    Palm Beach County Medical Society      Managing Thyroid Disease for the Primary Care Provider          5,000.00
     Services Palm Beach Diabetes &
     Endocrine Specialists, P.A.

    Penn State College of Medicine i3      Selecting Optimal Therapeutic Strategies for Patients          50,000.00
     Health                                 With Differentiated and Medullary Thyroid Cancer

    Penn State College of Medicine PVI     ``Science and Stories: Making the Most of the Complex         146,030.00
     PPerview Institute for Medical         Treatment Landscape in Prostate Cancer''
     Education Inc.

    Pharmacy Times Continuing Education    Reaching Out: A Pharmacist's Curriculum to Optimize           251,240.00
                                            Insulin Therapy Through Patient Engagement and
                                            Management

    Postgraduate Healthcare Education,     How Specialty Pharmacists Can Enhance Patient-Driven           58,000.00
     LLC Postgraduate Institute for         Care in Multiple Sclerosis
     Medicine

    Postgraduate Healthcare Education,     Providing Relief to Patients with Atopic Dermatitis:          137,250.00
     LLC Postgraduate Institute for         How Pharmacists Can Help                                               Collaboration \3\
     Medicine

    Potomac Center for Medical Education   MULTIPLE SCLEROSIS CARE IN THE HOSPITAL SETTING: Novel         75,000.00
     Rockpointe Corporation                 Neuroimaging Techniques, Individualized Treatment
                                            Strategies, and Management of Comorbidities

    Practicing Clinicians Exchange Boston  New and Emerging Strategies in T2DM Using Basal               375,000.00
     University School of Medicine          Insulin

    PRIME Education, LLC                   Advances in Psoriatic Diseases and Atopic Dermatitis          150,000.00
                                            for Clinicians in Federal and Public Healthcare                        Collaboration \3\
                                            Settings

    PRIME Education, LLC                   When Statin Therapy Isn't Enough                              192,435.00
                                                                                                                   Collaboration \3\

    ProCE Inc.                             Atopic Dermatitis: A Specialty Pharmacy 360-Degree             42,250.00
                                            View of the Patient                                                    Collaboration \3\

    Projects In Knowledge                  MedImages Cases: Multiple Sclerosis                           125,000.00

    Purdue University MCM Education        Managing Type 2 Diabetes: The Role of Insulin                 175,000.00

    Regents of the University of Colorado  Practical Ways to Achieve Targets in Diabetes Care            150,000.00

    Regents of the University of           Pharmacotherapy of Inherited Metabolic Diseases Post-          75,000.00
     Minnesota                              Doctoral PharmD Fellowship

    Society for Translational Oncology     Conference Perspectives: Lessons Learned                       40,000.00

    St. Vincent Neuroscience Institute,    MS: A Personal Approach                                         3,000.00
     St. Vincent Hospital, Indianapolis

    The University of Chicago MCM          Evolving Paradigms for Insulin Therapy of Type 2              150,000.00
     Education                              Diabetes

    Tisch Multiple Sclerosis Research      Tisch MS Research Center 20th Annual MS Patient                50,000.00
     Center of New York                     Symposium

    UMA Education Inc., dba Global         Coalition United for Better Eczema Care (CUBE-C)              320,000.00
     Education Group FactoRx Health                                                                                Collaboration \3\
     Advocacy Partners National Eczema
     Association Med Ed Consulting

    UMA Education Inc., dba Global         R.A.P.I.D.--Rheumatoid Arthritis: A Primary Care             150,000.00
     Education Group FactoRx MedEd          Initiative for Improved Diagnosis and Outcomes                         Collaboration \3\
     Consulting Improve CME, LLC Indegene

    UMA Education Inc., dba Global         The Role of Concentrated Insulins and Insulin                 127,500.00
     Education Group Physicians'            Combinations in Overcoming Insulin Resistance and
     Education Resource                     Improving Adherence A Patient Centered
                                            Multidisciplinary Approach

    UMA Education Inc., dba Global         Medical Crossfirer: Advances in Atopic Dermatitis: A          157,000.00
     Education Group Physicians'            Multidisciplinary, Patient-Centered Approach to
     Education Resources                    Addressing Unmet Therapeutic Needs

    UMA Education Inc., dba Global         Effective Management of Atopic Dermatitis: New                 99,585.00
     Education Group Physicians'            Approaches to Guiding Everyday Practice                                Collaboration \3\
     Education Resources

    UMA Education Inc., dba Global         Getting Beneath the Surface in Atopic Dermatitis: A           164,330.00
     Education Group Physicians'            Patient-Centered Approach to Optimize Outcomes                         Collaboration \3\
     Education Resources

    UMA Education, Inc. dba Global         Best Practices: Efficient and Cost Effective                  155,884.00
     Education Group Tarsus Cardio Inc.     Management of the Authorization Process                                Collaboration \3\
     dba Cardiometabolic Health Congress
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q2, 2017 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                              1st July 2017--30th Sep 2017
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    American Academy of PAs                2017 Adult Hospital Medicine Boot Camp                          5,490.00

    American Association of Clinical       Current Landscape in Medullary Thyroid Cancer: Updates        147,769.00
     Endocrinologists                       for Clinicians

    American Association of Clinical       Illinois-AACE 7th Annual Meeting                                5,000.00
     Endocrinologists

    American Association of Clinical       New Jersey Chapter of the American Association of               5,000.00
     Endocrinologists                       Clinical Endocrinologists

    American College of Allergy, Asthma &  Thursday Morning Session: Atopic Dermatitis Yardstick          40,000.00
     Immunology                                                                                                    Collaboration \3\

    American College of Medical Genetics   Genzyme ACMG Foundation Clinical Genetics Fellowships          75,000.00
     Foundation                             in Biochemical Genetics

    American Society of Transplant         11th Annual Surgical Fellows Symposium                         44,500.00
     Surgeons

    American Society of Transplantation    2017 Fellows Symposium on Transplantation                      40,000.00

    American Urological Association        Practical Management of Metastatic Prostate Cancer:            75,000.00
                                            Guidelines and Beyond

    Ann & Robert H. Lurie Children's       Lysosomal Storage Disease Training Program for Genetic         75,000.00
     Hospital of Chicago                    Counselors

    Ascendant Limited Albert Einstein      The Team-based Approach to Diagnosing and Managing            134,868.75
     College of Medicine and Montefiore     African American Patients with MS: A Quality
     Medical Center, Center for CME         Improvement Curriculum

    Carden Jennings Publishing Co., Ltd.   27th International Prostate Cancer Update                      20,000.00
     The Medical College of Wisconsin,
     Inc.

    Cleveland Clinic Educational           Pitfalls in Diagnosis of Multiple Sclerosis                    25,000.00
     Foundation

    Clinical and Patient Educators         Oncology Emergency Essentials: Addressing Tumor Lysis         117,394.90
     Association                            Syndrome in Your Practice

    Carden Jennings Publishing Co., Ltd.   27th International Prostate Cancer Update                      20,000.00
     The Medical College of Wisconsin,
     Inc.

    Cleveland Clinic Educational           Pitfalls in Diagnosis of Multiple Sclerosis                    25,000.00
     Foundation

    CMEducation Resources Postgraduate     Optimizing Insulin-Based Glycemic Control in Type 2           500,000.00
     Institute for Medicine                 Diabetes: The Foundational Role and Physiologic
                                            Rationale for Long-Acting Insulin: An Evidence-Based
                                            Roadmap for Clinical Success-Focus on the Safety-
                                            Efficacy and PK/PD Profiles of New Long-Acting
                                            Physiologic Insulin Formulations

    Connecticut Pharmacists Association    Current and Emerging Therapies in Multiple Sclerosis           10,000.00

    Continuing Education Alliance          PCE Interactive eCourse Series: New Pathways in Atopic        149,534.00
     Practicing Clinicians Exchange         Dermatitis: Novel Therapies for Optimizing Outcomes                    Collaboration \3\

    Dignity Health MandatoryCE             2017 Arkansas Diabetes Symposium: Focus on Treatment           25,000.00
                                            Advances, Nutrition Therapy, Obesity and Metabolic
                                            Syndrome

    DKBmed The Johns Hopkins University    The Johns Hopkins University School of Medicine               120,000.00
     School of Medicine                     eDiabetes Review Volume 3

    Duke University                        Duke Solid Organ Transplant Summit                             30,000.00

    E&S MedEd Group, Inc. American         Zeroing In on A1C Targets: Pinpointing the Optimal            284,660.00
     Association of Diabetes Educators      Basal Insulin Strategy in Every Patient with Type 2
                                            Diabetes

    Elsevier Office of Continuing          Evolving Treatment Paradigms for Rheumatoid Arthritis:         75,000.00
     Education Integritas Communications    Translating Comprehensive Patient Evaluations Into                     Collaboration \3\
                                            Personalized Therapy

    Elsevier Office of Continuing Medical  MS Paris 2017: Clinical Updates on Disease Modifying          161,920.00
     Education AcademicCME                  Therapies to Improve Outcomes for Patients with
                                            Multiple Sclerosis

    Enquiring Minds, LLC Postgraduate      Are My Patients Taking Their Meds as Prescribed?              106,205.00
     Institute for Medicine                 Addressing Suboptimal Therapeutic Response Among
                                            Patients with MS

    Euforea IVZW                           European Summit on the Prevention and Self-Management          10,676.50
                                            of Airway Diseases

    Excel Continuing Education             Expanding Horizons in ASMD/Niemann-Pick Disease                68,175.00

    Focus Medical Communications, LLC      2017 International Coalition of Rheumatology Education        100,000.00
     Siyemi Learning                        Providers Initiative

    Foundation for Orthopaedic Research &  2017 Orthopaedics for the Primary Care Practitioner &           5,000.00
     Education (FORE)                       Rehabilitation

    Global Academy Medical Education       Innovative Techniquesr: The Knee, Hip and Shoulder             25,000.00
     University of Cincinnati               Course

    Haymarket Medical Education Haymarket  Race to Remission: Timely Diagnosis and Early,                273,823.00
     Media/MIMS                             Intensive Treatment in Rheumatoid Arthritis Care: A                    Collaboration \3\
                                            Patient-Centered Global Curriculum Aligning With the
                                            Spirit of World Arthritis Day

    Indiana Academy of Physician           ``Multiple sclerosis 2017--Update on diagnostic                 5,000.00
     Assistants                             criteria, clinical descriptors, and treatments''

    International Niemann-Pick Disease     Support for the development and management of the             117,706.45
     Registry                               International Niemann Pick Disease Registry

    Kentucky Academy of Physician          Joint Injection Workshop                                        5,000.00
     Assistants

    Letters & Sciences                     Advances in Multiple Sclerosis Research & Practice,            69,000.00
                                            Annual CNE Conference Hosted by Columbia University,
                                            MS Clinical Care and Research Center

    Mattel Children's Hospital UCLA        Post Doc Fellowship                                            63,000.00

    Med Learning Group                     Pathologic Targets in Rheumatoid Arthritis: Modifying         288,350.00
                                            the Immune Response to Optimize Patient Outcomes                       Collaboration3

    Med Learning Group                     A 3-Dimensional View of Recent Advances in                    353,460.00
                                            Personalized Treatment for the Management of                           Collaboration \3\
                                            Uncontrolled Asthma

    Med-IQ, LLC                            Clinical and Translational Insights in Pompe Disease:         189,407.00
                                            Disease Pathology, Patient Identification, and
                                            Treatment

    Medscape LLC                           CME LIVE: A Late-Breaking Update on PCSK9 Inhibitors          500,000.00
                                            and Cardiovascular Outcomes                                            Collaboration \3\

    Medscape LLC                           Advances in Rheumatoid Arthritis 2017: What's the              99,500.00
                                            Conference Buzz?                                                       Collaboration \3\

    MedStar Georgetown University          4th Annual Current Issues in the Care of Dialysis and          10,000.00
     Hospital                               Transplant Patients

    Montefiore Medical Center MRCME, LLC   PCSK9 Inhibitor Therapy for Dyslipidemia: Implications        399,845.00
                                            of Outcome Trial Results and a Look to the Future                      Collaboration\3\

    MS Views and News                      The 2017 Multiple Sclerosis Symposium of South Florida-        20,000.00
                                             The Neurological Aspects of MS and Beyond                             Collaboration \3\

    National Association for Continuing    Utilizing Concentrated Insulins: A New Strategy for           260,000.00
     Education                              the Insulin Resistant Patient

    National Association of Managed Care   New Targets in the Therapeutic Landscape for Moderate-         57,000.00
     Physicians, Inc.                       to-Severe Atopic Dermatitis (AD): What Does Managed                    Collaboration \3\
                                            Care Need to Know?

    National Gaucher Foundation, Inc.      Medical Diagnostic/Testing Program                            150,000.00
                                                                                                                   Collaboration \3\

    National Multiple Sclerosis Society    Life-Changing Breakthroughs: African American                  10,000.00
                                            Education Conference

    National Organization for Rare         NORD Continuing Medical Education                              80,000.00
     Disorders University of
     Massachusetts Medical School

    Oregon Health & Science University     17th Annual Pacific Northwest Prostate Cancer                  20,000.00
                                            Conference

    Penn State College of Medicine MCM     Contemporary Management of Type 2 Diabetes                    166,694.00
     Education

    Penn State College of Medicine PVI     PeerView In Session, ``Analyzing the Latest Evidence          151,480.00
     Peerview Institute for Medical         in Atopic Dermatitis: Clinical Updates From Geneva''                   Collaboration \3\
     Education Inc.

    Pennsylvania Society of Physician      ``Joint Injections''                                            5,500.00
     Assistants                                                                                                    Collaboration \3\

    Pharmacy Times Continuing Education    Advances in Insulin and Insulin Combination Therapies:         68,300.00
                                            Opportunities for Convenient Care Providers to
                                            Improve Patient Outcomes

    PlatformQ Health Education, LLC        From Novice to Expert: A Series in Multiple Sclerosis         100,000.00
     Consortium of Multiple Sclerosis       Management
     Centers Nurse Practitioner
     Alternatives

    Postgraduate Healthcare Education,     Understanding the Mechanisms of DMARD Therapy in               53,500.00
     LLC Postgraduate Institute for         Patients with Rheumatoid Arthritis                                     Collaboration \3\
     Medicine

    Postgraduate Institute for Medicine    The Importance of Early Diagnosis and Timely Access to        349,850.00
     Global Academy for Medical Education   Treatment of RA                                                        Collaboration \3\

    Postgraduate Institute for Medicine    Defining Personalized Care Plans in Metastatic                 60,000.00
     i3 Health                              Castration-Resistant Prostate Cancer

    Postgraduate Institute for Medicine    Managing Multiple Sclerosis: Current Treatment and            150,000.00
     Impact Education, LLC                  Care Management Strategies for Managed Care

    PRIME Education, LLC                   Scaling-Up Shared Decision-Making in Multiple                 162,382.50
                                            Sclerosis Treatment

    Projects in Knowledge                  The Art & Science of Multiple Sclerosis Management            175,000.00

    Projects in Knowledge @Point of Care   Atopic Dermatitis @Point of Care                              200,000.00
                                                                                                                   Collaboration \3\

    Regents of the University of Michigan  Pompe Disease Patient Educational Booklet                       2,777.00
                                                                                                                   Collaboration \3\

    Regents University of California Los   Educational Seminars for Patients, Families, and               20,000.00
     Angeles                                Friends 2017-2018

    Research To Practice                   Year in Review--A Four-Part Multi-tumor Regional CME           40,000.00
                                            Symposia Series Focused on the Application of
                                            Emerging Research Information to the Care of Patients
                                            with Common Cancers: Genitourinary Cancers Module

    Rheumatology Nurses Society            RNS 2017 Annual Conference                                     25,000.00
                                                                                                                   Collaboration \3\

    RMEI Postgraduate Institute for        Achieving Success in RA Assessment and Management: A          349,547.00
     Medicine                               Learner Pathway to Improve Patient Outcomes                            Collaboration \3\

    Suffolk Academy of Medicine Long       The Long Island Allergy & Asthma Society 24th Annual           10,000.00
     Island Allergy & Asthma Society        Scientific Meeting                                                     Collaboration \3\

    Suffolk Academy of Medicine Long       The Long Island Allergy & Asthma Society 24th Annual           10,000.00
     Island Allergy & Asthma Society        Scientific Meeting                                                     Collaboration3

    The Regents of UC/Office of Cont Med   UCLA Review of Clinical Neurology                               2,500.00
     Educ

    Tufts University School of Medicine    Severe Asthma: Inspiring Change                               216,712.50
     DKBmed                                                                                                        Collaboration \3\

    UMA Education, Inc. dba Global         Closing the Gap Created by Clinical Inertia: New              207,845.00
     Education Group Tarsus Cardio Inc.     Strategies for T2DM Treatment
     dba Cardiometabolic Health Congress

    Universitatsmedizin Rostock, Albrecht- Recent advances in rare diseases: Gaucher disease as a         25,000.00
     Kossel-Institute for                   model (RARD 2017)
     Neuroregeneration (AKos)

    University of Louisville Research      10th Annual Perspectives in Rheumatic Diseases                 12,500.00
     Foundation Global Academy for          presented by Rheumatology News, Internal Medicine                      Collaboration \3\
     Medical Education, LLC Postgraduate    News & Family Practice News
     Institute for Medicine

    University of Nevada, Reno School of   2017 Fall Clinical Dermatology Conference                     125,000.00
     Medicine Foundation for Research and
     Education in Dermatology

    Vindico Medical Education, LLC         When Severe Asthma is Out of Control: Examining               137,340.00
                                            Phenotypic Approaches to Treatment                                     Collaboration \3\

    Yale New Haven Hospital                New and Emerging Multiple Sclerosis Therapies                  15,000.00

    Yale School of Medicine                The Yale-Cambridge Transplantation Symposium: Donor            20,000.00
                                            Decision-Making in an Era of Advanced Medical
                                            Complexity

    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q3, 2017 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Oct 2017-31th Dec 2017
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    AcademicCME, LLC.                      Applying Individualized Therapeutic Strategies of              98,000.00
                                            Switching and Sequencing to Improve Outcomes for
                                            Patients with Multiple Sclerosis: The Right Treatment
                                            at the Right Time for the Right Patient

    Albert Einstein College of Medicine/   Atopic Dermatitis (Eczema) Challenges: Recognition and        108,682.50
     Montefiore Medical Center M2           Assessment in Primary Care                                             Collaboration \3\
     Communications

    American Association of Clinical       New Jersey-AACE January Dinner Program: Treatment of            2,591.00
     Endocrinologists                       Advanced Thyroid Cancer

    American Association of Clinical       Minnesota/Midwest Chapter of the American Association           5,000.00
     Endocrinologists                       of Clinical Endocrinologists 8th Annual Meeting

    American College of Allergy, Asthma &  Biologics in Atopic Dermatitis Workshop                        25,320.00
     Immunology

    American College of Allergy, Asthma &  WSAAI 2018: 56th Annual Scientific Session                     20,000.00
     Immunology Western Society of                                                                                 Collaboration \3\
     Allergy, Asthma & Immunology

    Annenberg Center for Health Sciences   10th Annual Linda Morgante MS Nurse Leadership Program         35,000.00
     at Eisenhower Academy for Continued
     Healthcare Learning (ACHL)

    Association pulmonaire du Quebec       Biennale de l'Espace francophone de la pneumologie             12,150.00

    Boston University School of Medicine   Management of Knee Osteoarthritis in Primary Care: The        200,000.00
     Practicing Clinicians Exchange         Case for Viscosupplementation
     Continuing Education Alliance LLC

    California Optometric Association      2017 Monterey Symposium                                        10,400.00

    Cedars-Sinai Medical Center            7th Annual Symposium on Lysosomal Storage Disorders            15,000.00

    Children's Hospital of Philadelphia    Lysosomal Storage Disease (LSD) Fellowship                     75,000.00
     Foundation

    Cleveland Clinic--Lou Ruvo Center for  Advancing Therapeutics for Multiple Sclerosis                   5,000.00
     Brain Health

    Cleveland Clinic Center for            Clinical Updates on Fabry Disease: Diagnosis Through          159,750.00
     Continuing Medical Education           Treatment
     Medscape LLC

    Cleveland Clinic Educational           Medical Dermatology Therapy Update: Autoimmune                 10,000.00
     Foundation                             Diseases, Chronic Inflammatory and Advanced
                                            Malignancies

    Cleveland Clinic Educational           6th Annual Basic & Clinical Immunology for the Busy            25,000.00
     Foundation                             Clinician

    CME Outfitters, LLC                    Peeking Beneath the Surface of Atopic Dermatitis:             200,000.00
                                            Testing Your Skills from Pathogenesis to Treatment

    Division of Medical Genetics and       Better Outcomes of Lysosomal Diseases (BOLD)                   75,000.00
     Genomic Medicine                       Fellowship

    Elsevier Office of Continuing Medical  THE LSD DEBATE: OPTIMIZING DIAGNOSIS AND FUTURE               248,465.00
     Education Excerpta Medica BV           MANAGEMENT

    Elsevier Office of Continuing Medical  Clinical Issues in Severe Asthma: Debates and                 628,867.00
     Education Integritas Communications    Discussions About Personalizing Patient Management

    Elsevier Office of Continuing Medical  Clinical Issues in Atopic Dermatitis: Discussions and         784,641.50
     Education Integritas Communications    Debates on Managing Moderate-to-Severe Disease                         Collaboration \3\

    Emory University                       The Paul M. Fernhoff Genetic Counseling Fellowship in          75,000.00
                                            the Lysosomal Storage and Other Genetic Disorders

    EUFOREA IVZW                           European Rhinology Research Forum                              18,000.00

    European Respiratory Society           ERS Satellites                                                 72,000.00

    European Society for Dermatological    47th ESDR Meeting 2017                                         44,400.00
     Research

    Excel Continuing Education             Responding to the Challenge of Pompe Disease                  100,165.00
                                            (satellite symposium at 2018 World Congress)

    George Washington University (GW)      American Contact Dermatitis Society-Frontiers in               10,000.00
     Office of Continuing Education in      Dermatitis 2017                                                        Collaboration \3\
     the Health Profession (CEHP)
     American Contact Dermatitis Society

    Global Education Group Integritas      Clinical Issues in Atopic Dermatitis: Discussions and         177,074.00
     Communications                         Debates on Managing Moderate-to-Severe Disease                         Collaboration \3\

    Icahn School of Medicine at Mount      4th NY Masters Course in Endocrinology and Endocrine           10,000.00
     Sinai                                  Surgery                                                                Collaboration \3\

    Icahn School of Medicine at Mount      20th Annual Mount Sinai Winter Symposium ``Advances in         20,000.00
     Sinai                                  Medical & Surgical Dermatology''

    Indiana Academy of Physician           ``Anterior Knee Pain and Osteoarthritis''                       5,000.00
     Assistants

    Institute for Medical and Nursing      MEDS 2018: Going Flat-Out for Glycemic Control: The           381,055.00
     Education, Inc.                        Role of New Basal Insulins in Patient-Centered T2DM
                                            Management

    Institute for Medical and Nursing      MEDS 2018: Rationale, Recognition, and                        354,830.00
     Education, Inc.                        Recommendations: Expert Perspectives on Combining
                                            Basal Insulin and GLP-1 RAs to Intensify Treatment of
                                            T2DM

    Kidney Disease Improving Global        KDIGO Controversies Conference on Glomerular Diseases          25,000.00
     Outcomes (KDIGO)

    Med Learning Group                     Recognizing the Connection: A View into the Parallels         225,000.00
                                            between Asthma and Nasal Polyps

    Medical Education Resources, Inc.      Basic concepts in eczema diagnosis and management              20,000.00
     Dermveda Inc.

    Medical Learning Institute Inc. PVI,   PeerView ``Ascertaining the Potential Clinical                 80,000.00
     Peerview Institute for Medical         Implications of The Latest Data on Approved and
     Education Inc.                         Emerging Disease Modifying Therapies for Multiple
                                            Sclerosis Management: A Recap from Paris''

    Medical Learning Institute Inc. PVI,   PeerView in Session, ``Exploring the Latest Data in            74,490.00
     PeerView Institute for Medical         the Treatment of Uncontrolled Persistent Asthma:                       Collaboration \3\
     Education, Inc.                        Clinical Highlights from San Diego''

    Medical Learning Institute PVI,        PeerView Talks, ``A Patient-Centered Approach to the          153,580.00
     PeerView Institute for Medical         Diagnosis and Treatment of Atopic Dermatitis in                        Collaboration \3\
     Education                              Adults: An Expert's Story''

    Med-IQ, LLC                            Pragmatic Approaches to Improving Insulin Introduction        254,623.00
                                            and Integration in T2DM:Patient Simulations For
                                            Frontline Providers

    Med-IQ, LLC                            Addressing Bone Manifestations of GD: The Latest              382,736.00
                                            Evidence in Evaluation and Treatment

    Medscape LLC                           Updates and Perspectives in Diabetic Dyslipidemia:            246,500.00
                                            2017 in Review                                                         Collaboration \3\

    Medscape LLC                           Addressing Disease Burden in Asthma and Comorbidities:        400,000.00
                                            From Pathophysiology to Targeted Treatments

    Medstar Georgetown University          Multiple Sclerosis Patient Education Day                        7,500.00
     Hospital

    Mount Sinai School of Medicine         The Icahn School of Medicine at Mount Sinai NP                 75,000.00
                                            Fellowship Program in Lysosomal Storage Disease

    National Association For Continuing    Atopic Dermatitis: New Insights, New Therapies                150,000.00
     Education

    National Committee for Quality         A Patient-Centered Approach to Severe Asthma                  232,325.00
     Assurance NACCME, LLC                  Management: Embracing Diversity and Improving                          Collaboration \3\
                                            Outcomes with Emerging Therapies

    NCCN Foundation                        NCCN Guidelines for Patients: Prostate Cancer                  25,000.00

    Nurse Practitioner Alternatives        Advances In Multiple Sclerosis (AIMS) Primer: Third            59,150.00
     Consortium of Multiple Sclerosis       Edition
     Centers

    Nurse Practitioner Alternatives        1,800 SecondsTM in MS Management: An Online                    92,000.00
     Consortium of Multiple Sclerosis       Educational Series for MS Clinicians
     Centers

    Oakstone Publishing, LLC PeerVoice     A New Treatment Paradigm in Atopic Dermatitis: Expert         268,700.00
     America Limited                        Insights on Incorporating Biologic Therapy Among
                                            Available Options

    Oakstone Publishing, LLC PeerVoice     Optimizing Systemic Therapy for Atopic Dermatitis:            268,700.00
     America Limited                        Practical Strategies to Ensure Patient Safety

    Oregon Health and Science University   Annual OHSU Colloquium on Neuromuscular Disorders               5,000.00

    PEERVOICE AMERICA LIMITED Oakstone     ``Practical Strategies for Managing Inadequate                193,250.00
     Publishing, LLC                        Responders to Atopic Dermatitis Treatment''                            Collaboration \3\

    Penn State College of Medicine         Beyond the Guidelines: Investigator Perspectives on           100,000.00
     Research To Practice                   Current Clinical Issues and Ongoing Research in the
                                            Management of Advanced Prostate Cancer

    PESG Lysosomal And Rare Disorders      GRIDS2017: A workshop on immune aspects of Lysosomal           55,000.00
     Research And Treatment Center Inc.     Storage Disorders: From pathology to therapy

    Pharmacy Times Continuing Education    A Specialty Pharmacy Update on PCSK9 Inhibitor Therapy         10,000.00
                                            for Hypercholesterolemia                                               Collaboration \3\

    Pharmacy Times Continuing Education    An American Journal of Managed Care Webinar:                   75,255.00
                                            Evaluating Novel Therapies for Atopic Dermatitis

    Physician's Education Resource, LLC    Provider and Caregiver Connection--Getting Beneath the        167,850.00
                                            Surface: Addressing Patient Concerns In Moderate to
                                            Severe Atopic Dermatitis

    Postgraduate Institute for Medicine    Early Detection and New Approaches to the Management          150,000.00
     Catamount Medical Education, LLC       of Atopic Dermatitis in the Family Medicine Setting                    Collaboration3

    Postgraduate Institute for Medicine    The Role of Specialty Pharmacy and the Challenge of           150,000.00
     Impact Education, LLC                  Managing Moderate-to-Severe Atopic Dermatitis                          Collaboration \3\

    Postgraduate Institute for Medicine    The Management of Atopic Dermatitis: Entering a New           200,000.00
     Impact Education, LLC                  Paradigm

    Postgraduate Institute for Medicine    Rheumatoid Arthritis Management Strategies: New               150,000.00
     Impact Education, LLC                  Insights for Managed Care

    Postgraduate Institute for Medicine    The Learning Pathway in Atopic Dermatitis: Optimizing         382,947.00
     Robert Michael Educational Institute   Management Approaches in Patients with Moderate-to-                    Collaboration \3\
     LLC                                    Severe Disease

    Potomac Center for Medical Education   Targeting Improved Outcomes In Atopic Dermatitis:             449,955.00
     Rockpointe Corporation                 Strategies for Achieving Personalized Treatment Goals                  Collaboration \3\

    Potomac Center for Medical Education   Achieving New Treatment Goals In Multiple Sclerosis:          176,000.00
     Rockpointe Corporation Nurse           Strategies for Initial Treatment Selection and
     Practitioner Alternatives              Patient Engagement

    PRIME Education, LLC                   Aligning Managed Care Decision-Making with the Latest         272,543.00
                                            Evidence for Targeted Asthma Treatment

    PRIME Education, LLC                   Navigating the Intersection of Uncontrolled Asthma and        354,188.00
                                            Related Comorbidities: Implications of Novel
                                            Mechanisms of Action for Managed Care

    PRIME Education, LLC                   Advancing Specialty Pharmacy Decision-Making to               242,011.00
                                            Optimize Therapy Selection and Access in Uncontrolled
                                            and Severe Asthma

    PRIME Education, LLC                   Solving the Problem of Choice in Treatment Decisions          182,535.00
                                            for Patients with Rheumatoid Arthritis: Evidence-
                                            Based, Guideline-Directed, and Patient-Centered
                                            Strategies

    Pri-Med Institute, LLC                 Viscosupplementation for Osteoarthritis of the Knee:          149,499.92
                                            Who, When, and How?

    Projects In Knowledge                  Asthma--Practical Applications from ATS 2018: A Video          50,000.00
                                            Roundtable

    Rutgers, The State University of New   Cognitive Dysfunction and Fatigue in Multiple                   3,011.00
     Jersey                                 Sclerosis

    Sidney Kimmel Medical College at       Thyroid Cancer 2017: New Advances in Diagnosis &               10,000.00
     Thomas Jefferson                       Treatment

    Society for Inherited Metabolic        2017 North American Metabolic Academy                          20,000.00
     Disorders

    St. Joseph's Regional Medical Center   Multiple Sclerosis: A Changing Landscape                        1,300.00

    The France Foundation                  Achieving Better Control of Severe Asthma: New                262,700.00
                                            Understandings in Asthma Pathophysiology and Targeted
                                            Therapies

    The France Foundation                  Are You Ready? Recent Effective Atopic Dermatitis             240,720.00
                                            Therapy Considerations

    The Regents of the University of       Post Doc Fellowship                                            63,000.00
     California--UCLA Division of
     Nephrology

    UC Regents                             Genetic Neuromuscular Diseases Fellowship                      75,000.00

    UMA Education, Inc. dba Global         Beyond the Flare: A Practical Overview of the Newest           25,000.00
     Education Group Tarsus Cardio dba      Concepts in Atopic Dermatitis Pathogenesis and                         Collaboration \3\
     South Beach Symposium                  Treatment

    UMA Education, Inc. dba Global         2018 Masters of Pediatric Dermatology Symposium                20,000.00
     Education Group Tarsus Cardio Inc.,                                                                           Collaboration \3\
     dba South Beach Symposium

    University Neurology, Inc.             The 2017 New York State Multiple Sclerosis Consortium           5,000.00
                                            (NYSMSC) Annual Professional Research and Education
                                            Meeting

    University of Alabama at Birmingham    2017 Fabry Fellowship                                          73,714.12

    University of California, San Diego    Challenges in Pompe                                             4,800.00
     San Diego Neurology Society

    University of Colorado School of       87th Annual Meeting of the American Thyroid                    50,000.00
     Medicine American Thyroid              Association
     Association

    University of Louisville School of     Visiting Professor and Endocrine Grand Rounds                   3,320.00
     Medicine

    University of Louisville Global        Skin Disease Education Foundation's 18th Annual Las            25,000.00
     Academy for Medical Education          Vegas Dermatology Seminar featuring the 14th Annual                    Collaboration \3\
     Postgraduate Institute for Medicine    Psoriasis Forum

    University of Louisville Postgraduate  17th Annual Caribbean Dermatology Symposium                    50,000.00
     Institute of Medicine Global Academy                                                                          Collaboration \3\
     for Medical Education

    University of Louisville Postgraduate  Skin Disease Education Foundation's 42nd Annual Hawaii         50,000.00
     Institute of Medicine Global Academy   Dermatology Seminar                                                    Collaboration \3\
     for Medical Education

    University of Massachusetts Medical    New Frontiers and Pivotal Investigation-Based Advances        369,000.00
     School CMEducation Resources           in the Pathoimmunobiology and Management of Atopic                     Collaboration \3\
                                            Dermatitis

    Vindico Medical Education, LLC         Shutting Down MS: New Insights on Induction,                  196,378.58
                                            Escalation, Oral Agents, and Monitoring

    WEBMD Global                           Advancing the Care of Patients With Atopic Dermatitis-        301,000.00
                                            International Perspectives for OUS MDS: An Initiative
                                            developed in partnership with the University of
                                            Sheffield Medical School, Dermatology Research

    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q4, 2017 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.

                      Organization Name                          Amount

    Acid Maltase Deficiency Association INC.                       $5,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC           $50,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.         $117,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.          $25,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.          $25,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.          $25,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.          $25,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.          $60,000.00

    Allergy & Asthma Network Mothers of Asthmatics, INC.          $75,000.00

    Alliance for the Adoption of Innovations in Medicine          $50,000.00

    American Association Of Kidney Patients Inc.                 $362,293.31

    American Association Of Kidney Patients Inc.                  $10,000.00

    American College of Allergy, Asthma & Immunology               $6,000.00

    American College of Allergy, Asthma & Immunology              $30,000.00

    American College of Allergy, Asthma & Immunology              $70,000.00

    American College of Allergy, Asthma & Immunology             $100,000.00

    American College of Allergy, Asthma & Immunology              $60,000.00

    American College of Allergy, Asthma & Immunology              $55,000.00

    American College of Allergy, Asthma & Immunology              $95,000.00

    American College of Allergy, Asthma & Immunology             $165,000.00

    American College of Allergy, Asthma & Immunology              $35,000.00

    American College of Allergy, Asthma & Immunology              $30,000.00

    American College of Allergy, Asthma & Immunology             $150,000.00

    American College of Allergy, Asthma & Immunology             $175,000.00

    American Kidney Fund Inc.                                     $40,000.00

    American Kidney Fund Inc.                                     $10,000.00

    APFED (American Partnership for Eosinophilic                  $15,000.00
     Disorders)

    Arthritis Foundation                                         $100,000.00

    Arthritis Foundation                                          $25,000.00

    Arthritis Foundation                                          $25,000.00

    Arthritis Foundation                                           $3,500.00

    Arthritis Foundation                                           $1,250.00

    Arthritis Foundation                                           $5,000.00

    Arthritis Foundation                                          $10,000.00

    Arthritis Foundation                                           $3,500.00

    Arthritis Foundation                                         $250,000.00

    Arthritis Foundation                                         $250,000.00

    Arthritis Foundation                                          $30,000.00

    Arthritis Foundation                                         $100,000.00

    Arthritis Foundation                                         $100,000.00

    Arthritis Foundation Inc.                                      $2,500.00

    Arthritis Foundation of NENY                                   $5,000.00

    Association For Glycogen Storage Disease                       $3,000.00

    Asthma and Allergy Foundation of America                     $150,000.00

    Asthma and Allergy Foundation of America                      $24,200.00

    Asthma and Allergy Foundation of America                      $50,000.00

    Asthma and Allergy Foundation of America                      $75,000.00

    Asthma and Allergy Foundation of America                     $100,000.00

    Asthma and Allergy Foundation of America, New England         $20,000.00
     Chapter

    Aubrey Rose Foundation                                        $25,000.00

    Barbara Ann Karmanos Cancer Institute                         $10,000.00

    Be The Match Foundation                                       $40,000.00

    Berkshire Resource Project                                     $1,500.00

    Berkshire Resource Project                                     $1,500.00

    Beyond the Diagnosis                                          $10,000.00

    Can Do Multiple Sclerosis                                      $8,000.00

    Can Do Multiple Sclerosis                                     $40,000.00

    Can Do Multiple Sclerosis                                     $26,000.00

    Can Do Multiple Sclerosis                                     $10,000.00

    Can Do Multiple Sclerosis                                     $10,000.00

    Can Do Multiple Sclerosis                                     $20,000.00

    Can Do Multiple Sclerosis                                     $20,000.00

    Can Do Multiple Sclerosis                                     $30,000.00

    Can Do Multiple Sclerosis                                     $40,000.00

    Can Do Multiple Sclerosis                                     $70,000.00

    Can Do Multiple Sclerosis                                     $30,000.00

    Community Oncology Alliance                                   $75,000.00

    CrowdCare Foundation                                          $45,000.00

    Cure GM1 Incorporated                                          $5,000.00

    Cure GM1 Incorporated                                          $5,000.00

    Cystic Fibrosis Foundation                                    $10,000.00

    EveryLife Foundation for Rare Diseases                        $10,000.00

    EveryLife Foundation for Rare Diseases                        $30,000.00

    EveryLife Foundation for Rare Diseases                         $5,000.00

    EveryLife Foundation for Rare Diseases                        $30,000.00

    EveryLife Foundation for Rare Diseases                        $15,000.00

    EveryLife Foundation for Rare Diseases                        $25,000.00

    EveryLife Foundation for Rare Diseases                        $20,000.00

    Fabry Support & Information Group                             $22,000.00

    Fabry Support & Information Group                              $1,500.00

    Fabry Support & Information Group                             $50,000.00

    Fabry Support & Information Group                             $30,000.00

    Fabry Support & Information Group                            $100,000.00

    Florida Hemophilia Association                                 $3,000.00

    Foundation Fighting Blindness Inc.                             $5,000.00

    Fundacion de Esclerosis Multiple de Puerto Rico               $15,000.00

    Global Alliance for Patient Access                           $115,000.00

    Global Alliance for Patient Access                            $30,000.00

    Global Healthy Living Foundation, Inc.                       $100,000.00

    Global Healthy Living Foundation, Inc.                        $50,000.00

    Global Parents for Eczema Research, a project of              $47,438.00
     Heluna Health

    Great Lakes Hemophilia Foundation Inc.                         $2,500.00

    Hemophilia Foundation of Northern California                   $5,000.00

    Hemophilia of Iowa                                             $1,500.00

    Hemophilia of Iowa                                             $1,000.00

    Hemophilia of North Carolina                                   $5,000.00

    Hermansky-Pudlak Syndrome Network                             $24,935.00

    Holy Name Health Care MS Center                                $2,500.00

    Holy Name Health Care MS Center                                $2,500.00

    Hope for Hemophilia                                           $15,000.00

    Hope for Hemophilia                                           $15,000.00

    International Myeloma Foundation                              $75,000.00

    International Myeloma Foundation                              $50,000.00

    International Myeloma Foundation                              $75,000.00

    International Society For Mannosidosis & Related              $30,000.00
     Disease Inc.

    Kessler Foundation                                             $5,000.00

    Leukemia & Lymphoma Society--MA Chapter                       $20,000.00

    Light of Life Foundation                                       $5,000.00

    Little Miss Hannah Foundation                                  $1,000.00

    Lone Star Chapter of the National Hemophilia                  $15,000.00
     Foundation

    Lymphoma Research Foundation                                  $20,000.00

    March of Dimes Foundation                                     $10,000.00

    March of Dimes Foundation                                     $15,000.00

    Mercy Foundation                                              $20,000.00

    Mid America MS Achievement Center                              $5,000.00

    Mid America MS Achievement Center                              $5,000.00

    MLD Foundation                                                $12,000.00

    MLD Foundation                                                $12,000.00

    MS Bright Spots of Hope                                        $2,500.00

    MS Cure Fund                                                   $3,000.00

    MS Cure Fund                                                   $5,250.00

    MS Cure Fund                                                   $2,500.00

    MS Dream Center--RI, Inc.                                      $3,000.00

    MS HOPE FOR A CURE INC.                                       $10,000.00

    MS Views and News                                             $25,000.00

    MS Views and News                                             $50,000.00

    MS Views and News                                             $30,000.00

    MS Views and News                                             $30,000.00

    MS Views and News                                             $10,000.00

    MS Views and News                                             $40,000.00

    MS Views and News                                             $25,000.00

    MSWorld, Inc.                                                  $4,000.00

    Multiple Myeloma Cure Seeker Society                           $5,000.00

    Multiple Sclerosis Association of America                    $200,000.00

    Multiple Sclerosis Association of America                     $30,000.00

    Multiple Sclerosis Association of America                     $25,000.00

    Multiple Sclerosis Association of America                     $50,000.00

    Multiple Sclerosis Association of America                     $50,000.00

    Multiple Sclerosis Association of America                     $46,031.00

    Multiple Sclerosis Center of Georgia                          $10,000.00

    Multiple Sclerosis Center of Georgia                           $7,000.00

    Multiple Sclerosis Foundation                                 $30,000.00

    Multiple Sclerosis Foundation                                 $20,000.00

    Multiple Sclerosis Foundation                                 $50,000.00

    Multiple Sclerosis Resources of Central New York, Inc.         $7,500.00

    Muscular Dystrophy Association                                $20,000.00

    Muscular Dystrophy Association                               $430,000.00

    National Bone Marrow Transplant Link                           $3,000.00

    National Eczema Association                                  $100,000.00

    National Eczema Association                                   $85,000.00

    National Eczema Association                                  $100,000.00

    National Eczema Association                                   $75,000.00

    National Eczema Association                                  $100,000.00

    National Fabry Disease Foundation                            $100,000.00

    National Fabry Disease Foundation                            $100,000.00

    National Fabry Disease Foundation                             $40,000.00

    National Gaucher Foundation                                $1,500,000.00

    National Gaucher Foundation                                  $650,000.00

    National Gaucher Foundation                                  $200,000.00

    National Gaucher Foundation                                $1,900,000.00

    National Hemophilia Foundation                                $37,500.00

    National Hemophilia Foundation                               $100,000.00

    National Hemophilia Foundation                                 $9,479.00

    National Kidney Foundation                                     $3,700.00

    National Kidney Foundation                                    $10,000.00

    National Kidney Foundation                                    $10,000.00

    National MPS Society                                             $500.00

    National MPS Society                                          $20,000.00

    National MPS Society                                         $100,000.00

    National MS Society                                            $5,000.00

    National Multiple Sclerosis Society                          $780,000.00

    National Multiple Sclerosis Society                           $65,000.00

    National Multiple Sclerosis Society                           $15,000.00

    National Multiple Sclerosis Society                            $2,500.00

    National Multiple Sclerosis Society                           $15,000.00

    National Multiple Sclerosis Society                          $750,000.00

    National Multiple Sclerosis Society                          $150,000.00

    National Multiple Sclerosis Society New York City              $2,500.00
     Chapter

    National Multiple Sclerosis Society New York City              $1,100.00
     Chapter

    National Multiple Sclerosis Society New York City             $15,000.00
     Chapter

    National Multiple Sclerosis Society New York City            $122,100.00
     Chapter

    National Multiple Sclerosis Society New York City              $5,000.00
     Chapter

    National Multiple Sclerosis Society New York City              $1,250.00
     Chapter

    National Multiple Sclerosis Society New York City                $300.00
     Chapter

    National Multiple Sclerosis Society New York City              $1,000.00
     Chapter

    National Multiple Sclerosis Society New York City              $5,000.00
     Chapter

    National Multiple Sclerosis Society New York City              $5,000.00
     Chapter

    National Niemann-Pick Disease Foundation                      $40,000.00

    National Organization for Rare Disorders, Inc.                $50,000.00

    National Organization for Rare Disorders, Inc.                 $5,000.00

    National Organization for Rare Disorders, Inc.                $25,000.00

    National Organization for Rare Disorders, Inc.               $100,000.00

    National Organization for Rare Disorders, Inc.                $75,000.00

    National Organization for Rare Disorders, Inc.                $50,000.00

    National Tay-Sachs & Allied Diseases Association, Inc.        $20,000.00

    National Tay-Sachs & Allied Diseases Association, Inc.        $10,000.00

    National Tay-Sachs & Allied Diseases Association, Inc.        $10,000.00

    New England Hemophilia Association                             $5,000.00

    New England Hemophilia Association                            $10,000.00

    New England Hemophilia Association                             $2,500.00

    New England Hemophilia Association                             $7,500.00

    Next Step Fund Inc.                                           $10,000.00

    OhioHealth Corporation                                        $25,000.00

    Osteogenesis Imperfecta Foundation                             $5,000.00

    Patient Access Network Foundation                            $300,000.00

    Patient Empowerment Network                                   $20,000.00

    Patient Empowerment Network                                   $20,000.00

    Patient Services, Inc.                                       $662,500.00

    Patient Services, Inc.                                     $2,381,250.00

    Patient Services, Inc.                                     $4,797,500.00

    Patient Services, Inc.                                     $1,418,750.00

    Patient Services, Inc.                                     $1,365,000.00

    PKD Foundation                                                $50,000.00

    PKD Foundation                                                $20,000.00

    PKD Foundation                                                $25,000.00

    Prostate Cancer Foundation                                   $300,000.00

    Prostate Health Education Network Inc.                        $20,000.00

    Quinn Madeleine Inc.                                           $5,000.00

    Rare Disease United Foundation                                $15,000.00

    Rare New England, INC.                                         $4,000.00

    Rare New England, INC.                                         $4,000.00

    Rare New England, INC.                                         $4,000.00

    Rocky Mountain Multiple Sclerosis Center                       $2,500.00

    Rocky Mountain Multiple Sclerosis Center                       $5,000.00

    Rocky Mountain Multiple Sclerosis Center                       $5,000.00

    Rocky Mountain Multiple Sclerosis Center                       $2,500.00

    Rocky Mountain Multiple Sclerosis Center                       $3,000.00

    Sofia Sees Hope                                               $22,000.00

    Swiss Hemophilia Society (Schweizerische Hemophilie            $2,600.00
     Gesellschaft)

    The Assistance Fund, Inc.                                 $10,000,000.00

    The Leukemia & Lymphoma Society Eastern PA Chapter            $10,000.00

    ThyCa: Thyroid Cancer Survivors' Association, Inc.             $5,000.00

    ThyCa: Thyroid Cancer Survivors' Association, Inc.             $3,000.00

    ThyCa: Thyroid Cancer Survivors' Association, Inc.             $5,000.00

    ThyCa: Thyroid Cancer Survivors' Association, Inc.            $10,000.00

    Tisch Multiple Sclerosis Research Center of New York,         $15,000.00
     Inc.

    Tisch Multiple Sclerosis Research Center of New York,          $2,500.00
     Inc.

    Transplant Life Foundation                                    $12,000.00

    Tri-State Multiple Sclerosis Association                       $2,500.00

    United Pompe Foundation                                       $50,000.00

    United Pompe Foundation                                       $42,500.00

    United Pompe Foundation                                       $30,000.00

    United States Bone and Joint Initiative, NFP                  $80,000.00

    United States Bone and Joint Initiative, NFP                  $30,000.00

    United States Bone and Joint Initiative, NFP                  $25,000.00

    University of Minnesota Foundation                             $5,000.00

    Us TOO International                                           $2,500.00

    Us TOO International                                          $30,000.00

    Wylder Nation Foundation                                       $5,000.00

    Wylder Nation Foundation                                      $15,000.00

                                  Program/Event

    PCMA of Texas's Pull     Telehealth 2018          Patient Awareness
     for Pompe                                         Program

    Understanding Severe     2018 USAsthma Summit     Corporate Council 2018
     Asthma Program

    2018 Allergy & Asthma    2018 Asthma Bloggers     Understanding Severe
     Awareness Day            Conference               Asthma Guide

    Webinars on              Medical Education        Education Project
     Dermatological
     Conditions in the
     Workplace

    Eczema Online Program    Patient Awareness        Patient Awareness
                              Program                  Program

    Fellow-in-Training       Severe Atopic            2018 Corporate Council
     Travel Scholarships      Dermatitis Toolkit       Membership
                              Program

    Biologics Education      Severe Asthma Allergist  Webinar Education
     Program                  and Patient Education    Program

    Severe Asthma Patient    Practice Management      Educational Tools for
     Education                Center: Expansion and    Allergists and
                              Enhancement              Patient Education
                                                       Campaign

    Patient Education        Proposal Request in      Annual Patient
     Program                  Support of 360 Degrees   Education Conference
                              of Care

    Patient Voice Access     Arthritis Foundation     2018 Arthritis
     Project                  Patient Engagement at    Foundation Conference
                              ACR                      of Champions

    2018 Bone Bash           Silver Ball Fundraiser   Evening of Honors
     Fundraiser                                        Fundraiser

    Freedom of Movement      San Francisco Bone Bash  2018 Jingle Bell Run
     Fundraiser               Fundraiser

    Walk to Cure Arthritis   Arthritis Industry       Patient Awareness
                              Forum (AIF)              Program

    Patient Education and    2018 Bone Bash           Albany Commitment to a
     Awareness Program        Fundraiser               Cure Fundraiser

    Annual GSD Conference    Patient Education        Patient Access Program
                              Program

    My Life With AD          AAFA's Patient Support   My Kids' Life With
                              Center                   Asthma

    Be Smart and Breathe     Medical Resources for    8th Annual Prostate
     Easy Patient Education   Children: An             Cancer Symposium
                              Invaluable Database

    Be The Match 2018        Patient Education and    Patient Education
     National Walk+Run        Awareness Program        Program
     Series

    Operating Support        Patient Awareness        2019 SKI for MS
                              Program

    2019 JUMPSTART Program   2018 MS Global Patient   9th Annual Can Do
     Exhibits                 Programs                 Month

    2018 Young               2018 JUMPSTART Program   2018 Online Programs
     Professionals Program    Exhibition               Sponsorship

    2018 CAN DO Program      2018 JUMPSTART Program   2018 Can Do On Demand

    2018 COA Corporate       Patient Awareness        2nd GM1 Research
     Sponsorship              Program                  Symposium

    TORCH award donation     Fundraiser event         Patient Awareness
                                                       Program

    RareVoice Awards         Rare Disease Scientific  RARE on the Road
                              Workshop                 Leadership Series

    Patient Awareness        Rare Disease Week        Community Congress
     Program                  Sponsorship

    FSIG Patient Meetings    2018 Fun Run/Walk        2018 FSIG Expert Fabry
                                                       Conference

    Patient Assistance       Operating Support        35th Annual Florida
     Program                                           Bleeding Disorders
                                                       Conference

    Boston VisionWalk        Managing MS: A           European RA patient
                              multidisciplinary        online program
                              approach

    European Alliance for    Patient Education and    50-State Network
     Patient Access RA        Awareness Program        Patient Advocacy
     Stakeholders Workshop

    Assessing and            2018 Wisconsin Bleeding  BLeaders
     Communicating the        Disorders Conference
     Impact of AD on
     Patients and Families

    Annual Meeting           Teen Program             Family Education
     Sponsorship                                       Program

    Research Program         2018 MS Awards           21st Annual Spring
                              Reception                Fling for MS

    Superhero Run/Walk--     2018 Superhero Hope Run/ Long Term Care
     Covington                Walk--Wichita            Survivors Initiative

    2018 IMF Patient IMF     9th Annual               6th Glycoproteinoses
     Patient and Family       International Myeloma    International
     Seminars and Regional    Working Group Summit     Conference--Atlanta--
     Community Workshops                               USA

    Kessler Foundation's     Light The Night Boston   Light of Life
     2018 Stroll 'N Roll                               Foundation 2018
     Walk                                              Patient Activities

    3rd Annual Vegas Cares   Texas Bleeding           Research Program
     About Rare Kids 5K       Disorders Conference
                              2018

    Fundraising Event        Boston March for Babies  Multiple Sclerosis
                                                       Achievement Center
                                                       Wellness Education
                                                       programs

    Eat Bid Laugh 7 Program  Race to Nowhere 2018     RUSP Roundtable
                                                       Program

    RUSP Roundtable Program  MS Bright Spots Evening  6th ANNUAL MS ADAPTIVE
                              of Hope                  SKI DAY--THRIVING
                                                       BEYOND MS!

    Relapse Management and   MS ALPINE ADVENTURES    Exhibit Sponsorship
     Rehabilitation Program   2018 ADAPTIVE SKI DAY

    2018 MS Hope Day         Patient Education and    Patient Education and
                              Awareness Program        Awareness Program

    Patient Education and    Patient Education and    2018 Champions
     Awareness Program        Awareness Program        Tackling MS Awards
                                                       Dinner

    Patient Education and    Patient Education and    2018 ``MSWorld Talks''
     Awareness Program        Awareness Program        Cleveland Clinic:
                                                       Display Table

    2018 Defeat Multiple     Patient Assistance       A Better Understanding
     Myeloma Run/Walk         Program                  of MS within the
                                                       Hispanic Community

    Patient Education and    2018 Multiple Sclerosis  MS Awareness Month
     Awareness Program        Summit: A Community      2018
                              Conference and
                              Exposition

    2018 Needs Assessment    MS Fest for Patients     Health, Hope & Hops

    MS Focus' Homecare       MS Focus' Assistive      National MS Education
     Assistance Grant         Technology Program       and Awareness Month
     Program                                           2018

    2018 Mission Steps Walk  Congress Sponsorship     Community Education
     and MS Awareness Days                             and Engagement
                                                       Support

    Resource Guide of        Eczema Awareness Month-  The Face of Atopic
     Helpful Organizations    Unhide Eczema Campaign   Dermatitis in America

    Eczema Expo '18          Atopic Dermatitis Teen   Educational Webcasts
                              Commitment Campaign      for Patients &
                                                       Caregivers

    Operating Support        2018 Fabry Community     Community support
                              Support and Education    programs
                              programs

    Patient Assistance       Patient Education and    Patient Education and
     Program                  Awareness Program        Awareness Program

    Patient Assistance       NHF 2018 Bleeding        UNITE for Bleeding
     Program                  Disorders Conference     Disorders National
                                                       Walk 2018

    NHF Bleeding Disorders   Congress Sponsorship     New York City Kidney
     Conference 2018                                   Walk

    The Big Ask The Big      In-Kind Donation         National MPS Society
     Give                                              National Run Program

    2018--15th               Bike MS: City to Shore   National sponsorship
     International            Ride                     of Walk MS and local
     Symposium on MPS and                              sponsorship of select
     Related Diseases                                  Bike MS events

    MS Breakthroughs         2018 National MS         Women on the Move--
     Program                  Society Leadership       Pittsburgh
                              Conference

    Everyday Matters:        National MS Society      Fellowship Program
     Living Your Best Life    National Event
     with MS                  Sponsorship

    Knoxville Fall Crush     40th Annual Ambassadors  Mood Changes In MS
                              Fundraiser

    Alliance Industry Forum  On the Move Luncheon--   Women on the Move
     2018                     New Orleans              Luncheon and Fashion
                                                       Show--Cincinnati

    Women On the Move--      2018 On the Move         On The Move Luncheon-
     Washington, D.C.         Luncheon--St Louis       Houston

    2017 On The Move         Patient Education and    Patient Assistance
     Luncheon--Dallas TXH     Awareness Program        Program

    Running for Rare         2018 Corporate Council   Patient Education and
                              Membership--Corporate    Awareness Program
                              Product Member

    2018 Rare Diseases and   2018 Rare Impact Awards  Imagine & Believe
     Orphan Product                                    Program
     Breakthrough Summit

    Voices of                40th Annual Family       Congress Sponsorship
     Determination, An        Conference
     Evening to Benefit
     NTSAD

    Family Camp              Massachusetts Advocacy   New England Hemophilia
                              Days                     Association 9th
                                                       Annual Walk

    Face Forward             OhioHealth Multiple      Conference Sponsorship
     Campference and Year-    Sclerosis Wellness
     Round Programming for    Program
     Youth With Rare
     Genetic Disorders

    Patient Assistance       Multiple Myeloma         2018 Myeloma Patient
     Program                  Community Meetings       Cafe

    Patient Assistance       Patient Assistance       Patient Assistance
     Program                  Program                  Program

    Patient Assistance       Patient Assistance       Walk for PKD
     Program                  Program

    2018 Boston Walk for     2018 PKD Connect         25th Annual Scientific
     PKD                      National Conference      Retreat

    PHEN Rally Against       TORCH award donation     Beyond the Diagnosis
     Prostate Cancer

    Rare New England Inc.    RNE Honors Rare Disease  Patient Education and
                              Day Speakers Series      Awareness Program
                              2019

    2018 RMMSC Annual        2018 MS4MS (Multiple     Rocky Mountain MS
     Fundraiser               Summits for MS)          Center's Spring
                                                       Education Summit

    2018 Conversations on    2018 Webinar Series      LCA and IRD Community
     MS                                                Outreach and
                                                       Education

    70th NHF Bleeding        Patient Assistance       LLS Light The Night
     Disorders Conference     Program                  Events

    Website Update Project   Congress Sponsorship     21st International
                                                       Thyroid Cancer
                                                       Survivors' Conference

    Patient Education and    Patient Education and    2018 Future Without MS
     Awareness Program        Awareness Program        Fundraiser

    Donate Life Transplant   Autumn Walks             Fiscal Year 2018
     Games

    Patient Meeting          Patient Meeting          Experts in Arthritis
                                                       Program

    Access Program           Corporate Sponsorship    Marrow on the Move

    14th Annual SEA Blue     Us TOO Prostate Cancer   TORCH award donation
     Prostate Cancer Walk &   Regional Educational
     Run                      Symposiums

    5th Annual Living Like
     a Warrior Gala

                                          Independent Medical Education Grants
                                               1st Jan 2018-31th Mar 2018
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    University of Kansas Continuing        2017 Muscle Study Group Scientific annual Meeting--               25,000
     Education & Professional Development   Neuromuscular Therapeutics: Bench to Bedside and
                                            Beyond

    National Jewish Health PVI Peerview    PeerView inPlay and inClinic: ``Optimizing Asthma                209,000
     institute for Medical Education Inc.   Control Through Accurate Identification, Evidence-
                                            Based Management and Targeted Therapeutic Options''

    Aventura Hospital                      Miami Thyroid Oncology Symposium                                  10,000

    AcademicCME, LLC.                      ASCO GU 2018: A Clinical Analysis of Optimal                      82,300
                                            Therapeutics to Improve Outcomes in Patients with
                                            Prostate Cancer

    The Medical College of Wisconsin,      PeerView Live at BMT 2018, ``Integrated Myeloma                   88,555
     Inc. PVI, PeerView Institute for       Management & Enhanced Patient Outcomes: The
     Medical Education, Inc.                Conjunction of Novel Therapeutic Platforms,
                                            Innovative Agents, and Stem Cell Transplant''

    American Society of Transplant         18th Annual State of the Art Winter Symposium The                 75,000
     Surgeons                               Future Is Now: Saving More Lives Through
                                            Transplantation

    The Medical College of Wisconsin,      Optimal Use of Stem Cell Mobilization in Patients with           305,000
     Inc. Carden Jennings Publishing        Multiple Myeloma and Non-Hodgkin's Lymphoma

    Medical Learning Institute PVI,        PeerView inReview, ``Assessing the Potential Impact of           104,250
     PeerView Institute for Medical         New Consensus Recommendations and Ongoing Clinical
     Learning                               Trials of Emerging Therapies on the Diagnosis and
                                            Treatment of Acid Sphingolmyelinase Deficiency''

    National Society of Genetic            New Lysosomal Storage Disease Healthcare Advocate                 42,637
     Counselors (NSGC)                      Workshop 2018

    American Society of Clinical           2018 Genitourinary (GU) Cancers Symposium: Translating            30,000
     Oncology, Inc. Conquer Cancer          Evidence to Multidisciplinary Care
     Foundation of the American Society
     of Clinical Oncology

    American Association of Clinical       Advances in Medical & Surgical Management of Thyroid              15,000
     Endocrinologists                       Cancer

    ScientiaCME LLC                        Atopic Dermatitis (AD): Best Practices, Barriers to               19,100
                                            Care, and Emerging Therapies in Medication Management

    Potomac Center for Medical Education   Risk-Benefit Analysis and Personalized Treatment in              100,000
     Rockpointe Corporation                 Multiple Sclerosis: Basing Treatment Goals on the
                                            Latest Evidence

    Elsevier Office of Continuing Medical  Moving from Treating Atopic Dermatitis Symptoms to               165,000
     Education ASiM CE, LLC                 Treating Underlying Pathology

    University of Cincinnati Advances in   MauiDerm 2018                                                     50,000
     Cosmetics and Medical Dermatology

    Postgraduate Institute for Medicine    The Rheumatoid Arthritis Vital Education Initiative:             264,800
                                            New Horizons in Therapeutic Options (RAVE: New
                                            Horizons)

    American Society for Blood and Marrow  American Society for Blood and Marrow Transplantation             65,000
     Transplantation                        New Investigator Award

    UT Southwestern Medical Center         40th Annual Carrell-Krusen Neuromuscular Symposium                 5,000

    Regents of the University of           6th Annual UC San Diego Essentials and Advances in                 5,000
     California                             Apheresis

    Physicians' Education Resource         Multiple Sclerosis: A Treatment Paradigm Shift when               85,100
                                            Time is Brain

    Physicians' Education Resource, LLC    2018 New York GUTTM: 11th Annual Interdisciplinary                50,000
     (PER)                                  Prostate Cancer Congress

    National Comprehensive Cancer Network  NCCN 23rd Annual Conference: Improving the Quality,               25,000
                                            Effectiveness, and Efficiency of Cancer CareTM

    UNTHSC                                 Overcoming Persistent Barriers to Effective Management            72,500
                                            of Atopic Dermatitis

    Cleveland Clinic Educational           2018 Nephrology Update                                            10,000
     Foundation

    Medical Learning Institute, Inc. PVI,  PeerView in Session, ``New Developments in Allergic              168,730
     PeerView Institute for Medical         and Inflammatory Diseases: Clinical Updates From San
     Education, Inc.                        Diego and Orlando''

    Penn State College of Medicine PVI,    Science and Stories: Navigating the Prostate Cancer               90,000
     PeerView Institute for Medical         Landscape: Urologists at the Intersection of Emerging
     Education Inc.                         Evidence and Patient Centric Care

    UMA Education Inc., dba Global         Cutting Edge of Transplantation 2018: Breaking through            40,000
     Education Group American Society of    Regulatory Barriers to Unleash Transplant Innovation
     Transplantation                        to Success

    American College of Rheumatology       2018 ACR Rheumatology Courses                                     75,000

    PRIME Education, LLC                   Global Perspectives on Current and Emerging Biologic             151,341
                                            Therapies for Rheumatoid Arthritis

    The Medical College of Wisconsin,      The 28th Annual International Prostate Cancer Update              10,000
     Inc. Carden Jennings Publishing Co.,   (IPCU 28)
     Ltd.

    NYU Post-Graduate Medical School       NYU Langone Seminar in Advanced Rheumatology                      20,000

    AcademicCME, LLC.                      Individualizing Treatment Plans to Reduce Disease                 75,000
                                            Activity in Patients with Rheumatoid Arthritis

    Physicians' Education Resource, LLC    Medical Crossfire: Personalizing Care for Multiple               75,000
     (PER)                                  Myeloma Patients: Current and Future Sequencing
                                            Strategies

    American College of Surgeons           The changing face of thyroid cancer management for                40,900
                                            surgeons: real-life applications of the new ATA
                                            guidelines

    Penn State College of Medicine PVI,    PeerView Live at ASCO 2018: ``How I Think, How I                  75,000
     PeerView Institute for Medical         Treat: A Personal Look at Innovative Therapy and
     Education, Inc.                        Meeting Patient Needs in Multiple Myeloma''

    UMA Education Inc., LLC dba: Global    Evolving Management Strategies for Moderate-to-Severe            346,647
     Education Group (GLOBAL)               Atopic Dermatitis: Looking Beyond Barriers to
                                            Optimized Therapy

    Physicians' Education Resource, LLC    Advances InT Supportive Care: An Onco-Nurses Guide to             50,000
     (PER)                                  Managing Cancer Treatment-Related Toxicities

    National Association of Managed Care   Exploring the Challenges of Severe Asthma:                        45,000
     Physicians                             Implementing Personalized Treatment Plans for
                                            Improved Patient Outcomes

    National Association for Continuing    Conversations in Dermatology The Evolving Paradigm in             59,000
     Education                              Atopic Dermatitis: Integrating Evolving Treatments to
                                            Improve Outcomes

    Eastern Virginia Medical School        Multiple Sclerosis Symposium 2018                                  5,000

    University of Kansas Medical Center    Neuromuscular Review Course                                       25,000

    American Academy of Pas Medical        Moving Toward Improved Outcomes in MS: How PAs Can                50,000
     Logix, LLC                             Make a Difference

    Med-IQ, LLC                            Preventing Tumor Lysis Syndrome: Risk Assessment and              75,000
                                            Appropriate Prophylaxis

    Cleveland Clinic Educational           Cleveland Clinic Neurological Institute Summit 2018:              50,000
     Foundation                             MS Treatment Strategies

    Johns Hopkins University School of     14th Annual Advances in the Diagnosis and Treatment of            30,000
     Medicine                               the Rheumatic Diseases

    National Association of Managed Care   Implementing Newer Biologic Therapies to Improve                  57,000
     Physicians                             Economic and Clinical Outcomes in Patients with
                                            Moderate to Severe Atopic Dermatitis

    Annenberg Center for Health Sciences   Master Class for Oncologists                                      30,000
     at Eisenhower Dana Farber Cancer
     Institute

    Elsevier Office of Continuing Medical  Rising to the Challenge: Diagnosis and Optimal                   124,000
     Education ASiM CE LLC Dannemiller      Management of Atopic Dermatitis in the Primary Care
                                            Setting

    National Association of Managed Care   Novel Treatment Advances and Approaches in Rheumatoid             45,000
     Physicians                             Arthritis: Personalizing Therapy for Improved
                                            Clinical and Economic Outcomes

    National Kidney Foundation             Managing the Life-Long Impact of Fabry Disease                   265,995

    Annenberg Center for Health Sciences   Optimal Treatment sequencing in Metastatic Castration-            65,000
     at Eisenhower PlatformQ Health         Resistant Prostat Cancer: Expert Analysis through
     Education, LLC                         Case Studies

    Michael J Fox Foundation               MDS-PAS Movement Disorders School for Neurology                   20,000
                                            Residents

    Penn State College of Medicine PVI,    Science and Stories at ASCO 2018: Making an Impact in            100,000
     PeerView Institute for Medical         Prostate Cancer--Using Expert Experience and Evidence
     Education, Inc.                        to Personalize the Complex Treatment Landscape

    Purdue University Clinical Care        Advancing Care in Prostate Cancer: Aligning Your                  80,000
     Options, LLC                           Practice With Rapidly Evolving Standards of Care
                                            Throughout the Disease Continuum

    Continuing Education Alliance          2018 PCE Oncology Symposia Series Segment: Sequencing            125,000
                                            Therapy in Patients with Castration-Resistant
                                            Prostate Cancer

    University of Chicago                  At the Forefront of Hepatology                                     5,000

    National Association of Managed Care   The Value of Personalized Treatment Sequencing for                45,000
     Physicians                             Castration-Resistant Prostate Cancer

    Vindico Medical Education, LLC         Immunology Bootcamp                                              100,000

    American Urological Association        2018 Evidence-based Clinical Management of Advanced              100,000
                                            and Castration-Resistant Prostate Cancer

    International Transplant Nurses        European Transplant Nursing Symposium                             10,000
     Society

    UMA Education Inc., dba Global         R.A.P.I.D.--Rheumatoid Arthritis: A Primary Care                200,000
     Education Group FACTORx MedEd          Initiative for Improved Diagnosis and Outcomes
     Consulting Improve CME, LLC NACE Pri-
     Med Indegene, Inc.

    Postgraduate Institute for Medicine    The Learning Pathway in Atopic Dermatitis: Maximizing            362,310
                                            Positive Outcomes for Your Patients

    American Urological Association        AUA 2018 Highlights in Advanced and Castration-                   80,000
                                            Resistant Prostate Cancer

    PESI Inc.                              15th Annual World Congress on Insulin Resistance,                 50,000
                                            Diabetes & Cardiovascular Disease

    Horizon CME                            Improving the Quality of Care in Patients with                   237,900
                                            Diabetes through a Simulated QI Experience

    Joslin Diabetes Center                 Long-acting Insulins in Treatment of Type 2 Diabetes:            324,500
                                            Aligning Provider and Patient Perspectives to Address
                                            Therapeutic Barriers

    Boston University School of Medicine   Balancing Glycemic Control and Hypoglycemia in T2DM:             435,000
     Practicing Clinicians Exchange (PCE)   the Role of long-acting Basal Insulin Analogues

    Physicians' Education Resource         Physiologic Insulin Replacement: Practical Strategies            105,650
                                            for Insulin Initiation and Titration of Long-Acting
                                            Insulins

    University of Massachusetts Medical    The Foundational role of Physiologic, long-acting                341,000
     School CMEducation Resources           Basal Insulin: Optimizing the safety-efficacy
                                            equation in vulnerable patients with T2D

    Postgraduate Institute for Medicine    Targeting diabetic patients for Physiologic, long-               496,200
     CMEducation Resources                  acting Basal Insulin therapy--A best practice roadmap
                                            to clinical success

    The Endocrine Society Institute for    Diabetes Masters Series 2018: Getting to the heart of            249,885
     Medical and Nursing Education, Inc.    the matter: Multidisciplinary perspectives on patient-
                                            centered care in T2DM

    American Association of Diabetes       Leveraging CDEs to Improve Individualized Management           1,024,440
     Educators                              of T2D: Focus on Injectable Therapies

    Pharmacy Times Continuing Education    An American Journal of Managed Care Medical Crossfire:           202,150
                                            Evaluating New Generation Basal Insulin Therapy

    American Association of Nurse          The I's Have It: Improving Insulin Initiation Inertia            358,557
     Practitioners                          A Nurse Practitioner-Led Quality Initiative

    Pri-Med Institute, LLC                 Newer Long-acting Insulins: A Physiologic Approach to            721,504
                                            Glucose Control

    National Association for Continuing    Clinical Updates for NPs and PAs: 2018--Advances in              244,585
     Education                              Insulin Therapy: Another Step Closer to a More
                                            Physiological Strategy

    Institute for Medical and Nursing      AAFP 2018: Building Basal Knowledge: Establishing a              374,867
     Education, Inc.                        Solid Foundation for Using New Options in Basal
                                            Insulin for T2DM

    NACCME, LLC                            Incorporating Long-Acting Insulin Therapy into the               180,565
                                            Physiologic Approach to Diabetes Management

    Postgraduate Institute for Medicine    Multi-Mechanistic, Insulin-Based Approaches for                  347,000
     CMEducation Resources                  Achieving HA1c/PPG Targets and Optimizing Safety in
                                            Challenging Patients with T2D

    Pharmacy Times Continuing Education    Emerging Strategies for the Safe and Effective                    81,303
                                            Treatment of Uncontrolled Diabetes: The Application
                                            of Fixed Ratio Combination Insulin/GLP-1 RA Options

    Boston University School of Medicine   Type 2 Diabetes: New Treatment Combinations for Early            870,000
     Practicing Clinicians Exchange         and Aggressive Glucose Control

    Postgraduate Institute for Medicine    Complementary insulin-based approaches for achieving             935,000
     CMEducation Resources                  HA1c/PPG targets and optimizing safety in patients
                                            with T2D: A best practice roadmap

    American Academy of PAs                Achieving Quality Measures in T2DM: Addressing                   199,600
                                            Clinical Inertia and Patient Needs with Complementary
                                            Insulin-Based Therapies

    National Association for Continuing    Clinical Updates for NPs and PAs: 2018--Combination              244,585
     Education                              Basal Insulin and GLP-1 RA Therapy: A Physiologic
                                            Approach to Diabetes Care

    North Carolina Academy of Family       Ready, set, action: An intervention to combat clinical           372,477
     Physicians Med-IQ, LLC                 inertia and reduce prolonged hyperglycemia in T2DM

    Pharmacy Times Continuing Education    The Advent of Insulin/GLP-1 RA Fixed-Ratio Agents for            129,020
                                            Uncontrolled Diabetes: Moving Past the Barriers of
                                            Clinical Inertia

    Pri-Med Institute, LLC                 Treatment Intensification in T2DM: A Pathophysiologic            721,504
                                            Approach to Combining GLP-1 Receptor Agonists with
                                            Basal Insulin

    American Association of Clinical       Endocrine University: Lipids Module                                4,000
     Endocrinologists

    Elsevier Office of Continuing Medical  Raising the Bar by Lowering the Target: Integrating              419,083
     Education Integritas Communications    PCSK9 Inhibitors into Hypercholesterolemia Management

    University of Tennessee College of     Breaking Barriers to Diabetes Control with GLP-1RA/              165,000
     Pharmacy                               Insulin Combination Agents: Opportunities for the
                                            Community Pharmacist

    American Association of Nurse          Advances in Diabetes Management: Titratable Fixed-               235,873
     Practitioners                          Ratio Combination Therapy and its Role in T2DM
                                            Treatment

    University of California, San Diego    Comparing and Contrasting Basal Insulin Strategies in            481,775
                                            Type 1 and Type 2 Diabetes

    University of Massachusetts Medical    The Mechanistic and Therapeutic Rationale for Dual               342,750
     School CMEducation Resources           SGLT1/2 Inhibition in Adults with Type 1 Diabetes                      Collaboration \4\

    American Association of Clinical       AACE 2018--Reflecting on the Data Pool: Emerging Roles           357,151
     Endocrinologists Institute for         for SGLT1 and SGLT2 Inhibition in T1DM                                 Collaboration \4\
     Medical and Nursing Education, Inc.

    American Association of Diabetes       Reducing Glycemic Variability in Type 1 Diabetes: An             333,715
     Educators E&S MedEd Group, Inc.        Exploration of Non-Insulin Treatment Options                           Collaboration \4\

    Medscape LLC                           Maximizing Medical Management of Knee Osteoarthritis:            174,500
                                            Use of Injectable Therapy

    Oakstone Publishing, LLC. PeerVoice    Reducing Cardiovascular Risk in Patients With                    374,288
     America Limited                        Dyslipidemia: What Do We Know Now? (And What Should                    Collaboration \3\
                                            We Do About It?)

    Pharmacy Times Continuing Education    Managing Hypercholesterolemia: Clinical Updates for               85,201
                                            Specialty Pharmacists on PCSK9 Inhibitor Therapy                       Collaboration \3\

    Postgraduate Institute for Medicine    The Landmark Evidence and Clinical Rationale for PCSK9           486,800
     CMEducation Resources                  Inhibition in the diabetic patient                                     Collaboration \3\

    Preventive Cardiovascular Nurses       2018 PCNA Dyslipidemia Campaign                                   60,000
     Association                                                                                                   Collaboration \3\

    Oakstone Publishing, LLC. PeerVoice    Modern Management of Lipid-Related Cardiovascular Risk           375,000
     America Limited                        in Patients With Dyslipidemia                                          Collaboration \3\

    UMA Education, Inc. dba Global         Mastering the Prior Authorization Process to Meet                275,000
     Education Group                        Patient Needs                                                          Collaboration \3\
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q1, 2018 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. "Funding Amount" does not include funds that may have been provided
      by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.
    \4\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Lexicon, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                              1st April 2018-30th June 2018
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    Med-IQ, Inc.                           Getting Social About Multiple Sclerosis: Tools for                75,000
                                            Newly Diagnosed Patients and Their Care Teams

    National Association of Managed Care   Building a Better Understanding in Asthma Management:             57,000
     Physicians                             Best Practices for Treatment and Control

    Excel Continuing Education             Exploring the Genetics and Management of Fabry Disease            69,720

    The Trustees of Columbia University    The Columbia Renal Biopsy Course                                   5,000
     in the City of New York

    Rheumatology Nurses Society Medscape   Updates in RA, PsA, and Biosimilars: A Pipeline View              50,000
     Education                              for the Clinical Nurse

    University of Illinois at Chicago      Illinois Transplant Pharmacists Association Symposium              8,000
     College of Pharmacy

    Rush University Medical Center Plexus  Northern California Genitourinary Malignancy                      10,000
     Communications                         Symposium: Translating Clinical Advancements to
                                            Practical Patient Care

    Medscape, LLC                          Managing Multiple Myeloma: What's Next?                          116,000

    University of Louisville Research      11th Annual Perspectives in Rheumatic Diseases,                   30,000
     Foundation Inc. Global Academy for     presented by Rheumatology News, Internal Medicine
     Medical Education Postgraduate         News, Family Practice News
     Institute for Medicine

    AKH Inc, Advancing Knowledge in        Focusing on the Patient Voice: Utilizing Components of           100,000
     Healthcare 47-Consultants in Medical   a Patient Coach Module Contextually within Patient-
     Education                              Centric CME Activities

    University of Colorado Denver          Forty-fifth annual Renal Disease and Electrolyte                   5,000
                                            Disorders Course

    Annenberg Center for Health Sciences   Advancing Knowledge to Practice: Optimizing Severe               200,000
     at Eisenhower                          Asthma Care in the Age of Biologics

    USF Health i3 Health                   Challenges and Opportunities in Metastatic Castration-            90,000
                                            Resistant Prostate Cancer: A CME/CE/CPE-Certified VA/
                                            DoD Meeting Series

    Projects In Knowledge @Point of Care   Multiple Sclerosis @Point of Care                                 75,000

    New Jersey Academy of Family           Ascertaining the Role of the Primary Care Clinician in             5,000
     Physicians                             the Recognition and Management of Patients With
                                            Multiple Sclerosis in the Modern Era

    Med Learning Group                     Pathology-Based, Targeted Therapies--Managing Moderate-          124,745
                                            to-Severe Atopic Dermatitis in Adults

    Annenberg Center for Health Sciences   2018 SUNA Advanced Prostate Cancer Grant                          30,000
     at Eisenhower Prostate Cancer
     Education Council

    Consortium of Multiple Sclerosis       Immune Dysfunction in Multiple Sclerosis: Modern                  75,000
     Centers Catamount Medical Education    Considerations in Treatment and Management

    Dallas County Optometric Society       Eyes on Fabry Dallas County Optometric Society                     9,266
     Fabry Support & Information Group

    Association of Reproductive Health     Snap, Crackle and Pop: Provider Education and Targeted            52,000
     Professionals                          Training to Improve the Diagnosis and Therapeutic
                                            Management of Rheumatoid Arthritis in Female Patients

    AcademicCME                            Improving Individualized Outcomes in Asthma with                  45,000
                                            Evidence-based Treatment Strategies

    Integrity Continuing Education, Inc.   2018 Asthma State Society CME Meetings and BioDigital            319,350
                                            Human On-demand Simulation Activity--Improving Severe
                                            Asthma Control through Comprehensive Patient
                                            Assessment and Tailored Treatment Selection

    UMA MLG, LLC                           Targeted Therapies for the Management of Moderate-to-            249,975
                                            Severe Atopic Dermatitis in Adults--Animated
                                            Whiteboard View

    Society for Investigative Dermatology  Neuro-Immunology of Skin Symposia                                 75,000

    Penn State College of Medicine PVI,    PeerView Live: ``Unraveling the Complex Treatment                 60,000
     PeerView Institute for Medical         Landscape for Prostate Cancer: Guidance for
     Education, Inc.                        Delivering Evidence-Based, Patient-Centered Care''

    Medscape, LLC                          Minimizing the Effects of TLS and CRS in Patients with            74,000
                                            Hematologic Malignances

    Excel Continuing Education             Unraveling the Genetics and Management of MPS 1                   55,565

    Hereditary Disease Foundation          Hereditary Disease Foundation's ``Milton Wexler                   10,000
                                            Celebration of Life'' Symposium of international
                                            Huntington's disease researchers

    Medscape LLC                           Targeted Therapies for the Management of Severe                  261,500
                                            Asthma: Surveying an Evolving Landscape

    Seattle Children's Hospital            PLUGS Summit 2018: Clinical Laboratory Stewardship:                8,000
                                            Where Patient Safety and Financial Responsibility
                                            Meet

    University of Cincinnati Global        Skin Disease Education Foundation's 14th Women's &                10,000
     Academy for Medical Education          Pediatric Dermatology Seminar
     Postgraduate Institute for Medicine

    Physicians' Education Resource, LLC    2018 ASH Symposium: ``D'' is for Diagnosis: Solving              250,000
     (PER)                                  the Mystery of Rare Hematologic Disorders

    Boston University School of Medicine,  Practical Approach to Electromyography and                         7,500
     CME                                    Neuromuscular Disorders Conference

    Specialty Pharma Education Center      Renal Transplantation: Overview of Advances in                    49,750
                                            Clinical Understandings, Guidelines, and Treatment &
                                            Management Strategies

    University of California Irvine        8th Annual UC Irvine Neuromuscular Colloquium                     20,000

    Physicians' Education Resource, LLC    Oncology BriefingsTM: Current Perspectives on                     50,000
     (PER)                                  Preventing and Managing Tumor Lysis Syndrome

    UMA Education Inc., dba Global         Nursing Management of Treatment-Related Side Effects             120,000
     Education Group MCM Education          in Metastatic Prostate Cancer

    UMA Education Inc., dba Global         A Quality Improvement (QI) Educational Pilot on                  107,155
     Education Group Q Synthesis, LLC       Enhancing Prostate Cancer Management in Urology
                                            Practice

    Med Learning Group                     Evolving Therapeutic Options for Moderate-to-Severe              274,785
                                            Asthma: A Comprehensive 3-Dimensional Study

    University of Cincinnati               2018 International Rare Lung Diseases Research                    10,000
                                            Conference

    Consortium of Multiple Sclerosis       Therapeutic Decision-Making for Disease Modification              49,288
     Centers Inc. Delaware Media Group      in MS: 2018 Update

    Excel Continuing Education             Unraveling a Therapeutic Conundrum: ASMD Niemann Pick            106,790
                                            Disease

    University of Cincinnati Advances in   MauiDerm NP+PA Summer 2018                                        25,000
     Cosmetic and Medical Dermatology

    American Thoracic Society              ATS 2018 International Conference - Selected Sessions             20,000
                                            in Asthma

    Creighton University Physicians        Skin of Color Seminar Series 2018 (SOCSS 2018)                    15,000
     Continuing Education, Corporation

    UMA MLG, LLC                           Treating a Chronic Autoimmune Inflammatory Disease:              214,500
                                            Targeting Pathophysiologic Cytokines in the
                                            Management of Rheumatoid Arthritis--Animated
                                            Whiteboard View

    Tarrant County Organization Society    Eyes on Fabry Tarrant County Optometric Society                    7,998
     Fabry Support & Information Group

    University of Nevada, Reno School of   2018 Real World Dermatology for PAs and NPs                       25,000
     Medicine Dermatology University LLC

    American Society of Clinical           2018 ASCO Annual Meeting Genitourinary Cancer Tracks              40,000
     Oncology, Inc. Conquer Cancer          Bundle (Prostate and Nonprostate)
     Foundation of the American Society
     of Clinical Oncology

    Postgraduate Institute for Medicine    Clinical Care Team Exchange: The Role of New Biologics           425,170
                                            for Optimal RA Management

    PRIME Education, LLC                   Driving Practice Change in Systems-Based Care of                 344,805
                                            Patients with Atopic Dermatitis

    The Medical College of Wisconsin,      The 23rd Annual Southwest Prostate Cancer Symposium                5,000
     Inc. Carden Jennings Publishing Co.,   (SPCS 23)
     Ltd

    St. Joseph's Regional Medical Center   Acute Rejection of the Allograft--New Concepts and Old             1,810

    MS Cure Fund, Inc.                     2018 Q1 Lifestyle Management Patient Education                    20,000
                                            Programs for individuals diagnosed with multiple
                                            sclerosis, and their support team.

    Alaska Regional Hospital               Wheezin', Sneezin' & Itchin' in Alaska                             5,000

    American Academy of PAs                AAPA 2018--Rheumatology Track                                      5,000

    Postgraduate Institute for Medicine    The Specialty Pharmacy Review BoardTM--Examining                 235,000
     Impact Education, LLC                  Emerging Biologics for Difficult-to-treat or Severe
                                            Asthma

    National Association of Managed Care   Individualizing Therapy in the Management of Relapsing            45,000
     Physicians                             Multiple Sclerosis: Expert Switching and Sequencing
                                            Strategies

    Consortium of Multiple Sclerosis       Nursing Care in Multiple Sclerosis: Evidence-Based                75,000
     Centers Inc. International             Practice
     Organization of MS Nurses

    The Annenberg Center for Health        How I Treat Advanced Prostate Cancer: Making Sense of            100,000
     Sciences at Eisenhower prIME           the Ever-Increasing Options
     Oncology, LLC

    Elsevier Office of Continuing Medical  Clinical Issues in Atopic Dermatitis: Discussions and            784,642
     Education Integritas Communications    Debates on Managing Moderate-to-Severe Disease

    Horizon CME, Inc.                      How to Select and Start Insulin in Patients with Type             59,925
                                            2 Diabetes: A Hands-on Workshop

    National Assocation For Continuing     Getting Comfortable with Insulin: New Approaches to              355,396
     Education                              Getting Patients Safely to Target

    Medscape LLC                           Improving Use of Basal Insulin for Better Diabetes               800,000
                                            Outcomes

    Pri-Med Institute, LLC (d/b/a pmiCME)  The Southern Diabetes Initiative: Individualizing Care           400,000
                                            in the 21st Century

    Elsevier Office of Continuing Medical  Emerging Strategies for Achieving Glycemic Control in            179,950
     Education                              Adults with Type 1 Diabetes                                            Collaboration \4\

    The France Foundation                  When Insulin Isn't Enough: Exploring Dual SGLT1 and              153,900
                                            SGLT2 Inhibition in T1DM                                               Collaboration \4\

    NACCME, LLC.                           Integrating Emerging Evidence in Adjunctive Therapies            432,535
                                            Into Team-Based Management Strategies in Type 1                        Collaboration \4\
                                            Diabetes

    Med-IQ, LLC                            Evolving Evidence in Type 1 Diabetes Management:                 238,281
                                            Evaluating the Role of SGLT Inhibition                                 Collaboration \4\

    UMA Education Inc., dba Global         Type 1 Diabetes: New and Emerging Therapeutic                    511,628
     Education Group                        Strategies to Address Unmet Needs                                      Collaboration \4\

    Haymarket Medical Education            GLP-1 Receptor Agonists: Injecting More Confidence in             49,950
                                            Achieving Glycemic Control for Patients With T2DM The
                                            my CME Town Wall: A Live Clinical Forum for Multiple
                                            Viewpoints on a Virtual Stage

    Medscape LLC                           Novel Treatments for T1D                                         499,000
                                                                                                                   Collaboration \4\

    Med-IQ, Inc.                           Initiating Insulin in Patients Who Fear Needles: Using           297,385
                                            Evolving Basal Insulins to Improve Adoption

    National Association of Managed Care   The Role of PCSK9 Inhibitors in Lowering LDL-C in                 95,000
     Physicians                             Patients with Dyslipidemia: What Managed Care Needs                    Collaboration \3\
                                            to Know

    Allina Health Minneapolis Heart        PCSK9 Inhibitors--Science, Selection and Access                    5,000
     Institute Foundation                                                                                          Collaboration \3\

    Medscape LLC                           PCSK9 Inhibitors and Cardiovascular Outcomes: ACC 2018           237,125
                                            Data You Cannot Afford to Miss                                         Collaboration \3\

    Postgraduate Institute for Medicine    The Landmark trial-based evidence and rationale for              398,000
     CMEducation Resources, LLC             PCSK9 inhibition to prevent and treat Atherosclerotic                  Collaboration \3\
                                            Cardiovascular Disease (ASCVD)

    National Lipid Association Horizon     PCSK9 Inhibitors in Practice: Real-World Challenges              261,335
     CME, Inc.                              and Solutions                                                          Collaboration \3\

    National Lipid Association             The New Era of Preventive Cardiology: Applying PCSK9             153,000
                                            Inhibitor Therapeutics to Prevent Heart Attack and                     Collaboration \3\
                                            Stroke

    Postgraduate Institute for Medicine    New Evidence-Based, Therapeutic Strategies for                   397,000
     CMEducation Resources, LLC             applying CV outcome and trialbased evidence for PCSK9                  Collaboration \3\
                                            inhibition to the front lines of CAD Prevention and
                                            Treatment

    Med Learning Group                     A Virtual Reality Tour of Nonstatin LDL-C-lowering               573,725
                                            Agents that Decrease Cardiovascular Risk for Patients                  Collaboration \3\
                                            with Persistent Hypercholesterolemia

    Potomac Center for Medical Education   Role of Interventional Cardiologists in Secondary                198,450
                                            Prevention of Myocardial Infarction: Redefining                        Collaboration \3\
                                            Clinical Practice

    North American Center for Continuing   Cardiology Grand Rounds: Overcoming Access Barriers              476,838
     Medical Education, LLC                 and Practice Challenges to PCSK9 Inhibitor                             Collaboration \3\
                                            Implementation

    PRIME Education, LLC                   Applying the Latest Cardiovascular Outcomes Trial                146,740
                                            Evidence to PCSK9 Inhibitor Decision-Making in Lipid                   Collaboration \3\
                                            Management

    Pri-Med Institute, LLC (d/b/a pmiCME)  Translating Evidence to Practice: Improving Outcomes             575,150
     Horizon CME, Inc.                      in Patients with ASCVD with PCSK9 Inhibitors                           Collaboration \3\

    Med Learning Group                     A Virtual Reality In Practice View: Maximizing                   174,400
                                            Clinical Benefit Through Optimal LDL-C Reductions in                   Collaboration \3\
                                            Patients With Atherosclerotic Disease

    Physicians' Education Resource         2018 New York Multidisciplinary Cardio-Endo-Renal                 35,000
                                            Collaborative: Access to PCSK9i: Updates on                            Collaboration \3\
                                            Guidelines, Emerging Cardiovascular Benefits and
                                            Overcoming Barriers to Access

    PRIME Education, LLC                   Integrating Evidence from the Latest Cardiovascular              459,799
                                            Outcomes Data into Managed Care Decision-Making in                     Collaboration \3\
                                            Lipid Management

    The Academy for Continued Healthcare   Improving Outcomes and Expanding Opportunities for the           180,420
     Learning                               Treatment of Hyperlipidemia                                            Collaboration \3\
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appea r on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q2, 2018 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.
    \4\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Lexicon, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                              1st July 2018-30th Sept 2018
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    Integrity Continuing Education, Inc.   Advancing Diagnosis and Management of Atopic                     318,450
                                            Dermatitis in Children and Adolescents--
                                            Practitioner's Edge State Society Meeting Series,
                                            CaseScribe On-demand Activity, and Mobile Coach
                                            Platform

    Penn State College of Medicine PVI,    PeerView inSession, ``An Expert Analysis of New Data              76,740
     PeerView Institute for Medical         for Uncontrolled Persistent Asthma Treatments:
     Education, Inc.                        Clinical Updates From Paris''

    Medscape LLC                           Advances in Severe Asthma Management: Conference                 219,500
                                            Highlights and Perspectives

    PRIME Education, LLC                   4th Annual Regional Meetings for Providers in Federal            188,000
                                            and Public Healthcare Sectors: Interprofessional
                                            Education on Psoriatic Diseases, Atopic Dermatitis,
                                            and Rheumatoid Arthritis

    Medscape LLC                           Guide to Atopic Dermatitis: Clinical Pearls for                  198,400
                                            Dermatologists and Allergists

    MediCom Worldwide, Inc.                2018 ASH Meeting on Hematologic Malignancies: The Art             25,000
                                            and Science of Relapsed/Refractory Multiple Myeloma:
                                            A Practical Guide to Complex Therapeutic Choices

    Medscape LLC                           The Pediatrician's Role in Atopic Dermatitis                     458,225

    Integrity Continuing Education, Inc.   Strategies to Provide Individualized Treatment in                360,900
                                            Moderate-to-Severe Atopic Dermatitis--Practitioner's
                                            Edge State Society Meeting Series and Publication in
                                            Action On-demand Activity

    Regents of the University of           Frontiers in Autosomal Dominant Polycystic Kidney                 10,000
     California                             Disease (ADPKD)

    National Association of Managed Care   Optimizing Clinical and Economic Outcomes in the                  57,000
     Physicians                             Management of Moderate to Severe Atopic Dermatitis:
                                            Taking a Closer Look at the Role of Biologic
                                            Therapies

    National Jewish Health Catamount       What is Multiple Myeloma? A Game-Based Learning                   75,000
     Medical Education, LLC                 Experience on Novel Treatment Strategies for
                                            MultipleMyeloma

    Medical Learning Institute, Inc. PVI,  PeerView inVision, Expert Insights on Available and              122,250
     PeerView Institute for Medical         Emerging Therapies for the Management Pompe Disease
     Education, Inc.

    ScientiaCME LLC                        Treatment strategies in Fabry disease                             17,800

    UMA MLG, LLC                           Utilizing the Molecular/Physiologic Phenotype to                 289,400
                                            Direct Asthma Therapy: A Comprehensive Infographic
                                            View

    CME Outfitters, LLC                    Atopic Dermatitis: You Can't Improve What You Don't              279,850
                                            Measure

    The University of Kansas Medical       The Changing Landscape of Neuromuscular Disease: The              40,000
     Center--Continuing Medical Education   Future is Here

    Oakstone Publishing, LLC.              Getting Under the Skin with Targeted Therapy to                  170,000
                                            Improve Atopic Dermatitis Management

    University of Cincinnati Global        14th Annual Coastal Dermatology Symposium                         10,000
     Academy for Medical Education
     Postgraduate Institute For Medicine

    MediCom Worldwide, Inc.                2018 Meeting Highlights of the 4th International                  12,500
                                            Conference on Multiple Myeloma

    National Comprehensive Cancer Network  NCCN 13th Annual Congress: Hematologic MalignanciesTM             25,000

    Boston Children's Hospital/Division    Metabolism Conference Series                                      10,000
     of Genetics and Genomics

    Postgraduate Institute for Medicine    Incorporating New Agents into the Management of Atopic           375,400
     PlatformQ Health Education, LLC        Dermatitis
     Asthma and Allergy Foundation of
     America

    Purdue University MCM Education        Improving the Management of Severe Asthma in Patients            125,000
                                            with Type 2 Inflammation

    Cedars-Sinai                           8th Annual Symposium on Lysosomal Storage Disorders               20,000

    AMERICAN UROLOGICAL ASSOCIATION        Use of Novel Hormonal Agents and Systemic Therapy in              50,000
                                            Advanced Prostate Cancer

    Med Learning Group                     In Pursuit of Clinical Remission: Optimizing the                 249,850
                                            Pharmacologic Management of Rheumatoid Arthritis

    Physicians' Education Resource, LLC    Cancer Summaries and CommentariesT: Report from San               50,000
     (PER)                                  Diego on Advancements in Multiple Myeloma

    Physicians' Education Resource, LLC    2019 ASCO GU Symposium: Prostate Cancer Tumor Board:             100,000
     (PER)                                  Integration of Recent Data Sets Across Lines of Care

    University of Pittsburgh               2018 Pittsburgh International Lung Conference--                   10,000
                                            Pulmonary Medicine: Basic Biology and Novel Therapies

    American College of Chest Phys         Update on Moderate-to-Severe Asthma for Specialists:             500,000
                                            Conference Coverage from CHEST 2018

    American Academy of Physician          10th Annual Allergy, Asthma & ENT CME Conference                   5,000
     Assistants in Allergy, Asthma &
     Immunology

    Oakstone Publishing, LLC Answers in    Strategies for Success in Rheumatoid Arthritis                   170,000
     CME Inc.                               Treatment: Integrating the Patient Voice

    American College of Allergy, Asthma &  An interactive Case Discussion of a Young Adult with              40,000
     Immunology                             Severe Atopic Dermatitis: Insights from the Expert

    UT Southwestern Medical Center         Treatment Approaches and Therapies for Highly Active              83,350
     Medical Logix, LLC                     Multiple Sclerosis: Implementing Updated MS
                                            Guidelines

    National Association of Managed Care   Implementing Personalized Therapeutic Strategies of               45,000
     Physicians                             Switching and Sequencing to Improve Patient Outcomes
                                            in the Management of Multiple Sclerosis

    Projects In Knowledge                  MedImage Cases: Multiple Sclerosis                                75,000

    American Society of Transplant         12 Annual Surgical Fellows Symposium                             110,000
     Surgeons

    Medscape LLC                           Management Challenges in Rheumatoid Arthritis: A                 250,000
                                            Virtual Simulation Approach

    Michael J. Fox Foundation For          MDS-PAS Movement Disorders School for Neurology                   20,000
     Parkinson's Research                   Residents

    Society for Inherited Metabolic        2018 North American Metabolic Academy                             25,000
     Disorders

    Duke University                        2018 Duke Solid Organ Transplant Summit                           15,000

    American Society of Nephrology         Fabry Disease for the Nephrologist: Present and Future           125,000
     University of Minnesota

    American College of Allergy, Asthma &  Thursday Morning Session: Biologic Therapies in Your              77,875
     Immunology                             Practice

    Physicians' Education Resourcer        Advances inTM Therapies for Patients with Multiple                60,000
     (PER)                                 Myeloma: More Options. More Decisions. Better
                                            Outcomes

    Oakstone Publishing, LLC Answers in    Making the Case for Stepping Up Therapy for Atopic               185,000
     CME Inc.                               Dermatitis

    Oakstone Publishing, LLC Answers in    Assessing the Impact of AD: Physical and Beyond                  170,000
     CME Inc.

    Postgraduate Institute for Medicine    Recognizing and Managing Suboptimal Therapeutic                   35,000
     Enquiring Minds, LLC                   Response in MS: Expert Guidance on Challenging Cases

    JPatible                               JPatible Jewish Genetic Screening and Couple                      77,500
                                            Compatibility Matching Program

    Illinois Academy of Physician          Multiple Sclerosis                                                 6,500
     Assistants

    American Society for Reconstructive    Vascularized Composite Tissue Allografts: What it                 30,152
     Transplantation                        Takes to Succeed

    Massachusetts Association of           ``Multiple Sclerosis''                                             4,800
     Physician Assistants

    i3 Health                              Castration-Resistant Prostate Cancer: Implementing New            86,975
                                            Data and Evolving Standards

    Mayo Clinic College of Medicine and    International Myeloma Society Educational Workshop                50,000
     Science SPARGO Inc. on behalf of the
     International Myeloma Society

    UCSF Office of CME                     UCSF TRANSPLANT 2018: Pioneering Advances in                       5,000
                                            Transplantation

    The University of Texas MD Anderson    Emerging Therapeutic Strategies for Relapsed and                  50,000
     Cancer Center ASiM CE, LLC             Refractory Multiple Myeloma: Highlights from ASH 2018

    Regents of the University of Colorado  88th Annual Meeting of the American Thyroid                       75,000
     American Thyroid Association           Association and the 2018 Annual Ridgway Trainee
                                            Conference

    National Assocation For Continuing     Matching Pathogenesis and Treatment in Atopic                     92,800
     Education                              Dermatitis: The Evolving Science

    The Medical College of Wisconsin PVI,  PeerView Live at the 2019 TCT Meetings--``Innovative             119,477
     PeerView Institute for Medical         Therapies and Concepts in Transplant-Eligible
     Education                              Patients With Myeloma: Advancing Toward More
                                            Effective Care Across Treatment Settings''

    Physicians' Education Resource, LLC    Medical Crossfire: How Can We Best Leverage the Use              50,000
     (PER)                                  of MRD to Optimize Outcomes in the Management of
                                            Hematologic Malignances?

    Postgraduate Healthcare Education,     Identification and Management of Atopic Dermatitis:              154,500
     LLC Postgraduate Institute for         Applying Advances to Improve Outcomes A PHE/Power-Pak
     Medicine (PIM)                         Initiative Program 2: Treatment and Emerging
                                            Therapies in Moderate-to-Severe Atopic Dermatitis

    Physicians' Education Resource, LLC    Optimizing Outcomes Through Stem Cell Mobilization:              300,000
     (PER) The Medical College of           Applying Evidence to Patients with Multiple Myeloma
     Wisconsin, Inc.                        and Non-Hodgkin's Lymphoma

    Continuing Education Alliance          PCE Directed Learning eCourse plus eMinders and                  148,275
                                            Reinforcements: Changing Pathways in Moderate to
                                            Severe Atopic Dermatitis

    American Academy of CME, Inc.          Reversing the Trend in Living Kidney Donation:                   122,875
                                            Improving Risk Assessment and Increasing Access

    Postgraduate Institute for Medicine    Applying Precision Medicine in Severe and Difficult-to-          322,100
                                            Treat Asthma.

    Penn State College of Medicine         Consensus or Controversy? Clinical Investigators                  95,000
     Research To Practice                   Provide Perspectives on the Current and Future
                                            Management of Patients with Prostate Cancer--An
                                            Independent Satellite Symposium (ISS) Held as a
                                            Premium Ancillary Educational Event During the 2019
                                            Genitourinary Cancers Symposium

    Excel Continuing Education             Newborn Screening for Rare Disorders: Focusing on                 77,575
                                            Pompe Disease and Gaucher Disease

    Excel Continuing Education             ``Multiple Sclerosis: Treating and Managing Symptoms''             5,000

    Medical Learning Institute, Inc. PVI,  PeerView inSession, Taking Stock of Late-Breaking Data            50,000
     PeerView Institute for Medical         on Disease-Modifying Therapies for the Treatment of
     Education, Inc.                        Multiple Sclerosis: What Are the Key Learnings from
                                            Berlin?

    UMA MLG, LLC                           A 3D View: Moderate-to-Severe Atopic Dermatitis in the           425,000
                                            Pediatric Population: Long-term Treatment and Managed
                                            Care Issues

    Postgraduate Institute for Medicine    A Learning Pathway for Clinicians in Multiple                     50,000
     RMEI                                   Sclerosis: Practical Strategies for Early Diagnosis
                                            and Informed Management

    Postgraduate Institute for Medical     Atopic Dermatitis: A Specialist Perspective on                   300,000
     Education Global Academy for Medical   Diagnosis and Management Across the Age Spectrum
     Education

    American Academy of CME, Inc           Crucial Conversations in Rare & Orphan Disease:                   36,000
                                            Challenges of Diagnosing Rare Diseases: A Focus on
                                            Gaucher Disease

    Consortium of Multiple Sclerosis       Improving Multiple Sclerosis Care: Integrating Patient-           60,000
     Centers PlatformQ Health Education,    Provider Perspectives
     LLC

    Postgraduate Healthcare Education      The Pharmacist's Role in Managing Disease-Modifying               30,000
     Spire Learning                         Therapies in Adults With Multiple Sclerosis

    Integrity Continuing Education, Inc.   Improving Diagnosis and Treatment of Atopic Dermatitis           299,800
                                            through Collaborative Primary & Specialist Care--
                                            Practitioner's Edge State Society Meeting Series and
                                            CME Audit and Feedback Practice Assessment

    Regents of the University of Colorado  Practical Ways to Achieve Targets in Diabetes Care                25,000
                                            (ATDC)                                                                 Collaboration \4\

    Regents of the University of Colorado  Practical Ways to Achieve Targets in Diabetes Care                50,000
                                            (ATDC)

    Regents of the University of Colorado  Practical Ways to Achieve Targets in Diabetes Care                75,000
                                            (ATDC)

    Horizon CME, Inc.                      Can We Do It Better: Improving Outcomes in the                   165,100
                                            Management of Patients with Atrial Fibrillation

    Integrity Continuing Education, Inc.   2019 AAFP State Society CME Meetings, Hands-on                   160,000
                                            Workshop And BioDigital Human On-demand Simulation
                                            Activity: Overcoming Barriers to Initiating or
                                            Intensifying Insulin Therapy: Best Practices for the
                                            Family Physician

    NACCME, LLC.                           Cardiology Grand Rounds: Diagnostic and                          221,710
                                            Pharmacotherapeutic Strategies for the Individualized
                                            Management of Atrial Fibrillation

    University of Cincinnati               New Developments in Type 2 Diabetes Treatment to                 275,000
                                            Decrease the Risk of Hypoglycemia

    Medscape LLC                           Lipid Clinic Considerations: What Would You Do? A Live           447,220
                                            Patient Simulation                                                     Collaboration \3\

    PRIME Education, LLC                   Patients, Payers, Providers Opine: When to Treat with            445,879
                                            PCSK9s                                                                 Collaboration \3\

    Boston University School of Medicine   2018 PCE Series 3 Live and Enduring Home Study with              225,000
     Practicing Clinicians Exchange (PCE)   Eminders and Reinforcement Activities--Evolution of                    Collaboration \3\
                                            Dyslipidemia Management: The Expanding Role of PCSK9
                                            Inhibitors

    Association of Black Cardiologists,    Managing Lipids and Cardiovascular Risk: Using the               250,000
     Inc.                                   Data to Optimize Care                                                  Collaboration \3\

    Pharmacy Times Continuing Education    An American Journal of Managed Care (AJMC) Payor and              51,850
                                            Specialty Pharmacy Forum: Discussing Clinical Updates                  Collaboration \3\
                                            and Outcomes Data for PCSK9 Inhibitors

    Med-IQ, Inc.                           Exploring Treatment Intensification in Type 2                    250,050
                                            Diabetes: Focus on the Provider-Patient Collaborative

    UMA MLG, LLC                           An In Practice View: Moving Beyond Statins To Decrease           178,150
                                            Cardiovascular Events in Patients With                                 Collaboration \3\
                                            Atherosclerotic Disease

    Oakstone Publishing, LLC Answers in    Putting Cardiovascular Outcomes Data Into Context: How           170,000
     CME Inc.                               Will the Latest Information on PCSK9 Inhibitors                        Collaboration \3\
                                            Change Practice?
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q3, 2018 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.
    \4\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Lexicon, some
      or all of which may be shared between the collaborating entities.

                                          Independent Medical Education Grants
                                               1st Oct 2018--31st Dec 2018
        Sanofi US and its affiliate Genzyme Corporation are committed to supporting independent medical education
      activities in therapeutic areas in which the Company is involved, for healthcare professionals, patients, and
       consumers to improve patient care and health outcomes in therapeutic areas in which the Company is engaged.
            Sanofi US and Genzyme Corporation are part of the Sanofi Group, a global pharmaceutical company.
    ----------------------------------------------------------------------------------------------------------------
                                                                                                     Funding Amount
            Recipient Name(s) \1\                              Activity Title                           ($) \2\
    ----------------------------------------------------------------------------------------------------------------
    NACCME, LLC Horizon CME                Clinical and Cost Considerations for Value-Based                  74,875
                                            Multiple Sclerosis Care

    AKH, Inc. Catalyst Medical Education,  Improving Care for Patients with Pompe Disease: A Look           239,740
     LLC                                    at Emerging Therapies and Multidisciplinary
                                            Management Strategies

    Medical Education Resources Impact     Managing Clinical and Cost Outcomes in Multiple                   75,000
     Education, LLC                         Sclerosis: Expert Insights

    i3 Health                              Current Trends in the Management of Castration-                   47,530
                                            Resistant Prostate Cancer

    Oakstone Publishing, LLC Answers in    A Breath of Fresh Air: Exploring Pathophysiology and             340,000
     CME Inc.                               Novel Therapeutic Options to Improve Outcomes in
                                            Moderate-to-Severe Asthma

    ANA NY, ISONG                          2018 ISONG Congress--Building Connections to Genomic               2,500
                                            Health

    Affinity CE/PESG LDRTC                 Genetic Rare and Immune Disorders Symposium-GRIDS 2018            50,000
                                            GRIDS 2018 title: Late and Attenuated Presentations
                                            of Lysosomal Storage Disorders

    UMA MLG, LLC                           A Virtual Reality Experience--Pediatric Atopic                   230,950
                                            Dermatitis: Treatment and Management

    UMA MLG, LLC                           A Virtual Reality View--Long-term Management of Atopic           449,550
                                            Dermatitis: New and Emerging Targeted Systemic
                                            Therapies

    UMA Education, Inc. dba Global         Clinical Issues in Atopic Dermatitis: Discussions and            168,203
     Education Group Integritas             Debates on Improving Outcomes for Moderate-to Severe
     Communications                         Disease

    National Kidney Foundation             Evidence-Based New Insights on the Management of Fabry           145,000
                                            Disease

    UMA Education Inc., dba Global         Looking Ahead: Optimizing Management Strategies in               393,362
     Education Group Integritas             Moderate-to-Severe Atopic Dermatitis
     Communications

    Postgraduate Healthcare Education,     Type 1 Gaucher Disease: Optimizing Treatment and                  63,950
     LLC Postgraduate Institute for         Management Approaches
     Medicine (PIM)

    The France Foundation                  Severe Asthma Science: Endotypes and Precision                   292,680
                                            Medicine Presidential Case Studies

    UMA Education, Inc dba Global          Clearing the Air in Severe Asthma Management:                    549,981
     Education Group Integritas             Improving Patient Outcomes Through Shared Clinical
     Communications                         Decision Making

    AKH Inc. Advancing Knowledge in        Masters of Pediatric Dermatology                                  20,000
     Healthcare Tarsus Cardio dba South
     Beach Symposium

    PRIME Education, LLC                   Atopic Dermatitis Across the Life Cycle: Taking the              199,700
                                            Long View on Diagnostic, Treatment, and Management
                                            Strategies

    PRIME Education, LLC                   Linking Patients, Providers, and Payers in Coordinated           316,500
                                            Approaches to Severe Asthma Treatment

    AKH Inc., Advancing Knowledge in       17th Annual South Beach Symposium                                 20,000
     Healthcare Tarsus Cardio

    PRIME Education, LLC                   Stepping Up Managed Care and Specialty Pharmacy                  499,075
                                            Decision-Making to Support Integration of New
                                            Evidence and Mechanisms in Asthma Treatment

    Academy of Managed Care Pharmacy       AMCP Specialty Connect--Focus on Gene Therapy                     35,000
     (AMCP)

    UMA MLG, LLC                           The Unique Role of the Community Pharmacist in the               199,550
                                            Management of Moderate-to-Severe Atopic Dermatitis in
                                            the Pediatric Population

    Rush University Medical Center Plexus  Applying the Latest Clinical Data and Emerging                    60,000
     Communications                         Therapeutic Approaches in the Management of Prostate
                                            Cancer Throughout the Disease Spectrum

    Purdue University College of Pharmacy  PeerView Live, ``Unraveling the Complexities of                  109,387
     PVI, PeerView Institute for Medical    Prostate Cancer Management: Focus on Therapeutic
     Education, Inc.                        Decisions for Early Stage Disease and the
                                            Implications for Later Stage Disease''

    Rush University Medical Center Plexus  Community Uro-Oncology Forums: Understanding the                  80,000
     Communications                         Disease Continuum and Navigating the Evolving
                                            Treatment Paradigms in Prostate Cancer

    American Health Resources, LLC         Updates in Myeloma Therapeutics: Bone Health,                      8,000
                                            Smoldering Disease, and CAR-T Cells

    Siyemi Learning                        Action Eczema: Global Atopic Dermatitis Educational              383,320
                                            Resource Center

    ScientiaCME                            Genetic Disorders: Updates from The 15th Annual World             17,800
                                            Symposium

    NERGG, Inc.                            NERGG 2018 Annual Meeting                                          6,000

    UMA MLG, LLC                           The CATALYST Initiative--A 3D View--Targeting                    348,275
                                            Inflammatory Cytokines: Addressing Articular and
                                            Systemic Pathology in Patients with Moderate-to-
                                            Severe Rheumatoid Arthritis

    University of Nevada, Reno School of   2018 Fall Clinical Dermatology Conferencer and Beyond:           150,000
     Medicine Foundation for Research and   Practical Approaches to Patient Management--Focus on
     Education in Dermatology               Atopic Dermatitis

    Trustees of Boston University Talem    Talem ACO Summit Series--Atopic Dermatitis: Improving            198,555
     Health, LLC                            Outcomes Through a Patient-Centered Approach

    Cleveland Clinic Educational           7th Annual Basic & Clinical Immunology for the Busy               15,000
     Foundation                             Clinician

    University of Nebraska Medical Center  Rural Health Summit Series: Updates in Atopic                    201,343
     The Board of Regents of the            Dermatitis for the Rural Primary Care Physician
     University of Nebraska dba the
     University of Nebraska Medical
     Center

    International Eczema Council           Atopic Dermatitis Phenotypes and Biomarkers                       11,500

    Excel Continuing Education             Fabry Disease: Role of the Genetic Counselor in an                81,900
                                            Ever-Changing Landscape; The Role of the Genetic
                                            Counselor in Pompe Disease

    Specialty Pharma Education Center      Advancing Care in Prostate Cancer: Clinical                       49,750
                                            Understandings & Evolving Treatment and Management
                                            Approaches

    Massachusetts Eye And Ear Infirmary,   Surgery of the Thyroid and Parathyroid Glands                     15,000
     Department of Otolaryngology
     President and Fellows of Harvard
     College

    Rush University Medical Center Plexus  VHA UroOncology Clinical Forums ``Advancing Strategies            90,000
     Communications                         in Prostate Cancer: Individualizing Treatment Plans
                                            Based on the Rapidly Evolving Landscape and Disease
                                            Continuum''

    Physicians' Education Resource, LLC    ``D'' is for Diagnosis: Solving the Mystery of                   100,000
     (PER)                                  Lysosomal Storage Disorders

    Muscular Dystrophy Association         Medical Education Tactics for the Physician and Care             211,525
                                            Center Community: Hot Topics in NMD Webcast and MDA
                                            Speaker Slides

    Med-IQ, Inc.                           Bridging the Gap Between Research and Clinical                   245,887
                                            Advances in Gaucher Disease Type 3

    Medical Education Resources, Inc.      Managing Multiple Sclerosis: A Guide for Specialty                75,000
     Impact Education, LLC                  Pharmacy Professionals

    Med Learning Group                     A Multiple Sclerosis Virtual Reality Experience:                  50,000
                                            Reaching Diagnosis, Delivering Treatment, and Setting
                                            Goals for Long-Term Success

    Integrity Continuing Education, Inc.   2019 AAFP State Society CME Meetings and BioDigital              299,000
                                            Human On-demand Simulation Activity--Ensuring Early
                                            Diagnosis and Targeting Treatment to Remission in
                                            Patients with Rheumatoid Arthritis: Recommendations
                                            for Primary Care Clinicians

    Yale School of Medicine                2019 Update: What's New in the Field of Multiple                  15,000
                                            Sclerosis

    Annenberg Center for Health Sciences   11th Annual Linda Morgante MS Nurse Leadership Program            45,000
     at Eisenhower Academy for Continued
     Healthcare Learning

    Physicians' Education Resource, LLC    2019 ACTRIMS: An Interactive, Case-Based Discussion:             212,000
     (PER)                                  Interpreting the Therapeutic Landscape in Multiple
                                            Sclerosis

    The Medical College of Wisconsin,      29th Annual International Prostate Cancer Update (IPCU            15,000
     Inc. Carden Jennings Publishing Co.,   29)
     Ltd.

    UMA MLG, LLC                           In Pursuit of the Best Outcomes in Rheumatoid                    194,680
                                            Arthritis: Inhibiting Inflammatory Pathology

    NJ State Society of Physician          Focus on the Future                                               21,000
     Assistants College of Saint
     Elizabeth

    Postgraduate Institute for Medicine    Lysomal Storage Disorders--Common Presetations of                 99,885
     Enquiring Minds, LLC                   Uncommon Diseases: Expert Guidance on Early
                                            Identification and Therapeutic Optimization

    Greenwood Genetic Center               Spring 2019 and Spring 2020 educational program:                  82,003
                                            Enhancing genetic understanding of lysosomal storage
                                            diseases for practicing Physician Assistants (PA) and
                                            PA students

    ThinkGenetic Foundation                Closing the Genetics Gap: A Lecture for Healthcare                 9,320
                                            Advocates on Lysosomal Storage Diseases Designed to
                                            Increase Access to Genetics Services in Medically
                                            Underserved Parishes of Louisiana

    National Association for Continuing    Conversations in Primary Care 2019 Live Virtual                   64,000
     Education                              Symposium Series Individualizing Asthma Care:
                                            Addressing Type 2 Inflammation

    Excel Continuing Education             Newborn Screening for Fabry Disease: What                         86,735
                                            Neonatologists and Pediatricians Needs to Know

    Excel Continuing Education             Exploring the Genetic Counselor's Role in Gaucher                 42,330
                                            Disease (satellite symposium at NSGC)

    Mayo Clinic Arizona                    Mayo Clinic 2019 Multiple Sclerosis & Autoimmune                   7,500
                                            Neurology Update

    UT Southwestern Medical Center         41st Annual Carrell Krusen Neuromuscular Symposium                 5,000

    Medscape LLC                           Improving Appropriate Use of PCSK9 Inhibitors in                 736,125
                                            Interventional Cardiology: Patient-Centered Care                       Collaboration \3\
                                            Perspectives Post-MI

    Postgraduate Institute for Medicine    The iQ&A Case-by-Case, PCSK9 Cardiovascular Medicine             488,000
                                            Intelligence zone: from trials to treatment-How Do                     Collaboration \3\
                                            Recent Guidelines and CV Outcome Trials Help Identify
                                            High Risk Patients (Elevated LDL-C, Recent ACS,
                                            Advanced ASCVD, PCI, Statin Intolerance and
                                            Resistance, and Diabetes) Who Are Optimal Candidates
                                            for PCSK9 Inhibitor-Mediated Therapy
    ----------------------------------------------------------------------------------------------------------------
    \1\ Applicant names are provided by the requestor. If applicants apply as a group for a single educational
      activity; all applicants may be not be identified above. The Company funds other educational activities
      (including fellowships and non-physician and patient education); all of which do not appear on this report,
      but appear on other reports on this site.
    \2\ ``Funding Amount'' is the amount that the Company funded during Q4, 2018 identified above based upon an
      agreement. Recipients are required to return any unused funds. Information on unused funds returned by the
      applicant on activities are not reported. ``Funding Amount'' does not include funds that may have been
      provided by other affiliated Sanofi Company Entities (e.g., Sanofi Pasteur).
    \3\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Regeneron, some
      or all of which may be shared between the collaborating entities.
    \4\ Collaboration (Shared) Funding--is the full amount of a grant funded under an agreement with Lexicon, some
      or all of which may be shared between the collaborating entities.

                                Organization Name
    ------------------------------------------------------------------------

    ------------------------------------------------------------------------
    Hawaii Chapter--National Hemophilia  The Coalition for Hemophilia B
     Foundation

    Hemophilia of North Carolina         Virginia Hemophilia Foundation

    Hemophilia Foundation of Greater     West Virginia Chapter National
     Florida                              Hemophilia Foundation

    The Coalition for Hemophilia B       Brandywine Valley Hemophilia
     Annual Reqests                       Foundation

    Arizona Hemophilia Association       Hemophilia Association of the
                                          Capital Area

    Central California Hemophilia        National Hemophilia Foundation,
     Foundation                           Colorado Chapter

    Hemophilia Foundation of Arkansas,   Hemophilia Foundation of Northern
     Inc.                                 California

    United Hemophilia Foundation, Inc.   Lone Star Chapter of the National
                                          Hemophilia Foundation

    Lone Star Chapter of the National    Mississippi Hemophilia Foundation
     Hemophilia Foundation

    Lone Star Chapter of the National    Lone Star Chapter of the National
     Hemophilia Foundation                Hemophilia Foundation

    Utah Hemophilia Foundation           Hemophilia Association of the
                                          Capital Area

    Florida Hemophilia Association       Great Lakes Hemophilia Foundation

    Bleeding Disorders Alliance          Gateway Hemophilia Association
     Illinois

    Arizona Hemophilia Association       Tennessee Hemophilia and Bleeding
                                          Disorders Foundation

    Hemophilia Foundation of Northern    Nebraska Chapter of the National
     California                           Hemophilia Foundation

    Hemophilia Association of the        Northern Ohio Hemophilia Foundation
     Capital Area

    Hemophilia Foundation of Southern    Hemophilia Foundation of Southern
     California                           California

    Hemophilia Alliance of Maine         Bleeding Disorders Association of
                                          Northeastern New York, Inc.

    Connecticut Hemophilia Society,      Idaho Chapter of the National
     Inc.                                 Hemophilia Foundation

    Hemophilia Foundation of Minnesota/  Hemophilia Foundation of Michigan
     Dakotas

    Oklahoma Hemophilia Foundation       Hemophilia and Bleeding Disorders
                                          of Alabama, Inc.

    Cooley's Anemia Foundation           Oklahoma Hemophilia Foundation

    Louisiana Hemophilia Foundation      Gateway Hemophilia Association

    Virginia Hemophilia Foundation       Virginia Hemophilia Foundation

    Utah Hemophilia Foundation           Alaska Hemophilia Association

    Nevada Chapter of the National       Utah Hemophilia Foundation
     Hemophilia Foundation

    Alaska Hemophilia Association        Hemophilia of South Carolina

    Hemophilia Foundation of Oregon      Tennessee Hemophilia and Bleeding
                                          Disorders Foundation

    Tennessee Hemophilia and Bleeding    Hemophilia Foundation of Greater
     Disorders Foundation                 Florida

    Hemophilia of Indiana, Inc.          Hemophilia Foundation of Maryland,
                                          Inc.

    Hemophilia Foundation of Maryland    Northern Ohio Hemophilia Foundation
     Inc.

    National Hemophilia Foundation,      National Hemophilia Foundation,
     Colorado Chapter                     Colorado Chapter

    New England Hemophilia Association   Hemophilia Foundation of Arkansas,
                                          Inc.

    New England Hemophilia Association   New York City Hemophilia Chapter

    Hemophilia Foundation of WNY, INC.   The Coalition for Hemophilia B
                                          Woman's Retreat

    Arizona Hemophilia Association       Hemophilia Foundation of Greater
                                          Florida

    The Bleeding Disorder Foundation of  National Hemophilia Foundation
     Washington

    The Hemophilia Association of New    Great Lakes Hemophilia Foundation
     Jersey

    The Hemophilia Association of New    Texas Central Hemophilia
     Jersey                               Association

    National Hemophilia Foundation,      Hemophilia Association of San Diego
     Colorado Chapter                     County

    Kentucky Hemophilia Foundation       Kentucky Hemophilia Foundation
     (KHF)                                (KHF)

    Kentucky Hemophilia Foundation       Central California Hemophilia
     (KHF)                                Foundation

    West Virginia Chapter of the         Foundation for Sickle Cell Disease
     National Hemophilia Foundation       Research

    Federation of American Societies     Gateway Hemophilia Association
     for Experimental Biology

    Great Lakes Hemophilia Foundation    Hemophilia Foundation of Southern
                                          California

    United Hemophilia Foundation, Inc.   Florida Hemophilia Association

    Hemophilia Foundation of Southern    Nevada Chapter of the National
     California                           Hemophilia Foundation

    Nevada Chapter of the National       Hemophilia of North Carolina
     Hemophilia Foundation

    Hemophilia of North Carolina         Hemophilia of Indiana, Inc.

    Hemophilia of Indiana, Inc.          Hemophilia of Indiana, Inc.

    Hemophilia Association of San Diego  Hawaii Chapter--National Hemophilia
     County                               Foundation

    Oklahoma Hemophilia Foundation       Disabled Adventure Outfitters

    National Hemophilia Foundation,      Hawaii Chapter--NHF
     Colorado Chapter

    Rocky Mountain Hemophilia &          Rocky Mountain Hemophilia &
     Bleeding Disorders Association       Bleeding Disorders Association

    Virginia Hemophilia Foundation       Hemophilia Association of the
                                          Capital Area

    Hemophilia Association of the        The Western Pennsylvania Chapter of
     Capital Area                         the National Hemophilia Foundation

    Lone Star Chapter of the National    Central Ohio Chapter, NHF
     Hemophilia Foundation

    Bleeding Disorders Alliance          Central California Hemophilia
     Illinois                             Foundation

    Hemophilia Alliance of Maine         New England Hemophilia Asssociation

    Alaska Hemophilia Association        FAMOHIO, Inc.

    FOUNDATION HOPE AND LIFE USA CORP.   National Hemophilia Foundation

    Midwest Hemophilia Association       Great Lakes Hemophilia Foundation

    Hemophilia Foundation of WNY, INC.   Utah Hemophilia Foundation

    Hope for Hemophilia                  Hope for Hemophilia

    West Virginia Chapter of the         Hemophilia of Iowa, Inc.
     National Hemophilia Foundation

    New York City Hemophilia Chapter     New England Hemophilia Association

    Association of Pediatric Hematology  SISTERS AND CAREGIVERS BLEEDING
     Oncology Nurses                      DISORDER NETWORK, INC DBA BLOOD B

    National Hemophilia Foundation,      Colorado Chapter, National
     Colorado Chapter                     Hemophilia Foundation

    American Society of Hematology       Hemophilia Association of the
                                          Southern Tier, Inc.

    Mississippi Hemophilia Foundation    New York City Hemophilia Chapter

    Comprehensive Health Education       New England Hemophilia Association
     Services

    Northern Ohio Hemophilia Foundation  Hemophilia Association of the
                                          Capital Area

    Global Genes                         Mary M. Gooley Hemophilia Center,
                                          Inc.

    Midwest Hemophilia Association       Hemophilia of South Carolina

    Arizona Hemophilia Association       Sickle Cell Disease Association of
                                          America, Inc.

    Hemostasis and Thrombosis Research   Greater Boston Sickle Cell Disease
     Society, Inc.                        Association, Inc.

    Bleeding Disorders Alliance          Hope for Hemophilia
     Illinois

    Central Ohio Chapter National        New York City Hemophilia Chapter
     Hemophilia Foundation

    New York City Hemophilia Chapter     The Hemophilia Association of New
                                          Jersey

    Arizona Hemophilia Association       Nebraska Chapter of the National
                                          Hemophilia Foundation

    Nevada Chapter of the National       Sickle Cell Disease Association of
     Hemophilia Foundation                America, Michigan Chapter

    Hemophilia of South Carolina         Hemophilia of Iowa, Inc.

    Empowering Women with Bleeding and   Tennessee Hemophilia and Bleeding
     Clotting Disorders (Global Blood     Disorders Foundation
     Disorder Foundation)

    Hemophilia Foundation of Oregon      The Hemophilia Association of New
                                          Jersey

    Hemophilia Foundation of Arkansas,   Connecticut Hemophilia Society,
     Inc.                                 Inc.

    Bleeding Disorders Advocacy Network  National Hemophilia Foundation,
                                          West Virginia Chapter

    New England Hemophilia Association   Western Pennsylvania Chapter of the
                                          National Hemophilia Foundation

    Virginia Hemophilia Foundation       Hemophilia Foundation of Greater
                                          Florida

    Hemophilia Foundation of Greater     National Hemophilia Foundation,
     Florida                              West Virginia Chapter

    Idaho Chapter of the National        Tri-State Bleeding Disorder
     Hemophilia Foundation                Foundation

    Northwest Ohio Hemophilia            New York City Hemophilia Chapter
     Foundation

    Hemophilia Association of the        Hemophilia Foundation of Southern
     Capital Area                         California

    Hemophilia of North Carolina         Oklahoma Hemophilia Foundation

    Bleeding Disorders Association of    Louisiana Hemophilia Foundation
     Northeastern New York, Inc.

    Eastern Pennsylvania Chapter of the  Sangre De Oro, Inc.
     National Hemophilia Foundation

    National Hemophilia Foundation       Midwest Hemophilia Association

    United Hemophilia Foundation, Inc.   Texas Central Hemophilia
                                          Association

    Hemophilia Foundation of Northern    Central Ohio Chapter, NHF
     California

    The Bleeding Disorder Foundation of  Nebraska Chapter of the National
     Washington                           Hemophilia Foundation

    The Coalition for Hemophilia B       Northern Ohio Hemophilia Foundation

    West Virginia Chapter of the         Hemophilia and Bleeding Disorders
     National Hemophilia Foundation       of Alabama, Inc.

    Academia Medica del Sur, Inc.        Hemophilia Association of New York,
                                          Inc.

    Texas Central Hemophilia             New York City Hemophilia Chapter
     Association

    Tri-State Bleeding Disorder          Hemophilia Alliance of Maine
     Foundation

    Nevada Chapter of the National       FOUNDATION HOPE AND LIFE USA CORP.
     Hemophilia Foundation

    Central California Hemophilia        American Society of Gene & Cell
     Foundation                           Therapy

    The Coalition for Hemophilia B       Virginia Hemophilia Foundation

    Nevada Chapter of the National       Hemophilia Association of the
     Hemophilia Foundation                Capital Area

    Hemophilia Council of California     Hemophilia Foundation of Maryland,
                                          Inc.

    Tri-State Bleeding Disorder          Hemophilia Foundation of Southern
     Foundation                           California

    United Hemophilia Foundation, Inc.   The Bleeding Disorder Foundation of
                                          Washington

    The Bleeding Disorder Foundation of  Rocky Mountain Hemophilia &
     Washington                           Bleeding Disorders Association

    New England Hemophilia Association   Arizona Hemophilia Association

    Hemophilia Foundation of Maryland    Western Pennsylvania Chapter of the
                                          National Hemophilia Foundation

    Western Pennsylvania Chapter of the  Hemophilia Foundation of Arkansas,
     National Hemophilia Foundation       Inc.

    Virginia Hemophilia Foundation       Virginia Hemophilia Foundation

    Hemophilia Foundation of Southern    Hemophilia Council of California
     California

    Hemophilia Foundation of Maryland,   The Western Pennsylvania Chapter of
     Inc.                                 the National Hemophilia Foundation

    New England Hemophilia Association   Arizona Hemophilia Association

    Hawaii Chapter--National Hemophilia  Hawaii Chapter--National Hemophilia
     Foundation                           Foundation

    Hemophilia Foundation of Southern    Arizona Hemophilia Association
     California

    Hemophilia of North Carolina         Virginia Hemophilia Foundation

    Connecticut Hemophilia Society,      Idaho Chapter of the National
     Inc.                                 Hemophilia Foundation

    Hemophilia Association of New        Bleeding Disorders Alliance of
     Jersey                               North Dakota

    Hemophilia Foundation of Oregon
    ------------------------------------------------------------------------

    ------------------------------------------------------------------------
                                             Payment amount
                 Project name                  (in (USD))      Payment date
    ------------------------------------------------------------------------
    Industry Symposium                             $7,500.00       3/13/2018
    ------------------------------------------------------------------------
    The Coalition for Hemophilia B 12th           $20,000.00       3/14/2018
     Annual Symposium
    ------------------------------------------------------------------------
    2018 HNC Walks in Charlotte & Raleigh          $7,500.00       3/14/2018
    ------------------------------------------------------------------------
    Family Weekend                                 $2,500.00       3/16/2018
    ------------------------------------------------------------------------
    Gainesville Clot Trot                          $2,500.00       3/17/2018
    ------------------------------------------------------------------------
    WVNHF Men's and Women's Day                    $3,000.00       3/20/2018
    ------------------------------------------------------------------------
    The Coalition for Hemophilia B 2018            $8,000.00       3/20/2018
     Annual Sponsorship Run
    ------------------------------------------------------------------------
    Big Red Run 2018                               $1,500.00       3/20/2018
    ------------------------------------------------------------------------
    FAME Phoenix and Tucson                        $3,000.00       3/20/2018
    ------------------------------------------------------------------------
    Infusion Classes                               $1,000.00       3/20/2018
    ------------------------------------------------------------------------
    World Hemophilia Day                           $1,000.00       3/22/2018
    ------------------------------------------------------------------------
    Educations Days 2018                           $5,000.00       3/22/2018
    ------------------------------------------------------------------------
    Northwest Arkansas Educational Day             $1,500.00       3/22/2018
    ------------------------------------------------------------------------
    World Hemophilia Day                           $2,500.00       3/23/2018
    ------------------------------------------------------------------------
    Annual Meeting & Family Education              $3,000.00       3/26/2018
     Dinner
    ------------------------------------------------------------------------
    Hill Country Family Education Day              $1,000.00       3/26/2018
    ------------------------------------------------------------------------
    Southeast Texas Family Education Day           $1,000.00       3/26/2018
    ------------------------------------------------------------------------
    Men's Retreat                                  $2,500.00       3/26/2018
    ------------------------------------------------------------------------
    Texas Bleeding Disorders Conference            $6,000.00       3/27/2018
     Exhibit
    ------------------------------------------------------------------------
    Texas Bleeding Disorders Conference           $50,000.00       3/27/2018
    ------------------------------------------------------------------------
    Women and Bleeding Disorders                   $1,500.00       3/27/2018
     Conference
    ------------------------------------------------------------------------
    Family Education Day                           $2,500.00       3/27/2018
    ------------------------------------------------------------------------
    8th Annual Walk in the Jungle                  $5,000.00       3/27/2018
    ------------------------------------------------------------------------
    Family Camp                                    $1,000.00       3/28/2018
    ------------------------------------------------------------------------
    BDAI 2018 Statewide Family Education           $2,500.00       3/28/2018
     Weekend & World
    ------------------------------------------------------------------------
    2018 Bleeding Disorder Walk                    $1,000.00       3/28/2018
    ------------------------------------------------------------------------
    Camp HONOR                                     $1,000.00       3/29/2018
    ------------------------------------------------------------------------
    Be A Factor 5 k                                  $500.00       3/29/2018
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Health            $2,500.00       3/30/2018
     Fair
    ------------------------------------------------------------------------
    Family Education Weekend                       $3,000.00       3/30/2018
    ------------------------------------------------------------------------
    Family Education Weekend                       $2,000.00        4/3/2018
    ------------------------------------------------------------------------
    Spring Wellness Program                        $1,500.00        4/4/2018
    ------------------------------------------------------------------------
    Teen Leadership Summit                         $1,000.00        4/4/2018
    ------------------------------------------------------------------------
    Family Information Day                         $5,000.00        4/4/2018
    ------------------------------------------------------------------------
    Annual Meeting                                 $5,000.00        4/5/2018
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Walk              $2,500.00        4/5/2018
    ------------------------------------------------------------------------
    Spring Social                                  $1,500.00        4/5/2018
    ------------------------------------------------------------------------
    Victory for Women                              $2,800.00        4/5/2018
    ------------------------------------------------------------------------
    HFMD Annual Members Meeting                    $1,500.00        4/6/2018
    ------------------------------------------------------------------------
    HFM's 2018 National Conference for           $100,000.00        4/6/2018
     Women with Bleeding Disorders
    ------------------------------------------------------------------------
    OHF Camp Independence                          $4,000.00        4/9/2018
    ------------------------------------------------------------------------
    Camp Clot Not                                  $2,500.00        4/9/2018
    ------------------------------------------------------------------------
    2018 CAF Care Walk                             $7,500.00        4/9/2018
    ------------------------------------------------------------------------
    2018 ``Unite for Bleeding Disorders''          $2,500.00        4/9/2018
     Health Fair and Walk
    ------------------------------------------------------------------------
    2018 Camp Globeclotters                        $2,500.00        4/9/2018
    ------------------------------------------------------------------------
    2018 Camp Notaclotamongus                      $1,250.00       4/10/2018
    ------------------------------------------------------------------------
    Teen/Young Adult Program                      $15,000.00       4/10/2018
    ------------------------------------------------------------------------
    Annual State Educational Meeting               $3,500.00       4/10/2018
    ------------------------------------------------------------------------
    Website ad and direct mailing                  $4,000.00       4/11/2018
    ------------------------------------------------------------------------
    Youth Leadership Weekend 2018                    $500.00       4/11/2018
    ------------------------------------------------------------------------
    Camp Independent Firefly                       $1,000.00       4/11/2018
    ------------------------------------------------------------------------
    Utah Hemophilia Foundation's Family            $2,000.00       4/11/2018
     Resource Fair
    ------------------------------------------------------------------------
    Camp Frozen Chozen                             $3,500.00       4/11/2018
    ------------------------------------------------------------------------
    HELLO- State Annual Meeting and                $2,500.00       4/16/2018
     Educational Conference
    ------------------------------------------------------------------------
    2018 Oregon Unite for Bleeding                 $2,500.00       4/16/2018
     Disorders Walk
    ------------------------------------------------------------------------
    2018 Race for Ian                                $500.00       4/17/2018
    ------------------------------------------------------------------------
    2018 48th Annual Meeting                       $3,000.00       4/17/2018
    ------------------------------------------------------------------------
    17th Annual Family Education Program           $2,800.00       4/19/2018
    ------------------------------------------------------------------------
    Camp Brave Eagle                               $1,500.00       4/19/2018
    ------------------------------------------------------------------------
    Race to Stop the Bleeding                      $4,000.00       4/19/2018
    ------------------------------------------------------------------------
    HFM Family Educational Dinner and              $4,000.00       4/19/2018
     Display Night
    ------------------------------------------------------------------------
    Gears for Good Charity Bike Ride               $1,000.00       4/19/2018
    ------------------------------------------------------------------------
    Colorado Family Camp 2018                      $1,500.00       4/20/2018
    ------------------------------------------------------------------------
    Spanish Program: Greeley                       $1,000.00       4/20/2018
    ------------------------------------------------------------------------
    Family Camp                                    $5,000.00       4/20/2018
    ------------------------------------------------------------------------
    Eighth Annual Center for Bleeding              $1,500.00       4/20/2018
     Disorders Conference
    ------------------------------------------------------------------------
    9th Annual Walk                               $10,000.00       4/20/2018
    ------------------------------------------------------------------------
    NYC Unite for Bleeding Disorders Walk          $5,000.00       4/20/2018
     2018
    ------------------------------------------------------------------------
    New Patient Summer Social                      $1,000.00       4/20/2018
    ------------------------------------------------------------------------
    The Coalition for Hemophilia B Fall           $72,500.00       4/20/2018
     Woman's Retreat
    ------------------------------------------------------------------------
    Community Education Days                       $7,500.00       4/20/2018
    ------------------------------------------------------------------------
    Tampa Superhero Walk For Bleeding              $2,500.00       4/20/2018
     Disorders
    ------------------------------------------------------------------------
    Western Washington Spring Education            $1,500.00       4/20/2018
     Day
    ------------------------------------------------------------------------
    2018 New Jersey Hemophilia Walk                $4,000.00       4/23/2018
    ------------------------------------------------------------------------
    7th Annual Hemophilia Awareness Walk           $2,500.00       4/30/2018
    ------------------------------------------------------------------------
    2018 Wisconsin Bleeding Disorders              $4,000.00        5/1/2018
     Conference
    ------------------------------------------------------------------------
    Hemophilia Association Annual Meeting          $5,000.00       5/15/2018
    ------------------------------------------------------------------------
    2018 TexCen Annual Meeting and Summer          $3,000.00       5/20/2018
     Education Day
    ------------------------------------------------------------------------
    Social Factor: Colorado Spring                 $1,000.00       5/21/2018
    ------------------------------------------------------------------------
    2018 Industry Symposium                        $3,500.00       5/22/2018
    ------------------------------------------------------------------------
    2018 Kentucky Unite for Bleeding               $2,500.00        6/5/2018
     Disorders Walk
    ------------------------------------------------------------------------
    2018 Annual Education Meeting                  $1,750.00        6/5/2018
    ------------------------------------------------------------------------
    2018 KHF Camp Discovery--Summer Camp           $2,000.00        6/5/2018
     Program for Children and Teens
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Walk              $1,000.00        6/7/2018
    ------------------------------------------------------------------------
    WVNHF Industry Symposium                       $3,000.00        6/7/2018
    ------------------------------------------------------------------------
    12th Annual Sickle Cell Disease                $5,000.00       6/11/2018
     Research and Educational
    ------------------------------------------------------------------------
    FASEB Conference on ``Genome                   $2,000.00       6/13/2018
     Engineering: Cutting-Edge
    ------------------------------------------------------------------------
    2018 Family Education Weekend                  $2,000.00       6/14/2018
    ------------------------------------------------------------------------
    Camp Klotty Pine 2018                          $1,000.00       6/14/2018
    ------------------------------------------------------------------------
    Camp Blood Brothers and Sisters                $2,000.00       6/17/2018
    ------------------------------------------------------------------------
    Family Education Conference                    $5,000.00       6/17/2018
    ------------------------------------------------------------------------
    35th Annual Florida Bleeding Disorders         $6,000.00       6/17/2018
     Conference (Formerly known as the
     ``Family Education Symposium'')
    ------------------------------------------------------------------------
    Familia de Sangre                             $50,000.00       6/18/2018
    ------------------------------------------------------------------------
    Northern Nevada Family Education Day           $1,500.00       6/18/2018
    ------------------------------------------------------------------------
    Unite For Bleeding Disorders                   $1,000.00       6/18/2018
    ------------------------------------------------------------------------
    Union Latina (Latin Union) Educational         $2,500.00       6/18/2018
     Retreat
    ------------------------------------------------------------------------
    Men's Educational Retreat                      $1,500.00       6/18/2018
    ------------------------------------------------------------------------
    2018 Hemophilia of Indiana Annual              $4,000.00       6/19/2018
     Meeting
    ------------------------------------------------------------------------
    2018 Unite For Bleeding Disorders Walk         $3,500.00       6/19/2018
    ------------------------------------------------------------------------
    Doug Thompson Teen Leadership Camp             $1,500.00       6/19/2018
    ------------------------------------------------------------------------
    2018 Teen Camp                                 $2,000.00       6/20/2018
    ------------------------------------------------------------------------
    Hawaii Teen Summit                             $7,500.00       6/20/2018
    ------------------------------------------------------------------------
    OHF Annual Meeting 2018                        $3,500.00       6/20/2018
    ------------------------------------------------------------------------
    Teen Adventure Camp                            $2,500.00       6/20/2018
    ------------------------------------------------------------------------
    Mile High Summer Camp 2018                     $1,000.00       6/20/2018
    ------------------------------------------------------------------------
    Koko Ohana Family Camp                         $2,500.00       6/20/2018
    ------------------------------------------------------------------------
    RMHBDA Walk for Bleeding Disorders             $1,500.00       6/21/2018
    ------------------------------------------------------------------------
    RMHBDA BIG SKY FAMILY CAMP                     $1,000.00       6/21/2018
    ------------------------------------------------------------------------
    Camp Youngblood--Summer Camp                   $1,000.00       6/21/2018
    ------------------------------------------------------------------------
    Summer Camp                                    $1,000.00       6/21/2018
    ------------------------------------------------------------------------
    HACA Fall Festival and Walk                    $7,500.00       6/21/2018
    ------------------------------------------------------------------------
    Western Pennsylvania Walk, Run, and            $2,000.00       6/21/2018
     Cornhole Tournament
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Walk              $3,000.00       6/22/2018
    ------------------------------------------------------------------------
    COC-New Patient Orientstion                    $1,750.00       6/22/2018
    ------------------------------------------------------------------------
    BDAI 2018 Unite Walk for Bleeding              $2,500.00       6/25/2018
     Disorders Sponsorship
    ------------------------------------------------------------------------
    Family Education Day                           $5,500.00       6/26/2018
    ------------------------------------------------------------------------
    Hike4HAM                                       $2,500.00       6/27/2018
    ------------------------------------------------------------------------
    Women's Retreat                                $2,000.00       6/27/2018
    ------------------------------------------------------------------------
    Alaska Bleeding Disorder Walk--Exhibit         $1,750.00       6/27/2018
    ------------------------------------------------------------------------
    FAMOHIO Annual Meeting and Educational        $12,500.00       6/27/2018
     Symposium
    ------------------------------------------------------------------------
    Back to School Educational Event               $2,500.00       6/28/2018
    ------------------------------------------------------------------------
    NHF 2018 Bleeding Disorders Conference       $237,000.00       6/29/2018
     Sponsorships
    ------------------------------------------------------------------------
    MHA UNITE for Bleeding Disorders Walk-         $2,500.00        7/2/2018
     a-Thon
    ------------------------------------------------------------------------
    2018 Wisconsin Unite for Bleeding              $5,000.00        7/2/2018
     Disorders Walk
    ------------------------------------------------------------------------
    ``In my Blood'' Bleeding Disorders             $2,000.00        7/2/2018
     Awareness Walk
    ------------------------------------------------------------------------
    Camp Valor 2018                                $6,000.00        7/2/2018
    ------------------------------------------------------------------------
    Superhero Run/Walk--Covington, LA              $5,000.00        7/3/2018
    ------------------------------------------------------------------------
    Superhero HOPE Run/Walk--Wichita, KS           $5,000.00        7/3/2018
    ------------------------------------------------------------------------
    WVNHF Family Camp                              $3,000.00        7/5/2018
    ------------------------------------------------------------------------
    Annual Meeting                                 $1,500.00        7/5/2018
    ------------------------------------------------------------------------
    Kids Day Camp                                  $7,000.00        7/6/2018
    ------------------------------------------------------------------------
    BLeaders Teen Retreat                          $5,000.00       7/15/2018
    ------------------------------------------------------------------------
    BITS AND PIECES OF Pediatric                   $1,000.00       7/16/2018
     Hematology, Oncology & BM
    ------------------------------------------------------------------------
    BBBDN Back to School Educating for             $5,000.00       7/16/2018
     Success
    ------------------------------------------------------------------------
    Western Slope Social Factor                    $1,000.00       7/17/2018
    ------------------------------------------------------------------------
    Colorado Unite for Bleeding Disorders          $1,500.00       7/17/2018
     Walk
    ------------------------------------------------------------------------
    ASH Corporate Friends                         $35,000.00       7/17/2018
    ------------------------------------------------------------------------
    Annual BDAST 2018 Hike Fundraiser              $3,000.00       7/17/2018
    ------------------------------------------------------------------------
    Family Retreat                                 $4,000.00       7/17/2018
    ------------------------------------------------------------------------
    NYCHC 2018 Women's Retreat                    $10,000.00       7/23/2018
    ------------------------------------------------------------------------
    National LadyBugs Womens Summit               $50,000.00        8/2/2018
    ------------------------------------------------------------------------
    Hispanic Heritage Symposium                    $3,500.00        8/2/2018
    ------------------------------------------------------------------------
    UNITE for Bleeding Disorders Walk              $2,500.00        8/2/2018
    ------------------------------------------------------------------------
    Women's Retreat                                $2,000.00        8/2/2018
    ------------------------------------------------------------------------
    2018 Patient Advocacy Summit                  $33,000.00        8/7/2018
    ------------------------------------------------------------------------
    2018 Finger Lakes Triathlon                    $5,000.00        8/7/2018
    ------------------------------------------------------------------------
    MHA Family Education Weekend--                 $2,000.00        8/8/2018
     Connecting the Bleeding
    ------------------------------------------------------------------------
    Educational Family Camp and Adult              $3,000.00       8/10/2018
     Retreat
    ------------------------------------------------------------------------
    NACCHO 2019                                  $180,000.00       8/13/2018
    ------------------------------------------------------------------------
    46th Annual SCDAA National Convention         $25,000.00       8/14/2018
    ------------------------------------------------------------------------
    HTRS Corporate Colleague--Sustaining          $10,000.00       8/16/2018
     Member
    ------------------------------------------------------------------------
    Walk for Sickle Cell Disease                   $5,000.00       8/20/2018
    ------------------------------------------------------------------------
    Community Liaison Project                      $5,000.00       8/22/2018
    ------------------------------------------------------------------------
    2018 HOPE Conference                          $15,000.00       8/23/2018
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders 5K                $2,500.00       8/28/2018
    ------------------------------------------------------------------------
    TORCH Teen Retreat                             $7,000.00       8/29/2018
    ------------------------------------------------------------------------
    Bilingual Back to School Event                 $5,000.00       8/29/2018
    ------------------------------------------------------------------------
    Hemophilia Association of New Jersey           $2,500.00       8/29/2018
     (HANJ) Fall Education
    ------------------------------------------------------------------------
    Annual Statewide Meeting                      $10,000.00       8/29/2018
    ------------------------------------------------------------------------
    Unite for Bleeding Disorder Walk               $1,000.00        9/4/2018
    ------------------------------------------------------------------------
    Fall Fam Jam                                   $1,000.00        9/5/2018
    ------------------------------------------------------------------------
    Sickle CELLebration                            $3,000.00        9/5/2018
    ------------------------------------------------------------------------
    The Turkey Trot 5k Walk for Hemophilia         $2,500.00        9/6/2018
     and Bleeding Disorders
    ------------------------------------------------------------------------
    Unite for Bleeding Disorder Walk               $1,500.00        9/6/2018
    ------------------------------------------------------------------------
    Empowering Women with Bleeding and             $3,500.00        9/7/2018
     Clotting Disorders
    ------------------------------------------------------------------------
    Blazin for Bleeders 5k/walk                    $1,000.00        9/7/2018
    ------------------------------------------------------------------------
    2018 HFO Insurance Forum                       $3,000.00        9/7/2018
    ------------------------------------------------------------------------
    2018 PACT Workshop                            $15,000.00        9/8/2018
    ------------------------------------------------------------------------
    2018 Family Retreat/Annual Meeting             $3,500.00       9/10/2018
    ------------------------------------------------------------------------
    Annual Meeting                                 $1,500.00       9/10/2018
    ------------------------------------------------------------------------
    2018 BDAN Fall Family Retreat                  $2,500.00       9/10/2018
    ------------------------------------------------------------------------
    Spokes Men for Bleeders                          $500.00       9/11/2018
    ------------------------------------------------------------------------
    Fall Fest                                      $5,000.00       9/11/2018
    ------------------------------------------------------------------------
    WPCNHF'S Erie Educational Event                $2,000.00       9/11/2018
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Walk              $5,000.00       9/11/2018
    ------------------------------------------------------------------------
    Orlando Creepy Crawl 5K and Vampire            $3,000.00       9/11/2018
     Mile
    ------------------------------------------------------------------------
    Jacksonville Creepy Crawl 5K and               $3,000.00       9/11/2018
     Vampire Mile
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders--Annual           $2,500.00       9/17/2018
     Walk
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Walk              $1,000.00       9/17/2018
    ------------------------------------------------------------------------
    TSBDF Annual Meeting                           $1,500.00       9/17/2018
    ------------------------------------------------------------------------
    Unite for Bleeding Disorders Walk              $1,000.00       9/17/2018
    ------------------------------------------------------------------------
    Latino Retreat                                $10,000.00       9/17/2018
    ------------------------------------------------------------------------
    Spanish-Language Education Event               $1,500.00       9/17/2018
    ------------------------------------------------------------------------
    Inaugural Health Fair                          $2,500.00       9/18/2018
    ------------------------------------------------------------------------
    2018 Adult Retreat                             $1,500.00       9/19/2018
    ------------------------------------------------------------------------
    OHF Family Education Retreat                   $1,000.00       9/20/2018
    ------------------------------------------------------------------------
    Annual Meeting                                 $2,000.00       9/21/2018
    ------------------------------------------------------------------------
    42nd Annual Meeting and Educational            $5,500.00       9/26/2018
     Symposium
    ------------------------------------------------------------------------
    Trick or Trot Family Walk                      $3,000.00       9/26/2018
    ------------------------------------------------------------------------
    Patient and Family Education Weekend           $2,500.00       10/5/2018
    ------------------------------------------------------------------------
    2018 Bleeding Disorders Conference            $35,000.00       10/8/2018
     Final Night Event
    ------------------------------------------------------------------------
    Wichita Education Day                          $1,500.00       10/9/2018
    ------------------------------------------------------------------------
    Winter Education Meeting and Holiday           $3,500.00       10/9/2018
     Festival
    ------------------------------------------------------------------------
    8th Annual Unite for Bleeding                  $2,500.00       10/9/2018
     Disorders Walk and Fun Race
    ------------------------------------------------------------------------
    Family Education Day                           $2,500.00      10/11/2018
    ------------------------------------------------------------------------
    COC-Education Retreat                          $3,250.00      10/11/2018
    ------------------------------------------------------------------------
    Eastern Washington Annual Meeting 2018         $1,500.00      10/11/2018
    ------------------------------------------------------------------------
    Nebraska Industry Symposium                    $5,000.00      10/16/2018
    ------------------------------------------------------------------------
    The Coalition for Hemophilia B                 $3,000.00      10/16/2018
     Meetings on the Road
    ------------------------------------------------------------------------
    NOHF Annual Education Meeting                  $5,500.00      10/16/2018
    ------------------------------------------------------------------------
    Annual Meeting                                 $3,000.00      10/17/2018
    ------------------------------------------------------------------------
    Camp Harvest                                   $6,000.00      10/18/2018
    ------------------------------------------------------------------------
    Issues and Challenges in the                   $2,500.00      10/22/2018
     Management of Hemophilia
    ------------------------------------------------------------------------
    Steven Margolies, MD Family                    $6,000.00      10/22/2018
     Educational Conference
    ------------------------------------------------------------------------
    2018 TexCen Chapter Winter Education           $3,000.00       11/1/2018
     Day
    ------------------------------------------------------------------------
    NYCHC Annual Education Day                     $7,500.00       11/2/2018
    ------------------------------------------------------------------------
    TSBDF Education Dinner                         $2,000.00       11/5/2018
    ------------------------------------------------------------------------
    Winterfest                                     $1,500.00       11/6/2018
    ------------------------------------------------------------------------
    Annual Family Conference                       $2,250.00      11/19/2018
    ------------------------------------------------------------------------
    Holiday Educational Program                    $2,000.00       12/6/2018
    ------------------------------------------------------------------------
    College and Career Fair                        $1,500.00      12/11/2018
    ------------------------------------------------------------------------
    ASGCT Patient Education Videos                 $5,000.00      12/13/2018
    ------------------------------------------------------------------------
    The Coalition for Hemophilia B Patient        $10,000.00      12/18/2018
     Survey
    ------------------------------------------------------------------------
    Advocacy Training                              $2,500.00      12/18/2018
    ------------------------------------------------------------------------
    Grassroots Advocacy Project                    $5,000.00      12/19/2018
    ------------------------------------------------------------------------
    State Advocacy Training                          $500.00        1/3/2019
    ------------------------------------------------------------------------
    Annual Silver-level Corporate                 $15,000.00        1/4/2019
     Sponsorship
    ------------------------------------------------------------------------
    Annual Meeting and Family Educational         $10,000.00        1/7/2019
     Dinner
    ------------------------------------------------------------------------
    TSBDF Winter Program-Journey Around            $1,500.00        1/7/2019
     the World
    ------------------------------------------------------------------------
    4th Annual Industry Forum                      $5,000.00       1/11/2019
    ------------------------------------------------------------------------
    Advocacy Education and Training                $5,000.00       1/15/2019
     Seminar
    ------------------------------------------------------------------------
    Latino Group Weekend 2019                      $1,500.00       1/16/2019
    ------------------------------------------------------------------------
    Winter Education Day 2019                      $1,500.00       1/16/2019
    ------------------------------------------------------------------------
    RMHBDA EDUCATION WEEKEND AND ANNUAL            $2,000.00       1/16/2019
     MEETING
    ------------------------------------------------------------------------
    New England Hemophilia Association             $1,500.00       1/16/2019
     Winter Camp
    ------------------------------------------------------------------------
    Purpose Driven Leadership Program              $2,500.00       1/16/2019
    ------------------------------------------------------------------------
    Maryland Advocacy Days                         $5,000.00       1/21/2019
    ------------------------------------------------------------------------
    WPCNHF's New Parent Network                    $4,000.00       1/21/2019
    ------------------------------------------------------------------------
    WPCNHF's Semi-Annual Education Weekend         $5,000.00       1/21/2019
    ------------------------------------------------------------------------
    Men In Action/Infusing Love Group's            $1,500.00       1/21/2019
     Valentine Event
    ------------------------------------------------------------------------
    Medial Symposium                               $5,000.00       1/21/2019
    ------------------------------------------------------------------------
    Women's Retreat                                $5,000.00       1/21/2019
    ------------------------------------------------------------------------
    emPOWERment Forum                              $2,500.00       1/22/2019
    ------------------------------------------------------------------------
    2018 Corporate Program Sponsorship--           $1,875.00        2/4/2019
     Silver
    ------------------------------------------------------------------------
    Four Bioverativ Branded Educational            $1,250.00        2/4/2019
     Dinners
    ------------------------------------------------------------------------
    WPCNHF's New Parent Network                    $1,000.00        2/4/2019
    ------------------------------------------------------------------------
    Consumer Medical Symposium                     $3,000.00       2/12/2019
    ------------------------------------------------------------------------
    Zoo Walk 2019                                  $4,000.00       2/12/2019
    ------------------------------------------------------------------------
    Hawaii Future Leaders                          $2,500.00       2/13/2019
    ------------------------------------------------------------------------
    Hawaii Ohana Education Weekend 2019            $7,500.00       2/13/2019
    ------------------------------------------------------------------------
    Women's Retreat                                $3,500.00       2/13/2019
    ------------------------------------------------------------------------
    Bleeding Disorder Awareness Kick Off           $1,500.00       2/13/2019
    ------------------------------------------------------------------------
    2019 Annual Meeting                            $2,000.00       2/13/2019
    ------------------------------------------------------------------------
    Teen--Young Adult Program                     $15,000.00       2/13/2019
    ------------------------------------------------------------------------
    15th Annual CHS Alpine Walk                    $2,000.00       2/20/2019
    ------------------------------------------------------------------------
    Victory for Women                              $2,800.00        3/7/2019
    ------------------------------------------------------------------------
    Winter Membership Gathering                    $5,000.00        3/7/2019
    ------------------------------------------------------------------------
    2019 Annual Meeting                            $3,000.00       3/13/2019
    ------------------------------------------------------------------------
    YETI--Youth Effectively Transitioning          $5,000.00       3/18/2019
     to Independence
    ------------------------------------------------------------------------

                                 2015 SANOFI US
    ------------------------------------------------------------------------
          Legal Name                 Project Title            Payment Amount
    ------------------------------------------------------------------------
    A R M S Inc.            Homecoming & Project Little            $5,000.00
                             Soldier

    Academy of Managed      Improving patient outcomes and        $45,000.00
     Care Pharmacy           management of hyperlipidem

    ACS Organic Chemistry   Graduate Research Symposium            $1,000.00
     Division

    AHIP Foundation         Executive Leadership Program          $55,000.00

    Alabama Kidney          2015 Huntsville Kidney Walk            $1,000.00
     Foundation

    Alabama Kidney          2015 Birmingham Kidney Walk            $1,000.00
     Foundation

    Alabama Kidney          Dothan Kidney Walk                     $1,000.00
     Foundation

    Albany American         Saratoga Springs Tour de Cure          $5,000.00
     Diabetes Association

    ALL IN TOGETHER         All in Together Campaign:             $37,500.00
     CAMPAIGN INC.           Advancing and Empowering Women

    Allergy & Asthma        US Anaphylaxis Summit                 $30,000.00
     Network Mothers of
     Asthmatics

    Allergy & Asthma        AAP Anaphylaxis Champions            $100,000.00
     Network Mothers of      Program
     Asthmatics

    Allergy & Asthma        Allergy & Asthma Day Capitol          $50,000.00
     Network Mothers of      Hill 2015
     Asthmatics

    Alliance For A          Alliance for a Healthier              $25,000.00
     Healthier Generation    Generation
     Inc.

    Alliance for Aging      2015 Aging in Motion Coalition        $15,000.00
     Research

    Amerian Diabetes        American Diabetes Association          $2,500.00
     Association             Diabetes Health and Wellness
                             Expo

    American Academy of     American Academy of Pediatrics        $35,000.00
     Pediatrics-Key Cards    Key Card Sponsorship

    AMERICAN ASSOCIATION    2015 AACR Annual Meeting MICR         $10,000.00
     FOR CANCER RESEARCH     Networking and Resource Center

    AMERICAN ASSOCIATION    2015 AACR Network Hubs                $25,000.00
     FOR CANCER RESEARCH     Sponsorship

    American Cancer         ACS CAN Seattle Research               $2,500.00
     Society                 Breakfast and ACS CAN advocacy
                             activities

    American Cancer         ACS CAN CA Research Events and         $5,000.00
     Society                 ACS CAN advocacy activities

    American Cancer         ACS CAN's advocacy activities          $1,500.00
     Society                 in Arkansas and nationwide

    American Cancer         ACS CAN Virginia Research              $1,000.00
     Society                 Breakfast and advocacy
                             activities

    American Cancer         ACS CAN's advocacy activities          $1,000.00
     Society                 in Louisiana and nationwide

    American Cancer         ACS CAN Mississippi Health             $1,000.00
     Society                 Forum and ACS CAN advocacy
                             activities

    American Cancer         ACS CAN Iowa Research Event and        $2,000.00
     Society                 ACS CAN advocacy activities

    American Cancer         2015 Minnesota Policy Breakfast        $1,000.00
     Society                 and ACS CAN advocacy
                             activities

    American Cancer         2015 Oklahoma Policy Forums              $750.00
     Society

    American Cancer         2015 Pennsylvania Advocacy             $1,000.00
     Society                 Event

    American Cancer         2015 Maryland Advocacy                 $1,000.00
     Society                 Breakfast

    American Cancer         Gemson Awards                          $2,500.00
     Society

    American Cancer         Nationwide Hope Lodge                 $25,000.00
     Society Inc.            Partnership

    American Chemical       Division of Medicinal Chemistry        $2,500.00
     Society Division of     Program 250th ACS national me
     Medicinal Chemistry

    American College of     American College of Allergy,          $53,000.00
     Allergy, Asthma &       Asthma & Immunology FIT Bowl
     Immunology-FIT Bowl

    American College of     2015 Patient Engagement               $25,000.00
     Cardiology              Pavilion

    American College of     Sanofi/Regeneron Meeting              $10,412.60
     Cardiology

    American College of     Moving to the Quadruple Aim:         $280,369.00
     Physicians, Inc.        ACP Quality Connect: Diabetes

    American Diabetes       Step Out: Walk to Stop Diabetes        $5,000.00
     Assocation

    American Diabetes       Central Iowa Tour de Cure              $5,000.00
     Association

    American Diabetes       Tour de Cure Southeast                 $1,500.00
     Association             Wisconsin (Grafton)

    American Diabetes       Tour de Cure Madison                   $1,500.00
     Association

    American Diabetes       2015 American Diabetes                 $2,000.00
     Association             Association--WI Gala

    American Diabetes       Father of the Year/Camp Sugar          $2,000.00
     Association             Falls

    American Diabetes       Father of the Year Awards              $5,000.00
     Association

    American Diabetes       Stop Diabetes Through Advocacy         $2,000.00
     Association             Workshop

    American Diabetes       Boston Step Out Walk to STOP           $5,000.00
     Association             Diabetes

    American Diabetes       Central MA Step Out Walk to            $5,000.00
     Association             STOP Diabetes

    American Diabetes       2015 Kiss a Pig Gala                   $2,500.00
     Association

    American Diabetes       2015 Rochester Tour de Cure            $2,500.00
     Association

    American Diabetes       Step Out: Walk to Stop Diabetes        $5,000.00
     Association

    American Diabetes       Portland Father of the Year            $2,500.00
     Association             Awards Dinner

    American Diabetes       Jim Hansen, MD Memorial                $3,500.00
     Association             Symposium Series

    American Diabetes       St. Louis Tour de Cure                   $500.00
     Association

    American Diabetes       Diabetes Awareness and                $50,000.00
     Association             Intervention--via Step Out:
                             Walk to St

    American Diabetes       2015 World Diabetes Day                $5,000.00
     Association

    American Diabetes       75th Anniversary & Awards             $50,000.00
     Association             Celebration

    American Diabetes       Step Out Walk to STOP Diabetes         $2,500.00
     Association

    American Diabetes       American Diabetes Expo--Exhibit/      $57,000.00
     Association Expo-       Speaker/Booth Signage/Program
     Exhibit/Speaker/
     BoothSignage/Program

    AMERICAN DIABETES       Diabetes Hospitality Days: Stop       $75,000.00
     ASSOCIATION INC.        Diabetes In Boston

    AMERICAN DIABETES       2015 Pathways to Stop Diabetes     $2,500,000.00
     ASSOCIATION INC.

    AMERICAN DIABETES       Step Out: Walk to Stop Diabetes        $5,000.00
     ASSOCIATION INC.

    AMERICAN DIABETES       Step Out: Walk to Stop Diabetes        $2,500.00
     ASSOCIATION INC.

    AMERICAN DIABETES       Father of the Year Awards Gala         $5,000.00
     ASSOCIATION INC.

    American Diabetes       2015 Tour de Cure                      $5,000.00
     Association, Indiana
     Indiana

    American Diabetes       ADA Indiana's Josiah Kirby            $15,000.00
     Association, Indiana    Lilly Sr. Distinguished
                             Service Award

    American Diabetes       Father of the Year Gala                $5,000.00
     Associaton

    American Heart          AMERICAN HEART ASSOCIATION--          $75,000.00
     Association             MOBILE APP

    American Heart          2015 Walking Challenge               $100,000.00
     Association

    American Heart          American Heart Association            $50,000.00
     Association             Advertising Space (Key Cards)

    American Heart          2015 Heart Innovation Forum           $15,000.00
     Association

    American National Red   2015-2016 General Blood               $25,000.00
     Cross                   Services Support and High
                             School Sc

    American Pharmacists    Emerging Insulins                     $79,000.00
     Association

    American Society for    Second Regional Bone Marrow           $12,700.00
     Blood and Marrow        Transplant conference for
     Transplantation         Nurses

    American Society of     2015 ASN Abstract CD                  $80,000.00
     Nephrology              Sponsorship

    American Society of     2015 Sponsorship Opportunities        $50,000.00
     Transplantation

    Americares Foundation   US Disaster Assistance                $10,000.00
     Inc.

    America's Health        CMO Roundtable                        $45,000.00
     Insurance Plans

    APhA Foundation         Primary Care and Patient             $249,550.00
                             Empowerment through Diabetes
                             Patie

    Arizona Diabetes        Diabetes: A Prescription for           $5,000.00
     Foundation              Care

    Arrow Lake Foundation   Arrow Lake Foundation                 $50,000.00
                             Activities Plan

    Arthritis Foundation    Research Update Events                $10,000.00
     Northeast Region,
     Inc.

    Arthritis Foundation    Advocacy Program and Advocacy         $15,000.00
     Northeast Region,       Training Series
     Inc.

    Association for         IQ/AAALAC International Global         $5,000.00
     Assessment and          3Rs Awards
     Accreditation of
     Laboratory Animal Ca

    Association of          32 National Oncology Conference       $50,000.00
     Community Cancer
     Centers

    Association of          2015 Membership Dues                   $6,250.00
     Corporate
     Contributions
     Professionals

    Asthma & Allergy        Advocacy Day                           $1,000.00
     Foundation of
     America, St. Louis
     Chapter

    Asthma & Allergy        Allertrain Master Trainer              $1,500.00
     Foundation of           Program
     America, St. Louis
     Chapter

    Asthma and Allergy      2015 KFA Anaphylaxis Patient          $33,000.00
     Foundation of America   Education

    Asthma and Allergy      2015 Anaphylaxis Awareness           $250,000.00
     Foundation of America   Campaign

    ASTS Foundation         ASTS Program Support                  $75,000.00

    Autoimmune Advocacy     Living with Autoimmunity--3            $2,500.00
     Alliance                separate events

    Bay Area Association    Help! I Just Learned I have            $1,200.00
     of Kidney Patients      Chronic Kidney Disease! What
                             do I do?

    Bay Area Bioscience     CALBIO 2015                           $10,000.00
     Association

    Baylor Health Care      STEEEP Academy Lectureship           $135,000.00
     System Foundation       Series

    Be The Match            Quick Reference Guidelines--          $90,000.00
     Foundation              Transplant Consultation and
                             Post-Transplant

    BHCAG FOUNDATION        MNBTE Recognition Event                $5,000.00

    Bill, Hillary, and      Program Support--CHMI                $100,000.00
     Chelsea Clinton
     Foundation

    Bill, Hilary, and       National Health Transformation        $50,000.00
     Chelsea Clinton
     Foundation

    Biocom                  Global Life Science Partnering        $10,000.00
                             Conference

    BIONJ INC.              Bio NJ Sponsorship event              $10,000.00

    BIONJ INC.              BIONJ INC. BioPartnering               $3,000.00

    BIONJ INC.              CEO Summit                             $7,500.00

    Blood and Marrow        Survivorship Symposium Pre-Plan        $5,000.00
     Transplant
     Information Network

    Blood and Marrow        Ask the Multiple Myeloma Expert        $7,500.00
     Transplant
     Information Network

    Blood and Marrow        Transplant 101: An introduction        $7,500.00
     Transplant              to hematopoietic cell
     Information Network     transplant

    Blood and Marrow        Caregiver 101: The Role of             $7,500.00
     Transplant              Caregiver in Support of Bone
     Information Network     Marrow

    Blood and Marrow        Enhancing the Power of Peer            $7,500.00
     Transplant              Support
     Information Network

    Blood and Marrow        BMT InfoNet Web Site Redesign--       $75,000.00
     Transplant              Phase 1
     Information Network

    Bringing Hope Home      General Operating Support             $10,000.00
     Inc.

    Buffalo American        Buffalo Niagara Tour de Cure           $5,000.00
     Diabetes Association

    Cambridgeport           2015 Summer Programs at                $5,000.00
     Neighborhood            Magazine Beach Park
     Association, Inc.

    Camp Nejeda Foundation  Helping Children with type 1          $20,000.00
                             diabetes live happier,
                             healthier lives

    Cancer Resource         Boston Prostate Cancer Walk Run        $5,000.00
     Foundation

    Cancer Support          Celebration of Hope: A Free,           $5,000.00
     Community Greater       Full-Day, Educational and
     Philadelphia            Inspirational

    Cardio Renal Society    Path to Wellness National Pilot      $100,000.00
     of America

    Center for Healthcare   Diversity, Inclusion, & Life           $9,500.00
     Innovation              Sciences Symposium

    Central New Jersey      Leaders of Tomorrow (LOT)             $10,000.00
     Chapter Of The          Program
     National Black Mba
     Association

    CEO Roundtable On       Project Data Sphere initiative     $1,000,000.00
     Cancer, Inc.

    Chicago Hispanic        Vive tu Vida/Get Up! Get               $1,000.00
     Health Coalition        Moving! Health and Wellness
                             Fair

    Children with Diabetes  Platinum Sponsorship--Children        $75,000.00
                             With Diabetes--Friends for
                             Life

    Children with Diabetes  Gold Level sponsorship of the        $100,000.00
                             Children with Diabetes Friends
                             for Life

    Childrens Inn At NIH    Sanofi US Legacy Endowment Fund    $1,000,000.00
     Inc.                    at The Children's Inn at NIH

    Children's Medical      Food Allergy Camp                      $5,000.00
     Center Foundation

    Chordoma Foundation     New York Regional Chordoma             $2,500.00
                             Community Conference

    Chris4Life Colon        5th Annual Blue Hope Bash              $3,000.00
     Cancer Foundation

    Christ the King Prep    Corporate Work Study Program          $57,000.00

    Cleveland Clinic        Advances in Organ                    $134,276.00
                             Transplantation--Annual
                             Fellows Conference

    CNY American Diabetes   2015 CNY Tour de Cure                  $4,000.00
     Association

    Coastal Area Health     Community Health Worker Core          $25,000.00
     Education Center Inc.   Consensus (C3) Project

    Colon Cancer Alliance   Blue Star Concert                      $1,000.00

    Committee Encouraging   2015 Membership Dues                  $15,000.00
     Corporate
     Philanthropy

    Community Oncology      2015 Community Oncology Payer         $25,000.00
     Alliance                Exchange Summit III Oncology

    Conquer Cancer Fdn Of   Conquer Cancer Foundation             $50,000.00
     The American Society    General Mission Support
     Of Clinical Oncology

    Council on Foundations  2015 Membership Dues                  $15,000.00

    CT Coalition for Organ  Premier Charity of the Hartford        $1,500.00
     and Tissue Donation,    Marathon
     dba, Donate Life
     Connect

    Dallas Fort Worth       DFWBGH 11th Annual Benefits            $5,000.00
     Business Group on       Forum
     Health

    DaVita Village Trust    2015 Tour DaVita                       $2,500.00

    Deirdre O Brien Child   Clinical Counseling Program           $10,000.00
     Advocacy Center Inc.

    Diabetes Care and       DCE NewsFlash and 2 e-Blasts          $21,500.00
     Education with the
     Academy of Nutrition
     and Diete

    Diabetes Education and  2015 Industry Partners Advisory       $15,000.00
     Camping Association     Council (IPAC)

    Diabetes Foundation     Dancing for Diabetes Awards           $10,000.00
     Inc.                    Dinner

    Diabetes Hands          Online Community for People           $12,500.00
     Foundation              with Diabetes

    Diabetes Hands          DHF--Hero Sponsorship                 $25,000.00
     Foundation

    DiabetesSisters         2015 DiabetesSisters' PODS            $20,000.00
                             Meetup Program

    Diplomacy Matters       Spotlighting Humanitarian              $2,500.00
     Institute               Innovation & Patents for
                             Humanity

    Direct Relief           Auvi-Q epinephrine injections        $75,000.00
                             for students throughout
                             California

    Direct Relief           U.S. Hurricane/All Hazards            $10,000.00
                             preparedness Program

    Employers Health        Employer Health 2015 Annual            $6,500.00
     Coalition, Inc.         Symposium

    Epilepsy Foundation of  Parent Advocacy toolkit                $8,000.00
     NC

    Federal Circuit Bar     Global Series: 2015 Shanghai          $10,000.00
     Association             Conference
     Charitable and
     Educational Fund

    Federation of Clinical  FOCIS 2015 Annual Meeting             $14,500.00
     Immunology Societies

    Fight Colorectal        Patient Resource Guide for             $5,000.00
     Cancer                  Stage III and IV

    Finger Lakes American   2015 Finger Lakes Tour de Cure         $4,000.00
     Diabetes Association

    Florida Health Care     Seeking Value in Cancer Care           $5,000.00
     Coalition

    Florida Health Care     Health Care Purchasers as              $7,500.00
     Coalition               Consumers: Smart Shopping for
                             Health Care

    Food Allergy &          FAACT Education Programs             $150,000.00
     Anaphylaxis
     Connection Team

    Food Allergy Research   FARE National Food Allergy            $25,000.00
     Education               Conference

    Food Allergy Research   FARE Teen Summit                      $25,000.00
     Education

    Food Allergy Research   THE FOOD ALLERGY BALL                 $25,000.00
     Education

    Food Allergy Research   FAREWalk for Food Allergies          $200,000.00
     Education

    Food Bank of Somerset   Back Pack Program                      $5,000.00
     County Inc.

    Foundation for          FBR Educational Programs--Bench       $10,000.00
     Biomedical Research     to Bedside, Social Ambassadors

    Foundation For Prader   Multiple Projects                      $1,000.00
     Willi Research

    Fundacion Centro        Diabetes Summer Camp 2015             $10,000.00
     Pediatrico de
     Diabetes

    Fundacion Centro        XIV Gala                               $3,500.00
     Pediatrico de
     Diabetes

    Fundacion Centro        8th World Diabetes Month               $5,000.00
     Pediatrico de           Celebration
     Diabetes

    Garden State Equality   Teach and Affirm Students in           $2,500.00
     Education Fund Inc.     New Jersey

    Global Healthy Living   Managed Care Organization             $24,000.00
     Foundation              Education (Overview)

    Gordon Research         Gordon Research Atherosclerosis       $20,000.00
     Conference              Meeting

    Governors Books From    Tennessee's Imagination Library        $2,500.00
     Birth Foundation        Program

    Greater New England     Economic Development                   $4,000.00
     Minority Supplier
     Development Council

    Health Action Council   Annual Conference                      $4,200.00

    Healthcare              Woman of the Year                     $18,150.00
     Businesswomen's
     Association

    HEART OF FLORIDA        SP 2014 United Way Campaign            $2,269.50
     UNITED WAY              Payout

    Heart To Heart          US Crisis Readiness & Response        $10,000.00
     International Inc.

    Idaho Immunization      Immunization Summit                    $2,000.00
     Coalition

    Illinois Diabetes       Illinois Diabetes Caucus               $3,500.00
     Caucus Foundation       Foundation

    Illinois                Business Day & Annual Lunch            $1,000.00
     Manufacturers'          Sponsorships
     Association

    International Chinese   2015 International Chinese             $2,000.00
     Statistical             Statistical Association (ICSA)/
     Association             Graybi

    International Eczema    International Eczema Council         $100,000.00
     Council

    International Isotope   Sponsorship of 12th                    $3,250.00
     Society, Inc.           International Symposium on the
                             Synthesis

    International Myeloma   9th Annual Comedy Celebration          $5,000.00
     Foundation              benefiting the Peter Boyle
                             Research Fund

    International Myeloma   6th Annual International              $35,000.00
     Foundation              Myeloma Working Group Summit

    International Myeloma   Patient Programs 2015                $100,000.00
     Foundation

    International Society   RSG DREAM Conference                  $10,000.00
     for Computational
     Biology

    International Society   25th ISHC Congress                     $1,000.00
     of Heterocyclic
     Chemistry

    International Society   ACoP6                                  $5,000.00
     of Pharmacometrics

    JDRF                    Imagine Gala                         $100,000.00

    JDRF                    JDRF One Walk Philadelphia and         $2,500.00
                             Bucks County

    JDRF                    JDRF One Walk                          $7,500.00

    JDRF                    JDRF Central AR One Walk               $2,500.00

    JDRF--Eastern PA        JDRF One Walk Moosic, Poconos,         $2,500.00
     Chapter                 Lehigh Valley and Berks County

    JDRF Greater Dallas     JDRF One Walk, Dallas                  $2,500.00

    JDRF International      JDRF One Walk Boston 2015             $10,000.00

    JDRF International      JDRF OneWalk                           $5,000.00

    JDRF International      JDRF Research Updates                  $2,000.00

    Jefferson University    Quality and Safety Leadership        $100,000.00
     (School of Population   Series
     Health)

    Jefferson University    Supporting Patient Access to          $79,700.00
     (School of Population   Diabetes Care: Follow-on to
     Health)                 Janua

    Jersey Battered Womens  Vocational Development Program         $5,000.00
     Service

    Joslin Diabetes         A Taste of Ginger                     $25,000.00
     Center, Inc.

    Joslin Diabetes         National Diabetes Month/High          $50,000.00
     Center, Inc.            Hopes Gala

    Juvenile Diabetes       Rock the Cure                          $1,000.00
     Research Foundation

    Kean University         2015 Group Summer Scholars            $15,000.00
     Foundation Inc.         Research Program

    Keystone Symposia on    Cancer Immunotherapy: Immunity        $25,000.00
     Molecular and           and Immunosuppression Meds
     Cellular Biology

    Kidney Health Alliance  Share Your Spare 5k for Get              $750.00
     of KY                   Healthy Get Transplanted

    Kids Corporation li     Kids Corp General Operating           $10,000.00

    Lagrant Foundation      Internship Program                    $25,000.00

    Large Urological Group  LUGPA Annual Meeting Gold Level       $85,000.00
     Practice Association    Membership
     LUGPA

    Leukemia & Lymphoma      Man & Woman of the Year               $3,500.00
     Society

    Living Well Cancer      General Operating Support              $2,500.00
     Resource Center

    MA Conference for       MA Conference for Women               $20,000.00
     Women Inc.

    Map International       United States Disaster Relief         $10,000.00

    March of Dimes          Supporting NICU Babies and            $86,000.00
     Foundation              Families

    Maryland Health Care    Specialty Rx Forum                     $7,500.00
     Coalition DBA
     MidAtlantic Business
     Group on Health Care

    Massachusetts           Annual Conference. Payment             $2,000.00
     Association of Health   Reform--Three Years Later
     Plans

    MedStar Washington      MedStar Washington Medical             $3,000.00
     Hospital Center         Center--Current Issues in the
                             Care

    Mended Hearts           Patient Advocacy Network             $100,000.00

    Mended Hearts           2015 Mended Hearts National           $50,000.00
                             Education and Training
                             Conference

    Michigan Biosciences    MichBio Conference Description         $1,500.00
     Industry Association

    Mid Atlantic Lifespan,  Senior Care Providers                  $4,000.00
     Inc.                    Roundtables With Local
                             Hospitals

    Midland Adult Services  Midland Meals on Wheels               $10,000.00
     Inc.                    Employment Training Program

    Migrant Clinicians      Health Champions: Reducing               $500.00
     Network                 Disease to Improve Health

    Milken Institute        The Research Acceleration and         $10,000.00
                             Innovation Network (TRAIN)

    Milken Institute        2015 Milken Institute              $1,000,000.00
                             Conference Sponsorships &
                             Engagement

    Minnesota Society of    MSHP Corporate Sponsorship             $6,000.00
     Health-System
     Pharmacists

    MIT                     13th US-Japan Symposium on Drug        $7,000.00
                             Delivery Systems

    MIT                     14th Annual Koch Institute             $5,000.00
                             Summer Symposium ``CANCER
                             COMMITTEE''

    MIT $100K Competition   MIT $100K Competition                 $25,000.00

    Multiple Myeloma        Advances in Minimal Residual          $25,000.00
     Research Foundation     Disease Testing in Myeloma

    Multiple Myeloma        Advances in Minimal Residual          $25,000.00
     Research Foundation     Disease Testing in Myeloma

    NATIONAL ACADEMY OF     Forum on Drug Discovery,              $85,000.00
     SCIENCES                Development and Translation

    National Alliance of    11th Annual Meeting                    $5,000.00
     State Prostate Cancer
     Coalitions

    National Arbor Day      Chippewa National Forest tree          $4,138.00
     Foundation              planting

    National Association    Childhood Obesity                     $10,000.00
     for the Advancement
     of Colored People

    National Committee for  NCQA's 25th Anniversary               $10,000.00
     Quality Assurance
     (``NCQA'')

    National Consumers      Health Policies for Better             $5,000.00
     League                  Outcomes and Balanced Budgets

    National Eczema         The Decade of Eczema: Roadmap        $200,000.00
     Association             to Advocacy

    National Forum for      13th Annual Meeting of the            $25,000.00
     Heart Disease and       National Forum for Heart
     Stroke Prevention       Disease and Stoke Prevention
     Inc.

    National Foundation     TB Trials Consortium                 $671,292.00
     For The Ctrs For
     Disease Contr &
     Prevention Inc.

    National Health         Voluntary Health Leadership           $20,000.00
     Council                 Conference

    National Health         Policy Development Fund               $70,000.00
     Council

    National Kidney         Patient Empowerment Workshop           $2,000.00
     Foundation

    National Kidney         Kansas City Kidney Walk                $1,000.00
     Foundation

    National Kidney         Wichita Kidney Walk                      $250.00
     Foundation

    National Kidney         2015 Boston Kidney Walk               $15,000.00
     Foundation

    National Kidney         Champion of Hope Tribute Dinner        $1,000.00
     Foundation of
     Michigan

    National Kidney         Gift of Life Gala                      $1,500.00
     Foundation of West
     Tennessee

    National Kidney         NKF of West Tennessee Wolf Mash          $250.00
     Foundation of West      Dash 5K
     Tennessee

    National Kidney         2015 New York City Kidney Walk        $25,000.00
     Foundation, Inc.

    National Kidney         NKF Cares 2015                        $25,000.00
     Foundation, Inc.

    National Kidney         NKF Peers 2015                        $25,000.00
     Foundation, Inc.

    National Kidney         Eight Annual Mid-Atlantic First        $5,000.00
     Foundation, Inc.        Year Renal Fellowship
                             Symposium

    National Kidney         7th Annual Central New Jersey          $1,000.00
     Foundation, Inc.        Kidney Walk

    National Kidney         Philadelphia Kidney Walk                 $500.00
     Foundation, Inc.

    National Kidney         Chester County Kidney Walk               $500.00
     Foundation, Inc.

    National Kidney         Wilmington Kidney Walk                   $500.00
     Foundation, Inc.

    National Kidney         Pittsburgh Kidney Walk                   $500.00
     Foundation, Inc.

    National Kidney         Northeast Ohio Kidney Walk             $1,000.00
     Foundation, Inc.
     Serving Ohio

    National Kidney         2015 Patient Symposium                 $1,000.00
     Foundation, Inc.
     Serving Ohio

    National Patient        NPAF Policy Consortium                $20,000.00
     Advocate Foundation

    National Press          Training Journalists on               $40,000.00
     Foundation              Advances in Biologics and
                             Biosimilars

    National TB             2015 National TB Conference:             $500.00
     Controllers             Sponsorship Request
     Association

    National Transitions    National Transition of Care          $250,000.00
     of Care Coalition       Coalition

    NBCH                    Hypoglycemia Action Brief             $17,500.00

    NBCH                    Annual Conference                      $3,500.00

    NBCH                    ASCVD Action Brief                    $17,500.00

    NCOMS                   NC Oncology Management Society         $5,000.00

    NEHI                    New Policy: Better Use of             $25,000.00
                             Medicines in Diabetes

    Neuropathy Action       9th Annual ``Neuropathy Action         $2,500.00
     Foundation              Awareness Day''

     New Jersey Hall of     Mobile Museum                          $2,500.00
     Fame

    New Jersey Public       NJPHA Sponsorship                      $5,000.00
     Health Association

    New York Stem Cell      NYSCF 10th Annual Translational        $2,000.00
     Foundation, Inc.        Stem Cell Research Conference

    NJ SEEDS                College Scholars Program              $10,000.00

    North Coast Health      Celebration of Caring                  $2,500.00

    Northeast Business      eValue8 - Health Plan                  $9,000.00
     Group on Health         Performance Review

    Northeast Business      Specialty Pharmacy Conference          $5,000.00
     Group on Health

    Northeastern Section    German Exchange Program                $2,000.00
     of the American
     Chemical Society

    NSHMBA Foundation       NSHMBA New Jersey Annual               $5,000.00
                             Partnership

    Oklahoma Center for     The transformation of                  $3,500.00
     Healthcare              Healthcare
     Improvement

    Opportunity Through     Arizona Pavilion at BIO 2015           $1,000.00
     Entrepreneurship
     Foundation

    Organization for        OFII Annual Dinner                    $15,000.00
     International
     Investment

    Partnership For         2016 Membership Dues                  $19,000.00
     Quality Medical
     Donations

    Patient Advocate        Prostate and CRC Co-Pay Relief       $550,000.00
     Foundation              Fund

    PATIENT EMPOWERMENT     The Latest News on Advanced           $20,000.00
     NETWORK                 Prostate Cancer Research and
                             Treatment

    PCMA                    2015 sPCMA Business Forum             $60,000.00
                             Sponsorship

    PCMA                    2015 Annual Meeting                   $75,000.00
                             Presidential Sponsorship

    Pediatric Cancer        NHL 2015 Pediatric Sponsorship        $10,000.00
     Research Foundation

    Pennsylvania            CBO Dinner                             $5,000.00
     Biotechnology
     Association

    Perimeter Bicycling     2015 El Tour de Tucson                $15,000.00
     Association of
     America, Inc.

    Pharmaceutical          PhRMA Foundation Grants and          $100,000.00
     Research and            Fellowships
     Manufacturers of
     America Foundation

    Premier Cares           Premier Cares Foundation               $1,500.00
     Foundation              Prostate Cancer Walk

    Preventive              Cholesterol Patient Education        $100,000.00
     Cardiovascular Nurses
     Association

    PRIDE                   PRIDE Conference                       $6,000.00

    Project Hope The        Responding to the Nepal               $10,000.00
     People To People        Earthquake
     Health Foundation
     Inc.

    Prostate Cancer         22nd Annual Scientific Retreat       $300,000.00
     Foundation

    Raritan Valley          Galileo Scholarships: Providing       $17,500.00
     Community College       Access to STEM Education
     Foundation

    Raritan Valley          Preparing for the Next                $10,000.00
     Community College       Generation Science Standards
     Foundation

    Regents of the          V-BID Summit 2015: A Decade of        $40,000.00
     University of           Transforming the Health Care
     Michigan

    Renal Support Network   KidneyTalk Podcast                     $1,000.00

    Renal Support Network   Live & Give Newsletter                 $1,500.00

    Renal Support Network   CKD Patient Education Meetin           $1,500.00

    Renal Support Network   13th Annual Patient Essay              $1,000.00
                             Contest

    Resource Center of      Transitional Housing Program           $5,000.00
     Somerset Inc.

    Rutgers University      Vets 4 Warriors                       $10,000.00
     Foundation

    RVCC Foundation         STEM Education: Equity Issues         $10,000.00
                             and Workforce Pipeline

    RVCC Foundation         College Campus Experience Day          $3,000.00
                             for STEM High School Students

    Sage Bionetworks         2015 Paris Assembly                  $15,000.00

    Sanofi US Matching      Sanofi US Matching Gifts--Q2         $277,628.31
     Gifts--2015             2015

    Sanofi US Matching      Sanofi US Matching Gifts--Q1         $427,531.29
     Gifts--2015             2015

    SARSEF-SOUTHERN         The Future of Biomedical               $5,000.00
     ARIZONA RESEARCH        Research
     SCIENCE AND
     ENGINEERING

    Scripps Translational   The Future of Genomic Medicine        $10,000.00
     Science Institute       VIII

    Society of Toxicologic  2015 ACVP/ASVCP/STP Combined           $2,500.00
     Pathology               Annual Meeting

    Society of Toxicology   Society of Toxicology Annual          $10,000.00
                             Meeting

    Somerset County         SCBP 2015 program of work             $20,000.00
     Business Partnership

    Somerset Medical        Fun 'N Fit                            $25,000.00
     Center Foundation
     Inc.

    Somerset Medical        EMS Program                            $5,000.00
     Center Foundation
     Inc.

    Somerset Medical        El Poder Sobre La Diabetes            $10,000.00
     Center Foundation
     Inc.

    South Dakota Diabetes   Virtual Nurse Model: School            $5,100.00
     Coalition               Project

     St. Louis Children's   Food Allergy Management and           $75,000.00
     Hospital Foundation     Education

    Stop Hunger Now Inc.    Stop Hunger Now Program               $10,000.00
                             Expansion to New York City
                             Metro

    Stowe Weekend of Hope   Stowe Weekend of Hope                  $5,000.00

    T. Leroy Jefferson      2015 Community Health Fair             $2,500.00
     Medical Society

    Taking Control of Your  The 9th Annual Diabetes Forum         $10,000.00
     Diabetes

    Tennessee Kidney        2015 Gift of Life Walk/5K              $2,000.00
     Foundation

    Tennessee Kidney        Spring Soiree 2015                     $2,500.00
     Foundation

    Teratology Society      Teratology Society 55th Annual         $1,500.00
                             Meeting

    The American            Major Symposia--Roots and             $10,000.00
     Association of          Mechanisms of Human Autoimmun
     Immunologists, Inc.

    The American College    ACVP/ASVCP/STP Combined Annual         $6,000.00
     of Veterinary           Meeting
     Pathologists

    The American Fallen     Portrait Sponsorship                  $25,000.00
     Soldiers Project Inc.

    The American Kidney     A Pairing for Prevention 2015          $5,000.00
     Fund, Inc.

    The American Kidney     The Hope Affair 2015                  $50,000.00
     Fund, Inc.

    The American Kidney     9th Annual New York Spring             $1,500.00
     Fund, Inc.              Event

    The Bus Stops Here      Hall Of Fame Induction for            $35,000.00
     Foundation              Jerome Bettis

    The Center For Great    Adult Women's Program                 $10,000.00
     Expectations Inc.

    The Childrens Health    Medical Home Initiative              $665,000.00
     Fund

    The Cleveland Clinic    A Celebration of Survivorship          $5,000.00
     Foundation-BMT          An Educational Symposium for
     Cleveland Clinic        BM
     Sponsorship

    The Council of State    Bowhay Institute for                   $5,000.00
     Government, Ltd.        Legislative Leadership
                             Development

    The Diabetes Coalition  Giving Diabetes the Blues              $2,500.00
     of Mississippi/
     Mississippi Rural
     Health Association

    The FH Foundation       CASCADE FH Registry                  $500,000.00

    The Flood Sisters       7th Annual Love.Give.Life.             $2,000.00
     Kidney Foundation of    Fashion Show/Gala
     America

    The Friends of Matheny  Matheny Center of Medicine and         $5,000.00
                             Dentistry

    The Life Raft Group     Research Team Meeting                  $5,000.00

    The Salvation Army      Healthy Food Pantry Program            $5,000.00

    The University of       First Annual Immuno-Oncology in       $25,000.00
     Texas Foundation,       Myeloma 2015 Workshop
     Inc.

    Trustees of Boston      Boston University's 15th Annual        $1,500.00
     University              CMD Symposium on Molecular
                             Discovery

    Trustees of the         Research Training in                  $20,000.00
     University of           Pharmacoepidemiology
     Pennsylvania

    Tufts Medical Center    CEVR Database Subscription            $35,000.00

    TULANE CANCER CENTER    NOLA Bluedoo Party/Walk/Run            $1,000.00

    Tuskegee Human And      Donation for Public Education          $5,000.00
     Civil Rights
     Multicultural Center

    UCSF Cancer Center (c/  2015 HDFCCC Symposium:                 $5,000.00
     o UCSF Foundation)      Breakthroughs in Cancer
                             Immunotherapy

    United Network for      Transplant Living Program             $25,000.00
     Organ Sharing

    United States Soccer    Soccer for Success--Paterson,         $10,000.00
     Federation Foundation   NJ
     Inc.

    United Way of Greater   Merial--Duluth 2014 United Way        $23,984.25
     Atlanta                 Campaign

    United Way of Hall      2014 United Way Campaign Match--       $2,841.50
     County Inc.             Merial Select

    United Way of           SP 2014 United Way Campaign            $7,221.00
     Lackawanna and Wayne    Payout
     Counties

    United Way of           Sanofi Pasteur 2014 United Way           $521.00
     Massachusetts Bay       Campaign Payout
     Inc.

    United Way of Monroe    SP 2014 United Way Campaign           $56,881.53
     County                  Match

    United Way of           2014 United Way Campaign--             $5,000.00
     Northeast Georgia       Merial Athens

    United Way of Northern  Caregivers Coalition                 $100,000.00
     New Jersey

    Unitio Inc.             T1D Education Event Series            $45,000.00

    Univeristy of Arizona    Alternative Muscle Club               $2,700.00
     Foundation for the      meeting
     benefit of Univeristy
     of Arizona

    University of Arizona   Support for the Undergraduate          $3,000.00
     Foundation              Biology Research Program
                             Conference

    University of Arizona   Applied Biosciences GIDP Merit         $5,000.00
     Foundation              Scholarship

    University of Arizona   Keep Engaging Youth in Science         $6,400.00
     Foundation              (KEYS) High School Summer
                             Internships

    University of           UCSF Diabetes Center 15th              $5,000.00
     California, San         Anniversary Symposium
     Francsico Foundation

    University of Florida   New Developments in Clinical           $1,000.00
     Foundation, Inc.        Pharmacy and Clinical
                             Pharmacology

    UNIVERSITY OF MARYLAND  M-Cersi Conference on Patient         $10,000.00
     BALTIMORE FOUNDATION    Focused Drug Development
     INC.

    University of North     Pharmacoepidemiology Program          $20,000.00
     Carolina at Chapel      Donation
     Hill

    University of Southern  USC/UCLA/UCSF Tri-Institutional        $3,000.00
     California              Retreat

    University of Southern  National Unity 2015 Conference:        $5,000.00
     Mississippi             Community Health Workers
     Foundation

    US China Health Summit  5th US-China Health Summit at         $70,000.00
     Inc.                    Harvard University

    Us TOO International    Us TOO 25th Anniversary               $10,000.00
                             Educational Symposium & Gala
                             Celebration

    Vision y Compromiso     13th Annual Promotoras and            $10,000.00
                             Community Health Workers
                             Conference

    Washington Legal        2015 General Operating Support        $25,000.00
     Foundation

    Washington Policy       WPC's 2015 Annual Dinner               $3,500.00
     Center

    Wellness Community of   School-Based Support Groups           $15,000.00
     Central New Jersey

    Winter Urologic Forum   Winter Urologic Forum (WUF)           $15,000.00
     (WUF)                   Symposia Timeslot

    WomenHeart: The         WomenHeart Science & Leadership       $50,000.00
     National Coalition      Symposium
     for Women with Heart
     Disease

    WomenHeart: The         National Science & Policy             $25,000.00
     National Coalition      Summit on Women's Heart Health
     for Women with Heart
     Disease

    Women's Venture Fund    Highest Leaf Awards                   $15,000.00

    YMCA of Greater Boston  YMCA's Diabetes Prevention             $5,000.00
                             Program

    ZERO--The End of        ZERO Prostate Cancer Run/Walk          $1,500.00
     Prostate Cancer         Delaware
    ------------------------------------------------------------------------

                        Payments made by Sanofi US (2016)
    ------------------------------------------------------------------------
          Legal Name         Payment Amount           Project Title
    ------------------------------------------------------------------------
    AMERICAN DIABETES              $48,070   American Diabetes Association
     ASSOCIATION EXPOS                        EXPO
    ------------------------------------------------------------------------
    American Society of            $35,000   AMERICAN ASSOCIATION FOR CANCER
     Transplant Surgeons                      RESEARCH--Networking Hub
    ------------------------------------------------------------------------
    American Society of            $35,000   American Society of Transplant
     Transplant Surgeons                      Surgeons--Bronze Level Support
    ------------------------------------------------------------------------
    Taking Control of Your        $200,000   Taking Control of Your
     Diabetes                                 Diabetes--Gold Sponsorship
    ------------------------------------------------------------------------
    Children with Diabetes         $35,000   2016 Children with Diabetes
                                              (CWD) Sponsorship
    ------------------------------------------------------------------------
    MedStar Washington              $3,000   MedStar Washington Hospital
     Medical Center                           Center--Current Issues in the
                                              Care of Dialysis and
                                              Transplant Patient
    ------------------------------------------------------------------------
    Joslin Diabetes                $25,000   A Taste of Ginger
     Center, Inc.
    ------------------------------------------------------------------------
    Massachusetts General           $5,000   Collaborative Novel-Novel
     Hospital                                 Combination Therapies Workshop
    ------------------------------------------------------------------------
    Greater New England             $7,000   Economic Development
     Minority Supplier
    ------------------------------------------------------------------------
    Healthy Capital                 $2,500   Diabetes Community Resource
     District Initative                       Guide
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Get Moving Challenge
     Association
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Tour de Cure
     Association
    ------------------------------------------------------------------------
    American Diabetes               $2,500   2016 Step Out: Walk to Stop
     Association                              Diabetes
    ------------------------------------------------------------------------
    AMERICAN DIABETES               $2,500   Father of the Year Awards Gala
     ASSOCIATION INC.
    ------------------------------------------------------------------------
    Buffalo American                $2,500   2016 Buffalo Niagara Tour de
     Diabetes Association                     Cure
    ------------------------------------------------------------------------
    CNY American Diabetes           $2,500   2016 Tour de Cure
     Association
    ------------------------------------------------------------------------
    Albany American                 $2,500   Saratoga Springs Tour de Cure
     Diabetes Association
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Tour de Cure Michigan
     Association
    ------------------------------------------------------------------------
    American Diabetes               $2,000   2016 Finger Lakes Tour de Cure
     Association Inc.
    ------------------------------------------------------------------------
    American Diabetes              $10,000   2016 High Risk Community
     Association                              Initiatives for Southwest
                                              Florida
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Charlotte Step Out: Walk to
     Association                              Stop Diabetes
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Tour de Cure Hawaii
     Association
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Step Out: Walk to Stop Diabetes
     Association                              Upstate, SC
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              Boston Step Out Walk to STOP
                                              Diabetes
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              Connecticut Step Out Walk to
                                              STOP Diabetes
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              Central Massachusetts Step Out
                                              Walk to STOP Diabetes
    ------------------------------------------------------------------------
    American Diabetes               $2,500   2016 New Orleans Father of the
     Association                              Year
    ------------------------------------------------------------------------
    American Diabetes               $2,500   2016 Indiana Tour de Cure
     Association, Indiana
    ------------------------------------------------------------------------
    AMERICAN DIABETES              $75,000   Diabetes Hospitality Days: Stop
     ASSOCIATION INC                          Diabetes in New Orleans
    ------------------------------------------------------------------------
    National Kidney                $25,000   NKF Patient Programs 2016
     Foundation, Inc.
    ------------------------------------------------------------------------
    Asthma and Allergy            $100,000   AAFA Patient Education and
     Foundation of America                    Outreach
    ------------------------------------------------------------------------
    Asthma and Allergy             $10,000   KFA Strides for Safe Kids Mall
     Foundation of America                    Walk and Expo
    ------------------------------------------------------------------------
    Asthma and Allergy             $15,000   KFA Patient Education and
     Foundation of America                    Outreach
    ------------------------------------------------------------------------
    Northeast Business             $20,000   eValue8--Health Plan
     Group on Health                          Performance Review
    ------------------------------------------------------------------------
    Food Allergy Research         $100,000   FOOD ALLERGY 101 Online
     Education                                Training Component and School
                                              Action Campaign Grassroots
                                              Advocacy
    ------------------------------------------------------------------------
    American Heart                  $2,000   Peoria Heart and Stroke Ball
     Association |                            and Peoria and Bloomington
     American Stroke                          Heart Walk
     Association
    ------------------------------------------------------------------------
    American Heart                 $15,000   2016 Heart Innovation Forum
     Association
    ------------------------------------------------------------------------
    American Heart                  $2,000   Springfield Heart Ball
     Association |
     American Stroke
     Association
    ------------------------------------------------------------------------
    ATS Foundation Inc             $25,000   Eighth Annual ATS Foundation
                                              Research Program Benefit
    ------------------------------------------------------------------------
    BHCAG FOUNDATION                $2,500   Employer Leadership Summit
    ------------------------------------------------------------------------
    National Alliance of            $5,000   11th Annual Meeting
     State Prostate Cancer
     Coalitions
    ------------------------------------------------------------------------
    New York Stem Cell              $2,000   The NYSCF Conference
     Foundation, Inc.
    ------------------------------------------------------------------------
    Opportunity Through             $1,000   Arizona Pavilion at BIO 2016
     Entrepreneurship
     Foundation
    ------------------------------------------------------------------------
    Somerset Health Care            $1,000   Healthier Somerset
     Foundation
    ------------------------------------------------------------------------
    Diabetes Foundation            $10,000   25th Anniversary Awards Dinner
     Inc.                                     & Talent Competition
    ------------------------------------------------------------------------
    JDRF                            $2,500   One Walk Philadelphia
    ------------------------------------------------------------------------
    JDRF                            $2,500   JDRF One Promise Gala
                                              Allentown--Passport to a Cure
    ------------------------------------------------------------------------
    JDRF                            $2,500   Rockin' Docs for Diabetes Cure
    ------------------------------------------------------------------------
    JDRF                            $2,500   2016 JDRF Poconos One Walk
    ------------------------------------------------------------------------
    JDRF                           $12,000   JDRF One Promise Gala
                                              Philadelphia
    ------------------------------------------------------------------------
    JDRF                            $2,500   2016 JDRF Moosic One Walk
    ------------------------------------------------------------------------
    JDRF                            $2,500   2016 JDRF Reading One Walk
    ------------------------------------------------------------------------
    JDRF                            $2,500   One Walk Newtown
    ------------------------------------------------------------------------
    JDRF                            $2,500   2016 JDRF Lehigh Valley One
                                              Walk
    ------------------------------------------------------------------------
    JDRF                            $2,500   ACE For A Cure
    ------------------------------------------------------------------------
    JDRF Central PA                 $2,500   JDRF One Walk--Lancaster
     Chapter
    ------------------------------------------------------------------------
    JDRF New York City             $15,000   44th Annual Promise Ball
     Chapter
    ------------------------------------------------------------------------
    JDRF International              $2,500   34th Annual Boston Gala
    ------------------------------------------------------------------------
    JDRF INTERNATIONAL             $50,000   2016 TypeOneNation Summits
    ------------------------------------------------------------------------
    JDRF INTERNATIONAL             $50,000   2016 JDRF Government Day
    ------------------------------------------------------------------------
    JDRF Greater Dallas             $2,500   JDRF One Walk, Dallas
    ------------------------------------------------------------------------
    Juvenile Diabetes               $2,500   Rock the Cure
     Research Foundation
    ------------------------------------------------------------------------
    JDRF                           $10,000   JDRF Imagine Gala
    ------------------------------------------------------------------------
    National Comprehensive         $10,000   Emerging Issues in Oncology--An
     Cancer Network                           NCCN Roundtable Discussion
    ------------------------------------------------------------------------
    American Society for            $2,500   ASN Annual Meeting
     Neurochemistry
    ------------------------------------------------------------------------
    American Orthopaedic           $50,000   Early Osteoarthritis/Prevention
     Society for Sports                       of Disease Progression
     Medicine
    ------------------------------------------------------------------------
    Diabetes Foundation of          $2,000   LIVE-A-BETES: Learning To Live
     Mississippi                              Well With Diabetes
    ------------------------------------------------------------------------
    Renal Physicians               $10,000   RPA Kidney Quality Improvement
     Association                              Registry
    ------------------------------------------------------------------------
    New York & New Jersey           $8,000   Annual Sponsorship
     Minority Supplier
     Development Council
    ------------------------------------------------------------------------
    Gordon Research                 $3,000   2016 Gordon Research Conference
     Conference                               (GRC) entitled Autophagy in
                                              Stress, Development, and
                                              Disease: From the basics to
                                              therapeutic targets
    ------------------------------------------------------------------------
    Gordon Research                 $2,000   Drug Carriers in Medicine and
     Conference                               Biology
    ------------------------------------------------------------------------
    Gordon Research                $10,000   Gordon Research Conference
     Conference                               Antibody Biology & Engineering
                                              March 2016
    ------------------------------------------------------------------------
    PATIENT EMPOWERMENT            $20,000   2016 Town Meeting for Advanced
     NETWORK                                  Prostate Cancer Patients
    ------------------------------------------------------------------------
    PATIENT EMPOWERMENT            $25,000   Online Advanced Prostate News
     NETWORK                                  Coverage for Patients
    ------------------------------------------------------------------------
    Bioscience Association          $1,500   WV Bioscience Summit 2016
     of WV
    ------------------------------------------------------------------------
    Arthritis Foundation            $2,000   Sponsorship for Arthritis
                                              Foundation Crystal Ball
    ------------------------------------------------------------------------
    National Transitions          $125,000   NTOCC
     of Care Coalition
    ------------------------------------------------------------------------
    American Medical               $50,000   AMSSM Foundation Research Grant
     Society for Sports                       Awards
     Medicine Foundation,
     Inc.
    ------------------------------------------------------------------------
    Biocom                         $10,000   Global Life Science Partnering
                                              Conference
    ------------------------------------------------------------------------
    Biocom                         $10,000   Global Life Science Partnering
                                              Conference
    ------------------------------------------------------------------------
    Taking Control of Your        $200,000   Taking Control Of Your Diabetes
     Diabetes                                 Conferences and Health Fairs
    ------------------------------------------------------------------------
    Prescription Drug               $1,000   Legislative Reception and
     Assistance Foundation                    Celebration of Access
    ------------------------------------------------------------------------
    The Cleveland Clinic           $95,275   Advances in Organ
     Foundation                               Transplantation--Annual
                                              Fellows Conference
    ------------------------------------------------------------------------
    Employers Health                $6,500   Employer Health 2016 Annual
     Coalition, Inc.                          Symposium
    ------------------------------------------------------------------------
    Respiratory Health                $750   Lung Health Education
     Association
    ------------------------------------------------------------------------
    Us TOO International           $15,000   Prostate Cancer News You Can
                                              Use
    ------------------------------------------------------------------------
    Us TOO International            $5,000   Prostate Cancer Educational
                                              Webinar
    ------------------------------------------------------------------------
    Us TOO International            $5,000   Us TOO Prostate Cancer Business
                                              Leadership Council
    ------------------------------------------------------------------------
    Blood and Marrow               $25,000   Celebrating a Second Chance at
     Transplant                               Life 2016 Survivorship
     Information Network                      Symposium
    ------------------------------------------------------------------------
    Blood and Marrow                $7,500   2016 BMT InfoNet Transplant
     Transplant                               Webinar Series
     Information Network
    ------------------------------------------------------------------------
    PCMA                           $80,000   2016 sPCMA Business Forum
    ------------------------------------------------------------------------
    PCMA                           $95,000   2016 Annual Meeting
                                              Presidential Sponsorship
    ------------------------------------------------------------------------
    Regents of the                 $40,000   V-BID Summit 2016
     University of
     Michigan
    ------------------------------------------------------------------------
    Minnesota Society of            $6,000   MSHP 2016 Corporate Business
     Health-System                            Partnership Program
     Pharmacists
    ------------------------------------------------------------------------
    Be The Match                   $25,000   National Sponsorship for Be The
     Foundation                               Match Walk+Run
    ------------------------------------------------------------------------
    Mid-America Coalition           $5,000   4th Annual Workforce &
     on Health Care                           Community Well-Being Forum
    ------------------------------------------------------------------------
    Global Virus Network,          $10,000   8th International Global Virus
     Inc.                                     Network Meeting
    ------------------------------------------------------------------------
    CrowdCare Foundation,          $10,000   Muscles for Myeloma
     Inc.
    ------------------------------------------------------------------------
    PRIDE                           $6,000   PRIDE Conference
    ------------------------------------------------------------------------
    The diaTribe                  $100,000   d16 Executive Forum
     Foundation
    ------------------------------------------------------------------------
    US China Health Summit         $70,000   5th US-China Health Summit at
     Inc.                                     Harvard University
    ------------------------------------------------------------------------
    Greater Philadelphia            $5,000   GPBCH 2016 Annual Conference
     Business Coalition on
     Health
    ------------------------------------------------------------------------
    Food Allergy &                $100,000   FAACT Education Programs
     Anaphylaxis
     Connection Team
    ------------------------------------------------------------------------
    Deep South Cancer               $5,000   2016 Cycliad Charity Bicycle
     Foundation                               Ride
    ------------------------------------------------------------------------
    California Life                 $2,500   CLSA Life Sciences Academy
     Sciences Association
    ------------------------------------------------------------------------
    Globalization of                $3,500   GPEN2016
     Pharmaceutics
     Education Network,
     Inc.
    ------------------------------------------------------------------------
    American Association           $20,000   Public Policy Forum 2016
     of Diabetes Educators
    ------------------------------------------------------------------------
    Federation of American          $5,000   FASEB conference on Muscle
     Societies for                            Satellite Cells and
     Experimental Biology                     Regeneration
     (FASEB)
    ------------------------------------------------------------------------
    Teratology Society              $1,500   Teratology Society 56th Annual
                                              Meeting
    ------------------------------------------------------------------------
    Biotechnology                 $145,000   BIO International Convention
     Innovation
     Organization
    ------------------------------------------------------------------------
    Biotechnology                  $40,000   BIO Europe Spring and BIO
     Innovation                               Europe International
     Organization                             Partnering Conference
    ------------------------------------------------------------------------
    Maryland Black Caucus           $2,000   Maryland Black Caucus
     Foundation, Inc.                         Foundation, Inc.
    ------------------------------------------------------------------------
    American Cancer                $25,083   2016 ACS CAN Fundraising Events
     Society Cancer Action                    and ACS CAN advocacy
     Network                                  activities
    ------------------------------------------------------------------------
    Mid Atlantic Lifespan,          $4,000   Senior Care Providers
     Inc.                                     Roundtables With Local
                                              Hospitals
    ------------------------------------------------------------------------
    ACS Organic Chemistry           $1,500   ACS-DOC Graduate Research
     Division                                 Symposium
    ------------------------------------------------------------------------
    Society of Toxicology          $10,000   Society of Toxicology Annual
                                              Meeting
    ------------------------------------------------------------------------
    NATIONAL ACADEMY OF            $50,000   Forum on Neuroscience and
     SCIENCES                                 Nervous System Disorders
    ------------------------------------------------------------------------
    NATIONAL ACADEMY OF            $85,000   Forum on Drug Discovery,
     SCIENCES                                 Development and Translation
    ------------------------------------------------------------------------
    Allergy & Asthma              $100,000   AAP Asthma, Allergy &
     Network Mothers of                       Anaphylaxis Champion Program
     Asthmatics
    ------------------------------------------------------------------------
    Virginia Bio                    $1,500   Legislative Reception
    ------------------------------------------------------------------------
    AMGA Foundation Inc           $200,000   Together 2 Goal
    ------------------------------------------------------------------------
    International Society          $70,000   World Kidney Day 2016
     of Nephrology
    ------------------------------------------------------------------------
    Florida Health Care             $7,500   ``The Health Care Revolution:
     Coalition                                Building the Health Rosetta''
    ------------------------------------------------------------------------
    Florida Caucus of               $2,000    Scholarship
     Black State
     Legislators
    ------------------------------------------------------------------------
    Fundacion Centro               $15,000   Diabetes Summer Camp 2016
     Pediatrico de
     Diabetes
    ------------------------------------------------------------------------
    American Drug                  $15,000   American Drug Utilization
     Utilization Review                       Review Symposium
     Society
    ------------------------------------------------------------------------
    The University of              $25,000   Second Annual Immuno-Oncology
     Texas Foundation,                        and Myeloma Workshop
     Inc.
    ------------------------------------------------------------------------
    El Paso Diabetes                $2,500   2016 Diabetes Walk/Run
     Association, Inc.
    ------------------------------------------------------------------------
    National TB                     $2,500   Using the Stories and Voices of
     Controllers                              TB Survivors for Patient
     Association                              Education, Building a
                                              Supportive Community, and
                                              Advocacy
    ------------------------------------------------------------------------
    French American                 $1,000    FACS XVI
     Chemical Society
    ------------------------------------------------------------------------
    Texas Tech Foundation,        $286,000   Community Health Worker (CHW)
     Inc.                                     Core Consensus Project 2016:
                                              Increasing Stakeholder
                                              Engagement and Endorsement,
                                              Defining CHW Roles and Skills
                                              in Clinical and Community
                                              Settings, and CHW Skill
                                              Assessment Approaches and
                                              Tools
    ------------------------------------------------------------------------
    Houston Business                $6,000   The Employer's Specialty
     Coalition on Health                      Pharmaceutical Dilemma--
                                              Challenges & Opportunities
    ------------------------------------------------------------------------
    UNM Comprehensive               $1,000   Hoops4Hope
     Cancer Center
    ------------------------------------------------------------------------
    University of Utah             $50,000   Western Atrial Fibrillation
                                              Symposium
    ------------------------------------------------------------------------
    WithinReach                     $5,000   Improving Health Access and
                                              Immunization Policy
    ------------------------------------------------------------------------
    NASPA                           $5,000   NASPA Leadership Conference
                                              Awareness Walk
    ------------------------------------------------------------------------
    National Eczema               $300,000   Roadmap to Advocacy
     Association
    ------------------------------------------------------------------------
    American Society on             $5,000   2016 Aging in America
     Aging                                    Conference
    ------------------------------------------------------------------------
    Milken Institute              $500,000   2016 Milken Institute
                                              Conference Engagement
    ------------------------------------------------------------------------
    International Myeloma         $100,000   IMF Patient Programs 2016
     Foundation
    ------------------------------------------------------------------------
    International Myeloma           $5,000   IMF 10th Annual Comedy
     Foundation                               Celebration benefitting the
                                              Peter Boyle Research
                                              Foundation
    ------------------------------------------------------------------------
    International Myeloma          $35,000   7th Annual Internaltional
     Foundation                               Myeloma Working Group Summit
    ------------------------------------------------------------------------
    California Center for           $2,500   Pre-diabetes Epidemic in
     Public Health                            California--What Now?
     Advocacy
    ------------------------------------------------------------------------
    Out & Equal                    $25,000   2016 Out & Equal Workplace
                                              Summit
    ------------------------------------------------------------------------
    GLBTQ Legal Advocates           $3,000   GLAD 2016 Summer Party
     & Defenders
    ------------------------------------------------------------------------
    Gay Men's Health                $5,000   AIDS Walk New York
     Crisis, Inc
    ------------------------------------------------------------------------
    The Children's Aid             $25,000   The Children's Aid Society 5th
     Society                                  Annual KTP Gala
    ------------------------------------------------------------------------
    Jersey Battered                 $7,000   JBWS Grand Tastings XXII
     Women's Service, Inc.
    ------------------------------------------------------------------------
    Community Hope, Inc.           $10,000   2016 Silver Corporate Partner
    ------------------------------------------------------------------------
    RESOURCES USA INC               $7,500   French Talks
    ------------------------------------------------------------------------
    Court Appointed                 $1,000   Night of a Thousand Stars Gala
     Special Advocates of
     Mercer County, Inc.
    ------------------------------------------------------------------------
    Machestic Dragons               $5,000   10th Annual ``Paddle for Pink''
                                              Community Dragon Boat Festival
    ------------------------------------------------------------------------
    American Lebanese              $10,000   St. Jude Gourmet Gala
     Syrian Associated
     Charities, Inc.
    ------------------------------------------------------------------------
    National Kidney                 $1,000   Champion of Hope Tribute Dinner
     Foundation of
     Michigan
    ------------------------------------------------------------------------
    National Congressional         $25,000   Gold Membership
     Award Foundation
    ------------------------------------------------------------------------
    Research!America               $25,000   20th Annual Advocacy Awards
                                              Dinner
    ------------------------------------------------------------------------
    Society for Women's            $10,000   2016 SWHR Annual Gala Dinner
     Health Research
    ------------------------------------------------------------------------
    American Cancer                 $2,500   Relay For Life of Bridgewater
     Society Cancer Action
     Network
    ------------------------------------------------------------------------
    University of Arizona           $3,000   Sponsorship of the 28th Annual
     Foundation                               Undergraduate Biology Research
                                              Program Conference
    ------------------------------------------------------------------------
    Diabetes Hands                 $37,500   Online Community for People
     Foundation                               with Diabetes
    ------------------------------------------------------------------------
    Boston University               $2,500   Boston University School of
     School of Public                         Public Health 40th Anniversary
     Health                                   Gala
    ------------------------------------------------------------------------
    Pro Bono Partnership           $10,000   Pro Bono Partnership 2016 Gala
    ------------------------------------------------------------------------
    Christ The King                 $5,000   8th Annual President's Gala
     Preparatory School of
     Newark NJ Corp.
    ------------------------------------------------------------------------
    Children's Health Fund         $25,000   2016 Annual Benefit
    ------------------------------------------------------------------------
    The Children's Aid             $25,000   The Children's Aid Society's
     Society                                  Keeping the Promise Benefit
    ------------------------------------------------------------------------
    The American Heart              $5,000   Heart & Stroke Ball
     Association
    ------------------------------------------------------------------------
    Good Grief Inc.                 $2,500   2016 Great Pumpkin Ball
    ------------------------------------------------------------------------
    United Way of Northern            $500   Pathways for Caregivers 2016
     New Jersey                               Reprint
    ------------------------------------------------------------------------
    Easterseals New Jersey          $1,350   46th Annual Raritan Valley
                                              Workshop Dinner Dance
    ------------------------------------------------------------------------
    Safe+Sound Somerset            $10,000   Soaring to New Heights
    ------------------------------------------------------------------------
    Deirdre O'Brien Child           $2,000   Gala Sponsorship
     Advocacy Center Inc.
    ------------------------------------------------------------------------
    The Center For Great            $5,000   2016 Gift of Hope Gala
     Expectations Inc
    ------------------------------------------------------------------------
    Somerset County                   $500   Second Annual Workplace Health
     Business Partnership                     & Wellness Expo 2016
    ------------------------------------------------------------------------
    RESOURCES USA INC.              $5,000   Bastille Day 2016
    ------------------------------------------------------------------------
    RESOURCES USA INC               $5,000   Bastille Day events
    ------------------------------------------------------------------------
    CANCER SUPPORT                  $5,000   Inspiring Hope
     COMMUNITY CENTRAL NEW
     JERSEY
    ------------------------------------------------------------------------
    Auxiliary of the                $5,000   57th Annual Auxiliary Autumn
     Robert Wood Johnson                      Ball
     University Hospital
    ------------------------------------------------------------------------
    Pocono Mountains                $6,000   Pocono Mountains Community
     Community Challenge                      Fundraiser
     Fund
    ------------------------------------------------------------------------
    The American Kidney            $50,000   2016 The Hope Affair
     Fund, Inc.
    ------------------------------------------------------------------------
    Partnership for a               $4,500   PHA Fit to Celebrate Gala
     Healthier America
     Inc.
    ------------------------------------------------------------------------
    American Society of            $75,000   2017 Corporate Sponsor
     Transplant Surgeons
     Foundation
    ------------------------------------------------------------------------
    Vision y Compromiso             $5,000   Hacia Una Vida y Sana, the 13th
                                              Annual Promotoras and
                                              Community Health Workers
                                              Conference
    ------------------------------------------------------------------------
    Turn 2 Foundation Inc.         $15,000   Turn 2 Foundation 20th Annual
                                              Dinner
    ------------------------------------------------------------------------
    AAALAC International            $5,000   IQ/AAALAC International Global
                                              3Rs Award Program
    ------------------------------------------------------------------------
    Asthma & Allergy                $1,000   Fall 2016 AAFA-STL Printed
     Foundation of                            Newsletter
     America, St. Louis
     Chapter
    ------------------------------------------------------------------------
    Autoimmune Advocacy             $2,500   A Grapevine Grows
     Alliance
    ------------------------------------------------------------------------
    Operation Warrior               $7,500   Warrior Wishes 2016 Army/Navy
     Wishes Foundation                        Game
    ------------------------------------------------------------------------
    Washington Legal               $30,000   2016 General Operating Support
     Foundation
    ------------------------------------------------------------------------
    Maryland Black Caucus           $2,500   Legislative Weekend
     Foundation, Inc.
    ------------------------------------------------------------------------
    Research!America               $10,000   National Health Research Forum
    ------------------------------------------------------------------------
    Friends of Cancer              $25,000   Friends of Cancer Research 20th
     Research                                 Anniversary Cancer Leadership
                                              Awards Dinner
    ------------------------------------------------------------------------
    Project Hope The               $10,000   2016 Project HOPE Gala
     People To People
     Health Foundation
     Inc.
    ------------------------------------------------------------------------
    The Virginia Public               $700   Lighten Up, It's Just Politics
     Access Project
    ------------------------------------------------------------------------
    AMGA Foundation Inc.           $10,000   AMGA Foundation 50th
                                              Anniversary Gala
    ------------------------------------------------------------------------
    CEO Roundtable on             $500,000   Project Data Sphere initiative
     Cancer
    ------------------------------------------------------------------------
    Conference of Western           $5,000   CWAG 2016 Winter Dinner
     Attorneys General                        Sponsorship
    ------------------------------------------------------------------------
    Western Governors'             $10,000   WGA Annual Contribution
     Foundation
    ------------------------------------------------------------------------
    Colon Cancer Alliance           $3,500   2016 Blue Hope Bash
    ------------------------------------------------------------------------
    American Statistical            $9,500   Breiamn Award
     Association
    ------------------------------------------------------------------------
    Washington Policy               $4,000   2016 Annual Dinner
     Center
    ------------------------------------------------------------------------
    NEHI (Network for              $75,000   Health Care Without Walls
     Excellence in Health
     Innovation)
    ------------------------------------------------------------------------
    Cheshire Health                 $1,000   Cheshire Stepping Out for
     Foundation                               Diabetes Walk
    ------------------------------------------------------------------------
    Massachusetts General           $5,000   The Role of Tumor
     Hospital                                 Microenvironment: a 40-year
                                              Journey
    ------------------------------------------------------------------------
    Massachusetts General           $5,000   Massachusetts General Hospital
     Hospital                                 Immunology Seminar Series
    ------------------------------------------------------------------------
    YMCA of Greater Boston         $10,000   YMCA's Diabetes Prevention
                                              Program
    ------------------------------------------------------------------------
    MIT 100K                       $25,000   MIT 100K Entrepreneurship
     Entrepreneurship                         Competition
     Competition
    ------------------------------------------------------------------------
    Joslin Diabetes                $10,000   High Hopes Gala
     Center, Inc.
    ------------------------------------------------------------------------
    Joslin Diabetes                 $2,500   Ritmos de salud (healthy
     Center, Inc.                             rhythms)
    ------------------------------------------------------------------------
    Multi Regional                 $50,000   Multi Regional Clinical Trials
     Clinical Trials                          Center of Brigham and Women's
     Center of Brigham and                    Hospital and Harvard
     Women's Hospital and
     Harvard
    ------------------------------------------------------------------------
    Foundation for                 $12,500   Animal Research Communications
     Biomedical Research                      Campaign
    ------------------------------------------------------------------------
    Foundation for                 $20,000   Public Education to Advance
     Biomedical Research                      Understanding of Animal
                                              Research
    ------------------------------------------------------------------------
    Massachusetts Society           $2,500   The MSMR Annual Meeting of
     for Medical Research,                    Members
     Inc.
    ------------------------------------------------------------------------
    Children's Hospital            $10,000   PCMM Retreat
     Corporation
    ------------------------------------------------------------------------
    Foundation for                  $5,000   Scientific Symposium in honor
     Neurologic Diseases,                     Vijay K. Kuchroo
     Inc.
    ------------------------------------------------------------------------
    Lake Norman Community           $1,000   Sunset and Sandals
     Health Clinic
    ------------------------------------------------------------------------
    Multiple Myeloma               $50,000   Multiple Myeloma Educational
     Research Foundation                      Programming
    ------------------------------------------------------------------------
    American Diabetes               $2,500   CNY Diabetes Community Forum
     Association Inc.
    ------------------------------------------------------------------------
    American Diabetes               $5,000   Community Awareness Training
     Association
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Step Out Walk to Stop Diabetes--
     Association                              Phoenix
    ------------------------------------------------------------------------
    American Diabetes               $2,500   2016 Kiss a Pig Gala
     Association
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              Connecticut Tour de Cure
    ------------------------------------------------------------------------
    American Diabetes               $5,000   American Diabetes Association
     Association                              New England Classic Multi-Day
                                              Tour de Cure
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              Kennebunks Tour de Cure
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              Ocean State Tour de Cure
    ------------------------------------------------------------------------
    American Diabetes               $2,500   American Diabetes Association's
     Association                              North Shore Tour de Cure
    ------------------------------------------------------------------------
    American Diabetes              $10,000   ADA Indiana's Josiah Kirby
     Association, Indiana                     Lilly Sr. Distinguished
                                              Service Award Gala
    ------------------------------------------------------------------------
    American Diabetes               $2,500   2016 Father of the Year Awards
     Association                              Dinner
    ------------------------------------------------------------------------
    American Diabetes              $50,000   Diabetes Awareness and
     Association                              Intervention--via Step Out:
                                              Walk to Stop Diabetes, the Red
                                              Rider/Red Strider Program and
                                              the Annual Diabetes Conference
                                              in NJ
    ------------------------------------------------------------------------
    American Diabetes               $2,500   2016 World Diabetes Day Summit
     Association
    ------------------------------------------------------------------------
    American Diabetes              $20,000   Unmasking Diabetes Gala &
     Association                              Awards
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Step Out Walk to Stop Diabetes
     Association                              of the Triangle
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Tour De Cure + Step Out: Walk
     Association                              to Stop Diabetes
    ------------------------------------------------------------------------
    American Diabetes               $2,500   Father of the Year Awards
     Association
    ------------------------------------------------------------------------
    National Health               $100,000   The Patient Perspective on the
     Council                                  Value of Treatments
    ------------------------------------------------------------------------
    National Health                $95,000   Health Technology Assessments
     Council                                  and Value: The Patient
                                              Perspective
    ------------------------------------------------------------------------
    National Kidney                $50,000   2016 New York City Kidney Walk
     Foundation, Inc.                         and Patient Journeys
    ------------------------------------------------------------------------
    National Kidney                $15,000   2016 Boston Kidney Walk
     Foundation
    ------------------------------------------------------------------------
    Organization for               $15,000   2016 OFII Annual Dinner
     International
     Investment
    ------------------------------------------------------------------------
    Healthcare                      $8,850   HBA Woman of the Year Elite
     Businesswomen's                          Table
     Association
    ------------------------------------------------------------------------
    United States Bone and         $20,000   Burden of Musculoskeletal
     Joint Initiative, NFP                    Diseases in the United States
                                              (BMUS) Report
    ------------------------------------------------------------------------
    United States Bone and         $80,000   Experts in Arthritis (EIA)
     Joint Initiative, NFP
    ------------------------------------------------------------------------
    American College of           $150,000   LDL Address the Risk Think Tank
     Cardiology
    ------------------------------------------------------------------------
    The Leukemia &                  $2,500   Lowcountry Light The Night Walk
     Lymphoma Society
    ------------------------------------------------------------------------
    The Leukemia &                 $16,000   Light The Night Sponsorship
     Lymphoma Society
    ------------------------------------------------------------------------
    THE LEUKEMIA &                 $50,000   Band Against Cancer: The Sarah
     LYMPHOMA SOCIETY                         Cannon Tour
    ------------------------------------------------------------------------
    Moses E. Cheeks Slam            $2,500   Moses E. Cheeks Slam Dunk for
     Dunk for Diabetes                        Diabetes Basketball Camp
    ------------------------------------------------------------------------
    American Foundation            $25,000   2016 Get in Rhythm. Stay in
     for Women's Health                       Rhythm. Atrial Fibrillation
     (dbaStopAfib.org)                        Patient Conference
    ------------------------------------------------------------------------
    National Alliance of            $5,000   Advanced Prostate Cancer
     State Prostate Cancer                    Laminate
     Coalitions
    ------------------------------------------------------------------------
    National Alliance of            $5,000   12th Annual Meeting of the
     State Prostate Cancer                    National Alliance of State
     Coalitions                               Prostate Cancer Coalitions
    ------------------------------------------------------------------------
    Colorectal Cancer              $10,000   Guide in the Fight for Late
     Coalition Inc                            Stage CRC Patients
    ------------------------------------------------------------------------
    Myotonic Dystrophy              $3,000   MDF Annual Conference
     Foundation
    ------------------------------------------------------------------------
    New Jersey Association          $1,000   3Rs Sharing Conference V
     for Biomedical
     Research, Inc.
    ------------------------------------------------------------------------
    Academy of Managed             $15,000   AMCP 2016 Partnership Forum:
     Care Pharmacy                            Enabling the Exchange of
                                              Clinical and Economic Data Pre-
                                              FDA Approval
    ------------------------------------------------------------------------
    Academy of Managed             $18,000   AMCP Oncology Management
     Care Pharmacy                            Partnership Forum
    ------------------------------------------------------------------------
    BIONJ INC.                     $10,000   Annual Dinner
    ------------------------------------------------------------------------
    Community Oncology             $15,000   Oncology Care Model Filming
     Alliance
    ------------------------------------------------------------------------
    Community Oncology              $7,500   Community Oncology Alliance CMS
     Alliance                                 Oncology Care Model Payer
                                              Session
    ------------------------------------------------------------------------
    Community Oncology             $25,000   2016 Community Oncology Payer
     Alliance                                 Exchange Summit V Oncology
                                              Payment Reform
    ------------------------------------------------------------------------
    JDRF International              $2,500   JDRF One Walk 2016
    ------------------------------------------------------------------------
    JDRF                            $5,000   JDRF One Walk Pittsburgh
    ------------------------------------------------------------------------
    JDRF                            $5,000   JDRF One Walk Westmoreland
    ------------------------------------------------------------------------
    Juvenile Diabetes               $2,500   JDRF One Walk Rochester
     Research Foundation
    ------------------------------------------------------------------------
    Juvenile Diabetes               $2,500   JDRF One Walk Southern Tier
     Research Foundation
    ------------------------------------------------------------------------
    JDRF NENY                       $2,500   JDRF Saratoga One Walk
    ------------------------------------------------------------------------
    JDRF--Western New York          $2,500   JDRF Buffalo One Walk
     Chapter
    ------------------------------------------------------------------------
    JDRF International              $2,500   JDRF One Walk Boston 2016
    ------------------------------------------------------------------------
    American Society of            $10,000   Mambo for Myeloma ASH
     Hematology                               Sponsorship
    ------------------------------------------------------------------------
    The American Kidney             $5,000   2016 A Pairing For Prevention
     Fund, Inc.
    ------------------------------------------------------------------------
    The American Kidney            $75,000   New To Dialysis Campaign
     Fund, Inc.
    ------------------------------------------------------------------------
    THE TRANSPLANTATION            $50,000   TTS Transplantation Leadership
     SOCIETY                                  Series
    ------------------------------------------------------------------------
    PROMIS Health                  $10,000   PROMIS: Measuring Health
     Organization (PHO)                       Outcomes Around the World
    ------------------------------------------------------------------------
    The Foundation for              $5,000   International Research
     Peripheral Neuropathy                    Symposium/Advances in
                                              Neuropathy--Emerging Therapies
    ------------------------------------------------------------------------
    PQA, Inc.                       $5,000   PQA Leadership Summit 2016
    ------------------------------------------------------------------------
    PQA, Inc.                      $25,000   PQA Insulin Adherence Committee
    ------------------------------------------------------------------------
    MMORE: Multiple                 $5,000   MoveMMORE Seattle 2016
     Myeloma Opportunities
     for Research &
     Education
    ------------------------------------------------------------------------
    International Society           $5,000   ACoP7 meeting
     of Pharmacometrics
    ------------------------------------------------------------------------
    The Galien Foundation          $15,000   The Galien Forum
    ------------------------------------------------------------------------
    MassChallenge, Inc.             $4,000   2016 MC Awards
    ------------------------------------------------------------------------
    MassChallenge, Inc.            $40,000   MassChallenge
    ------------------------------------------------------------------------
    Alliance for                    $5,000   Cell & Gene Meeting on the Mesa
     Regenerative Medicine
    ------------------------------------------------------------------------
    Oklahoma Center for             $3,000   Transformation of Healthcare:
     Healthcare                               CPC Learning Session
     Improvement
    ------------------------------------------------------------------------
    Health Literacy               $225,000   The Blue Ribbon Online
     Missouri                                 Clearinghouse of Kidney
                                              Transplantation and Living
                                              Donation Resources (BROC)
    ------------------------------------------------------------------------
    Health Literacy                $50,000   My Transplant Coach Application
     Missouri                                 Development Project
    ------------------------------------------------------------------------
    Center for Medical             $40,000   GPC--Real World Evidence
     Technology Policy
    ------------------------------------------------------------------------
    Center for Healthcare           $7,500   2016 Diversity, Inclusion, &
     Innovation                               Life Sciences Symposium
    ------------------------------------------------------------------------
    BIO Ventures for               $10,000   2016 BIO International
     Global Health (BVGH)                     Convention Africa Pavilion
    ------------------------------------------------------------------------
    National Transitions           $50,000   NTOCC Mission Support
     of Care Coalition
    ------------------------------------------------------------------------
    The American College            $6,000   2016 ACVP/ASVCP Concurrent
     of Veterinary                            Annual Meeting
     Pathologists
    ------------------------------------------------------------------------
    South Dakota Diabetes           $1,000   Third Annual Sweet Success
     Coalition                                Extravaganza
    ------------------------------------------------------------------------
    T. Leroy Jefferson              $2,000   2016 Community Health Fair:
     Medical Society                          Healthy Children for a Healthy
                                              Future
    ------------------------------------------------------------------------
    North Coast Health              $1,000   Celebration of Caring 2016
    ------------------------------------------------------------------------
    Academy of Nutrition           $18,000   DCE On the Cutting Edge
     and Dietetics on                         newsletter
     behalf of Diabetes
     Care and Education
    ------------------------------------------------------------------------
    America's Health               $55,000   Executive Leadership Program
     Insurance Plans
    ------------------------------------------------------------------------
    American Liver                  $2,500   Diabetes and NASH Webinar
     Foundation
    ------------------------------------------------------------------------
    Us TOO International            $2,500   12th Annual SEA Blue Chicago
                                              Prostate Cancer Walk & Run
    ------------------------------------------------------------------------
    Blood and Marrow                $2,500   BMT InfoNet Resource Directory
     Transplant                               update and reprint
     Information Network
    ------------------------------------------------------------------------
    Chicago Hispanic                $1,000   10th Annual Vive tu Vida/Get
     Health Coalition                         Up! Get Moving! Health and
                                              Wellness Fair
    ------------------------------------------------------------------------
    The Council of State            $5,000   Bowhay Institute
     Government, Ltd.
    ------------------------------------------------------------------------
    National Bone Marrow            $5,000   Update, Edit and Transplant
     Transplant Link                          Survivors' Guide for Bone
                                              Marrow, Stem Cell and Cord
                                              Blood Transplant
    ------------------------------------------------------------------------
    International Society           $8,000   Corporate Membership
     for                                      Application
     Pharmacoepidemiology
    ------------------------------------------------------------------------
    Be The Match                   $90,000   Quick Reference Guidelines--
     Foundation                               Transplant Consultation and
                                              Post-Transplant Care
    ------------------------------------------------------------------------
    American Society of            $10,000   Meet the Faculty Networking
     Transplantation                          Session @ 2016 AST Fellows
                                              Symposium on Transplantation
    ------------------------------------------------------------------------
    Iowa Pharmacy                  $10,000   2016 Leadership in Pharmacy
     Association                              advocacy program
     Foundation
    ------------------------------------------------------------------------
    Mid-America Coalition           $4,000   Type 2 Diabetes in Kansas City:
     on Health Care                           A Collaborative Approach
    ------------------------------------------------------------------------
    St. Louis Children's           $50,000   Food Allergy Management and
     Hospital Foundation                      Education (FAME)
    ------------------------------------------------------------------------
    Missouri Biotechnology          $1,000   BIO Benchmarking Program
     Association
    ------------------------------------------------------------------------
    Metabolic Endocrine            $25,000   14th Annual World Congress on
     Education Foundation                     Insulin Resistance Diabetes
                                              and Cardiovascular Disease
                                              (WCIRDC)
    ------------------------------------------------------------------------
    The diaTribe                    $5,000   10th Annual Diabetes Forum
     Foundation
    ------------------------------------------------------------------------
    Greater Philadelphia            $1,000   GPBCH Annual Wellness Summit
     Business Coalition on
     Health
    ------------------------------------------------------------------------
    Project Access of                 $500   Diabetic Walk
     Howard County
    ------------------------------------------------------------------------
    National Diabetes              $14,000   Access to Insulin Patient
     Volunteer Leadership                     Advocacy Study
     Council
    ------------------------------------------------------------------------
    Keystone for                    $5,000   Foundation2016 Conference
     Incubating Innovation
     in Life sciences
     Network (KiiLN)
    ------------------------------------------------------------------------
    ALL IN TOGETHER                $25,000   All In Together Campaign Women
     CAMPAIGN INC                             in Healthcare Policy Forum
    ------------------------------------------------------------------------
    Washington Health               $6,600   2016 Alliance Membership
     Alliance
    ------------------------------------------------------------------------
    IIT Association of              $2,500   2016 PanIIT Leadership
     Greater New England                      Conference
    ------------------------------------------------------------------------
    California Life                 $7,500   2016 Life Sciences Academy
     Sciences Association
    ------------------------------------------------------------------------
    The Kansas Chamber                $884   Corporate Membership
    ------------------------------------------------------------------------
    Delaware Diabetes               $2,500   Delaware Diabetes Coalition
     Coalition                                2016 EXPO
    ------------------------------------------------------------------------
    American Legislative           $10,000    Life Sciences Academy
     Exchange Council
    ------------------------------------------------------------------------
    Biotechnology                  $10,000   ODTC White Paper
     Innovation
     Organization
    ------------------------------------------------------------------------
    Biotechnology                  $20,000   State Policy Maker Round Tables
     Innovation                               on Value of Biopharmaceutical
     Organization (BIO)                       Industry
    ------------------------------------------------------------------------
    American Association           $50,000   Sustaining Sponsorship
     of Pharmaceutical
     Scientists
    ------------------------------------------------------------------------
    Society for Women's            $10,000   National Conference on Women's
     Health Research                          Health Research--Diabetes/
                                              Metabolism
    ------------------------------------------------------------------------
    International                  $33,000   IPEC-Americas 2016 Membership
     Pharmaceutical                           Dues
     Excipients Council of
     the Americas (IPEC-
     Americas)
    ------------------------------------------------------------------------
    FSH Society                     $2,500   FSHD Connect Conference
    ------------------------------------------------------------------------
    International Society          $10,000   RECOMB/ISCB Conference on
     for Computational                        Regulatory and Systems
     Biology, Inc.                            Genomics with DREAM Challenges
    ------------------------------------------------------------------------
    WomenHeart: The                $25,000   Access NOW! Campaign
     National Coalition
     for Women with Heart
     Disease
    ------------------------------------------------------------------------
    Springboard 2000               $15,000   Health Innovation Hub
     Enterprises, Inc.
    ------------------------------------------------------------------------
    American Cancer                 $1,000   2016 ACS CAN Michigan Forum and
     Society Cancer Action                    ACS CAN advocacy activities
     Network                                  nationwide
    ------------------------------------------------------------------------
    APhA Foundation               $168,870   Consensus Consortium on Patient
                                              Self-Management Credentialing
                                              (PSMC) and Value-Based Health
                                              Benefit Design Considerations
                                              in Patient-Centered, Team-
                                              Based Care
    ------------------------------------------------------------------------
    Society of Toxicology           $2,500   The Use of Cardiomyocytes for
                                              the Assessment of
                                              Proarrhythmic Risk
    ------------------------------------------------------------------------
    Camp Holiday Trails             $2,500   Family Diabetes Camp and Summer
                                              Camperships
    ------------------------------------------------------------------------
    Women In Government             $5,000   2016 Healthcare Summit Diabetes
     Foundation, Inc.                         Programming
    ------------------------------------------------------------------------
    Women In Government            $20,000   Diabetes Campaign--Phase II
     Foundation, Inc.
    ------------------------------------------------------------------------
    Patient Advocate               $35,000   Understanding What Patients
     Foundation                               Value and What and Matters to
                                              Them During Their Treatment:
                                              The Prostate Cancer Research
                                              Program (PCRP)
    ------------------------------------------------------------------------
    Organ Donation and              $4,500   National Critical Issues Forum
     Transplantation
     Alliance
    ------------------------------------------------------------------------
    Arthritis Foundation,          $40,000   ICER Survey
     Inc.
    ------------------------------------------------------------------------
    Georgia Life Sciences           $1,500   Georgia Life Sciences Coalition
     Coalition
    ------------------------------------------------------------------------
    International Cytokine         $15,000   4TH ANNUAL MEETING OF THE
     and Interferon                           INTERNATIONAL CYTOKINE AND
     Society Inc.                             INTERFERON SOCIETY (ICIS)
    ------------------------------------------------------------------------
    American Association           $25,000   AACE Diabetes Resource Center,
     of Clinical                              2016-17
     Endocrinologists
    ------------------------------------------------------------------------
    ZERO--The End of                $5,000   ZERO Prostate Cancer Community
     Prostate Cancer                          Advocacy Events
    ------------------------------------------------------------------------
    The Diabetes Coalition          $2,500   Giving Diabetes the Blues
     of Mississippi/
     Mississippi Rural
     Health Association
    ------------------------------------------------------------------------
    University of Southern          $5,000   National Unity 2016 Conference:
     Mississippi                              Community Health Workers -
     Foundation                               Social Change Agents Advancing
                                              Health Equity and Improving
                                              Outcomes
    ------------------------------------------------------------------------
    NBCH                           $25,000   High Value Health: Making the
                                              Dream a Reality
    ------------------------------------------------------------------------
    Fundacion Centro                $5,000   World Diabetes Month
     Pediatrico de                            Celebration 2016
     Diabetes
    ------------------------------------------------------------------------
    Fundacion Centro                $3,500   XV Annual Gala Dinner
     Pediatrico de
     Diabetes
    ------------------------------------------------------------------------
    TULANE CANCER CENTER            $1,000   NOLA Bluedoo Run/Walk
    ------------------------------------------------------------------------
    NCSL Foundation for             $7,500   NCSL LegisBrief Sponsorship
     State Legislatures
    ------------------------------------------------------------------------
    Arizona Diabetes                $2,500   Arizona Diabetes Foundation
     Foundation
    ------------------------------------------------------------------------
    Federation of Clinical         $10,000   FOCIS 2016 Annual Meeting
     Immunology Societies
    ------------------------------------------------------------------------
    Society of Dermatology         $30,000   SDPA 14th Annual Fall
     Physician Assistants                     Dermatology Conference
    ------------------------------------------------------------------------
    Colon Cancer Alliance          $10,000   2016 Live Your Best Life mCRC
                                              Patient Symposium
    ------------------------------------------------------------------------
    National Eczema               $100,000   Leaders in Eczema Forum Series
     Association
    ------------------------------------------------------------------------
    Congress of California          $1,500   Script Your Future Senior
     Seniors Education and                    Leader Education
     Research Fund
    ------------------------------------------------------------------------
    Association of Black           $20,000   Improving Access to Innovative
     Cardiologists                            Therapies in High-Risk
                                              Populations
    ------------------------------------------------------------------------
    Lymphoma Research               $3,000   Understanding Transplantation
     Foundation                               and Lymphoma Patient Guide
    ------------------------------------------------------------------------
    Prostate Cancer               $250,000   23rd Annual Scientific Retreat
     Foundation
    ------------------------------------------------------------------------
                                $8,708,932
    Product Donations made
     by Sanofi US to the
     Sanofi Foundation for
     North America *
     (estimate)
                              $343,602,000
    ------------------------------------------------------------------------

            Donations made by the Sanofi Foundation for North America
    ------------------------------------------------------------------------
          Legal Name         Payment Amount           Project Title
    ------------------------------------------------------------------------
    Trustees of Boston            $125,000   National CHW Association
     University
    ------------------------------------------------------------------------
    Tufts Center for the           $12,500   Assessing the Use of Real World
     Study of Drug                            Evidence to Support Regulated
     Development                              Medical Research and Post-
                                              Marketing Safety Monitoring
    ------------------------------------------------------------------------
    Cambridge Arts Council          $5,000   2016 Summer Programs for
     Fund                                     Magazine Beach Park
    ------------------------------------------------------------------------
    Americares                     $25,000   Disaster Relief--Hurricane
                                              Matthew
    ------------------------------------------------------------------------
    Americares                      $5,000   AmeriCares Airlift Benefit
    ------------------------------------------------------------------------
    Americares                     $25,000   Ecuador Earthquake Response
    ------------------------------------------------------------------------
    Americares                     $10,000   U.S. Disaster Assistance
    ------------------------------------------------------------------------
    Christ The King                $59,000   Corporate Work Study Program
     Preparatory School of
     Newark NJ Corp
    ------------------------------------------------------------------------
    NAACP                          $10,000   Childhood Obesity
    ------------------------------------------------------------------------
    AMERICAN DIABETES           $2,500,000   Pathway to Stop Diabetes
     ASSOCIATION INC
    ------------------------------------------------------------------------
    National Kidney                 $5,000   New Jersey Kidney Transplant
     Foundation, Inc.                         Workshop
    ------------------------------------------------------------------------
    March of Dimes                 $86,000   Supporting NICU Babies and
     Foundation                               Families
    ------------------------------------------------------------------------
    Heritage of Pride,              $2,899   NYC Pride March
     Inc.
    ------------------------------------------------------------------------
    Children's Health Fund          $5,000   Baton Rouge--Emergency Response
    ------------------------------------------------------------------------
    The Salvation Army             $10,000   Healthy Food Pantry Program
    ------------------------------------------------------------------------
    Columbia Univeristy           $100,000   Project on Non-Communicable
     Mailman School of                        Diseases
     Public Health
    ------------------------------------------------------------------------
    THE LEUKEMIA &                 $19,640   Fiscal Year 2017 Myeloma
     LYMPHOMA SOCIETY                         Patient Education
    ------------------------------------------------------------------------
    Stop Hunger Now Inc.           $10,000   Stop Hunger Now Disaster Ready
                                              Response
    ------------------------------------------------------------------------
    Garden State Equality           $5,000   Pledge and Protect LGBT Seniors
     Education Fund Inc.
    ------------------------------------------------------------------------
    Camp Nejeda Foundation         $10,000   Camp Nejeda: Helping Kids with
                                              Type 1 Diabetes Live Happier,
                                              Healthier Lives
    ------------------------------------------------------------------------
    Matheny School and             $10,000   Matheny Center of Medicine and
     Hospital Inc.                            Dentistry
    ------------------------------------------------------------------------
    United Way of Northern        $100,000   Caregivers Coalition
     New Jersey
    ------------------------------------------------------------------------
    Jersey Battered                 $5,000   Community Counseling Services
     Women's Service, Inc.
    ------------------------------------------------------------------------
    Food Bank of Somerset          $10,000   Back Pack Program
     County Inc.
    ------------------------------------------------------------------------
    Community Hope, Inc.           $25,000   Residential Recovery Programs
                                              for Homeless Veterans and
                                              Disabled Individuals
    ------------------------------------------------------------------------
    Hyacinth Foundation, A         $15,000   Hyacinth Psychosocial Support
     New Jersey Non-profit                    Services
     Corporation
    ------------------------------------------------------------------------
    Kean University                $15,000   2016 Group Summer Scholars
     Foundation Inc                           Research Program
    ------------------------------------------------------------------------
    Visiting Nurse                 $10,000   Hospice Care and Adult Day Club
     Association of                           Services
     Somerset Hills
    ------------------------------------------------------------------------
    NJ SEEDS                       $10,000   Young Scholars Program--Health
                                              Sessions
    ------------------------------------------------------------------------
    Somerset Health Care           $30,000   Fun n' Fit
     Foundation
    ------------------------------------------------------------------------
    Somerset Health Care            $5,000   Quality CPR Saves Lives
     Foundation
    ------------------------------------------------------------------------
    Somerset Health Care           $10,000   El poder
     Foundation
    ------------------------------------------------------------------------
    Deirdre O'Brien Child          $10,000   Clinical Counseling
     Advocacy Center Inc
    ------------------------------------------------------------------------
    Midland Adult Services         $10,000   Midland Helping Hands
     Inc                                      Employment Training Program
                                              and Midland Meals on Wheels
                                              Employment Training Program
    ------------------------------------------------------------------------
    The Center For Great           $10,000   Adult Women & their Children
     Expectations Inc.
    ------------------------------------------------------------------------
    Dress For Success              $10,000   Dress for Success Morris County
     Morris County Inc.                       Transforming Lives Gala
    ------------------------------------------------------------------------
    Dress For Success              $10,000   FOUNDATIONS OF SUCCESS
     Morris County Inc.                       WORKSHOPS
    ------------------------------------------------------------------------
    The Partnership for            $10,000   Community of Practice
     Quality Medical
     Donations
    ------------------------------------------------------------------------
    Raritan Valley                  $3,000   College Campus Experience Day
     Community College                        for STEM High School Students
     Foundation
    ------------------------------------------------------------------------
    Raritan Valley                 $10,000   Preparing for the Next
     Community College                        Generation Science Standards
     Foundation
    ------------------------------------------------------------------------
    Raritan Valley                  $7,500   Galileo Scholarships: Expanding
     Community College                        Access to STEM Education
     Foundation
    ------------------------------------------------------------------------
    Rutgers University             $10,000   Vets4Warriors
     Foundation
    ------------------------------------------------------------------------
    The American Fallen            $15,000   Portrait Sponsorship
     Soldiers Project Inc.
    ------------------------------------------------------------------------
    Strengthen Orlando d/b/         $5,000   OneOrlando Fund
     a OneOrlando Fund
    ------------------------------------------------------------------------
    Alliance For A                 $25,000   America's Healthiest Schools
     Healthier Generation
     Inc.
    ------------------------------------------------------------------------
    Diabetes Scholars              $10,000   Diabetes Scholars Foundation
     Foundation                               College Scholarships
    ------------------------------------------------------------------------
    Map International              $10,000   US Disaster Relief
    ------------------------------------------------------------------------
    Head and Neck Cancer            $1,000   Research on Xerostomia in HNC
     Alliance                                 patients
    ------------------------------------------------------------------------
    United States Soccer           $10,000   Soccer for Success--Camden
     Federation Foundation
     Inc.
    ------------------------------------------------------------------------
    Camp Quality USA dba           $10,000   Camp Quality NJ
     Camp Quality NJ
    ------------------------------------------------------------------------
    Operation Warrior               $5,000   Warrior Wishes 2016 Mission
     Wishes Foundation
    ------------------------------------------------------------------------
    National Transitions           $25,000   NTOCC Program Support
     of Care Foundation
    ------------------------------------------------------------------------
    Sheltered Yoga                  $5,000   Sheltered Yoga Curriculum and
                                              Programming
    ------------------------------------------------------------------------
    Dare to Dream Ranch             $1,000   The Dare to Dream Ranch
    ------------------------------------------------------------------------
    Provention Health             $106,790   LDL Management Forum
     Foundation Inc.
    ------------------------------------------------------------------------
    Heart To Heart                 $50,000   Hurricane Matthew Response
     International Inc.
    ------------------------------------------------------------------------
    Heart To Heart                  $5,000   Louisiana Flood Reponse
     International Inc.
    ------------------------------------------------------------------------
    Heart To Heart                 $10,000   U.S. Disaster Relief
     International Inc.
    ------------------------------------------------------------------------
    American Society for            $1,265   General Operating Support
     Blood and Marrow
     Transplantation
    ------------------------------------------------------------------------
    Pharmaceutical                $270,000   PhRMA Foundation Grants &
     Research and                             Fellowships
     Manufacturers of
     America Foundation
    ------------------------------------------------------------------------
    Georgetown University         $100,000   Health Promotion and Chronic
                                              Illness: An Educational
                                              Approach
    ------------------------------------------------------------------------
    Patient Advocate              $550,000   Metastatic Prostate &
     Foundation                               Metastatic CRC Fund
    ------------------------------------------------------------------------
    University of North            $20,000   Pharmacoepidemiology Program
     Carolina at Chapel
     Hill
    ------------------------------------------------------------------------
    United Way of Greater          $23,226   2016 Merial United Way Campaign
     Atlanta                                  Sanofi Foundation Match
    ------------------------------------------------------------------------
    United Way of Greater          $24,000   Merial 2016 UW Campaign Match
     Atlanta
    ------------------------------------------------------------------------
    UNITED WAY OF                   $5,000   Merial 2016 UW Campaign Match
     NORTHEAST GEORGIA
     INC.
    ------------------------------------------------------------------------
    UNITED WAY OF                   $5,000   Merial Athens 2015 UW Campaign
     NORTHEAST GEORGIA INC                    Match
    ------------------------------------------------------------------------
    UNITED WAY OF HALL              $4,000   2016 Merial United Way Campaign
     COUNTY INC.                              Sanofi Foundation Match
    ------------------------------------------------------------------------
    UNITED WAY OF HALL              $3,615   2015 Merial United Way Campaign
     COUNTY INC.
    ------------------------------------------------------------------------
    University of Arizona           $5,000   Applied Biosciences Graduate
     Foundation for the                       Interdisciplinary Programs
     benefit of GIDP                          Merit Scholarship
    ------------------------------------------------------------------------
    Direct Relief                  $25,000   Hurricane Matthew Response in
                                              Haiti
    ------------------------------------------------------------------------
    Direct Relief                   $5,000   Louisiana Flood Response
    ------------------------------------------------------------------------
    Cancer Support                  $8,000   Bringing Multiple Myeloma
     Community                                Journey Partners to the Cancer
                                              Support Community
    ------------------------------------------------------------------------
    Partners in Research           $25,000   Sanofi Biogenius Canada
     Canada
    ------------------------------------------------------------------------
    Sanofi US Matching            $116,524   Sanofi US Matching Gifts--Q4
     Gifts--2015                              (December) 2015 Match
    ------------------------------------------------------------------------
    Tufts Medical Center           $35,000   CEVR Database Subscription
    ------------------------------------------------------------------------
    Multiple Myeloma               $19,640   Mambo for Myeloma
     Research Foundation
    ------------------------------------------------------------------------
    Children's Health Fund         $25,000   Flint Emergency Response & Long
                                              Term Need
    ------------------------------------------------------------------------
    Children's Health Fund        $665,000   Medical Home Initiative
    ------------------------------------------------------------------------
    Volunteers of America           $5,000   Agape House
     Delaware Valley
    ------------------------------------------------------------------------
    Cancer Support                 $15,000   School-Based Support Groups
     Community Central New
     Jersey
    ------------------------------------------------------------------------
    Trustees of the                $20,000   Research Training in
     University of                            Pharmacoepidemiology
     Pennsylvania
    ------------------------------------------------------------------------
    Foundation Fighting           $100,000   Supporting Research to Find
     Blindness                                Preventions, Treatments and
                                              Cures for Retinal Diseases
    ------------------------------------------------------------------------
    Raritan Valley                 $15,000   Galileo Scholarships: Providing
     Community College                        Access to STEM Education
     Foundation
    ------------------------------------------------------------------------
    Raritan Valley                 $10,000   Preparing for the Next
     Community College                        Generation Science Standards
     Foundation
    ------------------------------------------------------------------------
    Arbor Day Foundation            $5,305   Trees in Celebration-Green
                                              Printing Initiative
    ------------------------------------------------------------------------
    Rutgers University            $125,000   Health Outcomes, Policy, and
     Foundation                               Economics
    ------------------------------------------------------------------------
    Arrow Lake Foundation         $146,722   General Mission Support
    ------------------------------------------------------------------------
    Bill, Hillary, and             $50,000   National Health Transformation
     Chelsea Clinton
     Foundation
    ------------------------------------------------------------------------
    Regents of the                 $25,000   V-BID
     University of
     Michigan
    ------------------------------------------------------------------------
    The Medical College of          $1,265   CIBMTR General Operating
     Wisconsin, Inc.                          Support
    ------------------------------------------------------------------------
    ALL IN TOGETHER                $37,500   All in Together Campaign:
     CAMPAIGN INC.                            Advancing and Empowering Women
                                              Leaders
    ------------------------------------------------------------------------
    Childrens Inn at NIH          $500,000   Sanofi US Legacy Endowment Fund
     Inc.                                     at The Children's Inn at NIH
    ------------------------------------------------------------------------
    Kids Corporation II            $10,000   Kids Corp General Operating
    ------------------------------------------------------------------------
    American Cancer                $25,000   Nationwide Hope Lodge
     Society Cancer Action                    Partnership
     Network
    ------------------------------------------------------------------------
    Boy Scouts of America,          $1,000   STEM Scouts, BSA
     Catalina Council
    ------------------------------------------------------------------------
    Kino Learning Center            $2,000   STEM Funding
     Inc.
    ------------------------------------------------------------------------
    SARSEF-SOUTHERN                 $5,000   Finding the Next Generation of
     ARIZONA RESEARCH                         STEM Researchers
     SCIENCE AND
     ENGINEERING
     FOUNDATION
    ------------------------------------------------------------------------
    International Myeloma          $19,640   International Myeloma
     Foundation                               Foundation Mission Support
    ------------------------------------------------------------------------
    International Myeloma           $2,000   MMJP Donation to Support the
     Foundation                               International Myeloma
                                              Foundation
    ------------------------------------------------------------------------
                                $6,715,031

        Total 2016 Sanofi     $352,310,932
         US
    ------------------------------------------------------------------------

                        Payments made by Sanofi US (2017)
    ------------------------------------------------------------------------
          Legal Name         Payment Amount            Project Title
    ------------------------------------------------------------------------
    AAALAC International          $2,500.00   IQ Consortium/AAALAC
                                               International Global 3Rs
                                               Awards Program
    ------------------------------------------------------------------------
    Academy of Managed           $30,000.00   2017 AMCP Partnership Forums
     Care Pharmacy
    ------------------------------------------------------------------------
    Academy of Nutrition         $18,000.00   DCE On the Cutting Edge
     and Dietetics on                          newsletter
     behalf of Diabetes
     Care and Education
    ------------------------------------------------------------------------
    ALL IN TOGETHER              $25,000.00   National Women's Leadership
     CAMPAIGN INC.                             Initiative
    ------------------------------------------------------------------------
    Alliance for Patient        $150,000.00   Keep My Rx Campaign
     Access
    ------------------------------------------------------------------------
    Alliance for the             $50,000.00   Webinars on Nonmedical
     Adoption of                               Switching of Diabetes
     Innovations in                            Patients
     Medicine (Aimed
     Alliance)
    ------------------------------------------------------------------------
    Alliance for the             $42,000.00   Campaign to End Nonmedical
     Adoption of                               Switching of Diabetes
     Innovations in                            Patients
     Medicine (Aimed
     Alliance)
    ------------------------------------------------------------------------
    American Academy of         $250,000.00   Practice Management Center
     Dermatology Inc
    ------------------------------------------------------------------------
    American Association         $25,000.00   AACE 26th Annual Scientific &
     of Clinical                               Clinical Congress General
     Endocrinologists                          Support
    ------------------------------------------------------------------------
    American Association        $150,035.00   AACE Multi-Site Proposal to
     of Clinical                               Extend the
     Endocrinologists                          Transculturalization of
                                               Diabetes Care
    ------------------------------------------------------------------------
    American Association         $75,000.00   AADE Access and Affordability
     of Diabetes                               Forum
     Educators
    ------------------------------------------------------------------------
    American Association         $20,000.00   2017 Public Policy Forum
     of Diabetes
     Educators
    ------------------------------------------------------------------------
    American Cancer               $2,500.00   RUN FOR DAD
     Society
    ------------------------------------------------------------------------
    American Cancer              $10,000.00   ACS CAN State Government
     Society Cancer                            Relations Director Training
     Action Network                            and Advocacy Activities
                                               Nationwide
    ------------------------------------------------------------------------
    American Cancer              $25,000.00   2017 ACS CAN Fundraising
     Society Cancer                            Events and ACS CAN advocacy
     Action Network                            activities
    ------------------------------------------------------------------------
    American Cancer               $2,500.00   Relay For Life of Bridgewater
     Society Inc.
    ------------------------------------------------------------------------
    American Chemical             $3,000.00   Division of Medicinal
     Society Division of                       Chemistry Program 253rd ACS
     Medicinal Chemistry                       national meeting
    ------------------------------------------------------------------------
    American Chemical             $2,500.00   ACS MEDI-EFMC Frontiers in
     Society Division of                       Medicinal Chemistry 2017
     Medicinal Chemistry
    ------------------------------------------------------------------------
    American Chemical             $3,000.00   Division of Medicinal
     Society Division of                       Chemistry Program 254th ACS
     Medicinal Chemistry                       National Meeting
    ------------------------------------------------------------------------
    American College of         $100,000.00   Heart House Roundtable:
     Cardiology                                Effective Prior Authorization
     Foundation
    ------------------------------------------------------------------------
    American College of         $100,000.00   ACC's 2017 LDL: Address the
     Cardiology                                Risk Think Tank
     Foundation
    ------------------------------------------------------------------------
    American College of          $20,000.00   Donald C. Jones Leadership and
     Endocrinology                             Endocrine Excellence Award
    ------------------------------------------------------------------------
    American College of           $2,000.00   Expand the body of knowledge
     Laboratory Animal                         in the fields of laboratory
     Medicine                                  animal science and medicine
    ------------------------------------------------------------------------
    American College of           $1,500.00   2017 ACT Corporate Membership
     Toxicology
    ------------------------------------------------------------------------
    American Diabetes             $2,500.00   Tour de Cure Hawaii--Hele On
     Association                               Hawaii
    ------------------------------------------------------------------------
    American Diabetes             $2,500.00   American Diabetes Month--
     Association                               Malama Ohana
    ------------------------------------------------------------------------
    American Diabetes             $2,500.00   2017 RVA Tour de Cure &
     Association                               Fitness Walk
    ------------------------------------------------------------------------
    AMERICAN DIABETES         $2,000,000.00   Pathway to Stop Diabetes
     ASSOCIATION INC.
    ------------------------------------------------------------------------
    American Drug                $20,000.00   American Drug Utilization
     Utilization Review                        Review Symposium
     Society
    ------------------------------------------------------------------------
    American Foundation          $25,000.00   2017 Get in Rhythm. Stay in
     for Women's Health                        Rhythm. Atrial Fibrillation
     (dba StopAfib.org)                        Patient Conference
    ------------------------------------------------------------------------
    American Friends of          $15,000.00   Scholarship Fundraising Event--
     Toulouse School of                        Toulouse School of Economics
     Economics Inc                             Gala Event
    ------------------------------------------------------------------------
    American Heart               $25,000.00   2017 National Health Tech &
     Association                               Innovation Forum
    ------------------------------------------------------------------------
    American Heart               $30,000.00   Boston Heart & Stroke Ball
     Association                               Sponsor
    ------------------------------------------------------------------------
    American Heart               $15,000.00   Heart Innovation Forum
     Association Inc
    ------------------------------------------------------------------------
    American Medical             $50,000.00   AMSSM Research Grant Awards
     Society for Sports                        Program
     Medicine Foundation,
     Inc.
    ------------------------------------------------------------------------
    American Medical             $25,000.00   Multi-Site CRN OA Grant with
     Society for Sports                        Shark Tank competition
     Medicine Foundation,
     Inc.
    ------------------------------------------------------------------------
    American Orthopaedic         $55,000.00    Early Osteoarthritis and
     Society for Sports                        Prevention of OA Progression
     Medicine
    ------------------------------------------------------------------------
    American Pharmacists         $75,000.00    Osteoarthritis Pharmacist-
     Association                               Patient Companion Guide
    ------------------------------------------------------------------------
    American Pharmacists         $80,000.00   Osteoarthritis Pharmacist Quiz
     Association                               Platform
    ------------------------------------------------------------------------
    American Society for         $10,000.00   4th Annual ASBMT Fall Clinical
     Blood and Marrow                          Education Conference
     Transplantation
    ------------------------------------------------------------------------
    American Society for          $2,500.00   ASN Annual Meeting
     Neurochemistry
    ------------------------------------------------------------------------
    American Society for          $1,500.00   Myelin Satellite Meeting
     Neurochemistry
    ------------------------------------------------------------------------
    American Society for         $70,000.00   2017 Town Hall Presentation
     Preventive                                Series
     Cardiology
    ------------------------------------------------------------------------
    American Society of          $35,000.00   Kidney Week 2017--Sponsorships
     Nephrology
    ------------------------------------------------------------------------
    American Society of          $75,000.00   2018 Corporate Sponsor
     Transplant Surgeons
     Foundation
    ------------------------------------------------------------------------
    American Statistical          $1,000.00   ASA Princeton-Trenton chapter
     Association of                            2017 Spring Symposium
     Princeton-Trenton
     Chapter
    ------------------------------------------------------------------------
    Americans for Medical         $7,500.00   Raising Voices, Saving Lives
     Progress Educational
     Foundation
    ------------------------------------------------------------------------
    Americares                   $12,000.00   Air Lift Benefit Sponsorship
                                               2017
    ------------------------------------------------------------------------
    Americares                   $70,000.00   Sanofi Solar Power Puerto Rico
                                               Concept
    ------------------------------------------------------------------------
    AMGA Foundation Inc         $175,000.00   Together 2 Goal diabetes
                                               campaign
    ------------------------------------------------------------------------
    Amigos Together For           $5,000.00   Domino Night Gala for After
     Kids, Inc. d/b/a                          School Program, Nurturing
     Amigos For Kids                           Parent Program and Blue
                                               Ribbon Campaign
    ------------------------------------------------------------------------
    Arizona Diabetes              $3,000.00   Diabetes: A Prescription for
     Foundation                                Care
    ------------------------------------------------------------------------
    Arkansas Pharmacy             $1,000.00   Immunization Summit
     Foundation
    ------------------------------------------------------------------------
    Arthritis Foundation          $1,200.00   2017 Delaware Bone Bash
    ------------------------------------------------------------------------
    Asian American Legal         $10,000.00   2017 Justice in Action Awards
     Defense and                               Gala
     Education Fund
    ------------------------------------------------------------------------
    Association of                $7,500.00   Sponsorship of Health
     American Medical                          Workforce Research Conference
     Colleges
    ------------------------------------------------------------------------
    Association of Black         $25,000.00   Improving Healthcare Access
     Cardiologists                             for Minority and High Risk
                                               Population Gala Dinner
    ------------------------------------------------------------------------
    Association of Black        $100,000.00   ABC Advocacy Training Program
     Cardiologists
    ------------------------------------------------------------------------
    Association of                $5,000.00   AUTM 2017 Annual Meeting
     University                                Sponsorship
     Technology Managers
     Inc.
    ------------------------------------------------------------------------
    Asthma & Allergy              $1,000.00   Asthma Coalition Meeting
     Foundation of
     America, St. Louis
     Chapter
    ------------------------------------------------------------------------
    Austin Black                  $2,500.00   Austin Black Physicians
     Physicians                                Association Scholarship
     Association                               Fundraiser
    ------------------------------------------------------------------------
    Autoimmune Advocacy           $2,500.00   Living with Autoimmunity
     Alliance
    ------------------------------------------------------------------------
    Be The Match                 $37,500.00   Be The Match Walk+Run National
     Foundation                                Sponsorship
    ------------------------------------------------------------------------
    Biocom                       $10,000.00   Global Life Science Partnering
                                               Conference
    ------------------------------------------------------------------------
    BIONJ INC.                   $10,000.00   2017 Annual Dinner Meeting
    ------------------------------------------------------------------------
    BIONJ INC.                    $2,500.00   2017 bioNJ BioPartnering
                                               Conference
    ------------------------------------------------------------------------
    Biotechnology               $195,000.00   2017 BIO International
     Innovation                                Convention Sponsorship
     Organization
    ------------------------------------------------------------------------
    Biotechnology                $25,000.00   2017 BIO Europe Spring
     Innovation                                Sponsorship
     Organization
    ------------------------------------------------------------------------
    Biotechnology                $25,000.00   2017 BIO Europe Sponsorship--
     Innovation                                November
     Organization
    ------------------------------------------------------------------------
    Biotechnology                $10,000.00   2017 BIO Patient and Health
     Innovation                                Advocacy Summit
     Organization
    ------------------------------------------------------------------------
    Biotechnology                $57,500.00   2018 BIO International
     Innovation                                Convention
     Organization
    ------------------------------------------------------------------------
    Blood and Marrow             $25,000.00   Celebrating a Second Chance at
     Transplant                                Life 2017 Survivorship
     Information Network                       Symposium
    ------------------------------------------------------------------------
    Brigham and Women's           $2,000.00   PKD symposium
     Hospital
    ------------------------------------------------------------------------
    Cancer Support                $8,000.00   Bringing Multiple Myeloma
     Community                                 Journey Partners to the
                                               Cancer Support Community
    ------------------------------------------------------------------------
    CANCER SUPPORT                $5,000.00   2017 Wings of Hope
     COMMUNITY CENTRAL
     NEW JERSEY
    ------------------------------------------------------------------------
    CANCER SUPPORT                $2,500.00   Inspiring Hope Advocate
     COMMUNITY CENTRAL                         Sponsorship
     NEW JERSEY
    ------------------------------------------------------------------------
    CASSS                         $2,500.00   6th International Symposium on
                                               Higher Order Structure of
                                               Protein Therapeutics (HOS
                                               2017)
    ------------------------------------------------------------------------
    CASSS                         $2,500.00   WCBP 2017: 21st Symposium on
                                               the Interface of Regulatory
                                               and Analytical Sciences for
                                               Biotechnology Health Products
    ------------------------------------------------------------------------
    CASSS                         $2,500.00   Advances in the Biotechnology
                                               & Pharmaceutical Industries:
                                               19th Symposium on the
                                               Practical Applications for
                                               the Analysis of Proteins,
                                               Nucleotides and Small
                                               Molecules
    ------------------------------------------------------------------------
    CASSS                         $2,500.00   14th Symposium on the
                                               Practical Application of Mass
                                               Spectrometry in the
                                               Biotechnology Industry
    ------------------------------------------------------------------------
    CASSS                         $2,500.00   Analytical Technologies in the
                                               Biopharmaceutical Industry
                                               (AT Europe 2017)
    ------------------------------------------------------------------------
    CASSS                         $2,500.00   Bioassays 2017
    ------------------------------------------------------------------------
    Catalyst Inc.                $13,500.00   Catalyst International Women's
                                               Day Gala Dinner
    ------------------------------------------------------------------------
    Chicago Hispanic                $500.00   Vive tu Vida!Get up! Get
     Health Coalition                          moving! Health and Wellness
                                               Fair
    ------------------------------------------------------------------------
    Children's Health            $30,000.00   Children's Health Fund 2017
     Fund                                      Annual Benefit
    ------------------------------------------------------------------------
    Children's Health           $665,000.00   Medical Home Initiative
     Fund
    ------------------------------------------------------------------------
    Children's Health           $665,000.00   Medical Home Initiative
     Fund
    ------------------------------------------------------------------------
    Children's Hospital          $10,000.00   2017 PCMM Scientific Retreat
     Corporation
    ------------------------------------------------------------------------
    Children's Hospital             $500.00   Boston Postdoctoral
     Corporation                               Association Symposium on
                                               Careers and Collaboration in
                                               Science
    ------------------------------------------------------------------------
    Christ the King               $5,000.00   Annual President's Gala
     Preparatory School
     of Newark NJ Corp
    ------------------------------------------------------------------------
    CISCRP                       $25,000.00   AWARE for All: Clinical
                                               Research Education Day
    ------------------------------------------------------------------------
    CISCRP                      $160,000.00   AWARE for All Campaign
    ------------------------------------------------------------------------
    Coalition for                 $5,000.00   Health RX: Building
     Affordable Health                         Affordability & Access event
     Coverage                                  sponsorship
    ------------------------------------------------------------------------
    Coastal Volunteers in         $1,000.00   Care & Management of Diabetic
     Medicine                                  Patients
    ------------------------------------------------------------------------
    Cold Spring Harbor           $15,000.00   Cold Spring Harbor Laboratory
     Laboratory                                Corporate Sponsor Program
                                               2017
    ------------------------------------------------------------------------
    College Diabetes             $55,000.00   CDN Political Advocacy for
     Network Inc.                              Young Adults Guide
    ------------------------------------------------------------------------
    College Diabetes             $20,000.00   2017 Corporate Membership
     Network Inc.
    ------------------------------------------------------------------------
    Colorado Business             $7,000.00   Corporate Membership
     Group on Health
    ------------------------------------------------------------------------
    Community Health              $2,500.00   ``Patient-Centered and
     Coalition, Inc.                           Population Health for Us''
    ------------------------------------------------------------------------
    Community Health Task           $500.00   2017 World Diabetes Day 5th
     Force, Inc.                               Annual BridgeWalk for
                                               Diabetes Awareness and Care
    ------------------------------------------------------------------------
    Community Hope, Inc.          $4,800.00   Veterans Pre-Holiday Dinner
                                               and Gift Cards
    ------------------------------------------------------------------------
    Community Hope, Inc.         $10,000.00   2017 Corporate Partner Program
    ------------------------------------------------------------------------
    Community Oncology           $25,000.00   2017 Payer Exchange Summit VII
     Alliance
    ------------------------------------------------------------------------
    Conference of Western         $5,000.00   CWAG 2017 Chair Initiative
     Attorneys General                         Sponsorship
    ------------------------------------------------------------------------
    Congress of                   $2,500.00   Adherence Outreach and
     California Seniors                        Education with Seniors =
     Education and                             Script your Future
     Research Fund
    ------------------------------------------------------------------------
    Council for the              $60,000.00   10th World Conference of
     Advancement of                            Science Journalists
     Science Writing,
     Inc.
    ------------------------------------------------------------------------
    CrowdCare Foundation,        $20,000.00   Muscles for Myeloma
     Inc.
    ------------------------------------------------------------------------
    CSweetener                   $25,000.00   CSweetener Mentoring Program
    ------------------------------------------------------------------------
    Deep South Cancer             $5,000.00   Cycliad 2017
     Foundation
    ------------------------------------------------------------------------
    Deirdre O'Brien Child         $5,000.00   21st Annual Gala Solicitation
     Advocacy Center Inc.
    ------------------------------------------------------------------------
    Diabetes Foundation           $1,000.00   Tastings & Tapas Fundraiser
     Inc.
    ------------------------------------------------------------------------
    Diabetes Foundation           $2,500.00   Live-A-Betes: Living Well with
     of Mississippi                            Diabetes
    ------------------------------------------------------------------------
    Diversity Alliance            $5,500.00   DA4S East Coast 2017
     for Science, Inc.
    ------------------------------------------------------------------------
    Diversity Alliance            $3,500.00   DA4S West Coast 2017
     for Science, Inc.
    ------------------------------------------------------------------------
    Donate Life America          $26,025.00   Mission Support
    ------------------------------------------------------------------------
    Donate Life Northwest        $10,000.00   Part II. Removing Barriers
                                               through Knowledge: An
                                               Educational Series for
                                               Providers of Dialysis and
                                               ESRD Patients
    ------------------------------------------------------------------------
    Dress For Success            $15,000.00   Transforming Lives Celebration
     Northern New Jersey--
     10 Counties, Inc.
    ------------------------------------------------------------------------
    Employers Health              $7,500.00   2017 Employers Health
     Coalition, Inc.                           Innovations in Employee
                                               Benefits Conference
    ------------------------------------------------------------------------
    Endocrine Society           $150,000.00   Hypoglycemia Quality
                                               Improvement Program
    ------------------------------------------------------------------------
    Families of SMA DBA           $5,000.00   2017 Annual SMA Conference
     Cure SMA
    ------------------------------------------------------------------------
    Federal Circuit Bar           $2,500.00   Major Regional Program--Boston
     Association
     Charitable and
     Educational Fund
    ------------------------------------------------------------------------
    Federation of                 $2,000.00   FASEB SRC on the Biology of
     American Societies                        Cilia and Flagella
     for Experimental
     Biology (FASEB)
    ------------------------------------------------------------------------
    Federation of                $25,000.00   FOCIS 2017 Annual Meeting
     Clinical Immunology
     Societies
    ------------------------------------------------------------------------
    Florida Health Care           $5,000.00   FLHCC 24th Annual National
     Coalition                                 Conference: Getting to Better
                                               Care and Improved Outcomes
    ------------------------------------------------------------------------
    Florida International       $170,000.00   Expert Workshop State of the
     University                                Art Pertussis Prevention and
     Foundation Inc.                           Control in Latin America and
                                               the Caribbean
    ------------------------------------------------------------------------
    Florida International        $60,000.00   LATIN AMERICAN AND CARIBBEAN
     University                                DIABETES NETWORK: A FRAMEWORK
     Foundation Inc                            FOR ACTION
    ------------------------------------------------------------------------
    Florida International        $60,000.00   Assesment of acellular
     University                                vaccination programs in
     Foundation Inc.                           Mexico, Costa Rica and Panama
    ------------------------------------------------------------------------
    Florida International        $25,000.00   Develop Guidelines for
     University                                Antimicrobial Stewardship For
     Foundation Inc.                           Latin America and Caribbean
                                               region
    ------------------------------------------------------------------------
    Florida International        $62,000.00   REVIEW OF NATIONAL
     University                                IMMUNIZATION CALENDARS OF THE
     Foundation Inc.                           EXPANDED PROGRAM OF
                                               IMMUNIZATION (EPI) IN
                                               COUNTRIES OF LATIN AMERICA
                                               AND THE CARIBBEAN.
                                               PRELIMINARY OBSERVATIONS ON
                                               FINANCIAL AND FUNDING
                                               MECHANISMS OF THE NATIONAL
                                               IMMUNIZATION PROGRAMS.
    ------------------------------------------------------------------------
    Food Allergy Research        $50,000.00   FARE Patient Registry
     & Education, Inc.
    ------------------------------------------------------------------------
    Foundation Fighting         $100,000.00   Research to Overcome Retinal
     Blindness                                 Degenerative Diseases
    ------------------------------------------------------------------------
    Foundation for                $7,500.00   ANIMAL RESEARCH HELPS ANIMALS
     Biomedical Research                       CAMPAIGN
    ------------------------------------------------------------------------
    Foundation of the            $20,000.00   Foundation of the National
     National Lipid                            Lipid Association Young
     Association                               Investigator Abstract Award
                                               Program
    ------------------------------------------------------------------------
    French-American               $2,500.00   FACC Corporate Membership
     Chamber of Commerce
     in the United
     States, Inc.--New
     York Chapter
    ------------------------------------------------------------------------
    Friends of Cancer            $25,000.00   Exploring New Biomarkers for
     Research                                  Immunology
    ------------------------------------------------------------------------
    Friends of Cancer            $50,000.00   2017 Mission Support
     Research
    ------------------------------------------------------------------------
    George Washington           $130,000.00   The George Washington
     University                                University Forum on Arbovirus
                                               Infections
    ------------------------------------------------------------------------
    GLBTQ Legal Advocates         $3,000.00   18th Annual Spirit of Justice
     & Defenders                               Award Dinner
    ------------------------------------------------------------------------
    Good Grief Inc.               $7,500.00   2017 Golf ``Fore'' the Kids
    ------------------------------------------------------------------------
    Good Grief Inc.               $5,000.00   Great Pumpkin Ball Sponsorship
    ------------------------------------------------------------------------
    Gordon Research              $10,000.00   GRC: Pancreatic Diseases
     Conference                                ``Exocrine and Endocrine
                                               Pancreas: Molecules to
                                               Human''
    ------------------------------------------------------------------------
    Gordon Research               $1,000.00   High Throughput Chemistry and
     Conference                                Chemical Biology GRC
    ------------------------------------------------------------------------
    Gordon Research               $2,500.00   The Enduring Potential of
     Conference                                Heterocycles as Synthetic
                                               Targets, Cellular Probes, and
                                               Drug Candidates
    ------------------------------------------------------------------------
    Gordon Research               $2,000.00   2017 Gordon Research
     Conference                                Conference on Natural
                                               Products & Bioactive
                                               Compounds
    ------------------------------------------------------------------------
    Gordon Research               $3,000.00   2017 Gordon Research
     Conference                                Conference on Medicinal
                                               Chemistry
    ------------------------------------------------------------------------
    Gordon Research               $3,000.00   Gordon Research Conference and
     Conference                                Seminar on ``Lysosomal
                                               Diseases''
    ------------------------------------------------------------------------
    Gordon Research               $5,000.00   Gordon Research Conference
     Conference                                (GRC) entitled ``Neuroimmune
                                               communication in health and
                                               disease''
    ------------------------------------------------------------------------
    Gordon Research               $5,000.00   2018 Biology of Spirochetes
     Conference                                Gordon Research Conference
                                               and Gordon Research Seminar
    ------------------------------------------------------------------------
    Greater Detroit Area          $7,000.00   2017 GDAHC Membership Dues
     Health Council, Inc.
    ------------------------------------------------------------------------
    Greater New England           $4,000.00   Economic Development
     Minority Supplier                         Sponsorship opportunities
     Development Council
    ------------------------------------------------------------------------
    Health Action Council         $4,500.00   Health Action Council Annual
     Ohio                                      Event Sponsorship
    ------------------------------------------------------------------------
    HealthCare 21                $25,000.00   Data Impact: Evaluating the
     Business Coalition                        Impact of Formulary Exclusion
                                               on Pharmacy Data
    ------------------------------------------------------------------------
    Healthcare                    $3,000.00   2017 Woman of the Year event
     Businesswomen's
     Association
    ------------------------------------------------------------------------
    Healthcare                   $10,000.00   2017 HBA Woman of the Year
     Businesswomen's                           event sponsorship
     Association
    ------------------------------------------------------------------------
    Heart To Heart               $15,000.00   25th Anniversary Gala
     International Inc.
    ------------------------------------------------------------------------
    Heart To Heart                $8,500.00   Rutgers Fellows Volunteer
     International Inc.                        Service Trip
    ------------------------------------------------------------------------
    Hereditary Disease            $2,000.00   2017 Celebration of Discovery
     Foundation                                Symposium and Gala
    ------------------------------------------------------------------------
    Horton's Kids, Inc.          $15,000.00   Home Runs for Horton's Kids:
                                               Comprehensive Programming for
                                               At-Risk Children
    ------------------------------------------------------------------------
    Hunterdon Medical             $5,000.00   2017 Crystal Ball Sponsorship
     Center Foundation
    ------------------------------------------------------------------------
    Hyacinth Foundation A         $1,000.00   Hyacinth Gala & Silent Auction
     New Jersey Nonprofit
     Corporation
    ------------------------------------------------------------------------
    Hyacinth Foundation A         $2,500.00   Hyacinth Gala & Silent Auction
     New Jersey Nonprofit
     Corporation
    ------------------------------------------------------------------------
    Icahn School of               $5,000.00   ISMMS-Sanofi Quantitative
     Medicine at Mount                         Systems Pharmacology
     Sinai                                     Symposium
    ------------------------------------------------------------------------
    ILSI Health and              $99,074.00   2017 HESI Membership and
     Environmental Health                      Committee Assessments
     Institute
    ------------------------------------------------------------------------
    Institute for Cancer         $10,000.00   2017 In Vino Vita Sponsorship
     Research dba The                          Request
     Research Institute
     of Fox Chase Cancer
     Center
    ------------------------------------------------------------------------
    Institute for Safe            $1,000.00   20th Annual ISMP Cheers Awards
     Medication Practices
    ------------------------------------------------------------------------
    International                 $5,000.00   NIH Oxford-Cambridge 2017
     Biomedical Research                       Global Doctoral Partnerships
     Alliance                                  Annual Workshop
    ------------------------------------------------------------------------
    International                 $5,000.00   NIH Oxford-Cambridge 2016
     Biomedical Research                       Global Doctoral Partnerships
     Alliance                                  Annual Workshop
    ------------------------------------------------------------------------
    International Myeloma        $50,000.00   8th International Myeloma
     Foundation                                Working Group (IMWG) Summit,
                                               Madrid, Spain
    ------------------------------------------------------------------------
    International Myeloma        $50,000.00   2017 IMF Patient Programs
     Foundation
    ------------------------------------------------------------------------
    International Myeloma        $50,000.00   International Myeloma
     Foundation                                Foundation 2017 Asian Myeloma
                                               Network (AMN) Summit
    ------------------------------------------------------------------------
    Iowa Pharmacy                $10,000.00   2017 Leadership Pharmacy
     Association                               leadership training program
     Foundation
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   2017 One Walk Allentown
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   2017 One Walk Bucks County
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   2017 One Walk Reading
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   JDRF Passport to a Cure Gala
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   Rockin' Docs for Diabetes Cure
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   2017 One Walk Stroudsburg
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   2017 One Walk Moosic
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   2017 One Walk Philadelphia
    ------------------------------------------------------------------------
    JDRF                          $1,500.00   2017 JDRF One Walk Maine
    ------------------------------------------------------------------------
    JDRF                          $5,000.00   2017 Triangle Eastern NC
                                               OneWalk
    ------------------------------------------------------------------------
    JDRF                         $10,000.00   2017 Triangle Eastern NC Hope
                                               Gala
    ------------------------------------------------------------------------
    JDRF                          $5,000.00   JDRF One Promise Gala
                                               Philadelphia
    ------------------------------------------------------------------------
    JDRF                          $5,000.00   JDRF One Walk Westmoreland
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   JDRF One Walk
    ------------------------------------------------------------------------
    JDRF                          $5,000.00   25th Anniversary JDRF Promise
                                               Gala
    ------------------------------------------------------------------------
    JDRF                          $2,500.00   JDRF TypeOneNation Summit
    ------------------------------------------------------------------------
    JDRF                          $5,000.00   JDRF Imagine Gala
    ------------------------------------------------------------------------
    JDRF--Western New             $3,000.00   Journey to A Cure Gala
     York Chapter
    ------------------------------------------------------------------------
    JDRF--Western New             $2,500.00   Buffalo JDRF One Walk 2017
     York Chapter
    ------------------------------------------------------------------------
    JDRF--Western New             $5,000.00   Journey to a Cure Gala
     York Chapter
    ------------------------------------------------------------------------
    JDRF Greater Dallas           $2,500.00   JDRF One Walk, Dallas
    ------------------------------------------------------------------------
    JDRF International            $2,500.00   JDRF One Walk 2017
    ------------------------------------------------------------------------
    JDRF International            $5,000.00   JDRF 35th Annual Boston Gala
    ------------------------------------------------------------------------
    JDRF INTERNATIONAL           $50,000.00   2017 JDRF Government Day
    ------------------------------------------------------------------------
    JDRF International            $5,000.00   2017 JDRF One Walk Las Vegas
    ------------------------------------------------------------------------
    JDRF NENY                     $2,500.00   JDRF Saratoga One Walk
    ------------------------------------------------------------------------
    JDRF NENY                     $2,500.00   JDRF Albany One Walk
    ------------------------------------------------------------------------
    JDRF New York City           $10,000.00   45th annual Promise Ball
     Chapter
    ------------------------------------------------------------------------
    Jersey Battered              $14,000.00   Grand Tastings XXIII
     Women's Service,
     Inc.
    ------------------------------------------------------------------------
    Joslin Diabetes              $10,000.00   2017 High Hopes Gala
     Center, Inc.
    ------------------------------------------------------------------------
    Joslin Diabetes              $10,000.00   A Taste of Ginger
     Center, Inc.
    ------------------------------------------------------------------------
    Junior Achievement of         $5,000.00   Empowering NJ Students for
     New Jersey, Inc.                          Success
    ------------------------------------------------------------------------
    Juvenile Diabetes             $5,000.00   2018 Hope for a Cure Gala
     Research Foundation
    ------------------------------------------------------------------------
    Juvenile Diabetes             $2,500.00   2017 JDRF One Walk Southern
     Research Foundation                       Tier
    ------------------------------------------------------------------------
    Juvenile Diabetes             $2,500.00   2017 Hope for a Cure Gala
     Research Foundation
    ------------------------------------------------------------------------
    Juvenile Diabetes             $2,500.00   JDRF One Walk Rochester
     Research Foundation
    ------------------------------------------------------------------------
    Juvenile Diabetes             $2,500.00   2017 Rock the Cure
     Research Foundation
    ------------------------------------------------------------------------
    Juvenile Diabetes             $2,500.00    One Walk, Yonkers
     Research Foundation
     International
    ------------------------------------------------------------------------
    Keystone Symposia on         $50,000.00   Keystone Symposia Directors'
     Molecular and                             Fund
     Cellular Biology
    ------------------------------------------------------------------------
    Keystone Symposia on         $25,000.00   Keystone Symposia Directors'
     Molecular and                             Fund
     Cellular Biology
    ------------------------------------------------------------------------
    Lake Norman Community         $2,500.00   Sunset and Sandals
     Health Clinic
    ------------------------------------------------------------------------
    Lymphoma Research             $2,000.00   10th Annual Love to Find a
     Foundation                                Cure Dinner
    ------------------------------------------------------------------------
    Machestic Dragons             $5,000.00   2017 Machestic Dragons ``
                                               `Paddle for Pink' Community
                                               Dragon Boat Festival''
    ------------------------------------------------------------------------
    Machestic Dragons               $500.00   2017 Machestic Dragons ``
                                               `Paddle for Pink' Community
                                               Dragon Boat Festival''
    ------------------------------------------------------------------------
    Map International            $10,000.00   Bill Foege Event Sponsorship
    ------------------------------------------------------------------------
    March of Dimes                $2,500.00   Signature Chefs--Seattle
     Foundation
    ------------------------------------------------------------------------
    Massachusetts General         $1,500.00   18th Annual Paul S. Russell
     Hospital--Transplant                      Lecture in Transplantation
     Center
    ------------------------------------------------------------------------
    Massachusetts                 $5,000.00   Immune Engineering Symposium
     Institute of                              2017
     Technology
    ------------------------------------------------------------------------
    Massachusetts                 $5,000.00   Immune Engineering Symposium
     Institute of                              2017
     Technology
    ------------------------------------------------------------------------
    Massachusetts                 $5,000.00   Koch Institute Summer
     Institute of                              Symposium 2017
     Technology
    ------------------------------------------------------------------------
    Massachusetts Society         $1,000.00   MSMR Annual Meeting of Members
     for Medical
     Research, Inc.
    ------------------------------------------------------------------------
    MassChallenge, Inc.          $50,000.00   PULSE@MassChallenge 2018
                                               Sanofi Gold Sponsorship
    ------------------------------------------------------------------------
    Medical Foundation of        $10,000.00   Osteoarthritis Action Alliance
     North Carolina Inc                        (OAAA) Community mini-grant
                                               Program
    ------------------------------------------------------------------------
    Men's Health Network         $25,000.00   Men's Health Month Sponsorship
    ------------------------------------------------------------------------
    Mercy Health                  $2,500.00   Stick it to Diabetes
     Foundation Joplin
    ------------------------------------------------------------------------
    Mercy Health                  $2,500.00   Mercy Gala of Hope
     Foundation--Springfi
     eld
    ------------------------------------------------------------------------
    Metabolic Endocrine          $25,000.00   15th Annual World Congress on
     Education Foundation                      Insulin Resistance Diabetes
                                               and Cardiovascular Disease
                                               WCIRDC
    ------------------------------------------------------------------------
    Metabolic Endocrine         $100,000.00   1st Annual Congress--Heart in
     Education Foundation                      Diabetes (HiD)
    ------------------------------------------------------------------------
    Metabolic Endocrine          $25,000.00   15th Annual World Congress on
     Education Foundation                      Insulin Resistance Diabetes
                                               and Cardiovascular Disease--
                                               WCIRDC = Request 2
    ------------------------------------------------------------------------
    Mid-America Coalition         $5,000.00   5th Annual Workforce &
     on Health Care                            Community Well-Being Forum
    ------------------------------------------------------------------------
    Middle Atlantic               $1,000.00   Bradford award/student career
     Reproduction and                          event
     Teratology
     Association (MARTA)
    ------------------------------------------------------------------------
    Moses E. Cheeks Slam          $2,500.00   Chicago Camp Slam Dunk for
     Dunk for Diabetes                         Diabetes
    ------------------------------------------------------------------------
    Multiple Myeloma             $20,000.00   Stem Cell Care Package Program
     Research Foundation                       and Re Birthday Program
    ------------------------------------------------------------------------
    Multiple Myeloma             $20,000.00   Multiple Myeloma Patient
     Research Foundation                       Summits
    ------------------------------------------------------------------------
    Myotonic Dystrophy            $3,000.00   2017 MDF Conference
     Foundation                                Sponsorship
    ------------------------------------------------------------------------
    NASPA                         $5,000.00   OA Mobility Discussion and
                                               Event
    ------------------------------------------------------------------------
    NATIONAL ACADEMY OF          $50,000.00   Forum on Neuroscience and
     SCIENCES                                  Nervous System Disorders
    ------------------------------------------------------------------------
    NATIONAL ACADEMY OF          $85,000.00   Forum on Drug Discovery,
     SCIENCES                                  Development and Translation
    ------------------------------------------------------------------------
    National Alliance of         $17,000.00   Supporting Employers to
     Healthcare Purchaser                      Effectively Manage Rheumatoid
     Coalitions                                Arthritis Action Brief
    ------------------------------------------------------------------------
    National Alliance of          $2,000.00   13th Annual Meeting of NASPCC
     State Prostate
     Cancer Coalitions
    ------------------------------------------------------------------------
    National Bone Marrow          $5,000.00   PEER SUPPORT FOR BONE MARROW,
     Transplant Link                           STEM CELL TRANSPLANT
                                               COMMUNITY
    ------------------------------------------------------------------------
    National Bone Marrow          $2,500.00   Resource Directory
     Transplant Link
    ------------------------------------------------------------------------
    National Committee           $10,000.00    NCQA's Quality Talks 2017
     for Quality
     Assurance
     (``NCQA''')
    ------------------------------------------------------------------------
    National                     $10,000.00   NCCN 12th Annual Congress:
     Comprehensive Cancer                      Hematologic Malignancies
     Network                                   Patient Advocacy Pavilion
    ------------------------------------------------------------------------
    National Eczema              $50,000.00   National Eczema Association's
     Association                               Grassroots Advocacy Program
    ------------------------------------------------------------------------
    National Forum for           $25,000.00   National Forum Cholesterol
     Heart Disease and                         Initiative (Phase 3)
     Stroke Prevention
     Inc.
    ------------------------------------------------------------------------
    National Forum for           $25,000.00   National Forum Value & Access
     Heart Disease and                         Initiative
     Stroke Prevention
     Inc.
    ------------------------------------------------------------------------
    National Health             $130,000.00   Patient Perspective on the
     Council                                   Value of Treatments
    ------------------------------------------------------------------------
    National Hispanic             $5,000.00   Diabetes and Renal Disease
     Medical Association                       among Latino Patients
                                               Conference
    ------------------------------------------------------------------------
    National Kidney               $1,000.00   2017 Champion of Hope Tribute
     Foundation of                             Dinner
     Michigan
    ------------------------------------------------------------------------
    National Kidney              $50,000.00   Connecting Diabetes,
     Foundation, Inc.                          Cardiovascular Disease, and
                                               Kidney Disease `` Patient
                                               Awareness Campaign
    ------------------------------------------------------------------------
    National Lipid               $30,000.00   Expansion of Discovering the
     Association                               Barriers to Access of PCSK9
                                               Inhibitors: an NLA Assessment
    ------------------------------------------------------------------------
    National Minority            $25,000.00   Diabetes Working Group: Vision
     Quality Forum                             20/20
    ------------------------------------------------------------------------
    National TB                   $5,000.00   Sponsorship for the 2017
     Controllers                               National TB Conference:
     Association                               Poster Discussion
    ------------------------------------------------------------------------
    NCSL Foundation for           $7,500.00   NCSL LegisBrief Sponsorship
     State Legislatures
    ------------------------------------------------------------------------
    New England                   $5,000.00   New England Immunology
     Immunology                                Conference
     Conference, Inc.
    ------------------------------------------------------------------------
    New Jersey Public               $500.00   New Jersey Public Health
     Health Association                        Association 2017 Annual
                                               Conference
    ------------------------------------------------------------------------
    New Jersey Society of         $5,000.00   Sponsorship/Membership
     Oncology Managers
    ------------------------------------------------------------------------
    New York & New Jersey        $10,000.00   Annual Event Sponsorship
     Minority Supplier
     Development Council
    ------------------------------------------------------------------------
    NewYorkBIO                    $8,000.00   NewYorkBIO 2017 Annual
                                               Conference
    ------------------------------------------------------------------------
    NJ AIDS Services              $2,500.00   New Jersey AIDS Walk
    ------------------------------------------------------------------------
    North Eastern Section         $2,000.00   6th Advances in Chemical
     Of American Chemical                      Sciences
     Society
    ------------------------------------------------------------------------
    NorthCrest Medical            $2,500.00   NorthCrest Gala
     Center Foundation
    ------------------------------------------------------------------------
    Northeast Business           $20,000.00   eValue8--Health Plan
     Group on Health                           Performance Assessment
    ------------------------------------------------------------------------
    NYU School of                 $5,000.00   The Skirball Institute 18th
     Medicine, an                              Symposium Honoring Dan
     administrative unit                       Littman, MD
     of New York
     University
    ------------------------------------------------------------------------
    Ohio Chamber of               $1,250.00   2017 Salt Fork Policy
     Commerce                                  Conference
    ------------------------------------------------------------------------
    Operation Jersey                $500.00   Gala of Giving II
     Cares
    ------------------------------------------------------------------------
    Operation Warrior            $10,000.00   2017 Army Navy Game
     Wishes Foundation
    ------------------------------------------------------------------------
    Oregon State                  $7,500.00   OSU College of Pharmacy,
     University                                Pharmacy Partners Program
     Foundation
    ------------------------------------------------------------------------
    Organization for             $15,000.00   2017 OFII Annual Dinner
     International
     Investment
    ------------------------------------------------------------------------
    Out & Equal                  $25,000.00   2017 Workplace Summit
    ------------------------------------------------------------------------
    Patient Advocate              $5,000.00   16th Annual A Promise of Hope
     Foundation                                Affair
    ------------------------------------------------------------------------
    Patient Advocate            $250,000.00   Patient Advocate Foundation Co-
     Foundation                                Pay Relief Program Oncology
                                               Donation
    ------------------------------------------------------------------------
    PATIENT EMPOWERMENT          $25,000.00   Virtual Town Meeting for
     NETWORK                                   Advanced Prostate Cancer
                                               Patients
    ------------------------------------------------------------------------
    Patient Services Inc.         $5,000.00   PSI Advocacy Day and
                                               Congressional Reception
    ------------------------------------------------------------------------
    PCMA                         $80,000.00   2017 sPCMA Business Forum
                                               Sponsorship, Presidential
    ------------------------------------------------------------------------
    PCMA                         $95,000.00   2017 Annual Meeting
                                               Presidential Sponsorship
    ------------------------------------------------------------------------
    Pharmaceutical              $270,000.00   PhRMA Foundation Grants &
     Research and                              Fellowships
     Manufacturers of
     America Foundation
    ------------------------------------------------------------------------
    PQA, Inc.                     $7,500.00   PQA 2017 Leadership Summit:
                                               Connecting the Dots to
                                               Enhance Patient Care
    ------------------------------------------------------------------------
    PQA, Inc                    $100,000.00   An Accelerated Strategy for
                                               Advancing an Insulin
                                               Adherence/Persistence Quality
                                               Measure
    ------------------------------------------------------------------------
    Preventive                   $50,000.00   Access to Innovative Medicine
     Cardiovascular                            Campaign
     Nurses Association
    ------------------------------------------------------------------------
    Pro Bono Partnership         $15,000.00   Pro Bono Partnership 2017 Gala
    ------------------------------------------------------------------------
    Project Hope The             $10,000.00   2017 Gala--Project HOPE: A
     People To People                          Voice for Global Health
     Health Foundation
     Inc.
    ------------------------------------------------------------------------
    Prostate Cancer              $10,000.00   Chemotherapy Patient Education
     Education Council
    ------------------------------------------------------------------------
    Prostate Cancer              $25,000.00   Interactive Patient Education
     Education Council                         Programs
    ------------------------------------------------------------------------
    Prostate Cancer             $300,000.00   24th Annual Scientific Retreat
     Foundation
    ------------------------------------------------------------------------
    Public Health                 $5,000.00   Building Health Equity in
     Advocates                                 Diabetes Prevention and
                                               Treatment Conference
    ------------------------------------------------------------------------
    Raritan Valley                $3,000.00   College Campus Experience
     Community College                         Sessions for STEM High School
     Foundation                                Students
    ------------------------------------------------------------------------
    Raritan Valley               $10,000.00   Preparing for the Next
     Community College                         Generation Science Standards--
     Foundation                                District Partnership Program
    ------------------------------------------------------------------------
    Raritan Valley              $125,000.00   Sanofi Nursing Simulation Lab:
     Community College                         Preparing Nursing Students to
     Foundation                                Meet the Community's Health
                                               Care Needs
    ------------------------------------------------------------------------
    Raritan Valley               $25,000.00   Galileo Scholarships:
     Community College                         Providing Access to STEM
     Foundation                                Education
    ------------------------------------------------------------------------
    Raritan Valley               $46,100.00   Sanofi US Corporate Mentor
     Community College                         Program at RVCC
     Foundation
    ------------------------------------------------------------------------
    Raritan Valley                $3,250.00   An Evening of Elegance for
     Community College                         Education
     Foundation
    ------------------------------------------------------------------------
    Raritan Valley               $10,000.00   Preparing for the Next
     Community College                         Generation Science Standards
     Foundation
    ------------------------------------------------------------------------
    Raritan Valley               $15,000.00   Galileo Scholarships:
     Community College                         Providing Access to STEM
     Foundation                                Education
    ------------------------------------------------------------------------
    Regents University of        $10,000.00    March Kidney Fair, March 26,
     California Los                            2017
     Angeles
    ------------------------------------------------------------------------
    Research!America             $10,000.00   National Health Research Forum
    ------------------------------------------------------------------------
    Research!America             $25,000.00   Advocacy Awards Dinner
    ------------------------------------------------------------------------
    RESOURCES USA INC            $10,000.00   Bastille Day 2017--Washington
                                               DC--Celebrates the Franco-
                                               American relationship
    ------------------------------------------------------------------------
    RESOURCES USA INC.            $5,000.00   Bastille Day 2017--Boston
    ------------------------------------------------------------------------
    Rutgers University           $20,000.00   The Sanofi US Scholarship for
     Foundation                                Veterans in the Rutgers
                                               Business School Executive
                                               Education Program
    ------------------------------------------------------------------------
    Rutgers University            $5,000.00   Andrew Giovanni Woman in
     Foundation                                Neuroscience Endowed Travel
                                               Scholarship
    ------------------------------------------------------------------------
    SDHB Pheo-Para                $9,900.00   SDHB Pheo-Para Coalition Gala
     Coalition, Inc.
    ------------------------------------------------------------------------
    Seeding Labs                  $2,000.00   Positively Instrumental: 2017
                                               Instrumental Access Launch &
                                               Donor Recognition Event
    ------------------------------------------------------------------------
    Society for                  $25,000.00   Trainee Professional
     Neuroscience                              Development Awards at
                                               Neuroscience 2017
    ------------------------------------------------------------------------
    Society of Toxicology        $10,000.00   Society of Toxicology (SOT)
                                               Annual Meeting
    ------------------------------------------------------------------------
    SOME INC.                     $5,000.00   2017 SOME Gala
    ------------------------------------------------------------------------
    Somerset Alliance for         $1,000.00   NJ Smart Workplace Recognition
     the Future d.b.a                          Breakfast
     RideWise
    ------------------------------------------------------------------------
    Somerset Health Care          $2,500.00   Healthier Somerset
     Foundation
    ------------------------------------------------------------------------
    Springboard 2000             $25,000.00   Health Innovation Hub 2017
     Enterprises, Inc.
    ------------------------------------------------------------------------
    State University of           $2,500.00   Wellstone Family Conference
     Iowa Foundation                           2017
    ------------------------------------------------------------------------
    T1 Today, Inc., dba          $29,625.00   Round Table on Impact of Non-
     Children with                             Medical Switching of Insulin
     Diabetes
    ------------------------------------------------------------------------
    T1 Today, Inc., dba          $48,500.00   Forced Non-Medical Switching
     Children with                             Awareness--November 2017
     Diabetes
    ------------------------------------------------------------------------
    T1 Today, Inc., dba          $20,000.00   Friends for Life Orlando
     Children with                             Supporting Sponsorship
     Diabetes
    ------------------------------------------------------------------------
    T1 Today, Inc., dba          $49,500.00   Round Table on Impact of Non-
     Children with                             Medical Switching of Insulin--
     Diabetes                                  San Diego
    ------------------------------------------------------------------------
    Taking Control of            $25,000.00   Educating Patients and Their
     Your Diabetes                             Caregivers About The Role Of
                                               Treatments In Diabetes
                                               Management
    ------------------------------------------------------------------------
    Taking Control of            $60,000.00   Taking Control Of Your
     Your Diabetes                             Diabetes 2017
    ------------------------------------------------------------------------
    Taking Control of            $20,000.00   ONE: The Ultimate Conference &
     Your Diabetes                             Retreat for Adult Type 1's
    ------------------------------------------------------------------------
    TBA Foundation               $15,000.00   Pat's Myeloma Survival School
    ------------------------------------------------------------------------
    Teratology Society            $1,500.00   Teratology Society 57th Annual
                                               Meeting
    ------------------------------------------------------------------------
    THE ALBERT B SABIN          $300,000.00   Arbovirus Surveillance
     VACCINE INSTITUTE                         Strengthening Phase II
     INC.
    ------------------------------------------------------------------------
    The American Fallen           $5,700.00   2018 Portrait Donation
     Soldiers Project Inc
    ------------------------------------------------------------------------
    The American Heart           $25,000.00   American Heart Association
     Association                               Multicultural Initiatives
    ------------------------------------------------------------------------
    The American Heart           $50,000.00   Go Red for Women; Health
     Association                               Education Symposium
    ------------------------------------------------------------------------
    The American Heart           $25,000.00   Heart and Stroke Ball Campaign
     Association                               2017
    ------------------------------------------------------------------------
    The American Kidney          $50,000.00   The Hope Affair 2017--Imagine
     Fund, Inc.                                the Possibilities
    ------------------------------------------------------------------------
    The American Kidney           $5,000.00   2017 A Pairing For Prevention
     Fund, Inc.
    ------------------------------------------------------------------------
    The American Kidney          $20,000.00   The Hope Affair Sponsorship
     Fund, Inc.
    ------------------------------------------------------------------------
    THE BIOBREAK                  $5,000.00   BioBreak Industry Sponsorship
     ORGANIZATION INC.
    ------------------------------------------------------------------------
    The Broad Institute,          $2,000.00   Glom-NExT3 Symposium
     Inc.
    ------------------------------------------------------------------------
    The Center For Great          $5,000.00   2017 Gift of Hope Gala
     Expectations Inc.
    ------------------------------------------------------------------------
    The Children's Aid           $25,000.00   Children's Aid Keeping the
     Society                                   Promise Benefit
    ------------------------------------------------------------------------
    The Children's                $2,000.00   2017 Conference on Clinical
     Hospital of                               Trial Readiness in the
     Philadelphia                              Leukodystrophies
    ------------------------------------------------------------------------
    The Children's                $2,000.00   2017 Conference on Clinical
     Hospital of                               Trial Readiness in the
     Philadelphia                              Leukodystrophies
    ------------------------------------------------------------------------
    The Children's Inn at        $10,000.00   An Evening for Hope
     NIH, Inc.
    ------------------------------------------------------------------------
    The Council of State          $5,000.00   Bowhay Institute for
     Government, Ltd.                          Legislative Leadership
                                               Development
    ------------------------------------------------------------------------
    The Diabetes                  $2,500.00   Giving Diabetes the Blues
     Coalition of
     Mississippi/
     Mississippi Rural
     Health Association
    ------------------------------------------------------------------------
    The diaTribe                 $50,000.00   Consensus Conference Glycemic
     Foundation                                Outcomes Beyond A1C
    ------------------------------------------------------------------------
    The diaTribe                 $20,000.00   11th Annual Diabetes Forum
     Foundation
    ------------------------------------------------------------------------
    The diaTribe                 $90,000.00   Follow Up for d17: Executive
     Foundation                                Innovation Lab in Diabetes
                                               and Prediabetes
    ------------------------------------------------------------------------
    The Economic Alliance         $2,500.00   EAM Health Purchaser Forum
     for Michigan
    ------------------------------------------------------------------------
    The FH Foundation           $250,000.00   The CASCADE FHTM Registry
    ------------------------------------------------------------------------
    The FH Foundation           $100,000.00   Advocates for Awareness
    ------------------------------------------------------------------------
    The FH Foundation            $75,000.00   2017 FH Global Summit
    ------------------------------------------------------------------------
    The Galien Foundation        $15,000.00   PRIX GALIEN USA GALIEN FORUM
    ------------------------------------------------------------------------
    The Health                    $5,000.00   Inspire Sponsorship
     Collaborative
    ------------------------------------------------------------------------
    THE LEUKEMIA &               $50,000.00   Blood and Marrow Stem Cell
     LYMPHOMA SOCIETY                          Transplantation Booklet and
                                               Guide
    ------------------------------------------------------------------------
    The Medical College          $10,000.00   2017 BMT Tandem Meetings--
     of Wisconsin, Inc.                        Administrative Directors
                                               Reception
    ------------------------------------------------------------------------
    The Mended Hearts,           $25,000.00   Patient Advocacy Network (PAN)
     Inc.                                      Training
    ------------------------------------------------------------------------
    The Mended Hearts,           $10,000.00   National Education & Training
     Inc.                                      Conference
    ------------------------------------------------------------------------
    The Mesothelioma              $2,000.00   Sponsorship--Clinical Trial
     Applied Research                          Awareness
     Foundation
    ------------------------------------------------------------------------
    The New York Academy          $5,000.00   Challenge 2030: Tomorrow's
     of Science                                innovators tackle today's
                                               grand challenges
    ------------------------------------------------------------------------
    The Ohio State               $25,000.00   Pharmacy Patient Counseling
     University                                Education
     Foundation
    ------------------------------------------------------------------------
    The Ohio State                $1,000.00   Pharmathon 5k
     University
     Foundation
    ------------------------------------------------------------------------
    The Partnership for           $5,000.00   PQMD London Educational Forum
     Quality Medical
     Donations
    ------------------------------------------------------------------------
    The Pennsylvania            $150,000.00   SARP SUPPLEMENTAL FUNDING
     State University                          AGREEMENT
    ------------------------------------------------------------------------
    THE TRANSPLANTATION           $7,500.00   The 14th Congress of the
     SOCIETY                                   International
                                               Xenotransplantation
                                               Association
    ------------------------------------------------------------------------
    THE TRANSPLANTATION          $15,000.00   9th Congress of the
     SOCIETY                                   International Pediatric
                                               Transplant
    ------------------------------------------------------------------------
    The Virginia Public             $700.00   Lighten Up, It's Just Politics
     Access Project
    ------------------------------------------------------------------------
    The World Orphan Fund           $500.00   2017 Annual Wisconsin Gala
     Inc.
    ------------------------------------------------------------------------
    Thomas Jefferson             $65,000.00   Population Health Leadership
     University                                Series (formerly Quality and
                                               Safety Leadership Series)
    ------------------------------------------------------------------------
    Thomas Jefferson            $100,000.00   Quality and Safety Leadership
     University                                Series
    ------------------------------------------------------------------------
    Tree Canada                  $14,089.00   Operation ReLeaf Fort McMurray
    ------------------------------------------------------------------------
    Trustees of Boston           $65,000.00   National Association of
     University                                Community Health Workers
                                               Communications and
                                               Organizational Development
                                               Project
    ------------------------------------------------------------------------
    Trustees of Boston            $1,000.00   Boston University's 16th
     University                                Annual CMD Symposium on
                                               Molecular Discovery: From
                                               Chemical Synthesis to
                                               Biological Applications
    ------------------------------------------------------------------------
    Trustees of Boston           $20,000.00   iHEA's 12th World Congress in
     University                                Health Economics
    ------------------------------------------------------------------------
    Trustees of                   $5,000.00   Translational Retinal Research
     University of                             & Therapies 2017 Symposium
     Pennsylvania
    ------------------------------------------------------------------------
    Tufts Center for the         $30,000.00   Tufts CSDD 2017 Sponsorship
     Study of Drug
     Development c/o
     Trustees of Tufts
     College
    ------------------------------------------------------------------------
    TULANE CANCER CENTER          $2,500.00   NOLA Bluedoo 2017
    ------------------------------------------------------------------------
    University of Florida         $5,000.00   11th Annual Clinical Pharmacy
     Foundation                                and Pharmacology Symposium
    ------------------------------------------------------------------------
    University of                 $5,000.00   UMN John S. Najarian Lecture &
     Minnesota Foundation                      50 Years of Pancreas
                                               Symposium
    ------------------------------------------------------------------------
    University of New             $1,000.00   2017 Hoops4Hope Legislative
     Mexico Foundation =                       Basketball Game
     Hoops for Hope
    ------------------------------------------------------------------------
    University of North          $20,000.00   Pharmacoepidemiology Program
     Carolina at Chapel
     Hill
    ------------------------------------------------------------------------
    University of                $10,000.00   Unity 2017 Conference
     Southern Mississippi
     Foundation
    ------------------------------------------------------------------------
    University of Texas          $50,000.00   Third Annual International
     Foundation-UT Austin                      Immuno-Therapy in Myeloma
                                               Scientific Workshop
    ------------------------------------------------------------------------
    University of Utah           $50,000.00   2017 Western Atrial
                                               Fibrillation Symposium
    ------------------------------------------------------------------------
    Us TOO International         $15,000.00   Prostate Cancer Support Group
                                               Meeting Webcast
    ------------------------------------------------------------------------
    Us TOO International         $20,000.00   Prostate Cancer News You Can
                                               Use
    ------------------------------------------------------------------------
    Virginia Bio                  $3,000.00   Women Building Bio--the XX
                                               Factor
    ------------------------------------------------------------------------
    Virginia Quality              $1,000.00   VQHN Eighteenth Annual Wrap Up
     Healthcare Network                        Event
    ------------------------------------------------------------------------
    Vision y Compromiso          $10,000.00   Vision y Compromiso's 15th
                                               Annual Conference for
                                               Promotoras and CHWs,
                                               ``Resiliency: Our Strength in
                                               Times of Change''
    ------------------------------------------------------------------------
    Waltham West Suburban         $6,000.00   Waltham West Suburban Chamber
     Chamber of Commerce,                      of Commerce Sponsorship
     Inc.                                      Opportunities
    ------------------------------------------------------------------------
    Washington Legal             $30,000.00   2017 General Operating Support
     Foundation
    ------------------------------------------------------------------------
    Washington Policy             $3,500.00   2017 Annual Dinner
     Center
    ------------------------------------------------------------------------
    Western Governors'           $10,000.00   2017-2018 Bi-annual
     Foundation                                Conferences
    ------------------------------------------------------------------------
    Women In Government           $5,000.00   2017 Healthcare Summit--
     Foundation, Inc.                          Inspiration Station
    ------------------------------------------------------------------------
    Women In Government          $65,000.00   2017 Healthcare Summit--
     Foundation, Inc.                          Diabetes PSAs
    ------------------------------------------------------------------------
    WomenHeart: The              $25,000.00   2017 Wenger Awards
     National Coalition
     for Women with Heart
     Disease
    ------------------------------------------------------------------------
    WomenHeart: The              $45,000.00   Access NOW! Key Opinion
     National Coalition                        Leaders Thought Workshop &
     for Women with Heart                      Congressional Briefing
     Disease
    ------------------------------------------------------------------------
    Wyoming Congressional         $5,000.00   WY Congressional Award
     Award Council                             Council's Spring Awards
                                               ceremony
    ------------------------------------------------------------------------
    ZERO--The End of              $8,000.00   Chemotherapy and Immunotherapy
     Prostate Cancer                           Sequencing in Prostate Cancer
                                               Webinar
    ------------------------------------------------------------------------
                            $13,245,248.00
    ------------------------------------------------------------------------
    Product Donations          $594,228,133
     made by Sanofi US to
     the Sanofi
     Foundation for North
     Americaestimate as
     of March 2018)
    ------------------------------------------------------------------------

            Donations made by the Sanofi Foundation for North America
    ------------------------------------------------------------------------
          Legal Name         Payment Amount           Project Title
    ------------------------------------------------------------------------
    American Cancer              $5,000.00   Hope Lodge of Framingham
     Society Inc.                             Operating Support
    ------------------------------------------------------------------------
    American Cancer             $25,000.00   Nationwide American Cancer
     Society Inc.                             Society Hope Lodge
    ------------------------------------------------------------------------
    American National Red       $25,000.00   2017-2018 American Red Cross
     Cross                                    Biomedical Services
    ------------------------------------------------------------------------
    American Recreational        $3,200.00   Project Homecoming
     Military Services
    ------------------------------------------------------------------------
    American Red Cross          $10,000.00   Disaster Relief & Home Fire
                                              Preparedness Campaign
    ------------------------------------------------------------------------
    American Red Cross         $177,422.00   Disaster Relief--special
                                              employee match
    ------------------------------------------------------------------------
    American Society of          $5,000.00   Daniel R. Salomon Frontiers in
     Transplantation                          Transplantation Endowment
                                              (FITE)
    ------------------------------------------------------------------------
    Americares                  $50,000.00   Hurricane Maria Response
    ------------------------------------------------------------------------
    Americares                 $100,000.00   Hurricane Harvey Response
    ------------------------------------------------------------------------
    Americares                  $10,000.00   U.S. Disaster Assistance
    ------------------------------------------------------------------------
    Camp Nejeda Foundation       $5,000.00   Camp Nejeda Campership Program
    ------------------------------------------------------------------------
    Camp Nejeda Foundation      $10,000.00   Camp Nejeda: Helping Kids with
                                              Type 1 Diabetes Live Happier,
                                              Healthier Lives
    ------------------------------------------------------------------------
    Camp Quality USA dba        $10,000.00   Camp Quality USA dba Camp
     Camp Quality NJ                          Quality NJ
    ------------------------------------------------------------------------
    CANCER SUPPORT              $15,000.00   Teens Connect School Based
     COMMUNITY CENTRAL NEW                    Support Groups
     JERSEY
    ------------------------------------------------------------------------
    Children's Health Fund      $30,000.00   Asthma Video
    ------------------------------------------------------------------------
    Children's Health Fund     $665,000.00   Medical Home Initiative
    ------------------------------------------------------------------------
    Children's Health Fund     $665,000.00   Medical Home Initiative
    ------------------------------------------------------------------------
    Christ the King             $59,000.00   Christ the King Corporate Work
     Preparatory School of                    Study Program
     Newark NJ Corp.
    ------------------------------------------------------------------------
    Christopher & Dana           $5,000.00   Reeve Patient Care & Cures--NJ
     Reeve Foundation
    ------------------------------------------------------------------------
    Coastal Bend Food Bank       $1,000.00   Diabetes Hands On
    ------------------------------------------------------------------------
    Deirdre O'Brien Child       $10,000.00   Advocacy Program for Child
     Advocacy Center Inc.                     Victims of Abuse and/or
                                              Neglect
    ------------------------------------------------------------------------
    Direct Relief              $100,000.00   Hurricane Harvey Response
    ------------------------------------------------------------------------
    Direct Relief               $50,000.00   Responding to Hurricane Maria
                                              in Puerto Rico
    ------------------------------------------------------------------------
    Direct Relief               $10,000.00   Emergency Prep Programs
    ------------------------------------------------------------------------
    Dress For Success            $5,000.00   General Operating Expenses
     Northern New Jersey--
     10 Counties, Inc.
    ------------------------------------------------------------------------
    Food Bank of Somerset       $12,500.00   Back Pack Program
     County Inc.
    ------------------------------------------------------------------------
    Heart To Heart              $25,000.00   Hurricane Relief Maria
     International Inc.
    ------------------------------------------------------------------------
    Heart To Heart              $10,000.00   US Crisis Relief
     International Inc.
    ------------------------------------------------------------------------
    Heart To Heart              $25,000.00   Hurricane Harvey Response
     International Inc.
    ------------------------------------------------------------------------
    Hyacinth Foundation A       $10,000.00   General Support-Sanofi in Our
     New Jersey Nonprofit                     Communities, Celebrating
     Corporation                              Diversity
    ------------------------------------------------------------------------
    Hyacinth Foundation A       $10,000.00   General Support
     New Jersey Nonprofit
     Corporation
    ------------------------------------------------------------------------
    International Myeloma       $18,950.00   International Myeloma
     Foundation                               Foundation Mission Support
    ------------------------------------------------------------------------
    Jersey Battered              $5,000.00   General Operating
     Women's Service, Inc.
    ------------------------------------------------------------------------
    Kids Corporation II         $10,000.00   Kids Corp General Operating
    ------------------------------------------------------------------------
    Map International           $10,000.00   MAP's Domestic Medicine Program
    ------------------------------------------------------------------------
    March of Dimes              $86,000.00   Supporting NICU Babies and
     Foundation                               Family's
    ------------------------------------------------------------------------
    Matheny School and           $5,000.00   Matheny Center for Medicine and
     Hospital Inc.                            Dentistry
    ------------------------------------------------------------------------
    Matheny School and           $5,000.00   Matheny School STEM Program
     Hospital Inc.
    ------------------------------------------------------------------------
    Midland Adult Services       $5,000.00   Midland Helping Hands & Midland
     Inc.                                     Meals on Wheels Employment
                                              Training Programs
    ------------------------------------------------------------------------
    Multiple Myeloma            $18,950.00   Mambo for Myeloma
     Research Foundation
    ------------------------------------------------------------------------
    NJ SEEDS                    $10,000.00   Young Scholars Program--Health
                                              Sessions
    ------------------------------------------------------------------------
    NJ Sharing Network           $5,000.00   Multicultural Outreach
     Foundation                               Initiative
    ------------------------------------------------------------------------
    Partners in Research        $25,000.00   Sanofi Biogenius Canada
     Canada
    ------------------------------------------------------------------------
    PATIENT EMPOWERMENT         $25,000.00   ASCO, AUA Coverage for Advanced
     NETWORK                                  Prostate Cancer Patients
    ------------------------------------------------------------------------
    Rise Against Hunger          $7,500.00   Rise Against Hunger Disaster
                                              Ready Response Program
    ------------------------------------------------------------------------
    Rutgers University          $10,000.00   Vets4Warriors
     Foundation
    ------------------------------------------------------------------------
    Safe + Sound Somerset       $10,000.00   Residential Children's Program
    ------------------------------------------------------------------------
    Sheltered Yoga               $5,000.00   Sheltered Yoga NJ Programming
    ------------------------------------------------------------------------
    Somerset County YMCA         $6,000.00   Somerville YMCA/Annual Campaign
    ------------------------------------------------------------------------
    Somerset Health Care         $5,000.00   Quality CPR Saves Lives
     Foundation
    ------------------------------------------------------------------------
    Somerset Health Care        $10,000.00   El poder
     Foundation
    ------------------------------------------------------------------------
    Somerset Health Care        $10,000.00   El poder
     Foundation
    ------------------------------------------------------------------------
    Somerset Health Care        $18,560.00   1st Healthcare Conference for
     Foundation                               the LGBT Community
    ------------------------------------------------------------------------
    Somerset Health Care         $5,000.00   Quality CPR Saves Lives
     Foundation
    ------------------------------------------------------------------------
    The Center For Great        $10,000.00   Adult Women & their Children
     Expectations Inc.
    ------------------------------------------------------------------------
    The Center For Great        $10,000.00   Adult Women & their Children
     Expectations Inc.
    ------------------------------------------------------------------------
    The Children's Inn at      $500,000.00   Sanofi US Legacy Endowment Fund
     NIH, Inc.                                at The Children's Inn at NIH
                                              Sanofi US Legacy Endowment
                                              Fund at The Children's Inn at
                                              NIH
    ------------------------------------------------------------------------
    The Children's Inn at      $500,000.00   Sanofi US Legacy Endowment Fund
     NIH, Inc.                                at The Children's Inn at NIH
    ------------------------------------------------------------------------
    The Children's Inn at      $500,000.00   Sanofi US Legacy Endowment Fund
     NIH, Inc.                                at The Children's Inn at NIH
    ------------------------------------------------------------------------
    THE LEUKEMIA &              $18,950.00   Fiscal Year 2017 Myeloma
     LYMPHOMA SOCIETY                         Patient Education
    ------------------------------------------------------------------------
    The Partnership for          $5,000.00   General Support for PQMD
     Quality Medical
     Donations
    ------------------------------------------------------------------------
    The Salvation Army          $10,000.00   Healthy Food Pantry Program
    ------------------------------------------------------------------------
    Trustees of University      $20,000.00   Research Training in
     of Pennsylvania                          Pharmacoepidemiology
    ------------------------------------------------------------------------
    Tyler Clementi               $5,000.00   New Jersey Programs
     Foundation Inc
    ------------------------------------------------------------------------
    United Way of Monroe        $59,069.70   SP 2017 UW Campaign Match
     County
    ------------------------------------------------------------------------
    United Way of Northern      $75,000.00   Caregivers Coalition
     New Jersey
    ------------------------------------------------------------------------
    Visiting Nurse              $10,000.00   General Operating
     Association of
     Somerset Hills
    ------------------------------------------------------------------------
                             $3,682,101.70
    ------------------------------------------------------------------------
        Grand Total            $16,927,350
    ------------------------------------------------------------------------

                     Sponsorships and Charitable Donations
                           1st Jan 2015-31st Dec 2015
        Sanofi US and its affiliate Genzyme Corporation are committed to
       supporting sponsorships for specific activities and initiatives of
        healthcare organizations and institutions, independent medical or
    professional societies, trade organizations and organized patient groups
      to improve patient care and provide information to the medical and/or
      patient communities. The goal of our charitable giving approach is to
     fund general operational support for patient/disease organizations, or
    program support for community-based organizations. Sanofi US and Genzyme
        Corporation are part of the Sanofi Group, a global pharmaceutical
                                    company.
     Applicant names are provided by the requestor. If applicants apply as a
      group for a single activity; all applicants may be not be identified
     above. ``Funding Amount'' is the amount that the Company funded during
      2015 identified above. ``Funding Amount'' does not include funds that
       may have been provided by other affiliated Sanofi Company Entities
                             (e.g., Sanofi Pasteur).

       Recipient Name(s)             Activity Title          Funding Amount

    Acacia In Kenya          Volunteer Match                       $1,000.00

    Acacia In Kenya          Volunteer Match                       $1,000.00

    Accelerated Cure         MS Discovery: The Podcast of        $102,400.00
     Project                  the MS Discovery Forum

    Accelerated Cure         Data Visualizations in               $89,400.00
     Project                  Multiple Sclerosis

    Acid Maltase Deficiency  AMDA Patient Education               $35,000.00
     Association Inc.         Programs

    Acid Maltase Deficiency  The 2015 AMDA/IPA                    $20,000.00
     Association Inc.         International Pompe Patient
                              and Scientific Conference

    Acid Maltase Deficiency  AMDA Patient Education               $12,000.00
     Association Inc.         Programs

    Acid Maltase Deficiency  Pull for Pompe Event                  $3,000.00
     Association Inc.

    ALD Connect Inc.         ALD Connect Meeting                   $4,000.00

    Alport Syndrome          2015 International Workshop           $2,500.00
     Foundation, Inc.         on Alport Syndrome

    American Academy of      2015 Palatucci Advocacy              $50,000.00
     Neurology Institute      Leadership Forum

    American Academy of      Fellows Scholarship Program          $20,000.00
     Neurology Institute

    American Academy of      Residents Scholarship Program        $20,000.00
     Neurology Institute

    American Academy of      2014-2015 Emerging Leaders           $17,500.00
     Neurology Institute      Forum

    American Academy of      Brain Health Fair                    $10,000.00
     Neurology Institute

    American Association of  2015 Pan-American Scientific         $50,000.00
     Clinical                 Symposia on Clinical
     Endocrinologists         Endocrinology in Latin
                              America

    American Autoimmune and  50 Cents for 50 Million               $5,000.00
     Related Diseases         Campaign AND Fight For
     Association              Immunity Comedy Show

    American Chemical        ACS BIOT 2015 Annual Meeting          $5,000.00
     Society Merck And Co
     Inc.

    American College of      Summer Genetics Scholars             $75,000.00
     Medical Genetics         Program
     Foundation

    American Physiological   Experimental Biology 2015             $3,000.00
     Society

    American Red Cross of    Women Who Care, A Leadership          $5,000.00
     Massachusetts            Breakfast

    American Society of      ASGCT 18th Annual Meeting             $5,000.00
     Gene Therapy

    American Society of      ASN Kidney Week 2015                 $30,000.00
     Nephrology               Exhibitor Spotlight

    Andrew's Buddies         FightSMA Annual Research              $3,000.00
     Corporation dba          Conference 2015
     FightSMA

    ANERA (American Near     ANERA (American Near East             $5,000.00
     East Refugee Aid)        Refugee Aid) Annual Dinner

    Ann & Robert H. Lurie    MPS Patient and Family                $2,000.00
     Children's Hospital of   Conference
     Chicago

    Arizona Kidney           16th Annual Southwest                 $6,000.00
     Foundation               Nephrology Conference

    Ashland Fire Department  Community Support for Ashland        $40,000.00
     Association              Fire Department Association

    Assistance Fund Inc.     Multiple Sclerosis Disease        $5,300,000.00
                              Patient Assistance Fund
                              Program

    Assistance Fund Inc.     Multiple Sclerosis Disease          $500,000.00
                              Patient Assistance Fund
                              Program

    Association For          Annual Conference; Family             $6,000.00
     Glycogen Storage         Assistance; The Ray
     Disease

    Beauty Bus Foundation    6th Annual Beauty Drive for           $3,000.00
                              Patients and Caregivers

    Berkshire Resource       2015 Annual Gala                      $5,000.00
     Project, Inc.

    Big Brothers Big         Big Brothers Big Sisters             $10,000.00
     Sisters of Central       Central Mass/Metrowest
     Mass Metrowest Inc.      (BBBSCM) STEM Institute

    Biomedical Science       Evening of Hope: To support          $75,000.00
     Careers Program          underrepresented minority
                              students/fellows interested
                              in science

    Biomedical Science       Hope Scholarship 2015-2016            $7,500.00
     Careers Program

    Boston Health Care For   Life Essentials Community            $25,000.00
     The Homeless Program     Support Program
     Inc.

    Boston Plan For          Boston Teacher Residency: A          $15,000.00
     Excellence in the        High-Quality Pipeline for
     Public Schools           Boston Public Schools' STEM
     Foundation               Teachers

    Boston Private Industry  2015 Corporate Contribution's        $15,000.00
     Council                  Campaign

    Boston Private Industry  Volunteer Match                       $1,000.00
     Council

    Bottom Line              Boston STEM Success Program          $15,000.00

    Boys and Girls Clubs of  Staffing & Transportation for        $25,000.00
     MetroWest                Increased Membership at
                              BGCMW's Framingham Clubhouse

    Boys and Girls Clubs of  2015 Bids for Kids Auction &         $10,000.00
     MetroWest                Gala

    Boys and Girls Clubs of  Volunteer Match                       $4,000.00
     MetroWest

    Boys and Girls Clubs of  The 2015 Great Pumpkin Glow           $5,000.00
     Middlesex County Inc.

    Breakthrough Greater     Full STEAM (Science                  $10,000.00
     Boston                   Technology, Engineering,
                              Arts, and Math) Ahead
                              Program

    Cambridge Family &       2015 Circle of Friends Gala &         $5,000.00
     Children's Service       Auction

    Cambridge School         Volunteer Match                       $1,000.00
     Volunteers, Inc.

    Camp Korey               Metabolic Disorders Family            $5,000.00
                              Weekend

    Can Do Multiple          2015 TAKE CHARGE Program             $55,000.00
     Sclerosis

    Can Do Multiple          Can Do Program                       $50,000.00
     Sclerosis

    Can Do Multiple          2015 JUMPSTART Program               $50,000.00
     Sclerosis

    Can Do Multiple          Can Do 2015 Online                   $40,000.00
     Sclerosis                Programming

    Can Do Multiple          Vertical Express for Can Do          $25,000.00
     Sclerosis                MS Events

    Canavan Foundation       Jewish Genetic Disease                $4,500.00
                              Leadership Database
                              Expansion Project

    Case Management Society  CMSA 25th Annual Conference &        $14,000.00
     of America               Expo

    Case Management Society  CMSA 25th Annual Conference &         $4,800.00
     of America               Expo (Booth)

    Case Management Society  Case Management Society of            $1,000.00
     of New England           New England's 26th Annual
                              Conference and Exhibitor
                              Expo

    CASSS--An International  CMC Strategy Forums                   $2,500.00
     Separation Science
     Society

    Charcot-Marie-Tooth      CMTA's Boston Patient/Family          $5,000.00
     Association              Conference

    Charcot-Marie-Tooth      CMTA's Boston Patient/Family          $2,000.00
     Association              Conference

    Children's Hospital      Global Pediatric Innovation          $20,000.00
     Boston                   Summit + Awards 2015

    Children's Hospital      La Gala de Milagros para              $5,000.00
     Corporation              Ninos

    Church Hillers Inc.      Volunteer Match                       $1,000.00

    City Sprouts, Inc.       After School Ecology Clubs            $7,000.00

    Colon Cancer Coalition   Volunteer Match                       $2,000.00

    Community Boating, Inc.  Universal Access Program             $15,000.00
                              2015--Patient Assistance
                              Program

    Community Farms          Fresh Food Access Program            $12,000.00
     Outreach

    Community Rowing, Inc.   Let's Row Boston                     $15,000.00

    Community Servings,      Pie in the Sky                       $10,000.00
     Inc.

    Consortium of Multiple   29th Annual Meeting of the           $52,000.00
     Sclerosis Centers        Consortium of Multiple
                              Sclerosis Centers Breakfast

    Council on Renal         Patient Empowerment Workshop          $1,000.00
     Nutrition of Western
     PA

    Courage to Make a        Courage: Living life without          $1,000.00
     Difference Inc.          limit patient videos

    Cradles to Crayons Inc.  Ready for School and Backpack-       $20,000.00
                              a-Thon

    Cystic Fibrosis          Uncork the Cure Event                $10,000.00
     Foundation

    DEAF, Inc.--             Deaf-Accessible Medical Case         $10,000.00
     Developmental            Management and Health
     Evaluation and           Education
     Adjustment Facilities,
     Inc.

    Deliver The Dream Inc.   Community Champions Awards            $2,500.00

    Department of Neurology  Shop to Stop Multiple                $10,000.00
     Multiple Sclerosis       Sclerosis
     Center of Excellence

    Dimock Community Health  Building the Road to                $150,000.00
     Center                   Recovery--Expanding and
                              Renovating Acute Treatment
                              Services

    DISARM Education FUND,   Combating Rare Diseases and          $20,000.00
     INC.                     Raising Awareness in the
                              Developing World

    East End House Inc.      Generating and Evaluating New        $20,000.00
                              Adventures in Science After
                              School (GENASAS)

    East End House Inc.      Volunteer Match                       $2,000.00

    Emory Genetics           LSDC Patient Meetings                $27,390.00
     Laboratory

    Engineering Conferences  Integrated Continuous                $10,000.00
     International            Biomanufacturing II
                              Conference

    EveryLife Foundation     Rare Voice Awards Gala               $20,000.00
     for Rare Diseases

    EveryLife Foundation     EveryLife Foundation Annual          $10,000.00
     for Rare Diseases        Rare Disease Scientific
                              Workshop: Patient Engagement
                              in the Clinical Development
                              Process

    Fabry Support &          FSIG Expert Fabry Conference         $50,000.00
     Information Group        2015

    Fabry Support &          FSIG Patient Assistance Fund         $40,000.00
     Information Group

    Fabry Support &          FSIG Patient Assistance Fund         $40,000.00
     Information Group

    Fabry Support &          Rapid Assistance Funds--             $30,000.00
     Information Group        Patient Assistance Program

    Fabry Support &          FSIG Newsletter                      $12,000.00
     Information Group

    Fabry Support &          2015 FSIG Fabry Fun Run/Walk          $1,500.00
     Information Group        & FSIG Fabry Get Together
                              Meeting

    Family Promise           Keep the Promise: An evening          $2,500.00
     Metrowest Inc.           of food tasting to benefit
                              families that are homeless

    Foundation of the        2016 CMSC Annual Meeting--          $414,000.00
     Consortium of Multiple   Celebrating 30 Years of MS
     Sclerosis Centers        Care

    Foundation of the        FCMSC 2015-2016 Pilot                $44,000.00
     Consortium of Multiple   Research Grant Award in
     Sclerosis Centers        Multiple Sclerosis

    Foundation of the        NARCOMS Now Patient Quarterly        $33,358.00
     Consortium of Multiple   Magazine
     Sclerosis Centers

    Foundation of the        2015-2016 FCMSC Medical              $22,000.00
     Consortium of Multiple   Resident Annual Meeting
     Sclerosis Centers        Scientific Scholarships

    Foundation of the        2015-2016 Workforce of the           $22,000.00
     Consortium of Multiple   Future: Medical Student
     Sclerosis Centers        Scholarships

    Framingham Townwide PTO  Volunteer Match                       $1,000.00
     Council

    Franciscan Children's    Adaptive Sports Program for          $10,000.00
     Hospital and             Children with Disabilities
     Rehabilitation Center

    Friends of Hopkinton     Community Support for general         $4,000.00
     SPEAC                    operating

    Friends of Resiliency    Academic Support component of        $10,000.00
     for Life Inc.            Resiliency for Life (RFL)

    Friends of Resiliency    Volunteer Match                       $1,000.00
     for Life Inc.

    Friends of the           Community Support for Friends        $16,000.00
     Hopkinton Seniors        group to raise funds for
                              nutrition programs

    FSH Society, Inc.        FSH Society                           $2,000.00
                              Facioscapulohumeral Muscular
                              Dystrophy [FSHD] 2015
                              International Research
                              Consortium & Research
                              Planning Meetings

    Fundacion de Esclerosis  MS Community Educational             $20,000.00
     Multiple de Puerto       Conferences
     Rico

    Fundacion de Esclerosis  Abrazarte a la vida Patient           $2,500.00
     Multiple de Puerto       Fundraising Event
     Rico

    Gateway Area Chapter     Community Walk MS 2015                $5,000.00

    Gateway Area Chapter     Women on the Move Luncheon            $2,500.00
                              2015

    Generation Citizen Inc.  Generation Citizen Spring             $5,000.00
                              2015 Civics Day

    Georgia Chapter of the   Non-AAP industry/foundation           $3,500.00
     American Academy of      symposium
     Pediatrics

    Girl Scouts of Eastern   Girls Building Self-esteem           $10,000.00
     Massachusetts Inc.

    Global Genes             4th Annual RARE Tribute to           $25,000.00
                              Champions Event

    Global Genes             Global Genes RARE Patient            $25,000.00
                              Advocacy Summit

    Global Genes             Global Genes Corporate               $15,000.00
                              Alliance Program

    Global Genes             Give RARE Disease Giving Day         $10,000.00

    Global Genes             Pixar's The Good Dinosaur--          $10,000.00
                              Exclusive Screening &
                              Fundraiser

    Global Genes             Tribute to Champions--                $7,460.00
                              Expression of Hope Art
                              Exhibit

    Global Genes             RARE Toolkit & Educational            $5,000.00
                              Podcast Programs

    Gordon Research          Lysosomal Diseases Gordon             $5,000.00
     Conferences              Research Conference and
                              Gordon Research Seminar

    Gordon Research          2015 CAG Repeat Disorders             $2,000.00
     Conferences              Gordon Research Conference

    Greater Boston Chamber   Chamber's 2015 Annual Meeting        $10,000.00
     of Commerce

    Habitat For Humanity     Holliston Build Project              $15,000.00
     Metrowest--Greater
     Worcester Inc.

    Habitat For Humanity     Volunteer Match                       $2,000.00
     Metrowest--Greater
     Worcester Inc.

    Health Care For All      Ethnic Media and Grassroots          $10,000.00
     Inc.                     Outreach to Improve Health
                              Coverage Access in
                              Framingham

    Health Technology        HTAI Annual Meeting 2015             $20,000.00
     Assessment
     International

    Hearts & Noses Hospital  Ongoing Hospital Clown Visits        $15,000.00
     Clown Troupe Inc.        to Ill and Disabled Children
                              in Greater Boston

    Holy Name Health Care    18th Annual Spring Fashion           $15,000.00
     Foundation Inc.          Fling for MS

    Horizons for Homeless    17th Annual Women's Breakfast         $3,500.00
     Children

    Huntington Study Group   HSG 2015: Building Our Future         $1,500.00
     Ltd.

    Huntington's Disease     Huntington's Disease Society          $2,500.00
     Society of America       of America 30th Annual
                              Convention

    Icahn School of          13th Annual Gala in Support          $25,000.00
     Medicine at Mount        of the Corinne Goldsmith
     Sinai                    Dickinson Center for
                              Multiple Sclerosis at Mount
                              Sinai

    Icahn School of          13th Annual Gala in Support          $12,000.00
     Medicine at Mount        of the Corinne Goldsmith
     Sinai                    Dickinson Center for
                              Multiple Sclerosis at Mount
                              Sinai

    International            2015 MS Perspectives                 $75,000.00
     Organization of          Publication
     Multiple Sclerosis
     Nurses

    International            2015 Annual Meeting IOMSN            $30,000.00
     Organization of          Dinner
     Multiple Sclerosis
     Nurses

    International Society    Glycoproteinoses: Fourth              $5,000.00
     For Mannosidosis &       International Conference on
     Related Disease Inc.     Advances in Pathogenesis and
                              Therapy

    International Society    31st International Conference         $2,000.00
     For                      on Pharmacoepidemiology
     Pharmacoepidemiology

    International Society    ISN Forefronts                        $3,500.00
     of Nephrology            ``Immunomodulation of Cardio-
                              Renal Function--A focus on
                              cardio-renal pathophysiology
                              and immunity'' (Oct 22-25,
                              2015, Shenzhen, China)

    Italian Home For         City Lights Gala                      $5,000.00
     Children Inc.

    Japan Society of Boston  2015 Japan Society of Boston          $5,000.00
                              Annual Dinner

    Jewish Federation of     Expanding Footprint of Jewish        $10,000.00
     southern New Jersey      Genetic Disease Awareness in
                              South Jersey

    Jewish Genetic Disease   Jewish Genetic Disease                $5,000.00
     Consortium (JGDC)        Consortium Screening
                              Awareness Program

    Jewish Genetic Diseases  PHOENIX--Our Heritage and our           $980.00
     Center of Greater        Health--Ashkenazi Jewish
     Phoenix                  Genetics Disease and the
                              Founder Effect

    Jewish Genetic Diseases  TUCSON--Our Heritage and our            $950.00
     Center of Greater        Health--Ashkenazi Jewish
     Phoenix                  Genetic Disease and the
                              Founder Effect

    Joseph M. Smith          JMSCHS's Prenatal Program            $15,000.00
     Community Health
     Center, Inc.

    Kidney Foundation of     24th Annual Wine Affair Event         $1,000.00
     Northwest Ohio           for Disease Awareness

    Kidney Foundation of     Kilometers for Kidneys                  $500.00
     Northwest Ohio

    Light of Life            Light of Life Foundation 2015        $25,000.00
     Foundation               Patient Support Activities

    Light of Life            Light of Life Foundation             $20,000.00
     Foundation               Patient Awareness Program

    Light of Life            Light of Life Foundation              $1,000.00
     Foundation               Night of Comedy Fundraiser

    Little Brothers/Friends  Medical Escort/Transport and          $7,500.00
     of the Elderly           Prescription Escort Patient
                              Assistance Program

    Little Miss Hannah       Little Miss Hannah Foundation         $8,000.00
     Foundation               General Operating Support

    Little Miss Hannah       Little Miss Hannah's Rainbows         $1,000.00
     Foundation               in the Wind Festival

    Lysosomal and Rare       Towards a patient-centered           $10,000.00
     Disorders Research and   disease registry; Connecting
     Treatment Center Inc.    the patches for Gaucher
                              Disease

    March of Dimes           March for Babies                     $15,000.00

    March of Dimes           Black Ties for Babies Gala           $10,000.00

    March of Dimes           Volunteer Match                       $2,000.00

    March of Dimes           Volunteer Match                       $1,000.00

    March of Dimes           Volunteer Match                       $1,000.00

    Margaret Fuller          Scholarships for Port/Area IV        $15,000.00
     Neighborhood House       Youth to Attend Summer Camp
                              at Margaret Fuller House

    Mass Insight Education   College Success Program              $15,000.00
     and Research Institute
     Inc.

    Massachusetts Bay        STEM Mentor Program                  $26,500.00
     Community College
     Foundation

    Massachusetts            Patient Advocacy Summit--Live        $10,000.00
     Biotechnology Council    & Breathe: Building a
                              Patient Centered Biotech

    Massachusetts            BioTeach Life Sciences               $50,000.00
     Biotechnology            Student Program
     Education Foundation
     Inc.

    Massachusetts Institute  Cambridge Science Festival            $5,000.00
     of Technology

    Massachusetts Outdoor    DFW Plymouth Red-bellied              $5,000.00
     Heritage Foundation      Cooter Head-starting Program
     Inc.

    Massachusetts Outdoor    Volunteer Match                       $1,000.00
     Heritage Foundation
     Inc.

    Massachusetts State      Massachusetts State Science &        $50,000.00
     Science and              Engineering Fair
     Engineering Fair, Inc.

    Mercy Foundation         Mercy Multiple Sclerosis (MS)        $20,000.00
                              Achievement Center Wellness
                              Programs

    Metrowest Free Medical   Chronic Disease Patient              $10,000.00
     Program Inc.             Assistance Program

    Mid America MS           The Race to Nowhere 2015              $5,000.00
     Achievement Center

    Mid America MS           The Race to Nowhere 2015              $2,500.00
     Achievement Center

    Mid America MS           Eat Bid Laugh Event                   $2,500.00
     Achievement Center       benefiting the Mid-America
                              Multiple Sclerosis
                              Achievement Center (MSAC) in
                              Kansas City

    Milwaukee Synagogue for  Gaucher Disease Education             $5,000.00
     Russian Jews             Program

    MLD Foundation           RUSP Roundtable                       $4,000.00

    MS Cure Fund             Women Thriving With MS              $125,000.00

    MS Cure Fund             Risks & Benefits Program            $103,700.00

    MS Cure Fund             Resource Information Database        $12,360.00
                              Conversion and Website
                              Integration

    MS Cure Fund             MS Cure Newsletter                   $10,000.00

    MS Cure Fund             Lifestyle Management Programs         $8,250.00
                              Fall 2015

    MS Hope for a Cure Inc.  2015 MS Cycle for a Cure--A           $5,000.00
                              Ride for Research (6 event
                              sites)

    MS Views and News Inc.   2015--MS Symposium SERIES--          $64,491.00
                              ``The Neurological Aspects
                              of MS''

    MS Views and News Inc.   Empowering MS Communities in         $46,000.00
                              America's Heartland series--
                              2

    MS Views and News Inc.   BRING IT ON!--``Everything           $27,835.00
                              You Want to Know about MS''
                              a Q&A program

    MS Views and News Inc.   Empowering MS Communities in         $22,000.00
                              America's Hearthland series

    MS Views and News Inc.   Women's Health Issues with           $16,924.75
                              Multiple Sclerosis

    MS Views and News Inc.   New and Emerging Therapies           $15,925.00
                              plus Invisible Symptoms of
                              MS

    MS Views and News Inc.   New and Emerging Treatment           $14,750.00
                              Options plus Invisible
                              Symptoms of MS--Chicago

    MS Views and News Inc.   BRING IT ON!--Everything you         $12,295.00
                              want to Know about MS--Q&A

    MS Views and News Inc.   Women's Health with Multiple          $9,582.00
                              Sclerosis

    MS Views and News Inc.   Men's Health Issues with              $9,178.50
                              Multiple Sclerosis

    MS Views and News Inc.   2015 Renewal of Annual                $7,900.00
                              Display Sponsorship

    MS Views and News Inc.   MS Views and News--5th Annual         $3,000.00
                              Bowlathon Fundraiser to
                              Benefit MS Education and
                              Stem Cell Research

    MSWorld, Inc.            2015 MSWorld Conference              $20,000.00
                              Coverage

    MSWorld, Inc.            2015 MSWorld ``Wellness              $20,000.00
                              Unleashed Program''

    Multiple Sclerosis       Crossfire: The Science and          $436,320.00
     Association of America   Emotion of Risk

    Multiple Sclerosis       MSAA MRI Patient Assistance         $350,000.00
     Association of America   Fund

    Multiple Sclerosis       Hot Topics in Multiple              $217,941.00
     Association of America   Sclerosis: An Interactive
                              Series of MS Patient
                              Education Programs

    Multiple Sclerosis       Swim for MS In Person Program        $58,985.00
     Association of America   Pilot Series

    Multiple Sclerosis       MSAA's 2015 Improving Lives          $15,000.00
     Association of America   Benefit

    Multiple Sclerosis       MS Festival Program                  $10,000.00
     Center of Georgia

    Multiple Sclerosis       Health, Hope & Hops Program           $7,000.00
     Center of Georgia

    Multiple Sclerosis       Foundation's Assistive               $50,000.00
     Foundation               Technology Program

    Multiple Sclerosis       Support Group News quarterly         $27,300.00
     Foundation               informational newsletter

    Multiple Sclerosis       African Americans with MS--          $20,000.00
     Foundation               The Medical, Cultural and
                              Psychological Differences

    Multiple Sclerosis       Resource Website                    $117,367.00
     International            Communications Support
     Federation Foundation
     Inc.

    Multiple Sclerosis       Middle East Patient Awareness        $78,245.00
     International            Program
     Federation Foundation
     Inc.

    Multiple Sclerosis       Arab Region Patient Awareness        $60,117.00
     International            Program
     Federation Foundation
     Inc.

    Multiple Sclerosis       World MS Day 2015 Campaign           $46,947.00
     International
     Federation Foundation
     Inc.

    Multiple Sclerosis       Latin America Resource               $41,950.00
     International            Analysis Project
     Federation Foundation
     Inc.

    Multiple Sclerosis       Global Patient Awareness             $39,122.00
     International            Program
     Federation Foundation
     Inc.

    Multiple Sclerosis       MSQLP's 9th Annual Walk 'n            $1,500.00
     Quality of Life          Roll Fundraiser
     Project Corporation

    Multiple Sclerosis       2015 Mission Steps Wak & MS           $8,000.00
     Resources of Central     Awareness Day
     New York, Inc.

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Lake
     Mary, FL

    Muscular Dystrophy       2015 MDA Muscle Summit                $8,000.00
     Association--Alameda,
     CA

    Muscular Dystrophy       MDA Newsletter                        $2,000.00
     Association--Albany,
     NY

    Muscular Dystrophy       2015 MDA Research Seminar             $2,000.00
     Association--Albany,
     NY

    Muscular Dystrophy       New Mexico MDA Muscle Walk            $1,000.00
     Association--Albuquerq
     ue, NM

    Muscular Dystrophy       2015 MDA Muscle Summit                $8,000.00
     Association--Allentown
     , PA

    Muscular Dystrophy       Muscle Walk Greater Lehigh            $1,000.00
     Association--Allentown   Valley
     , PA

    Muscular Dystrophy       17th Annual Black and Blue            $5,000.00
     Association--Ark         Ball
     Valley, Richmond, VA

    Muscular Dystrophy       Muscle Walk Greater Fort              $1,000.00
     Association--Ark         Wayne
     Valley, Richmond, VA

    Muscular Dystrophy       Muscle Walk Ft Myers, FL              $1,000.00
     Association--Ark
     Valley, Richmond, VA

    Muscular Dystrophy       Muscle Walk Pittsburgh                $1,000.00
     Association--Ark
     Valley, Richmond, VA

    Muscular Dystrophy       Muscle Walk Springfield, MO           $1,000.00
     Association--Ark
     Valley, Richmond, VA

    Muscular Dystrophy       Muscle Walk Richmond, VA              $1,000.00
     Association--Ark
     Valley, Richmond, VA

    Muscular Dystrophy       Muscle Walk Central Texas             $1,000.00
     Association--Austin,
     TX

    Muscular Dystrophy       2015 Muscular Dystrophy               $1,000.00
     Association--Billings,   Summer Camp of Montana
     MT

    Muscular Dystrophy       Muscle Walk Montana                   $1,000.00
     Association--Billings,
     MT

    Muscular Dystrophy       MDA Health Patient Care               $1,000.00
     Association -            Services Program
     Birmingham, AL

    Muscular Dystrophy       MDA Idaho Summer Camp                 $1,000.00
     Association--Boise, ID

    Muscular Dystrophy       MDA Superhero Muscle Walk and         $1,000.00
     Association--Boise, ID   5k Fun Run

    Muscular Dystrophy       Muscle Walk of Chattanooga            $2,500.00
     Association--Brentwood
     , TN

    Muscular Dystrophy       Muscle Walk of Nashville              $1,000.00
     Association--Brentwood
     , TN

    Muscular Dystrophy       2015 Nashville Muscle Team            $1,000.00
     Association--Brentwood   Gala
     , TN

    Muscular Dystrophy       Muscle Walk of Nashville              $1,000.00
     Association--Brentwood
     , TN

    Muscular Dystrophy       Muscle Walk of Greater                $1,000.00
     Association--Brookfiel   Milwaukee
     d, WI

    Muscular Dystrophy       Muscle Walk of Greater                $1,000.00
     Association--Brookfiel   Madison
     d, WI

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Broomall,
     PA

    Muscular Dystrophy       Muscle Walk Quad Cities               $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk Des Moines                $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk Iowa City                 $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk Iowa City                 $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk Waterloo                  $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk Des Moines                $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Mucscle Walk Morgantown               $1,000.00
     Association--Charlesto
     n, WV

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Charlotte
     , NC

    Muscular Dystrophy       MDA--LGMD Genetic Testing           $700,000.00
     Association--Chicago,    Program
     IL

    Muscular Dystrophy       MDA Pompe Testing Program            $60,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       2015 Muscle Summit                    $8,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       MDA Illinois Muscle Summit            $8,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       Muscular Dystrophy                    $2,000.00
     Association--Chicago,    Association, Third Quarter
     IL                       Newsletter

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       MDA-ALS Muscle Walk                   $1,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       2015 Southern Ohio Muscular           $1,000.00
     Association--Cincinnat   Dystrophy Association Summer
     i, OH                    Camp

    Muscular Dystrophy       Muscle Walk of Greater                $1,000.00
     Association--Cincinnat   Cincinnati
     i, OH

    Muscular Dystrophy       Muscle Walk of Greater                $1,000.00
     Association--Cleveland   Cleveland
     , OH

    Muscular Dystrophy       MDA Winter Newsletter                 $2,500.00
     Association--Columbia,
     SC

    Muscular Dystrophy       Road Map to Independence for          $2,000.00
     Association--Columbia,   Young Adults Resource
     SC                       Program

    Muscular Dystrophy       MDA Fall Newsletter                   $2,000.00
     Association--Columbia,
     SC

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Columbia,
     SC

    Muscular Dystrophy       Muscle Walk of Denver                 $1,000.00
     Association--Denver,
     CO

    Muscular Dystrophy       Muscle Walk of Chicagoland &          $2,000.00
     Association--Downers     Muscle Walk of Rockford
     Grove, IL

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--El Paso,
     TX

    Muscular Dystrophy       Muscle Walk Greater Mishawaka         $1,000.00
     Association--Fort
     Wayne, IN

    Muscular Dystrophy       Muscle Walk of Greater                $1,000.00
     Association--Fort        Mishawaka
     Wayne, IN

    Muscular Dystrophy       Muscle Walk Western Colorado          $1,000.00
     Association--Grand
     Junction, CO

    Muscular Dystrophy       Partners in Progress: an MDA          $5,000.00
     Association--Green       Muscle Symposium
     Bay, WI

    Muscular Dystrophy       Muscle Walk of Green Bay              $1,000.00
     Association--Green
     Bay, WI

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Greenvill
     e, SC

    Muscular Dystrophy       Limb-Girdle Muscular                 $10,000.00
     Association--Harrisbur   Dystrophy Education Program,
     g, PA                    First Quarter, 2015

    Muscular Dystrophy       2015 Central PA MDA Muscle            $8,000.00
     Association--Harrisbur   Summit
     g, PA

    Muscular Dystrophy       Muscle Walk Central PA                $1,000.00
     Association--Harrisbur
     g, PA

    Muscular Dystrophy       Muscle Walk Hawaii                    $1,500.00
     Association--Honolulu,
     HI

    Muscular Dystrophy       Muscle Walk Houston                   $1,000.00
     Association--Houston,
     TX

    Muscular Dystrophy       Patient and Family Healthcare         $2,000.00
     Association--Jacksonvi   Newsletter
     lle, FL

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Knoxville
     , TN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Knoxville
     , TN

    Muscular Dystrophy       Family Engagement Events              $1,000.00
     Association--Knoxville
     , TN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Las
     Vegas, NV

    Muscular Dystrophy       Muscle Walk of Little Rock            $1,000.00
     Association--Little
     Rock, AR

    Muscular Dystrophy       MDA Summer Camp                       $5,000.00
     Association--Los
     Angeles, CA

    Muscular Dystrophy       Muscle Walk Louisville                $1,000.00
     Association--Louisvill
     e, KY

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Louisvill
     e, KY

    Muscular Dystrophy       MDA Conference                        $1,500.00
     Association--Mancheste
     r, NH

    Muscular Dystrophy       Muscle Walk St Louis                  $1,000.00
     Association--Maryland
     Heights, MO

    Muscular Dystrophy       2015 Central New Jersey MDA           $8,000.00
     Association--Maywood,    Muscle Summit
     NJ

    Muscular Dystrophy       2nd Quarter/4th Quarter Print         $2,000.00
     Association--Maywood,    Newsletters 2015
     NJ

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Memphis,
     TN

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Metairie,
     LA

    Muscular Dystrophy       Muscle Walk Baton Rouge               $1,000.00
     Association--Metairie,
     LA

    Muscular Dystrophy       MDA South Alabama Chapter             $2,000.00
     Association--Montgomer   Quarterly Family Newsletter
     y, AL

    Muscular Dystrophy       Muscular Dystrophy                    $2,000.00
     Association--New         Association 2015 2nd Quarter
     Haven, CT                Newsletter

    Muscular Dystrophy       Muscle Walk Metro NY                  $1,000.00
     Association--New York,
     NY

    Muscular Dystrophy       Muscular Dystrophy                    $2,000.00
     Association--North       Association 1st Quarter 2015
     Haven, CT                Newsletter

    Muscular Dystrophy       18th Annual MDA Black and             $2,000.00
     Association--North       Blue Ball
     Haven, CT

    Muscular Dystrophy       Muscular Dystrophy                    $1,500.00
     Association--North       Association 2015 3rd Quarter
     Haven, CT                Newsletter

    Muscular Dystrophy       2015 Mohegan Sun Southern New         $1,000.00
     Association--North       England MDA Muscle Walk
     Haven, CT

    Muscular Dystrophy       Muscle Walk of Greater                $1,000.00
     Association--Okemos,     Lansing Area
     MI

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Okemos,
     MI

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Omaha, NE

    Muscular Dystrophy       Muscle Walk Medford                   $1,000.00
     Association--Portland,
     OR

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Portland,
     OR

    Muscular Dystrophy       Muscle Walk Raleigh                   $1,000.00
     Association--Raleigh,
     NC

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Reston,
     VA

    Muscular Dystrophy       Fall 2015 Newsletter                  $1,200.00
     Association--Rochester
     , NY

    Muscular Dystrophy       Muscle Walk 2015                      $1,000.00
     Association--Salt Lake
     City, UT

    Muscular Dystrophy       Muscle Walk Salt Lake City            $1,000.00
     Association--Salt Lake
     City, UT

    Muscular Dystrophy       Muscle Walk San Antonio & 5K          $1,000.00
     Association--San         Fun Run
     Antonio, TX

    Muscular Dystrophy       Muscle Walk Twin Cities               $1,500.00
     Association--Shrevepor
     t, LA

    Muscular Dystrophy       Patient Newsletter                    $1,500.00
     Association--Southfiel
     d, MI

    Muscular Dystrophy       MDA Summer Camp 2015                  $1,000.00
     Association--Spokane,
     WA

    Muscular Dystrophy       Muscle Walk Spokane                   $1,000.00
     Association--Spokane,
     WA

    Muscular Dystrophy       MDA Summer Camp 2015                  $1,000.00
     Association--St
     Petersburg, FL

    Muscular Dystrophy       MDA Summer Camp 2015                  $1,000.00
     Association--St
     Petersburg, FL

    Muscular Dystrophy       Muscle Walk Tampa Bay                 $1,000.00
     Association--St
     Petersburg, FL

    Muscular Dystrophy       MDA Muscle Walk--Exhibit              $1,000.00
     Association--Tempe, AZ   Booth for Patient Education

    Muscular Dystrophy       MDA Muscle Walk Tucson--              $1,000.00
     Association--Tempe, AZ   Exhibit Booth for Patient
                              Education

    Muscular Dystrophy       Muscle Walk of Baltimore              $1,000.00
     Association--Towson,
     MD

    Muscular Dystrophy       Muscle Walk Ark-La-Tex                $1,000.00
     Association--Tucson,
     AZ

    Muscular Dystrophy       Muscle Walk Central New               $1,000.00
     Association--Tucson,     Jersey
     AZ

    Muscular Dystrophy       MDA 4th Quarter Newsletter            $2,000.00
     Association--Warwick,
     RI

    Muscular Dystrophy       Newsletter-CAMP                       $2,000.00
     Association--Westborou
     gh, MA

    Muscular Dystrophy       Volunteer Match                       $1,000.00
     Association--Westborou
     gh, MA

    Muscular Dystrophy       Quarterly Newsletter                  $3,000.00
     Association--Westbrook
     , ME

    Muscular Dystrophy       Pompe Support Dinner                  $2,000.00
     Association--Westbrook
     , ME

    Muscular Dystrophy       Pompe Awareness and Education         $1,500.00
     Association--Westbrook   Day
     , ME

    Muscular Dystrophy       Pompe Awareness and                   $1,000.00
     Association--Westbrook   EducationDay
     , ME

    Muscular Dystrophy       Limb-Girdle Support Group             $1,000.00
     Association--Westbrook
     , ME

    Muscular Dystrophy       Muscle Walk Maine                     $1,000.00
     Association--Westbrook
     , ME

    Muscular Dystrophy       2015 MDA Muscle Walk and              $2,000.00
     Association--Wilmingto   Educational Symposium
     n, NC

    Muscular Dystrophy       Muscle Walk of Greenville and         $1,500.00
     Association--Wilmingto   Patient Educational
     n, NC                    Symposium

    Muscular Dystrophy       Muscle Walk of Central Ohio           $1,000.00
     Association--Worthingt
     on, OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Worthingt
     on, OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Westborou
     gh, MA

    Museum of Science        Genzyme/Museum of Science            $66,980.00
                              Teacher Sabbatical Program
                              2014

    Museum of Science        The Science Behind the Stars         $10,000.00
                              Event

    National Fabry Disease   2015 NFDF Education and              $45,000.00
     Foundation               Community Patient Assistance
                              Program

    National Fabry Disease   2015 NFDF Core Patient               $40,000.00
     Foundation               Assistance Program

    National Fabry Disease   2015 NFDF Core Patient               $40,000.00
     Foundation               Assistance Program

    National Fabry Disease   2015 Fabry Family Camp and           $25,000.00
     Foundation               Annual Educational
                              Conference

    National Fabry Disease   2015 Fabry Family Camp and           $25,000.00
     Foundation               Annual Educational
                              Conference

    National Fabry Disease   2015 Fabry Family Camp and           $25,000.00
     Foundation               Annual Educational
                              Conference

    National Fabry Disease   2015 Fabry Educational               $14,000.00
     Foundation               Meetings

    National Fabry Disease   2015 Fabry Emergency                 $10,000.00
     Foundation               Assistance and Ancillary
                              Expense Support

    National Fabry Disease   2015 Fabry Emergency                 $10,000.00
     Foundation               Assistance and Ancillary
                              Expense Support

    National Fabry Disease   2015 Family Patient                   $5,000.00
     Foundation               Assistance Program

    National Fabry Disease   2015 Family Patient                   $5,000.00
     Foundation               Assistance Program

    National Family          RareCaregivers.org: Caring           $10,000.00
     Caregivers Association   for Rare Disease Caregivers
     DBA Caregiver Action
     Network

    National Family          Creating the Voice: A                 $5,000.00
     Caregivers Association   Celebration of Family
     DBA Caregiver Action     Caregiving Event
     Network

    National Gaucher         CARE Program--Patient             $1,250,000.00
     Foundation               Assistance Program

    National Gaucher         NGF Education, Awareness and        $400,000.00
     Foundation               Resources Program for
                              Patients

    National Gaucher         2015 National Gaucher                $25,000.00
     Foundation               Conference

    National Kidney          Louisville Kidney Walk                $1,000.00
     Foundation Inc.

    National Kidney          Great Chefs of the West Gala            $200.00
     Foundation Inc.

    National Kidney          Evansville Kidney Walk                  $500.00
     Foundation of Indiana

    National Kidney          Northwest Kidney Walk                   $500.00
     Foundation of Indiana

    National Kidney          Northeast Indiana Kidney Walk           $500.00
     Foundation of Indiana

    National Kidney          2015 Mardi Gras Kidney Ball           $1,000.00
     Foundation of Michigan

    National MPS Society     National MPS Society 29th            $20,000.00
                              Annual Family Conference

    National MPS Society     National MPS Society 29th            $15,000.00
                              Annual Family Conference

    National MPS Society     National MPS Society 5K Walk/        $10,000.00
                              Run

    National Multiple        Southern New York Chapter's         $100,000.00
     Sclerosis Society--New   Walk MS 2015
     York, NY

    National Multiple        Chapter Women Against MS              $1,000.00
     Sclerosis Society--      Luncheon
     Arizona

    National Multiple        Spring Fling/Fall Ball               $10,000.00
     Sclerosis Society--New   Socialization Programs for
     York, NY                 People with MS

    National Multiple        Moving Forward: An                    $3,000.00
     Sclerosis Society--New   Educational Program for
     York, NY                 Those Newly Diagnosed with
                              Multiple Sclerosis

    National Multiple        The National Multiple                 $2,500.00
     Sclerosis Society--      Sclerosis Society, Alabama--
     Alabama-Mississippi      Mississippi Chapter's MS
     Chapter                  Dinner of Champions

    National Multiple        MS Symposium                          $1,000.00
     Sclerosis Society--
     Alabama-Mississippi
     Chapter

    National Multiple        Arizona Chapter's Walk MS            $10,000.00
     Sclerosis Society--      2015
     Arizona Chapter

    National Multiple        Women Against MS Luncheon--           $2,500.00
     Sclerosis Society--      Patient Wellness Program
     Brentwood, TN

    National Multiple        Newly Diagnosed with MS               $1,150.00
     Sclerosis Society--      Meeting
     Brentwood, TN

    National Multiple        Women's Day Out: Health,                $450.00
     Sclerosis Society--      Beauty, Wellness and MS
     Brentwood, TN

    National Multiple        Central Virginia Chapter's           $15,000.00
     Sclerosis Society--      Walk MS 2015
     Central Virginia
     Chapter

    National Multiple         Women on the Move Luncheon           $2,500.00
     Sclerosis Society--
     Central Virginia
     Chapter

    National Multiple        Mind and Body Wellness                $1,000.00
     Sclerosis Society--      Educational Symposium
     Central Virginia
     Chapter

    National Multiple         Colorado-Wyoming Chapter's          $15,000.00
     Sclerosis Society--      Walk MS 2015
     Colorado-Wyoming
     Chapter

    National Multiple         I Ride with MS at Bike MS           $10,000.00
     Sclerosis Society--      Colorado Event
     Colorado-Wyoming
     Chapter

    National Multiple        2015 SH & Patient Support             $8,610.00
     Sclerosis Society--      Groups
     Colorado-Wyoming
     Chapter

    National Multiple        Optimal Health with MS--              $8,350.00
     Sclerosis Society--      Integrating Lifestyle,
     Colorado-Wyoming         Alternative & Conventional
     Chapter                  Medicine

    National Multiple        Fitness as a Lifestyle 2015--         $4,710.00
     Sclerosis Society--      Patient Wellness Program
     Colorado-Wyoming
     Chapter

    National Multiple        National MS Society                  $25,000.00
     Sclerosis Society--      Scholarship Program
     Denver, CO

    National Multiple        Navigator Patient Resource           $15,000.00
     Sclerosis Society--      Program
     Gateway Area Chapter
     MS

    National Multiple        Walk MS 2015                          $5,000.00
     Sclerosis Society--
     Gateway Area Chapter

    National Multiple        Walk MS                              $50,000.00
     Sclerosis Society--
     Greater Illinois
     Chapter

    National Multiple        MuckFest MS Chicago Race             $15,000.00
     Sclerosis Society--
     Greater Illinois
     Chapter

    National Multiple        7th Annual Women on the Move          $7,000.00
     Sclerosis Society--      Luncheon
     Greater Illinois
     Chapter

    National Multiple        Walk MS Boston                       $25,000.00
     Sclerosis Society--
     Greater New England
     Chapter

    National Multiple        Muckfest MS Boston                   $25,000.00
     Sclerosis Society--
     Greater New England
     Chapter

    National Multiple        Bike MS Ride the Vineyard            $10,000.00
     Sclerosis Society--
     Greater New England
     Chapter

    National Multiple        National MS Walks Worcester           $2,000.00
     Sclerosis Society--      and Boston
     Greater New England
     Chapter

    National Multiple        Maine Living Well with MS             $1,500.00
     Sclerosis Society--      Program
     Greater New England
     Chapter

    National Multiple        Vermont Living Well with MS           $1,250.00
     Sclerosis Society--      Conference
     Greater New England
     Chapter

    National Multiple        Hidden Symptoms of MS                 $1,250.00
     Sclerosis Society--      Conference
     Greater New England
     Chapter

    National Multiple        New Hampshire Spring                  $1,250.00
     Sclerosis Society--      Education Conference
     Greater New England
     Chapter

    National Multiple        Rhode Island Living Well with         $1,250.00
     Sclerosis Society--      MS Spring Conference
     Greater New England
     Chapter

    National Multiple        Connecticut Walk MS 2015              $2,500.00
     Sclerosis Society--
     Hartford, CT

    National Multiple        National MS Society South            $20,000.00
     Sclerosis Society--      Central Region BP 150 Bike
     Houston, TX              Race Event

    National Multiple        North Texas Walk MS 2015             $18,000.00
     Sclerosis Society--
     Houston, TX

    National Multiple        Tulsa & Central, OK Walk MS          $10,000.00
     Sclerosis Society--      2015
     Houston, TX

    National Multiple        San Antonio MS Walk 2015             $10,000.00
     Sclerosis Society--
     Houston, TX

    National Multiple        2015 Oklahoma Leadership             $10,000.00
     Sclerosis Society--      Events
     Houston, TX

    National Multiple        Lydia Emily Project                  $10,000.00
     Sclerosis Society--      supporting BP 150 Bike Race
     Houston, TX              Event

    National Multiple        North Texas Bike MS 2015              $7,500.00
     Sclerosis Society--
     Houston, TX

    National Multiple        On The Move Luncheon program          $5,000.00
     Sclerosis Society--      to raise funds and awareness
     Houston, TX              for Multiple Sclerosis

    National Multiple        I Ride With MS Oklahoma Bike          $5,000.00
     Sclerosis Society--      Event
     Houston, TX

    National Multiple        Louisiana--New Orleans,               $3,500.00
     Sclerosis Society--      Shreveport, and Baton Rouge
     Houston, TX              Walk MS 2015

    National Multiple        Bike MS Event--Midland                $3,000.00
     Sclerosis Society--
     Houston, TX

    National Multiple        On The Move Luncheon Baton            $2,500.00
     Sclerosis Society--      Rouge
     Houston, TX

    National Multiple        Ohio Buckeye Chapter's Walk           $5,000.00
     Sclerosis Society--      MS 2015
     Independence, OH

    National Multiple        North Florida Walk MS 2015            $7,500.00
     Sclerosis Society--
     Jacksonville, FL

    National Multiple        MS On the Move Luncheon               $2,500.00
     Sclerosis Society--
     Jacksonville, FL

    National Multiple        MS On the Move Luncheon               $1,000.00
     Sclerosis Society--
     Jacksonville, FL

    National Multiple        MS Awareness Mural                   $10,000.00
     Sclerosis Society--
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Walk MS Kentucky                     $10,000.00
     Sclerosis Society--
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Moving Mountains For MS: 2015         $7,500.00
     Sclerosis Society--      Family Weekend Retreat
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Crystal Boots & Silver Spurs          $5,000.00
     Sclerosis Society--      Fundraising Event
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Best of Louisville 2015               $3,000.00
     Sclerosis Society--      Patient Resources Event
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Women on the Move--Patient            $1,000.00
     Sclerosis Society--      Awareness Program
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Long Island Walk MS 2015              $5,000.00
     Sclerosis Society--
     Long Island Chapter

    National Multiple        10th Annual Spring into               $3,000.00
     Sclerosis Society--      Awareness Luncheon
     Long Island Chapter

    National Multiple        Southern California & Nevada         $25,000.00
     Sclerosis Society--Los   Chapter's Walk MS 2015
     Angeles, CA

    National Multiple        40th Annual Dinner of                 $5,000.00
     Sclerosis Society--Los   Champions
     Angeles, CA

    National Multiple        Program on Fueling Impact in          $4,000.00
     Sclerosis Society--Los   MS Research
     Angeles, CA

    National Multiple        Lydia Emily ``Make Your Mark          $2,500.00
     Sclerosis Society--Los   on MS'' Mural Project that
     Angeles, CA              will provide hope to the
                              local MS community and
                              greatly increase public
                              awareness of MS

    National Multiple        Dinner of Champions Northern          $2,500.00
     Sclerosis Society--Los   Nevada
     Angeles, CA

    National Multiple        Maryland Walk MS 2015                 $7,500.00
     Sclerosis Society--
     Maryland Chapter

    National Multiple        Walk MS 2015                          $5,000.00
     Sclerosis Society--MI
     Chapter

    National Multiple        The 37th Annual Ambassadors          $25,000.00
     Sclerosis Society--      Ball
     National Capital
     Chapter

    National Multiple        National Capital Chapter's           $10,000.00
     Sclerosis Society--      Walk MS 2015
     National Capital
     Chapter

    National Multiple        National Capital Chapter's            $5,000.00
     Sclerosis Society--      Walk MS 2015
     National Capital
     Chapter

    National Multiple        11th Annual Women On The Move         $5,000.00
     Sclerosis Society--      Luncheon
     National Capital
     Chapter

    National Multiple        Bike MS Ride the Vine Event           $5,000.00
     Sclerosis Society--
     National Capital
     Chapter

    National Multiple        A Day for Men Living with MS          $1,500.00
     Sclerosis Society--      Program
     National Capital
     Chapter

    National Multiple        Bike MS 'I Ride with MS'            $600,000.00
     Sclerosis Society--New   Program
     York, NY

    National Multiple        The International Progressive       $100,000.00
     Sclerosis Society--New   MS Alliance 2015
     York, NY

    National Multiple        National MS Society E-               $75,000.00
     Sclerosis Society--New   Communications Program
     York, NY

    National Multiple        North American Education             $35,000.00
     Sclerosis Society--New   Program for people with MS
     York, NY                 and their families

    National Multiple        Knowledge is Power 2015 at           $35,000.00
     Sclerosis Society--New   Home Educational series
     York, NY

    National Multiple        MS Navigator: Information            $25,000.00
     Sclerosis Society--New   Program
     York, NY

    National Multiple        National MS Society                  $25,000.00
     Sclerosis Society--New   educational video
     York, NY                 programming for people with
                              MS and their families
                              through ``MS Learn Online''

    National Multiple        2015 National MS Society,            $15,000.00
     Sclerosis Society--New   Southern NY Chapter
     York, NY                 Scholarship Program

    National Multiple        2015 Women on the Move               $12,000.00
     Sclerosis Society--New   Program
     York, NY

    National Multiple        2015 Gala/Dinner of Champions        $12,000.00
     Sclerosis Society--New
     York, NY

    National Multiple        Research Symposium 2015: MS           $3,000.00
     Sclerosis Society--New   Research Discoveries:
     York, NY                 Wellness and Treatments for
                              Living Your Best Life

    National Multiple        Medical Student Clinical              $1,500.00
     Sclerosis Society--New   Summer Fellowship
     York, NY

    National Multiple        MS Awareness and Education           $15,000.00
     Sclerosis Society--NJ    Newsletter
     Metro Chapter

    National Multiple        New Jersey Metro Chapter's           $10,000.00
     Sclerosis Society--NJ    Walk MS 2015
     Metro Chapter

    National Multiple        Northern California Chapter's        $25,000.00
     Sclerosis Society--      Walk MS 2015
     Northern California

    National Multiple        Chapter DuskBuster 5k Race            $2,500.00
     Sclerosis Society--      Event
     Northern California

    National Multiple        Ohio Valley Chapter's Walk MS        $10,000.00
     Sclerosis Society--      2015
     Ohio Valley Chapter

    National Multiple        Women on the Move Luncheon            $2,500.00
     Sclerosis Society--      and Fashion Show
     Ohio Valley Chapter

    National Multiple        Lydia Emily ``Make Your Mark         $33,554.00
     Sclerosis Society--      on MS'' Mural Project that
     Oregon Chapter           will provide hope to the
                              local MS community and
                              greatly increase public
                              awareness of MS

    National Multiple        Oregon Chapter's Walk MS 2015        $10,000.00
     Sclerosis Society--
     Oregon Chapter

    National Multiple        Bike MS 2015: Willamette              $5,000.00
     Sclerosis Society--      Valley
     Oregon Chapter

    National Multiple        Gala MS 2015                          $5,000.00
     Sclerosis Society--
     Oregon Chapter

    National Multiple        Relationship Matters--Spring          $5,000.00
     Sclerosis Society--      2015
     Oregon Chapter

    National Multiple        Greater Delaware Valley and           $7,500.00
     Sclerosis Society--      Delaware Chapter's Walk MS
     Philadelphia, PA         2015

    National Multiple        Women Against MS Luncheon--           $2,500.00
     Sclerosis Society--      Patient Wellness Program
     Philadelphia, PA

    National Multiple        Pennsylvania Keystone                $25,000.00
     Sclerosis Society--      Chapter's Walk MS Champaign
     Pittsburgh, PA           (to include 23 Walk Events)

    National Multiple        Walk MS 2015                         $10,000.00
     Sclerosis Society--
     Rochester, NY

    National Multiple        2015 National MS Society,             $7,000.00
     Sclerosis Society--      Upstate NY Chapter
     Rochester, NY            Scholarship Program

    National Multiple        Bike MS Event                         $5,000.00
     Sclerosis Society--
     Rochester, NY

    National Multiple        2015 MS Research Nights               $5,000.00
     Sclerosis Society--
     Rochester, NY

    National Multiple        Champions On the Move                 $3,000.00
     Sclerosis Society--      Luncheon
     Rochester, NY

    National Multiple        8th Annual Hudson Valley              $3,000.00
     Sclerosis Society--      Multiple Sclerosis Symposium
     Rochester, NY

    National Multiple        2015 Health and Wellness Fair         $2,000.00
     Sclerosis Society--
     Rochester, NY

    National Multiple        Everyday Matters: Living Your         $2,000.00
     Sclerosis Society--      Best Life with MS Program
     Rochester, NY

    National Multiple        On the Move Luncheon program          $1,500.00
     Sclerosis Society--      to raise funds and awareness
     Rochester, NY            for Multiple Sclerosis

    National Multiple        MS Service Day--Patient               $1,000.00
     Sclerosis Society--      Assistance Program
     Rochester, NY

    National Multiple        Free From Falls--Patient                $750.00
     Sclerosis Society--      Wellness Program
     Rochester, NY

    National Multiple        Utah-Southern Idaho Walk MS          $15,000.00
     Sclerosis Society--      2015
     Salt Lake City, UT

    National Multiple        Women on the Move Luncheon            $2,500.00
     Sclerosis Society--      and Fashion Show 2015
     Salt Lake City, UT

    National Multiple        Walk MS San Diego                    $15,000.00
     Sclerosis Society--San
     Diego, CA

    National Multiple        28th Annual MS Dinner Charity        $10,000.00
     Sclerosis Society--San   Auction
     Diego, CA

    National Multiple        MS Dinner Auction Hawaii              $5,000.00
     Sclerosis Society--San
     Diego, CA

    National Multiple        UC Irvine Lunch & Learn               $4,000.00
     Sclerosis Society--San   Symposium
     Diego, CA

    National Multiple        Challenge Walk MS                     $2,500.00
     Sclerosis Society--San
     Diego, CA

    National Multiple        South Florida Chapter's Walk         $25,000.00
     Sclerosis Society--      MS 2015
     South Florida Chapter

    National Multiple        MS Gala Luncheon 2015                $10,000.00
     Sclerosis Society--
     South Florida Chapter

    National Multiple        Festival Hispano 2015--               $4,000.00
     Sclerosis Society--      Patient Awareness Program
     South Florida Chapter

    National Multiple        Mind, Body & Soul--ESTERO             $1,500.00
     Sclerosis Society--      Event
     South Florida Chapter

    National Multiple        Mind, Body & Soul--Boca Raton         $1,500.00
     Sclerosis Society--      Event
     South Florida Chapter

    National Multiple        Walk MS: North Dakota Walks,          $5,500.00
     Sclerosis Society--      South Dakota Walks, and Twin
     Upper Midwest Chapter    Cities Challenge Walk

    National Multiple        Upper Midwest Chapter's Walk          $5,000.00
     Sclerosis Society--      MS 2015
     Upper Midwest Chapter

    National Multiple        Taste of Generosity Gala              $2,500.00
     Sclerosis Society--      Dinner
     Upper Midwest Chapter

    National Multiple        St. Cloud MS Walk 2015                $1,000.00
     Sclerosis Society--
     Upper Midwest Chapter

    National Multiple        Wisconsin Chapter's Walks MS         $10,000.00
     Sclerosis Society--      2015 (to include 20 Walk
     Wisconsin Chapter        Events)

    National Multiple        Georgia Chapter's Walk MS             $5,000.00
     Sclerosis Society--      2015
     Georgia Chapter

    National Multiple        Bike MS Cape Cod Getaway, the        $50,000.00
     Sclerosis Society--      largest MS ride in New
     Greater New England      England
     Chapter

    National Multiple        MileStones 2015 Program Ad            $5,000.00
     Sclerosis Society-
     Greater New England
     Chapter

    National Multiple        Greater Northwest Chapter's          $25,000.00
     Sclerosis Society-       Walk MS Events
     Greater Northwest
     Chapter

    National Multiple        Bike MS Race Event: I Ride           $10,000.00
     Sclerosis Society-       with MS
     Greater Northwest
     Chapter

    National Multiple        Mood & Cognition in MS: What          $8,230.00
     Sclerosis Society-       you can do--Patient Wellness
     Greater Northwest        Program
     Chapter

    National Multiple        Northwest Chapter's Dinner of         $2,500.00
     Sclerosis Society-       Champions Gala
     Greater Northwest
     Chapter

    National Multiple        Indiana Chapter's Walk MS             $8,500.00
     Sclerosis Society        2015
     Indiana State Chapter

    National Multiple        Society's Financial Patient           $5,000.00
     Sclerosis Society        Assistance Program
     Indiana State Chapter

    National Multiple        MS Navigator: Information             $5,000.00
     Sclerosis Society        Program
     Indiana State Chapter

    National Multiple        39th Annual Dinner of                 $5,000.00
     Sclerosis Society--Los   Champions
     Angeles, CA

    National Multiple        Everyday Matters Patient                $909.00
     Sclerosis Society--      Wellness Program
     Upstate New York
     Chapter

    National Niemann-Pick    Hope is on the Horizon Family        $30,000.00
     Disease Foundation       Patient Services Program

    National Organization    Portraits of Courage 2015            $50,000.00
     for Rare Disorders

    National Organization    Volunteer Match                       $9,000.00
     for Rare Disorders

    National Organization    Rare Disease Day Relay                $6,000.00
     for Rare Disorders

    National Organization    NORD's Rare Diseases and             $50,000.00
     for Rare Disorders,      Orphan Products Breakthrough
     Inc.                     Summit

    National Tay-Sachs &     Imagine & Believe 2015 Event         $10,000.00
     Allied Diseases
     Association, Inc.

    National Tay-Sachs &     37th Annual Family Conference         $5,000.00
     Allied Diseases
     Association, Inc.

    National Tay-Sachs &     Raising Awareness of                  $1,200.00
     Allied Diseases          Ashkenazi Jewish Genetic
     Association, Inc.        Diseases through the
                              Forward's annual genetics
                              issue

    Nebraska Kidney          Patient & Family Education              $500.00
     Association              Day

    Neurologic Disease       MS: Today and Tomorrow                $5,995.00
     Foundation               Caregiver Wellness Program

    Neurologic Disease       Newly Diagnosed MS Patient            $4,995.00
     Foundation               Educational Series 2015

    Neuropathy Action        9th Annual Neuropathy Action          $2,500.00
     Foundation               Awareness Day

    New England Healthcare   The Nick Littlefield Health          $25,000.00
     Institute                Policy Fellowship

    New England Healthcare   Innovators in Health Awards          $25,000.00
     Institute

    Next Step Fund Inc.      Expansion of year-round              $10,000.00
                              programming in Song.Studio
                              and the Media Lab for youth
                              with rare genetic disorders

    Norton Healthcare        2015 Neuro Expo                      $10,000.00
     Foundation, Inc.

    OhioHealth Corporation   OhioHealth Multiple Sclerosis        $20,000.00
                              Patient Education Program

    Oligonucleotide          11th Annual Meeting of the            $2,500.00
     Therapeutic Society      Oligonucleotide Therapeutics
                              Society

    Operation Warm Inc.      Community support for Boston         $15,000.00
                              Warmth in Winter

    Oregon Health & Science  At the Frontier & Beyond: MS          $8,850.00
     University               2015

    Oregon Health & Science  On the Horizon: Updates in            $8,700.00
     University               Multiple Sclerosis

    Our Space Inc.           Volunteer Match                       $1,000.00

    Partners Healthcare      World Medical Innovation             $50,000.00
     System, Inc.             Forum--Neurosciences

    Patient Access Network   Patient Assistance Program          $260,000.00
     Foundation               for Homozygous Familial
                              Hypercholesterolemia (HoFH)
                              Patients

    Patient Access Network   Patient Assistance Program          $125,000.00
     Foundation               for Patients with Thyroid
                              Cancer

    Patient Access Network   Patient Assistance Program           $50,000.00
     Foundation               for Homozygous Familial
                              Hypercholesterolemia (HoFH)
                              Patients

    Patient Access Network   Patient Assistance Program           $50,000.00
     Foundation               for Homozygous Familial
                              Hypercholesterolemia (HoFH)
                              Patients

    Patient Services Inc.    Fabry Financial Patient           $3,150,000.00
                              Assistance Program

    Patient Services Inc.    Pompe Patient Assistance            $237,422.00
                              Program

    Patient Services Inc.    Pompe Patient Assistance            $237,422.00
                              Program

    Patient Services Inc.    MPS1 Patient Assistance             $212,778.00
                              Program

    Patient Services Inc.    Patient Assistance Program          $212,378.00
                              for Gauchers Disease

    Peer Health Exchange     Peer Health Exchange:                 $5,000.00
     Inc.                     Empowering Boston Youth to
                              Make Healthy Decisions

    Perkins School for the   Perkins eLearning: Accessible        $20,000.00
     Blind                    Science Education

    Pharmacy Quality         Development of Quality               $75,000.00
     Alliance                 Measurement Strategy for
                              Multiple Sclerosis Program

    Phillips Brooks House    Put on a Helmet!                      $5,755.76
     Association
     Incorporated

    Portland VA Research     PDX Patient Workshop                  $4,000.00
     Foundation Inc.

    Pro Player Foundation    Flavors of Austin hosted by           $5,000.00
                              Earl Campbell

    Project Eden Inc.        Volunteer Match                       $1,000.00

    Race--Run Against        Super Sunday 5K Sponsorship          $10,000.00
     Cancer Events

    Race to Erase MS         22nd Annual Race to Erase MS         $60,000.00

    Resolve Community        Volunteer Match                       $1,000.00
     Counseling Center,
     Inc.

    Rhode Island Rare        World Rare Disease Dar Art            $5,000.00
     Disease Foundation       Exhibit 2015

    Rhode Island Rare        Beyond the Diagnosis Art              $2,500.00
     Disease Foundation       Exhibit

    Rocky Mountain Multiple  Rocky Mountain MS Center              $5,000.00
     Sclerosis Center         Annual Gala

    Room to Grow             Clinical Community Support            $5,000.00
                              Program

    S S Cosmas & Damian      88th Annual East Cambridge            $2,500.00
     Society Inc.             Festival

    Samaritans of Greater    Community Support for Youth          $25,000.00
     Boston                   Suicide Prevention Program

    Science Club For Girls   Campus Chapters Supporting K-        $10,000.00
     Inc.                     12 Science Clubs

    Science From Scientists  69th Annual Boston Citywide          $10,000.00
     Inc.                     Science Fair

    Seattle Children's       MPS Family Day 2015                   $6,000.00
     Hospital Foundation

    Special Olympics         Bio-Ball 2015                         $2,000.00
     Massachusetts Inc.

    Stop Hunger Now, Inc.    Meal Packaging Event--Take            $3,044.08
                              Our Sons & Daughters to Work
                              Day

    Student Clubs of HBS,    12th Annual Healthcare                $1,500.00
     Inc.                     Conference at Harvard
                              Business School

    Temple University        Genzyme Allston/Brighton              $5,000.00
                              Biotechnology College
                              Scholarship

    Terrapinn Inc.           World Orphan Drug Congress           $50,000.00
                              USA 2015

    Texas Neurological       TNS 18th Annual Winter                $5,000.00
     Society                  Conference

    THANC Foundation, Inc.   A Starry Night to benefit the         $5,000.00
                              THANC (Thyroid, Head and
                              Neck Cancer) Foundation
                              honoring R. Michael Tuttle,
                              MD

    THANC Foundation, Inc.   A Starry Night to benefit the         $5,000.00
                              THANC (Thyroid, Head and
                              Neck Cancer) Foundation
                              honoring R. Michael Tuttle,
                              MD

    The Boston Home, Inc.    B.Fit! Day Wellness Program          $18,000.00

    The Boston Home, Inc.    iPads Communication System           $12,000.00
                              for Wheelchair Users--
                              Patient Assistance Program

    The Boston Home, Inc.    The Boston Home Art Program          $10,000.00

    The Boston Home, Inc.    Volunteer Match                       $1,000.00

    The Community Art        Community Teen Media Program         $10,000.00
     Center

    The Familial             FH Patient Speakers Bureau           $25,000.00
     Hypercholesterolemia     Program
     Foundation

    The Familial             Homozygous Familial                  $20,000.00
     Hypercholesterolemia     Hypercholesterolemia (HoFH)
     Foundation               Community Program

    The FH Foundation        2015 FH Global Summit                $25,000.00

    The Forsyth Institute    The ForsythKids School Oral          $10,000.00
                              Health Program: Expansion to
                              serve Homeless Youth in
                              Cambridge

    The Friends of the       Community Support of The              $4,000.00
     Hopkinton Public         Friends of the Hopkinton
     Library                  Public Library

    The Life Sciences        Leadership Mid-Term Funding          $50,000.00
     Foundation               for Educational Programs

    The McCourt Foundation   MS Educational Update Program        $20,000.00

    The McCourt Foundation   McCourt Foundation Gala &            $15,000.00
                              Auction

    The McCourt Foundation   Tour de South Shore Bike             $10,000.00
                              Event

    The McCourt Foundation   The Immune System and The             $5,000.00
                              Brain With a Focus on MS

    The National Cancer      Gaucher's Disease Relief              $5,000.00
     Coalition, Inc.          Patient Assistance Program

    The Oak Clinic           2015 Diamond Run for MS               $5,000.00

    The Posse Foundation     Community Support for Posse          $20,000.00
                              Boston's Students Program

    Thompson Island Outward  Connections--STEM learning to        $10,000.00
     Bound Education Center   empower urban youth
     Inc.

    Thyca Thyroid Cancer     18th International Thyroid           $30,000.00
     Survivors Association    Cancer Survivors' Conference
     Inc.

    Thyca Thyroid Cancer     Informational Resource                $7,875.00
     Survivors Association    Support for ``After the
     Inc.                     Diagnosis, Medullary Thyroid
                              Cancer Memoirs'' to all
                              ThyCa Support Group

    Tisch Multiple           18th Annual Patient Symposium        $30,000.00
     Sclerosis Research
     Center of New York,
     Inc.

    Tisch Multiple           Healing MS Patient Newsletter        $15,000.00
     Sclerosis Research
     Center of New York,
     Inc.

    Trustees of Boston       Genzyme Youth Science &               $5,050.00
     University               Engineering Workshop
                              Scholarships for U-Design
                              Program at Boston University

    Trustees of Boston       Genzyme Allston/Brighton              $2,000.00
     University               Biotechnology College
                              Scholarship

    Trustees of Boston       Genzyme Allston/Brighton              $2,000.00
     University               Biotechnology College
                              Scholarship

    Trustees of Tufts        Genzyme Allston/Brighton              $5,000.00
     College                  Biotechnology College
                              Scholarship

    Tutoring Plus of         Science & Math Enrichment             $5,000.00
     Cambridge, Inc.          Programs

    Tutoring Plus of         Volunteer Match                       $1,000.00
     Cambridge, Inc.

    United Pompe Foundation  Pompe Community Support              $46,500.00
                              Programs

    United Pompe Foundation  Duke Late Onset Pompe Patient        $20,000.00
                              Meeting

    United Way of Tri        Volunteer Match                       $1,000.00
     County Inc.

    University of Florida    8th International Conference          $2,000.00
                              on Unstable Microsatellites
                              and Human Disease

    University of            Massachusetts STEM Summit            $10,000.00
     Massachusetts            2015: Promising Practices,
                              Proven Results

    University of            Student Success Program for         $200,000.00
     Massachusetts            UMass Boston, College of
     Foundation Inc.          Science and Mathematics

    University of Southern   Genzyme Allston/Brighton              $5,000.00
     California               Biotechnology College
                              Scholarship

    Urban Kidney Alliance,   Prescription Medication                 $500.00
     Inc.                     Assistance Program (PMAP)

    Veterans Inc.            Volunteer Match                       $1,000.00

    Visiting Nurse           Heroes in Health Care Gala           $10,000.00
     Association of Boston
     & Affiliates

    Weill Medical College    Talk MS Program                      $10,000.00
     of Cornell University

    West County MS Center    10th Annual Trivia and                $7,500.00
                              Auction

    West End House Boys and  Volunteer Match                       $1,000.00
     Girls Club

    WGBH                     WGBH Pledge Night                    $12,000.00

    Whitehead Institute for  Whitehead Institute's 2015           $10,000.00
     Biomedical Research      CampBio Program

    Whitehead Institute for  Whitehead Institute's 2016           $10,000.00
     Biomedical Research      CampBio Program

    Women's Lunch Place      Community Support for Meals          $35,000.00
                              Program

    Worcester County Food    Volunteer Match                       $1,000.00
     Bank Inc.

    Worcester Polytechnic    Genzyme Allston/Brighton              $1,000.00
     Institute                Biotechnology College
                              Scholarship

    WriteBoston              STEM Teacher Excellence:             $10,000.00
                              Powered By Genzyme

    Wylder Nation            2nd Annual Living Like a             $10,000.00
     Foundation               Warrior Gala

    YMCA of Greater Boston   Oak Square YMCA--Summer Day          $15,000.00
                              Camp Scholarship

                      Sponsorships and Charitable Donations
                           1st Jan 2016-31st Dec 2016
        Sanofi US and its affiliate Genzyme Corporation are committed to
       supporting sponsorships for specific activities and initiatives of
        healthcare organizations and institutions, independent medical or
    professional societies, trade organizations and organized patient groups
      to improve patient care and provide information to the medical and/or
      patient communities. The goal of our charitable giving approach is to
     fund general operational support for patient/disease organizations, or
    program support for community-based organizations. Sanofi US and Genzyme
        Corporation are part of the Sanofi Group, a global pharmaceutical
                                    company.
     Applicant names are provided by the requestor. If applicants apply as a
      group for a single activity; all applicants may be not be identified
     above. ``Funding Amount'' is the amount that the Company funded during
      2015 identified above. ``Funding Amount'' does not include funds that
       may have been provided by other affiliated Sanofi Company Entities
                             (e.g., Sanofi Pasteur).

       Recipient Name(s)             Activity Title          Funding Amount

    Acid Maltase Deficiency  General Operating Support            $48,000.00
     Association Inc.

    ACTRIMS                  Congress Sponsorships                $30,000.00

    Allston Brighton         Feastworthy: Pilot Prepared          $15,000.00
     Community Development    Meals Delivery Program
     Corporation

    American Academy of      Congress Sponsorships               $482,897.00
     Neurology Institute

    American Academy of      Palatucci Advocacy Leadership        $50,000.00
     Neurology Institute      Forum

    American Academy of      Brain Health Fair                     $7,500.00
     Neurology Institute

    American Academy of      Fellows Scholarship Fund             $20,000.00
     Neurology Institute

    American Academy of      Residents Scholarship Fund           $20,000.00
     Neurology Institute

    American Academy of      Emerging Leaders Program             $20,000.00
     Neurology Institute

    American Association of  Congress Sponsorships                 $4,300.00
     Clinical
     Endocrinologists

    American Association of  Fabry Family Member Testing         $164,970.00
     Kidney Patients          and Education Project

    American Autoimmune and  50 Cents for 50 Million               $5,000.00
     Related Diseases         Laughs Campaign
     Association

    American Brain           Patient Advocacy Organization         $5,000.00
     Coalition                Membership Sponsorship

    American Cancer Society  Volunteer Match                       $1,000.00

    American Cancer Society  Volunteer Match                      $11,000.00

    American Chemical        Recovery of Biological                $5,000.00
     Society Merck and Co     Products XVII Conference
     Inc.

    American Chemical        Biochemical Technology ACS            $5,000.00
     Society Merck and Co     National Meeting
     Inc.

    American College of      Congress Sponsorships                $50,875.00
     Medical Genetics and
     Genomics

    American Red Cross of    American Red Cross Blood              $5,000.00
     Massachusetts            Services

    American Red Cross of    American Red Cross of                 $5,000.00
     Massachusetts            Massachusetts Women Who Care
                              Breakfast

    American Thyroid         Congress Sponsorships                 $3,000.00
     Association

    American Thyroid         Congress Sponsorships                $15,000.00
     Association

    ANERA (American Near     ANERA Annual Dinner                   $5,000.00
     East Refugee Aid)

    Angel's Hands            Family Assistance Program             $5,000.00
     Foundation

    Ann & Robert H. Lurie    MPS Patient and Family                $2,000.00
     Children's Hospital of   Conference
     Chicago

    Arthritis Foundation     Orange County & Inland Empire         $2,500.00
                              Jingle Bell Run

    Assistance Fund Inc.     Patient Assistance Program        $7,750,000.00
                              for MS

    Association For          Annual Conference; Family             $6,000.00
     Glycogen Storage         Assistance; The Ray
     Disease                  (newsletter)

    Association For          Annual Conference; Family             $6,000.00
     Glycogen Storage         Assistance; The Ray
     Disease                  (newsletter)

    Barth Syndrome           Barth Syndrome Foundation             $2,000.00
     Foundation               Conference

    Batten Disease Support   NCL Congress Boston                   $5,000.00
     And Research
     Association

    Berkshire Resource       8th Annual GALA Fundraiser            $5,000.00
     Project

    Berkshire Resource       When IWalk - An MS Story              $8,000.00
     Project

    Big Brothers Big         MySTEM--Mentoring Youth in           $10,000.00
     Sisters Of Central       Science, Technology,
     Mass Metrowest Inc.      Engineering, and Mathematics

    Biomedical Science       Hope Scholarship                      $7,500.00
     Careers Program

    Biomedical Science       Evening of Hope                      $75,000.00
     Careers Program

    Biotechnology            BIO Patient and Health               $10,000.00
     Innovation               Advocacy Summit
     Organization

    Boston Area Rape Crisis  Community Program                    $25,000.00
     Center

    Boston Area Rape Crisis  Advocacy Program                     $25,000.00
     Center

    Boston College Trustees  Allston Brighton College              $2,000.00
                              Scholarship

    Boston College Trustees  Allston Brighton College              $4,000.00
                              Scholarship

    Boston Educational       Boston Public Schools Science        $10,000.00
     Development              Fair
     Foundation, Inc.

    Boston Health Care For   Life Essentials for Homeless         $35,000.00
     The Homeless Program     Patients
     Inc.

    Boston Health Care For   Volunteer Match                       $1,000.00
     The Homeless Program
     Inc.

    Boston Health Care For   General Operating Support            $10,000.00
     The Homeless Program
     Inc.

    Boston Partners in       Power Lunch Program                   $6,000.00
     Education, Inc.

    Boston Private Industry  Corporate Contributions              $15,000.00
     Council                  Campaign

    Boston Private Industry  Volunteer Match                       $1,000.00
     Council

    Bottom Line              Boston STEM Success Program          $15,000.00

    Bottom Line              Volunteer Match                       $1,000.00

    Boys and Girls Clubs of  Staffing & Transportation for        $25,000.00
     MetroWest                Membership at BGCMW's
                              Framingham Clubhouse

    Boys and Girls Clubs of  Volunteer Match                       $1,000.00
     MetroWest

    Boys and Girls Clubs of  Volunteer Match                       $4,000.00
     MetroWest

    Boys and Girls Clubs of  Volunteer Match                       $1,000.00
     MetroWest

    Boys and Girls Clubs of  Bids for Kids Auction & Gala         $10,000.00
     MetroWest

    Boys and Girls Clubs Of  Great Pumpkin Glow                    $6,000.00
     Middlesex County Inc.

    BPE                      Boston Teacher Residency:            $15,000.00
                              Putting Students at the
                              Center of STEM Teacher
                              Training

    Breakthrough Greater     Full STEAM Ahead Program With        $10,000.00
     Boston                   Low-Income Students

    Brian J. Honan           Brian Honan 5K Road Race              $2,500.00
     Charitable Fund

    California Association   Congress Sponsorships                 $1,500.00
     of Physician Groups
     (CAPG)

    California Association   Congress Sponsorships                 $1,000.00
     of Physician Groups
     (CAPG)

    California District      Congress Sponsorships                 $3,000.00
     American Academy of
     Pediatrics

    California Pharmacists   Congress Sponsorships                 $1,500.00
     Association
     Educational Foundation

    Cambridge Chamber of     Women in Business Programming         $4,350.00
     Commerce                 Series Sponsor

    Cambridge Health         Volunteer Match                       $1,000.00
     Alliance Foundation
     Inc.

    Cambridge School         Volunteer Match                       $1,000.00
     Volunteers, Inc.

    Cambridge School         Volunteer Match                      $15,825.00
     Volunteers, Inc.

    Cambridge School         Volunteer Match                      $13,755.00
     Volunteers, Inc.

    Cambridge School         Community Program                    $11,000.00
     Volunteers, Inc.

    Cambridge School         Community Program                    $11,000.00
     Volunteers, Inc.

    Camp Korey               Metabolic Disorders Family            $5,000.00
                              Weekend Camp

    Can Do Multiple          JUMPSTART Programs                  $60,000.00
     Sclerosis

    Can Do Multiple          Annual Autumn Benefit for Can         $5,000.00
     Sclerosis                Do Multiple Sclerosis

    Can Do Multiple          Vertical Express for Can Do          $30,000.00
     Sclerosis                MS

    Can Do Multiple          Annual Autumn Benefit                $10,000.00
     Sclerosis

    Can Do Multiple          CAN DO Program                      $60,000.00
     Sclerosis

    Can Do Multiple          TAKE CHARGETM Program                $37,500.00
     Sclerosis

    Case Management Society  CMSA 26th Annual Conference &         $4,650.00
     of America               Expo

    Case Management Society   Congress Sponsorships               $14,000.00
     of America

    Case Management Society  Congress Sponsorships                 $5,500.00
     of America

    Case Management Society  New Frontiers of                      $1,050.00
     of New England           Technological Advancement
                              Program

    Case Management Society  Corporate Sponsorship of              $1,250.00
     of New England           CMSNE

    Case Management Society  Creativity, Inspiration &             $1,000.00
     of New England           Collaboration: Building
                              Blocks of Successful
                              Leadership

    CASSS--An International  WCBP--20th Symposium                  $7,500.00
     Separation Science
     Society

    Charles River Community  Mom & Baby Program                   $15,000.00
     Health

    Charles River            Volunteer Match                       $1,000.00
     Conservancy

    Charles River            Volunteer Match                       $4,000.00
     Conservancy

    Chelsea Jewish Nursing   ALS & MS Walk for Living              $2,500.00
     Home Foundation, Inc.

    Childrens Gaucher        Gaucher Related Research Fund        $75,000.00
     Research Fund

    Children's Hospital      La Gala de Milagros para              $5,000.00
     Boston                   Ninos

    Children's Hospital      Volunteer Match                       $1,000.00
     Boston

    Children's Hospital of   Lysosomal Day at The                 $16,370.33
     Philadelphia             Philadelphia Zoo
     Foundation

    Chronic Disease Fund,    Medullary Thyroid Cancer            $300,000.00
     Inc DBA Good Days from   Patient Assistance Program
     CDF

    Chronic Disease Fund,    Medullary Thyroid Cancer            $150,000.00
     Inc DBA Good Days from   Patient Assistance Program
     CDF

    Church Hillers Inc.      Volunteer Match                       $1,000.00

    Cincinnati Children's    Meeting for Patients with             $5,000.00
     Hospital Medical         Fabry Disease
     Center

    Citizen Schools          Expanding STEM Learning at           $15,000.00
                              Boston Schools

    Citizen Schools          Deepening the Impact of STEM         $15,000.00
                              Education

    City Sprouts, Inc.       CitySprouts Middle School             $8,000.00
                              Program in Cambridge

    City Sprouts, Inc.       CitySprouts Middle School             $8,000.00
                              Program

    Cleveland Clinic         Multiple Sclerosis (MS)              $10,125.00
     Foundation               Promoting Wellness and
                              Healthy Lifestyle

    Community Boating, Inc.  Universal Access Program 2016        $15,000.00

    Community Farms          Fresh Food Access Program            $15,000.00
     Outreach

    Community Living and     The Giving Tree Campaign              $6,500.00
     Support Services, Inc.

    Community Rowing, Inc.   Let's Row Boston                     $10,000.00

    Community Servings,      Pie in the Sky                       $10,000.00
     Inc.

    Consortium of MS         Congress Sponsorships                 $5,000.00
     Centers

    Courageous Parents       Patient Education and                 $7,000.00
     Network                  Awareness Program

    Cradles To Crayons Inc.  Ready for School                     $20,000.00

    Cradles To Crayons Inc.  General Operating Support            $10,000.00

    Cradles To Crayons Inc.  Volunteer Match                       $1,000.00

    Cystic Fibrosis          Volunteer Match                       $4,000.00
     Foundation

    Cystic Fibrosis          Uncork the Cure                      $10,000.00
     Foundation

    Damon Runyon Cancer      General Operating Support             $5,000.00
     Research Foundation

    DEAF, Inc.--             Community Program                    $10,000.00
     Developmental
     Evaluation and
     Adjustment Facilities,
     Inc.

    Dimock Community Health  29th Annual Steppin' Out for         $25,000.00
     Center                   The Dimock Center

    Dimock Realty            Building the Road to Recovery        $50,000.00
     Corporation              Campaign

    Direct Relief            Patient Assistance Fund for          $10,000.00
     International            Rare Diseases

    Direct Relief            Patient Assistance Fund for           $5,000.00
     International            Rare Diseases

    DPC Education Center     Fabry Disease Newsletter             $25,000.00
                              Support

    Duke University          Patient Assistance Program          $400,000.00

    Duke University          Hospitals Patient Assistance        $224,000.00
                              Program

    East End House Inc.      Generating and Evaluating New        $20,000.00
                              Adventures in Science After
                              School (GENASAS)

    East End House Inc.      Generating and Evaluating New        $20,000.00
                              Adventures in Science After
                              School (GENASAS)

    Engineering Conferences  Cell Culture Engineering XV          $10,000.00
     International            Conference

    EveryLife Foundation     Community Congress                   $15,000.00
     for Rare Diseases

    EveryLife Foundation     Rare Disease Advocacy Program        $20,000.00
     for Rare Diseases

    EveryLife Foundation     Rare Voice Awards                    $15,000.00
     for Rare Diseases

    EveryLife Foundation     Patient Education and                 $5,000.00
     for Rare Diseases        Awareness Program

    EveryLife Foundation     Community Congress                    $5,000.00
     for Rare Diseases

    Fabry Support &          Fabry Support &Information           $30,000.00
     Information Group        Group Patient Assistance
                              Fund Program

    Fabry Support &          Fabry Support & Information         $100,000.00
     Information Group        Group General Operating
                              Support

    Fabry Support &          Fun Run/Walk St. Louis, MO            $1,500.00
     Information Group

    Fabry Support &          FSIG Expert Fabry Conference         $50,000.00
     Information Group

    Families of SMA          Annual SMA Conference                $10,000.00

    Family Promise           Keep the Promise, Food                $2,500.00
     Metrowest Inc.           Program for the Homeless

    Florida Society of       Congress Sponsorships                $15,000.00
     Rheumatology

    Food For Free            Community Program                     $1,000.00
     Committee, Inc.

    Foundation Fighting      Volunteer Match                       $2,000.00
     Blindness Inc.

    Framingham Townwide Pto  Volunteer Match                       $1,000.00
     Council

    Franciscan Hospital For  Adaptive Sports Program              $10,000.00
     Children Inc.

    Friends of Resiliency    Community Program                    $10,000.00
     for Life Inc.

    Friends of Resiliency    Volunteer Match                       $1,000.00
     for Life Inc.

    Generation Citizen Inc.  Spring and Fall Civics Day            $5,000.00

    Genetic Alliance Inc.    Industry Program                     $20,000.00

    Girl Scouts of Eastern   Girls Building Self-eSTeEM           $10,000.00
     Massachusetts Inc.

    Girl Scouts of Eastern   Volunteer Match                       $1,000.00
     Massachusetts Inc.

    Girl Scouts of Eastern   Volunteer Match                       $1,000.00
     Massachusetts Inc.

    Global Genes             RARE Tribute To Champions of         $25,000.00
                              Hope

    Global Genes             RARE Webinars & RARE Toolkits        $30,000.00

    Global Genes             Patient Assistance Program           $20,000.00

    Global Genes             RARE Patient Advocacy Summit         $25,000.00

    Gordon Research          Barriers of the Central               $2,000.00
     Conferences              Nervous System Gordon
                              Research Conference

    Greater Boston Chamber   Annual Meeting                       $10,000.00
     of Commerce

    Habitat For Humanity     Home Build for Four Low-             $20,000.00
     Metrowest--Greater       Income Families Program
     Worcester Inc.

    Habitat For Humanity     Volunteer Match                       $1,000.00
     Metrowest--Greater
     Worcester Inc.

    Habitat For Humanity     Volunteer Match                       $1,500.00
     Metrowest--Greater
     Worcester Inc.

    Habitat For Humanity     Volunteer Match                       $2,000.00
     Metrowest--Greater
     Worcester Inc.

    Habitat For Humanity     High Heels and Hard Hats              $7,500.00
     Metrowest - Greater      Auction and Gala
     Worcester Inc.

    Harvard College          Allston Brighton College              $2,000.00
                              Scholarship

    Health Care For All      Public Education Campaign to         $15,000.00
     Inc.                     Improve Access to Health
                              Care in Framingham

    Health Resources In      The Leaders through                  $20,000.00
     Action Inc.              Education, Action and Hope
                              (LEAH) Project

    Health Resources in      The Leaders through                  $20,000.00
     Action Inc.              Education, Action, and Hope
                              (LEAH) Project

    Hearts & Noses Hospital  Hospital Clown Visits to Ill         $15,000.00
     Clown Troupe Inc.        and Disabled Children in
                              Greater Boston

    Hereditary Disease       Milton Wexler Celebration of          $5,000.00
     Foundation               Life Symposium

    Holy Name Health Care    MS Awards Reception                   $2,500.00
     Foundation Inc.

    Holy Name Health Care    19th Annual spring Fling to           $5,000.00
     Foundation Inc.          benefit MS

    Holy Name Health Care    MS Awards Reception                   $5,000.00
     Foundation Inc.

    Horizons for Homeless    18th Annual Women's Breakfast         $5,000.00
     Children

    Huntington's Disease     Patient Education and                 $5,000.00
     Society of America       Awareness Program

    Huntington's Disease     Huntington's Disease Society          $2,000.00
     Society of America       of America 31st Annual
                              Convention

    International Institute  Patient Navigation Services          $10,000.00
     of New England           for Refugees in Boston

    International Institute  Golden Door Award Gala               $10,000.00
     of New England

    International            Stress--You Can't Avoid It,          $10,000.00
     Organization of          But You Can Manage It!
     Multiple Sclerosis
     Nurses

    International            Annual Meeting IOMSN Dinner          $30,000.00
     Organization of
     Multiple Sclerosis
     Nurses

    International            MS Perspectives                      $75,000.00
     Organization of
     Multiple Sclerosis
     Nurses

    Italian Home For         Annual Gala                           $5,000.00
     Children Inc.

    Jewish Family Service    Patient Navigator Program            $15,000.00
     of Metrowest Inc.

    Jewish Family Service    Patient Navigator Program            $15,000.00
     of Metrowest Inc.

    Jewish Genetic Disease   Community and Rabbinic                  $500.00
     Consortium (JGDC)        Education for Jewish Genetic
                              Diseases

    Just-A-Start             St. Patrick's Fund                    $5,000.00
     Corporation

    Just-A-Start             Biomedical Careers Program           $22,950.00
     Corporation

    LGMD2D Foundation        Patient Assistance Program          $650,000.00

    LGMD2D Foundation        Patient Assistance Program          $600,000.00

    Light of Life            Light of Life Foundation             $40,000.00
     Foundation               Program

    Little Brothers/Friends  Community Program                     $7,500.00
     of the Elderly

    Louisiana Association    Congress Sponsorships                 $5,285.00
     of Health Plans

    MagellanRx Management    Congress Sponsorships                 $5,000.00

    Manchaug Pond            Volunteer Match                       $1,000.00
     Association

    March of Dimes           Volunteer Match                       $2,000.00

    March of Dimes           Black Ties for Babies                $10,000.00

    March of Dimes           March for Babies                     $15,000.00

    Margaret Fuller          Please Help a Crumbling              $20,000.00
     Neighborhood House       Community Resource

    Margaret Fuller          Margaret Fuller Kids Summer          $15,000.00
     Neighborhood House       Explorations Program

    Mass Insight Education   Advanced Placement (AP)              $15,000.00
     and Research Institute   Science, Technology,
     Inc.                     Engineering, and Math (STEM)
                              and English Program

    Massachusetts Bay        STEM Mentor Program (SMP)            $37,000.00
     Community College
     Foundation

    Massachusetts            Congress Sponsorships                $25,000.00
     Biotechnology Council

    Massachusetts            Patient Advocacy Summit              $10,000.00
     Biotechnology Council

    Massachusetts            MassBio Annual Meeting               $10,000.00
     Biotechnology Council

    Massachusetts            2016 MassBio Policy                   $5,000.00
     Biotechnology Council    Leadership Breakfast

    Massachusetts            Volunteer Match                       $1,000.00
     Biotechnology
     Education Foundation
     Inc.

    Massachusetts            BioTeach                             $50,000.00
     Biotechnology
     Education Foundation
     Inc.

    Massachusetts            Volunteer Match                       $1,000.00
     Biotechnology
     Education Foundation
     Inc.

    Massachusetts            Champions for Biotechnology           $2,500.00
     Biotechnology            Education Program
     Education Foundation
     Inc.

    Massachusetts Black      Massachusetts Black Women             $5,000.00
     Women Attorneys          Attorneys 35th Anniversary
     Foundation Inc.          Celebration

    Massachusetts College    Next Generation of Women             $10,000.00
     of Pharmacy and Health   Leaders in STEM
     Sciences

    Massachusetts Institute  Cambridge Science Festival            $5,000.00
     of Technology

    Massachusetts Outdoor    Volunteer Match                       $1,000.00
     Heritage Foundation
     Inc.

    Massachusetts State      Massachusetts State Science &        $50,000.00
     Science and              Engineering Fair
     Engineering Fair, Inc.

    Mattel Children's        Educational Seminars for             $59,000.00
     Hospital UCLA            Patients with Fabry Disease

    Mercy Foundation         Multiple Sclerosis                   $25,000.00
                              Achievement Center Wellness
                              Education Programs

    Metrowest Free Medical   Expanding Access to Women's          $10,000.00
     Program Inc.             Health Care and Health
                              Education in Framingham

    Miami Childrens Health   Education and Outreach                $5,000.00
     System Foundation Inc.   Activities of Jewish Genetic
                              and Pan-Ethnic Diseases

    Mid America MS           The Race to Nowhere                   $5,000.00
     Achievement Center

    Mid America MS           Your MS Depression Toolkit            $8,210.00
     Achievement Center

    Mint For Mounts Inc.     Volunteer Match                       $1,000.00

    MITS Inc.                STEM Professional Development        $20,000.00
                              Institutes for teachers

    MITS Inc.                Professional Development             $20,000.00
                              Institutes for teachers

    MS Cure Fund             Women Thriving with MS--How         $125,000.00
                              to be a partner, a mother, a
                              woman--FIRST

    MS Cure Fund             Lifestyle Management Programs        $13,500.00
                              Spring

    MS Cure Fund             eNewsletter                          $24,000.00

    MS Cure Fund             Patient Education and                $22,580.00
                              Awareness Program

    MS Hope for a Cure Inc.  MS Hope Day                          $10,000.00

    MS Views and News Inc.   Wheelchairs for Charity               $6,000.00

    MS Views and News Inc.   Effective Communication              $19,775.00
                              Program

    MS Views and News Inc.   Champions Tackling MS Awards          $5,000.00
                              Dinner Gala

    MS Views and News Inc.   Congress Sponsorships                 $7,900.00

    MS Views and News Inc.   MS Views and News 6th Annual          $3,500.00
                              Bowlathon Fundraiser

    MS Views and News Inc.   Patient Education and                $10,406.75
                              Awareness Program

    MS Views and News Inc.   The Evolution of MS Care--           $14,200.00
                              Making Impacts on Health and
                              Wellness

    MS Views And News Inc.   Patient Education and                $26,910.75
                              Awareness Program

    MSWorld, Inc.            MSWorld Conference Coverage          $12,000.00

    Multiple Sclerosis       Patient Assistance Program          $125,000.00
     Association of America

    Multiple Sclerosis       MSAA Cooling Equipment               $15,000.00
     Association of America   Distribution Program

    Multiple Sclerosis       Patient Assistance Program           $50,000.00
     Association of America

    Multiple Sclerosis       Navigating MS Program                $75,000.00
     Association of America

    Multiple Sclerosis       ``MS Health and Wellness''           $20,000.00
     Association of America   Program

    Multiple Sclerosis       Patient Education and               $105,000.00
     Association of America   Awareness Program

    Multiple Sclerosis       MSAA's Improving Lives               $10,000.00
     Association of America   Benefit

    Multiple Sclerosis       MSAA Annual Healthcare               $24,887.00
     Association of America   Advisory Council Summit

    Multiple Sclerosis       Patient Education and                $17,409.50
     Association of America   Awareness Program

    Multiple Sclerosis       MS Fest                              $10,000.00
     Center of Georgia

    Multiple Sclerosis       Health, Hope & Hops                   $7,000.00
     Center of Georgia

    Multiple Sclerosis       Health, Hope & Hops                   $7,000.00
     Center of Georgia

    Multiple Sclerosis       Multiple Sclerosis                   $50,000.00
     Foundation               Foundation's Assistive
                              Technology Program

    Multiple Sclerosis       EmpowerSource Support Group          $28,000.00
     Foundation               Newsletter

    Multiple Sclerosis       Chapter Meetings Support              $7,000.00
     Foundation

    Multiple Sclerosis       National March MS Education          $40,000.00
     Foundation               and Awareness Monthr 2016

    Multiple Sclerosis       MS Dinner of Hope                     $1,500.00
     Resources of Central
     New York, Inc.

    Multiple Sclerosis       Mission Steps Walk & MS               $8,000.00
     Resources of Central     Awareness Day
     New York, Inc.

    Muscular Dystrophy       MDA Summer Camp                       $3,500.00
     Association

    Muscular Dystrophy       Volunteer Match                       $1,000.00
     Association

    Muscular Dystrophy       Care Services Program                 $1,500.00
     Association

    Muscular Dystrophy       Live Unlimited Program               $30,000.00
     Association

    Muscular Dystrophy       Patient Assistance Program          $700,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Fresno                 $1,000.00
     Association

    Muscular Dystrophy       Muscular Dystrophy                    $2,000.00
     Association              Association, Second Quarter
                              Newsletter

    Muscular Dystrophy       Muscular Dystrophy                    $2,000.00
     Association              Association 2nd Quarter
                              Newsletter

    Muscular Dystrophy       Quarterly Newsletter                  $5,000.00
     Association

    Muscular Dystrophy       Kids Art Auction                      $1,500.00
     Association

    Muscular Dystrophy       Patient Assistance Program            $2,000.00
     Association

    Muscular Dystrophy       Patient, Provider and Family          $2,000.00
     Association              Healthcare Newsletter

    Muscular Dystrophy       Muscular Dystrophy                    $2,500.00
     Association              Association of Montana
                              Summer Camp

    Muscular Dystrophy       MDA Summer Camp                       $2,500.00
     Association

    Muscular Dystrophy       MDA Summer Camp                       $2,500.00
     Association

    Muscular Dystrophy       Newsletter                            $2,500.00
     Association

    Muscular Dystrophy       Muscular Dystrophy                    $2,000.00
     Association              Association Quarter
                              Newsletter

    Muscular Dystrophy       Patient Education and                 $1,000.00
     Association              Awareness Program

    Muscular Dystrophy       MDA Black N Blue comedy event         $2,500.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Dayton                 $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Albany                 $1,000.00
     Association

    Muscular Dystrophy       MDA Wisconsin Muscle Summit           $8,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk MA                     $1,000.00
     Association

    Muscular Dystrophy       MDA Central Texas MuscleWalk          $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Cincinnati

    Muscular Dystrophy       MDA MuscleWalk MN                     $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Green Bay           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Knoxville              $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Omaha                  $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Jacksonville           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Hawaii                 $1,000.00
     Association

    Muscular Dystrophy       Passport to a Cure Program            $1,500.00
     Association

    Muscular Dystrophy       MDA MuscleWalk St. George             $1,000.00
     Association              Utah

    Muscular Dystrophy       MDA MuscleWalk Miami                  $1,000.00
     Association

    Muscular Dystrophy       MDA Muscle Team                       $3,000.00
     Association

    Muscular Dystrophy       3rd and 4th Quarter                   $3,000.00
     Association              Newsletter

    Muscular Dystrophy       MDA of Maine MuscleWalk               $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Kansas City            $1,000.00
     Association

    Muscular Dystrophy       Fourth Quarter Newsletter             $2,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Northwest              $1,000.00
     Association              Indiana

    Muscular Dystrophy       MDA MuscleWalk Tucson                 $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Houston                $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Metro NY            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk NH                     $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Raleigh             $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Northwest           $1,000.00
     Association              Arkansas

    Muscular Dystrophy       3rd Quarter Newsletter                $3,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Columbia            $1,000.00
     Association

    Muscular Dystrophy       3rd Quarter Newsletter                $5,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Madison

    Muscular Dystrophy       MDA MuscleWalk FL                     $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Amarillo               $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Manasota            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk MO                     $1,000.00
     Association

    Muscular Dystrophy       Northern California Muscle            $8,000.00
     Association              Summit

    Muscular Dystrophy       MDA MuscleWalk of Palm Beach          $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk FL                       $500.00
     Association

    Muscular Dystrophy       MDA MuscleWalk WA                     $1,000.00
     Association

    Muscular Dystrophy       2nd Annual Nashville Muscle           $1,000.00
     Association              Team Gala

    Muscular Dystrophy       MDA MuscleWalk Hartford/New           $1,000.00
     Association              Haven

    Muscular Dystrophy       MDA MuscleWalk of Colorado            $1,000.00
     Association              Springs

    Muscular Dystrophy       MDA MuscleWalk of San Diego           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Tri-Cities             $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Chattanooga            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Greater Lehigh         $1,000.00
     Association              Valley

    Muscular Dystrophy       MDA MuscleWalk Midland                $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Lubbock                $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Orlando                $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk South Alabama          $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Peoria              $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Baton Rouge

    Muscular Dystrophy       MDA MuscleWalk of Greater New         $1,000.00
     Association              Orleans

    Muscular Dystrophy       MDA MuscleWalk of Central New         $1,000.00
     Association              Jersey

    Muscular Dystrophy       MDA MuscleWalk Central                $1,000.00
     Association              Illinois

    Muscular Dystrophy       MDA MuscleWalk of Omaha               $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Little Rock         $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Baltimore           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Jackson             $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Spokane                $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk CA                     $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Rockford            $1,000.00
     Association

    Muscular Dystrophy       MDA Summer Newsletter                 $1,500.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Tulsa

    Muscular Dystrophy       MDA MuscleWalk of Chicagoland         $1,000.00
     Association              & Rockford

    Muscular Dystrophy       MDA MuscleWalk Pittsburgh             $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of San Antonio         $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Tampa Bay           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Jacksonville           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Fort Wayne

    Muscular Dystrophy       MDA MuscleWalk Salt Lake City         $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Warwick RI             $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Portland OR            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Eugene                 $1,000.00
     Association

    Muscular Dystrophy       MuscleWalk: Portland                  $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of St. Louis           $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Indianapolis

    Muscular Dystrophy       MDA Muscle Walk of Wichita            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Cleveland

    Muscular Dystrophy       MDA MuscleWalk of                     $1,000.00
     Association              Springfield, MO

    Muscular Dystrophy       MDA MuscleWalk Missoula               $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Montana                $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Twin Cities            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Charleston             $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Greater             $1,000.00
     Association              Milwaukee

    Muscular Dystrophy       MDA MuscleWalk of Los Angeles         $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk LA                     $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Iowa City           $1,000.00
     Association

    Muscular Dystrophy       Northeast PA Muscle Summit            $4,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Waterloo            $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of Des Moines          $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk of the Quad            $1,000.00
     Association              Cities

    Muscular Dystrophy       MDA MuscleWalk of Denver              $1,000.00
     Association

    Muscular Dystrophy       MDA MuscleWalk Western                $1,000.00
     Association              Colorado

    Muscular Dystrophy       MDA MuscleWalk VA                     $1,000.00
     Association

    Museum of Science        Science Teacher Sabbatical           $66,980.00
                              Program

    Museum of Science        Stars of STEM                        $10,000.00

    National Fabry Disease   Volunteer Match                       $1,000.00
     Foundation

    National Fabry Disease   Philadelphia Fabry Family             $2,200.00
     Foundation               Meeting

    National Fabry Disease   Family Assistance Program            $10,000.00
     Foundation

    National Fabry Disease   Conference and Camp Part 2           $70,000.00
     Foundation

    National Fabry Disease   NFDF 2016 Fabry Family               $15,000.00
     Foundation               Educational Meetings

    National Fabry Disease   Urgent and Unmet Needs               $40,000.00
     Foundation               Program

    National Fabry Disease   NFDF Core Program                    $50,000.00
     Foundation

    National Fabry Disease   Fabry Conference and Camp            $50,000.00
     Foundation

    National Fabry Disease   NFDF Core Program                    $50,000.00
     Foundation

    National Fabry Disease   Volunteer Match                       $7,000.00
     Foundation

    National Gaucher         Patient Assistance CARE           $1,200,000.00
     Foundation, Inc.         Program

    National Gaucher         Patient Assistance Program          $400,000.00
     Foundation, Inc.

    National Gaucher         Optimal Health Initiative &         $225,000.00
     Foundation, Inc.         Education/Awareness

    National Kidney          South Bend Indiana Kidney             $2,500.00
     Foundation               Program

    National Kidney          Nutrition Program for Chronic         $1,000.00
     Foundation               Kidney Disease, Diabetes and
                              Hypertension

    National Kidney          Indianapolis Kidney Health            $1,500.00
     Foundation               Awareness Program

    National Kidney          Kidney Health Awareness               $1,500.00
     Foundation               Program

    National Kidney          Evansville Kidney Health              $1,500.00
     Foundation               Awareness Program

    National Kidney          Kidney Health Awareness               $1,500.00
     Foundation               Program

    National Kidney          Patient Education and                $77,000.00
     Foundation               Awareness Program

    National Kidney          NKF Clinical Bulletin on             $95,775.00
     Foundation               Fabry Disease

    National MPS Society     Family Support Programs              $30,000.00

    National MPS Society     Symposium funding                     $4,000.00

    National MPS Society     National MPS Society                 $24,000.00
                              Conferences

    National MPS Society     National MPS Society                 $24,000.00
                              Conferences

    National MPS Society     Congress Sponsorships                $50,000.00

    National MPS Society     National Run--National MPS           $10,000.00
                              Society

    National Multiple        Volunteer Match                       $4,000.00
     Sclerosis Society

    National Multiple        National MS Society                  $15,000.00
     Sclerosis Society        Nationwide Connection
                              Programs

    National Multiple        Everyday Matters: Living Your        $25,000.00
     Sclerosis Society        Best Life with MS

    National Multiple        Volunteer Match                      $25,000.00
     Sclerosis Society

    National Multiple        Information Resource Center          $25,000.00
     Sclerosis Society

    National Multiple        North American Education             $35,000.00
     Sclerosis Society        Program

    National Multiple        Knowledge is Power                   $35,000.00
     Sclerosis Society

    National Multiple        Volunteer Match                       $9,000.00
     Sclerosis Society

    National Multiple        MS Care Management Program            $5,000.00
     Sclerosis Society

    National Multiple        Free From Falls                       $1,000.00
     Sclerosis Society

    National Multiple        MS Service Day                        $3,000.00
     Sclerosis Society

    National Multiple        Day at the Bay                        $3,500.00
     Sclerosis Society

    National Multiple        MS Exercise/Wellness Program          $5,000.00
     Sclerosis Society

    National Multiple        Scholarship Program                  $10,000.00
     Sclerosis Society

    National Multiple        41st annual Dinner of                 $2,500.00
     Sclerosis Society        Champions

    National Multiple        Bike MS: I Ride with MS               $5,000.00
     Sclerosis Society        Greater NW

    National Multiple        Bike MS Cape Cod Getaway             $50,000.00
     Sclerosis Society

    National Multiple        National MS Society E-               $75,000.00
     Sclerosis Society        Communications Program

    National Multiple        Muckfest MS Boston                   $25,000.00
     Sclerosis Society

    National Multiple        Dinner of Champions Seattle          $10,000.00
     Sclerosis Society

    National Multiple        Bike MS Ride the Vineyard            $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Walks MT                      $5,000.00
     Sclerosis Society

    National Multiple        Walk MS Southern California &        $25,000.00
     Sclerosis Society        Nevada

    National Multiple        MS Walks Pacific                     $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Boston                       $25,000.00
     Sclerosis Society

    National Multiple        Fast Forward Research                $75,000.00
     Sclerosis Society        Showcase Meeting

    National Multiple        Bike MS ``I Ride With MS'' NY       $350,000.00
     Sclerosis Society

    National Multiple        Walk MS Phoenix                       $5,000.00
     Sclerosis Society

    National Multiple        National MS Society Tykeson          $10,000.00
     Sclerosis Society        Fellows Conference

    National Multiple        National MS Society                  $50,000.00
     Sclerosis Society        Leadership Conference

    National Multiple        Bike MS Coastal Challenge Los        $10,000.00
     Sclerosis Society        Angeles

    National Multiple        Dinner of Champions Las Vegas         $2,500.00
     Sclerosis Society

    National Multiple        Are You What You Eat?:                $5,000.00
     Sclerosis Society        Studying Diet and
                              Supplements in Multiple
                              Sclerosis

    National Multiple        National MS Society                  $15,000.00
     Sclerosis Society        Leadership Conference

    National Multiple        Live Fully, LiveWell:                $15,000.00
     Sclerosis Society        Discover Your Personal Path
                              to Living Your Best Life
                              with MS

    National Multiple        Chicago Symposium                     $5,000.00
     Sclerosis Society

    National Multiple        MS Walks Greater Houston Area        $10,000.00
     Sclerosis Society

    National Multiple        Moving Forward: Annual                $5,000.00
     Sclerosis Society        Meeting and Resource Fair

    National Multiple        Bike MS NYC                           $6,000.00
     Sclerosis Society

    National Multiple        Dallas On The Move Luncheon           $5,000.00
     Sclerosis Society

    National Multiple        MuckFest MS                           $3,000.00
     Sclerosis Society

    National Multiple        Gala MS                               $2,500.00
     Sclerosis Society

    National Multiple        Bike MS: City to Shore Ride           $5,000.00
     Sclerosis Society

    National Multiple        Crystal Boots & Silver Spurs          $2,400.00
     Sclerosis Society

    National Multiple        Bike MS--Northern California          $5,000.00
     Sclerosis Society

    National Multiple        MS Auction Hawaii                     $3,500.00
     Sclerosis Society

    National Multiple        Orange Country MS Research            $2,500.00
     Sclerosis Society        Symposium

    National Multiple        MS Walks Central Texas                $2,500.00
     Sclerosis Society

    National Multiple        Ambassadors Ball                     $25,000.00
     Sclerosis Society

    National Multiple        Weekend Escape VA                     $5,000.00
     Sclerosis Society

    National Multiple        Cooling Shirts Gel Packs              $4,500.00
     Sclerosis Society

    National Multiple        Bike MS Willamette Valley             $5,000.00
     Sclerosis Society

    National Multiple        Smarty Pants Trivia Night             $2,500.00
     Sclerosis Society

    National Multiple        Spellbound on the Farm                $1,500.00
     Sclerosis Society

    National Multiple        Bike MS                               $5,000.00
     Sclerosis Society

    National Multiple        MS On the Move Luncheon               $2,500.00
     Sclerosis Society

    National Multiple        Women Against MS (WAMS)               $5,000.00
     Sclerosis Society        Luncheon PA

    National Multiple        Walk MS Jones Beach                   $5,000.00
     Sclerosis Society

    National Multiple        On The Move Luncheon New              $5,000.00
     Sclerosis Society        Orleans

    National Multiple        Women on the Move Luncheon            $6,000.00
     Sclerosis Society

    National Multiple        Walk MS PA                            $5,000.00
     Sclerosis Society

    National Multiple        Women on the Move Program             $2,500.00
     Sclerosis Society

    National Multiple        Walk MS Greater Illinois             $50,000.00
     Sclerosis Society

    National Multiple        Walk MS Knoxville                       $750.00
     Sclerosis Society

    National Multiple        Walk MS Michigan Chapter              $5,000.00
     Sclerosis Society

    National Multiple        Walk MS Rochester NY                  $2,500.00
     Sclerosis Society

    National Multiple        Walk MS Denver                       $20,000.00
     Sclerosis Society

    National Multiple        MS Walks Minnesota, Dakotas          $15,500.00
     Sclerosis Society

    National Multiple        Women on the Move Luncheon MO         $5,000.00
     Sclerosis Society

    National Multiple        Walk MS Clarksville                     $750.00
     Sclerosis Society

    National Multiple        MS Walk Indiana                      $12,000.00
     Sclerosis Society

    National Multiple        MS Walks Iowa                         $2,500.00
     Sclerosis Society

    National Multiple        Walk MS Wisconsin                    $10,000.00
     Sclerosis Society

    National Multiple        20th Anniversary: Books for a        $20,000.00
     Sclerosis Society        Better Life Awards

    National Multiple        MS Walks PA                          $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Chattanooga                     $750.00
     Sclerosis Society

    National Multiple        Walk MS NJ                           $10,000.00
     Sclerosis Society

    National Multiple        Walk MS MO                            $5,000.00
     Sclerosis Society

    National Multiple        Walk MS Northern California          $25,000.00
     Sclerosis Society

    National Multiple        MS Walks Utah & Southern             $20,000.00
     Sclerosis Society        Idaho

    National Multiple        Walk MS CT                            $2,500.00
     Sclerosis Society

    National Multiple        Walk MS OR                           $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Middle Tennessee                $750.00
     Sclerosis Society

    National Multiple        Walk MS Kentucky                     $10,000.00
     Sclerosis Society

    National Multiple        Walk MS NY                          $100,000.00
     Sclerosis Society

    National Multiple        Walk MS OH                            $5,000.00
     Sclerosis Society

    National Multiple        Walk MS Jacksonville                  $7,500.00
     Sclerosis Society

    National Multiple        Walk MS Arkansas                      $3,000.00
     Sclerosis Society

    National Multiple        Walk MS New Mexico                    $2,500.00
     Sclerosis Society

    National Multiple        Walk MS Oklahoma                     $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Washington DC                $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Cincinnati                   $10,000.00
     Sclerosis Society

    National Multiple        Walk MS Memphis                         $750.00
     Sclerosis Society

    National Multiple        Walk MS Louisiana                     $5,000.00
     Sclerosis Society

    National Multiple        Walk MS San Diego                    $20,000.00
     Sclerosis Society

    National Multiple        Women on the Move Louisville          $1,000.00
     Sclerosis Society

    National Multiple        On The Move Luncheon--Houston         $5,000.00
     Sclerosis Society

    National Multiple        Walk MS Atlanta                       $5,000.00
     Sclerosis Society

    National Multiple        Walk MS San Antonio                  $10,000.00
     Sclerosis Society

    National Multiple        On the Move Luncheon                  $3,000.00
     Sclerosis Society

    National Multiple        Runway for MS--Fashion Show           $2,500.00
     Sclerosis Society        Luncheon

    National Multiple        Michigan Chapter's Annual             $2,500.00
     Sclerosis Society        Meeting & Recognition
                              Breakfast

    National Multiple        MS Walks Arizona                     $24,000.00
     Sclerosis Society

    National Multiple        Walk MS Alabama Mississippi           $7,500.00
     Sclerosis Society

    National Multiple        On The Move Luncheon--Baton           $2,500.00
     Sclerosis Society        Rouge

    National Multiple        Walk MS Ft. Lauderdale               $15,000.00
     Sclerosis Society

    National Multiple        Women Against MS Luncheon TN          $2,500.00
     Sclerosis Society

    National Multiple        Health Issues in Multiple             $9,000.00
     Sclerosis Society        Sclerosis Hawaii

    National Multiple        6th Annual Festival Hispano           $4,000.00
     Sclerosis Society

    National Multiple        MS Gala Luncheon                      $5,000.00
     Sclerosis Society

    National Multiple        New Jersey Metro Chapter             $10,000.00
     Sclerosis Society        Volunteer Program

    National Multiple        Annual Meeting and Education          $8,500.00
     Sclerosis Society        Conferences

    National Multiple        MuckFest MS Houston                   $2,500.00
     Sclerosis Society

    National Multiple        Women Against MS Luncheon             $3,000.00
     Sclerosis Society        (WAMS)

    National Multiple        Fall Crush Nashville                  $2,500.00
     Sclerosis Society

    National Multiple        Walk MS Houston                      $20,000.00
     Sclerosis Society

    National Multiple        FallCrush Nashville                   $2,500.00
     Sclerosis Society

    National Multiple        Symposium Educational                 $7,500.00
     Sclerosis Society        Programs

    National Multiple        MuckFest MS                           $5,000.00
     Sclerosis Society

    National Multiple        Team Finish MS at the                 $3,000.00
     Sclerosis Society        Hartford Marathon

    National Multiple        Bike MS Louisiana                     $5,000.00
     Sclerosis Society

    National Multiple        Bike MS: City to Shore Ride           $5,000.00
     Sclerosis Society        PA

    National Multiple        San Antonio Bike MS                  $10,000.00
     Sclerosis Society

    National Multiple        New Hampshire Living Well             $1,500.00
     Sclerosis Society        with MS Conference

    National Multiple        Chapter Annual Meeting and            $5,000.00
     Sclerosis Society        Education Program:
                              Contemporary Issues in MS

    National Multiple        Moving Mountains for MS--            $10,000.00
     Sclerosis Society        Family Weekend Retreat

    National Multiple        Relationship Matters                  $5,000.00
     Sclerosis Society

    National Multiple        MOVING FORWARD                        $1,500.00
     Sclerosis Society

    National Multiple        Men with MS Elevation                $10,000.00
     Sclerosis Society        Conference

    National Multiple        Children's Hope for                   $3,800.00
     Sclerosis Society        Understanding Multiple
                              Sclerosis

    National Multiple        MS Research Nights                    $5,000.00
     Sclerosis Society

    National Multiple        Day of Discovery                      $7,500.00
     Sclerosis Society

    National Niemann-Pick    Volunteer Match                       $1,000.00
     Disease Foundation

    National Niemann-Pick    Staying Strong as we                 $50,000.00
     Disease Foundation       Persevere in our Quest for a
                              Cure

    National Organization    Volunteer Match                       $9,000.00
     for Rare Disorders,
     Inc.

    National Organization    Volunteer Match                       $6,000.00
     for Rare Disorders,
     Inc.

    National Organization    Running For Rare                      $5,000.00
     for Rare Disorders,
     Inc.

    National Organization    NORD's Rare Diseases and             $50,000.00
     for Rare Disorders,      Orphan Products Breakthrough
     Inc.                     Summit

    National Organization    Rare Impact Awards                   $50,000.00
     for Rare Disorders,
     Inc.

    National Tay-Sachs &     Raising Awareness of                  $1,100.00
     Allied Diseases          Ashkenazi Jewish Genetic
     Association, Inc.        Diseases

    National Tay-Sachs &     Expand Family Support Through         $5,000.00
     Allied Diseases          Technology
     Association, Inc.

    National Tay-Sachs &     Imagine & Believe                    $10,000.00
     Allied Diseases
     Association, Inc.

    National Tay-Sachs &     38th Annual Family Conference         $5,000.00
     Allied Diseases
     Association, Inc.

    NCCN Foundation          NCCN Guidelines for Patients:        $25,000.00
                              Thyroid Cancer

    NEHI                     The Nick Littlefield Health          $25,000.00
                              Policy Fellowship

    NEHI                     Innovators in Health Awards          $25,000.00

    Nephcure Foundation      11th International Podocyte           $3,000.00
                              Conference

    Neurologic Disease       21st Fall MS Seminar--                $5,995.00
     Foundation               Optimizing Management of MS

    Neuropathy Action        General Patient Advocacy and          $2,500.00
     Foundation               Organizational Support

    Next Step Fund Inc.      FaceForward Campference and          $10,000.00
                              general operating support

    North American Vascular  19th International Vascular          $10,000.00
     Biology Organization     Biology Meeting
     Inc.

    North Shore Community    Volunteer Match                       $1,000.00
     Health Inc.

    Northeast Business       Congress Sponsorships                 $5,000.00
     group on Health

    Northeastern University  Allston Brighton College              $2,000.00
                              Scholarship

    Northwest Animal Rights  Volunteer Match                       $1,000.00
     Network

    Northwest Animal Rights  Volunteer Match                       $1,000.00
     Network

    Norton Healthcare        Moonlight & Moonshine Gala            $5,000.00
     Foundation, Inc.

    Norton Healthcare        Neuroscience Expo                    $10,000.00
     Foundation, Inc.

    Norton Healthcare        1-N-3 Gala                            $5,000.00
     Foundation, Inc.

    Operation Warm Inc.      Boston Warmth in Winter              $18,000.00

    OptumHealth Education    Congress Sponsorships                 $7,500.00

    Oregon Health & Science  On the Horizon: Updates in            $9,930.00
     University Foundation    Multiple Sclerosis

    Pan Massachusetts        Volunteer Match                      $11,000.00
     Challenge

    Pan Massachusetts        Volunteer Match                      $11,000.00
     Challenge

    Patient Access Network   Patient Assistance Program          $100,000.00
     Foundation               for Thyroid Cancer

    Patient Access Network   Patient Assistance Program          $100,000.00
     Foundation               for Thyroid Cancer

    Patient Access Network   Patient Assistance Fund for         $100,000.00
     Foundation               Thyroid Cancer

    Patient Access Network   Patient Assistance Program           $50,000.00
     Foundation               for Thyroid Cancer

    Patient Access Network   Patient Assistance Program           $50,000.00
     Foundation               for Homozygous Familial
                              Hypercholesterolemia

    Patient Access Network   Patient Assistance Program          $125,000.00
     Foundation               for Homozygous Familial
                              Hypercholesterolemia

    Patient Services Inc.    Patient Assistance Program        $4,440,000.00
                              for Fabry, Pompe, MPS1, and
                              Gaucher Disease

    Patient Services Inc.    Patient Assistance Program        $2,000,000.00

    Patient Services Inc.    Patient Assistance Program        $6,500,000.00

    Peer Health Exchange     Peer Health Exchange:                 $5,000.00
     Inc.                     Empowering Boston Youth to
                              Make Healthy Decisions

    Perkins School for the   Perkins eLearning: Enhancing         $20,000.00
     Blind                    Accessible Science Education

    Phillips Brooks House    Community Program                     $5,000.00
     Association
     Incorporated

    Phoenix Children's       MPS patient meeting                   $1,200.00
     Hospital Foundation

    Portland VA Research     PDX Patient Workshops                 $3,150.00
     Foundation Inc.

    President and Fellows    Community Program                    $20,000.00
     of Harvard College

    President and Fellows    Patient Assistance Program           $50,000.00
     of Harvard College

    Pro Player Foundation    Flavors of Austin                     $5,000.00

    Pro Player Foundation    Flavors of Austin                     $5,000.00

    Project Eden Inc.        Volunteer Match                       $1,000.00

    Project Just Because,    211 Domestic Abuse/Emergency         $10,000.00
     Inc.                     Program & Keep A Family Warm
                              Program

    Race to Erase MS         Race to Erase MS--MS Forum           $10,000.00

    Race to Erase MS         23rd Annual Race to Erase MS         $50,000.00

    Read to a Child, Inc.    Community Program                     $5,000.00

    Read to a Child, Inc.    Community Program                     $2,500.00

    Resolve Community        Volunteer Match                       $1,000.00
     Counseling Center,
     Inc.

    Restore                  Volunteer Match                       $1,000.00

    Rocky Mountain Multiple  KADEP (King Adult Day                 $5,000.00
     Sclerosis Center         Enrichment Program) Annual
                              Winter Community Gathering

    Rocky Mountain Multiple  Rocky Mountain MS Center             $10,000.00
     Sclerosis Center         Annual Gala

    Rocky Mountain Multiple  MS4MS Event                           $5,000.00
     Sclerosis Center

    Rocky Mountain Multiple  KADEP Annual Holiday                  $5,000.00
     Sclerosis Center         Celebration

    Rocky Mountain Multiple  Webinar Series                        $5,000.00
     Sclerosis Center

    Room to Grow             Community Program                     $5,000.00

    Runkle School Extended   Volunteer Match                       $1,000.00
     Day Program Inc.

    S S Cosmas & Damian      Community Program                     $2,500.00
     Society Inc.

    Saint Francis Hospital   International Symposium: The         $50,000.00
     and Medical Center       Multiple Sclerosis Brain--
     Foundation               Bridging the Gap

    Salute the Ribbon        Meet, Greet n' Eat Luncheon           $1,000.00
     Incorporated             ``Opening Doors for Health
                              Care Access to Cancer Care''

    Samaritans Inc.          Community Program                    $25,000.00

    Science Club For Girls   Community Program                    $10,000.00
     Inc.

    Science Club For Girls   Catalyst Awards                      $10,000.00
     Inc.

    Science From Scientists  STEM enrichment program for          $25,000.00
     Inc.                     Boston Public Schools

    Science From Scientists  In-School Module-Based (ISMB)        $20,000.00
     Inc.                     STEM enrichment program

    Science From Scientists  70th Annual Boston Citywide          $10,000.00
     Inc.                     Science Fair

    Sharp Rees-Stealy        Congress Sponsorships                 $5,000.00
     Medical Group Sharp
     Healthcare

    Society for Inherited    North American Metabolic             $20,000.00
     Metabolic Disorders      Academy

    Society of Nuclear       SNMMI Patient Education Day           $5,000.00
     Medicine and Molecular
     Imaging

    Special Olympics         Bio-Ball                              $2,500.00
     Massachusetts Inc.

    St. Francis House        Community Program                    $10,000.00

    Stop Hunger Now, Inc.    Volunteer Match                       $2,944.08

    Strongwater Farm         Riding group for individuals          $7,500.00
     Therapeutic Equestrian   living with MS
     Center

    Temple Beth Sholom [The  Patient Education and                 $6,200.00
     Tribe]                   Awareness Program

    Temple University        Allston Brighton College              $2,000.00
                              Scholarship

    The Boston Home, Inc.    Volunteer Match                       $1,000.00

    The Boston Home, Inc.    The Boston Home iPad InstaAid        $12,000.00
                              Program Expansion

    The Boston Home, Inc.    The Boston Home Arts Program         $10,000.00

    The Boston Home, Inc.    The Boston Home B.Fit                $18,000.00
                              Wellness Program

    The Boston Home, Inc.    The Boston Home Resident             $10,000.00
                              Family Picnic

    The Boston Home, Inc.    Finding Your Voice                    $5,000.00

    The Community Art        Teen Media Program                   $15,000.00
     Center

    The Discovery Museums    Genzyme Discovery Science            $15,000.00

    The Discovery Museums    Discovery Science Program            $15,000.00

    The Forsyth Institute    Community Program                    $10,000.00

    The Greater Boston Food  Volunteer Match                       $2,000.00
     Bank Inc.

    The Greater Boston Food  General Operating Support            $10,000.00
     Bank Inc.

    The Greater Boston Food  Volunteer Match                       $1,000.00
     Bank Inc.

    The Jewish Community     Our Heritage and Our Health--         $1,250.00
     Center of Greater        Ashkenazi Jewish Genetic
     Kansas City              Disease and the Founder
                              Effect

    The Jewish P.O.C.E.T.    Greater Chicago Jewish                $3,240.00
                              Festival

    The Leukemia & Lymphoma  Light The Night Walk                  $6,500.00
     Society Inc.

    The Life Sciences        Leadership Mid-Term Funding          $50,000.00
     Foundation               for Educational Programs

    The McCourt Foundation   Tour de South Shore                  $10,000.00

    The McCourt Foundation   McCourt Gala                         $20,000.00

    The McCourt Foundation   McCourt Foundation MS                $20,000.00
                              Educational Update

    The Oak Clinic           Oak Clinic Acorn Run                  $3,500.00

    The Oak Clinic           Diamond Run                           $5,000.00

    The Posse Foundation     Community Program                    $25,000.00

    The Possible Project     The Possible Project's               $10,000.00
                              Powering Possibilities
                              Annual Gala

    The Salvation Army       Volunteer Match                       $2,000.00

    Thompson Island Outward  Community Program                    $10,000.00
     Bound Education Center
     Inc.

    Thompson Island Outward  Islands Expedition Gala               $5,000.00
     Bound Education Center
     Inc.

    Thompson Island Outward  Thompson Island 4K Trail Run          $5,000.00
     Bound Education Center
     Inc.

    ThyCa: Thyroid Cancer    Patient Education and                $15,000.00
     Survivors'               Awareness Program
     Association, Inc.

    ThyCa: Thyroid Cancer    19th International Thyroid           $35,000.00
     Survivors'               Cancer Survivors' Conference
     Association, Inc.

    Tisch Multiple           Tisch MS Research Center             $15,000.00
     Sclerosis Research       Newsletter
     Center of New York,
     Inc.

    Tisch Multiple           Future Without MS Gala                $5,000.00
     Sclerosis Research
     Center of New York,
     Inc.

    Tisch Multiple           Future Without MS Gala               $15,000.00
     Sclerosis Research
     Center of New York,
     Inc.

    Tisch Multiple           Tisch MS Research Center 19th        $25,000.00
     Sclerosis Research       Annual MS Patient Symposium
     Center of New York,
     Inc.

    Triangle, Inc.           Volunteer Match                       $1,000.00

    Triangle, Inc.           Triangle's 45th Annual Spring         $5,000.00
                              Gala

    Tri-State Multiple       Evansville Autumn Walk                $2,500.00
     Sclerosis Association

    Tri-State Multiple       Owensboro Autumn Walk                 $2,500.00
     Sclerosis Association

    Tri-State Multiple       Evening of Excellence                 $2,000.00
     Sclerosis Association

    Tri-State Multiple       Tri-State Multiple Sclerosis          $4,500.00
     Sclerosis Association    Association Autumn Walks

    Tutoring Plus of         STEAM Enrichment Programs             $7,500.00
     Cambridge, Inc.

    Tutoring Plus of         Community Program                     $5,000.00
     Cambridge, Inc.

    U C San Diego            UCSD Regional MS Expositions         $50,000.00
     Foundation

    United Network for       Congress Sponsorship                  $7,800.00
     Organ Sharing

    United Pompe Foundation  Duke Late Onset Pompe Patient        $19,000.00
                              Meeting

    United Pompe Foundation  Pompe Patient Meeting                $19,000.00

    United Pompe Foundation  General Operating Support            $50,000.00

    United Rheumatology      Congress Sponsorship                 $60,000.00

    United Way of Tri        Volunteer Match                       $1,000.00
     County Inc.

    United Way of Tri        Volunteer Match                       $1,000.00
     County Inc.

    United Way of Tri        Volunteer Match                       $1,000.00
     County Inc.

    United Way of Tri        Volunteer Match                       $2,000.00
     County Inc.

    University of            Student Success Program,            $200,000.00
     Massachusetts            UMass Boston, College of
     Foundation Inc.          Science and Mathematics

    University of            Massachusetts STEM Summit             $5,000.00
     Massachusetts
     Foundation Inc.

    University of Southern   Allston Brighton College              $4,000.00
     California               Scholarship

    Visiting Nurse           Heroes in Health Care Gala           $10,000.00
     Association of Boston
     & Affiliates

    VNA Care Hospice Inc.    Community Program                     $5,000.00

    VNA Care Hospice Inc.    Community Program                     $5,000.00

    Wentworth Institute of   Allston Brighton College              $2,000.00
     Technology               Scholarship

    West End House Boys and  Volunteer Match                       $1,000.00
     Girls Club

    West End House Boys and  Community Program                    $25,000.00
     Girls Club

    West End House Boys and  Community Program                    $25,000.00
     Girls Club

    WGBH                     Pledge Night Sponsorship             $12,000.00

    Whitehead Institute for  Whitehead Institute's CampBio        $10,000.00
     Biomedical Research      Program

    Women's Lunch Place      Meals Program                        $35,000.00

    Women's Lunch Place      General Operating Support            $10,000.00

    Women's Lunch Place      Community Program                    $10,000.00

    World Unity Inc.         Volunteer Match                       $1,000.00

    WriteBoston              Community Program                    $10,000.00

    Wylder Nation            Patient Education and                $15,000.00
     Foundation               Awareness Program

    Wylder Nation            3rd Annual Living Like a             $15,000.00
     Foundation               Warrior Gala

    YMCA of Greater Boston   Oak Square YMCA--Summer Day          $15,000.00
                              Camp Scholarships

    ziMS Foundation          ziMS STRIKE DOWN MS Event             $5,000.00

                      Sponsorships and Charitable Donations
                           1st Jan 2017-31st Dec 2017
        Sanofi US and its affiliate Genzyme Corporation are committed to
       supporting sponsorships for specific activities and initiatives of
        healthcare organizations and institutions, independent medical or
    professional societies, trade organizations and organized patient groups
      to improve patient care and provide information to the medical and/or
      patient communities. The goal of our charitable giving approach is to
     fund general operational support for patient/disease organizations, or
    program support for community-based organizations. Sanofi US and Genzyme
        Corporation are part of the Sanofi Group, a global pharmaceutical
                                    company.
     Applicant names are provided by the requestor. If applicants apply as a
      group for a single activity; all applicants may be not be identified
     above. ``Funding Amount'' is the amount that the Company funded during
      2017 identified above. ``Funding Amount'' does not include funds that
       may have been provided by other affiliated Sanofi Company Entities
                             (e.g., Sanofi Pasteur).

       Recipient Name(s)             Activity Title          Funding Amount

    American Academy of      Congress Sponsorship                 $35,317.50
     Neurology

    Academy of Managed Care  Congress Sponsorship                  $1,000.00
     Pharmacy A New Jersey
     Nonprofit Corporation

    Academy of Managed Care  Congress Sponsorship                 $26,500.00
     Pharmacy A New Jersey
     Nonprofit Corporation

    Accelerated Cure         2017 Leadership Summit               $15,000.00
     Project

    Acid Maltase Deficiency  Annual Fundraiser                     $3,000.00
     Association Inc.

    Acid Maltase Deficiency  General Operating Support            $50,000.00
     Association, Inc.

    Alabama Kidney           Patient Education Conferences         $2,500.00
     Foundation

    Allergy & Asthma         Understanding Atopic                 $75,000.00
     Network Mothers of       Dermatitis Guide
     Asthmatics, Inc.

    Allergy & Asthma         Patient Activation                  $200,000.00
     Network Mothers of       Measurement Study
     Asthmatics, Inc.

    Allergy & Asthma         GlobalSkin Conference                 $3,000.00
     Network Mothers of
     Asthmatics, Inc.

    Allergy & Asthma         Severe Asthma Awareness             $150,000.00
     Network Mothers of       Campaign
     Asthmatics, Inc.

    Allergy & Asthma         Project Access Initiative            $25,000.00
     Network Mothers of
     Asthmatics, Inc.

    Allergy & Asthma         Allergy & Asthma Awareness           $25,000.00
     Network Mothers of       Day
     Asthmatics, Inc.

    Allergy & Asthma         Allergy & Asthma Network             $25,000.00
     Network Mothers of       Corporate Council 2017
     Asthmatics, Inc.

    Alliance for Patient     2018 Membership                     $100,000.00
     Access

    Allston Village Main     Taste of Allston Event                $1,000.00
     Streets, Inc.

    American Academy of      Patient AccessDerm Program          $250,000.00
     Dermatology

    American Academy of      President's Summit on                 $5,000.00
     Dermatology              Diversity in Dermatology

    American Academy of      Congress Sponsorship                 $17,800.00
     Neurology

    American Academy of      Congress Sponsorship                $432,935.00
     Neurology

    American Academy of      Emerging Leaders Program             $20,000.00
     Neurology Institute

    American Academy of      Women Leading in Neurology           $20,000.00
     Neurology Institute      Program

    American Academy of      Clinical Research Training           $50,000.00
     Neurology Institute      Scholarship in Multiple
                              Sclerosis

    American Academy of      Palatucci Advocacy Leadership        $50,000.00
     Neurology Institute      Forum

    American Academy of      Residents Scholarship Fund           $20,000.00
     Neurology Institute

    American Academy of      Fellows Scholarship Fund             $20,000.00
     Neurology Institute

    American Academy of      Brain Health Fair                    $10,000.00
     Neurology Institute

    American Academy of      Neurology Annual Meeting 2017       $208,632.90
     Neurology Institute

    American Academy of      Transforming Leaders Program         $20,000.00
     Neurology Institute

    American Association     AAAS 2017 Annual Meeting--           $25,000.00
     For The Advancement of   Family Science Days
     Science

    American Association of  Congress Sponsorship                  $4,300.00
     Clinical
     Endocrinologists

    American Association of  Congress Sponsorship                 $18,500.00
     Endocrine Surgeons

    American Association of  Congress Sponsorship                 $67,600.00
     Neuromuscular &
     Electrodiagnostic
     Medicine

    American Brain           Membership                           $20,000.00
     Coalition

    American Cancer Society  25th Making Strides Against           $1,000.00
                              Breast Cancer Walk

    American Cancer Society  Bicycles Battling Cancer 2017        $11,000.00

    American Cancer Society  Bicycles Battling Cancer 2016        $11,000.00

    American Cancer Society  10th Annual ACS CAN New              $10,000.00
     Cancer Action Network    England Research Breakfast

    American College of      Shared Decision Making              $125,000.00
     Allergy, Asthma &        Toolkit for Severe Atopic
     Immunology               Dermatitis

    American College of      Severe Pediatric Asthma              $60,000.00
     Allergy, Asthma &        Shared Decision Making
     Immunology               Toolkit

    American College of      Shared Decision Making              $125,000.00
     Allergy, Asthma &        Toolkit for Severe Pediatric
     Immunology               Asthma

    American College of      Practice Management Center          $240,000.00
     Allergy, Asthma &
     Immunology

    American College of      Patient Education Brochure           $31,000.00
     Allergy, Asthma &
     Immunology

    American College of      Atopic Dermatitis Yardstick         $145,000.00
     Allergy, Asthma &        Educational Manuscript
     Immunology

    American College of      Membership                           $60,000.00
     Chest Physicians

    American College of      Congress Sponsorship                  $2,000.00
     Rheumatology

    American Lung            Membership                           $20,000.00
     Association

    American Lung            Asthma Care Coverage Project         $75,000.00
     Association

    American Optometric      Congress Sponsorship                  $3,150.00
     Association

    American Red Cross of    Women Who Care Leadership             $5,000.00
     Massachusetts            Breakfast

    American Society of      ASCO Annual Meeting                 $118,000.00
     Clinical Oncology

    American Society of      59th Annual ASH Convention          $224,300.00
     Hematology

    American Society of      Congress Sponsorship                 $56,600.00
     Hematology

    American Society of      Congress Sponsorship                  $3,300.00
     Human Genetics

    American Society of      Congress Sponsorship                 $35,000.00
     Nephrology

    American Society of      Congress Sponsorship                 $20,950.00
     Nephrology

    American Society of      Congress Sponsorship                 $40,000.00
     Nephrology

    American Society of      Congress Sponsorship                 $35,000.00
     Transplant Surgeons

    American Society of      Congress Sponsorship                  $6,000.00
     Transplant Surgeons

    American Society of      Congress Sponsorship                 $35,000.00
     Transplantation

    American Society of      Congress Sponsorship                 $35,000.00
     Transplantation

    American Thoracic        Corporate Membership Program         $50,000.00
     Society

    American Thyroid         Congress Sponsorship                 $11,950.00
     Association

    American Thyroid         Congress Sponsorship                 $18,000.00
     Association

    American Transplant      Congress Sponsorship                 $45,000.00
     Congress

    Americas Committee for   Congress Sponsorship                 $15,000.00
     Treatment and Research
     in Multiple Sclerosis,
     Inc.

    ANERA (American Near     Annual Dinner                         $5,000.00
     East Refugee Aid)

    Ann & Robert H. Lurie    MPS Patient and Family Day            $2,500.00
     Children's Hospital of
     Chicago

    Arizona Myeloma Network  Cancer Patient & Caregivers           $3,250.00
                              Outreach & Seminar Series

    Arthritis Foundation--   37th Annual Silver Ball Gala          $1,250.00
     St. Louis, MO

    Arthritis Foundation--   Arthritis Industry Forum             $25,000.00
     Atlanta, GA

    Arthritis Foundation--   Casino Night Gala                     $2,500.00
     St. Paul, MN

    Arthritis Foundation--   Patient Engagement Program           $25,000.00
     Atlanta, GA

    Arthritis Foundation--   Taste of the Town Gala                $5,000.00
     Hawaii Chapter

    Arthritis Foundation--   Freedom of Movement Gala              $5,000.00
     Chicago, IL

    Arthritis Foundation--   Houston Bone Bash Gala               $10,000.00
     Houston, TX

    Arthritis Foundation--   PREOP Training and Engagement       $250,000.00
     Atlanta, GA              Initiative

    Arthritis Foundation--   Walk to Cure Arthritis and          $250,000.00
     Atlanta, GA              Jingle Bell Run

    Arthritis Foundation--   Walk to Cure Arthritis                $3,500.00
     Green Bay, WI

    Arthritis Foundation--   Walk to Cure Arthritis                $5,000.00
     Sacramento, CA

    Arthritis Foundation--   Walk to Cure Arthritis                $2,500.00
     Irvine, CA

    Arthritis Foundation--   Walk to Cure Arthritis                $1,000.00
     St. Paul, MN

    Arthritis Foundation--   Ambassador Program                  $125,000.00
     Atlanta, GA

    Arthritis Foundation--   Advocacy Summit                      $25,000.00
     Atlanta, GA

    Arthritis Foundation--   Walk to Cure Arthritis                $5,000.00
     Boston, MA

    Arthritis Foundation--   Walk to Cure Arthritis                $5,000.00
     Los Angeles, CA

    Arthritis Foundation--   Patient Voice Accumulator            $50,000.00
     Atlanta, GA              Project

    Arthritis Foundation--   51st Annual Knowles Lecture           $7,500.00
     Northern California

    Arthritis Foundation--   Walk to Cure Arthritis                $1,000.00
     Hawaii Chapter

    Arthritis Foundation--   Walk to Cure Arthritis                $2,500.00
     Chicago, IL

    Arthritis Foundation--   Walk to Cure Arthritis                $2,500.00
     New England Chapter

    Arthritis Foundation--   Walk to Cure Arthritis                $2,500.00
     New England Chapter

    Arthritis Foundation--   Evening of Honors Event               $5,000.00
     New Jersey Chapter

    ASCO                     Congress Sponsorship                  $5,495.00

    Asembia Specialty        Asembia Specialty Pharmacy           $20,000.00
     Pharmacy Summit LLC      Summit

    Assistance Fund Inc      Patient Assistance Program       $10,000,000.00
                              for MS

    Association For          Annual Conference                     $7,000.00
     Glycogen Storage
     Disease

    Association of           41st Annual APHON Conference          $6,850.00
     Pediatric Hematology/
     Oncology Nurses

    Association of VA        13th Annual AVAHO Meeting            $10,000.00
     Hematology/Oncology

    Asthma and Allergy       Strengthening the Asthma            $200,000.00
     Foundation of America    Community

    Asthma and Allergy       Asthma Capitals Report              $125,000.00
     Foundation of America

    Asthma and Allergy       Supporting Patients and             $110,000.00
     Foundation of America    Families Program

    Asthma and Allergy       Research Project                    $200,000.00
     Foundation of America

    Asthma and Allergy       Research Project                    $120,000.00
     Foundation of America

    Barbara Ann Karmanos     Seventh Annual Prostate               $7,500.00
     Cancer Institute         Cancer Advocacy Symposium

    Bendcare                 National Meeting                     $10,310.00

    Bendcare                 Educational Conferences              $92,790.00

    Berkshire Resource       People Living with MS that            $4,000.00
     Project                  have Impaired Vision Program

    Berkshire Resource       Functional Ability Skills for         $3,500.00
     Project                  Everyday Living With
                              Multiple Sclerosis

    Berkshire Resource       9th Annual Gala ``Let's Kiss          $5,000.00
     Project                  MS Goodbye''

    Berkshire Resource       Coping With The Emotional             $4,000.00
     Project                  Aspects of MS Program

    Big Brothers Big         MySTEM Program                       $15,000.00
     Sisters of Central
     Mass Metrowest Inc.

    Biomedical Science       Evening of Hope 2017                $100,000.00
     Careers Program

    Biomedical Science       Hope Scholarship 2017-2018            $7,500.00
     Careers Program

    Blue Cross Blue Shield   Blues National Summit                $15,975.00
     Association

    Boston Business          Boston Business Journal               $5,500.00
     Journal, Inc.            Corporate Citizenship Awards

    Boston Health Care For   Charitable Contribution--Life        $35,000.00
     The Homeless Program,    Essentials for Homeless
     Inc.                     Patients

    Boston Partners in       Power Lunch Program                   $6,000.00
     Education, Inc.

    Boston Private Industry  2017 Corporate Contributions         $15,000.00
     Council                  Campaign

    Boston Private Industry  Volunteer Match                       $1,000.00
     Council

    Bottom Line              Boston STEM Success Program          $15,000.00

    Boys & Girls Clubs of    Fall Flashback Festival               $5,000.00
     Medford and Somerville
     Inc.

    Boys and Girls Clubs of  Volunteer Match                       $2,000.00
     MetroWest

    Boys and Girls Clubs of  Volunteer Match                       $1,000.00
     MetroWest

    Boys and Girls Clubs of  Bids for Kids Auction & Gala         $10,000.00
     MetroWest

    Boys and Girls Clubs of  Membership                           $25,000.00
     MetroWest

    Boys and Girls Clubs of  Volunteer Match                       $2,000.00
     MetroWest

    BPE                      Boston Teacher Residency:            $15,000.00
                              Innovative STEM Educators
                              Program

    Breakthrough Greater     Full STEAM Ahead Program             $15,000.00
     Boston

    Breakthrough Greater     Full STEAM Ahead Program             $10,000.00
     Boston

    California Life          CLSA Life Sciences Academy            $8,000.00
     Sciences Association

    California rheumatology  Annual Meeting                       $50,000.00
     Alliance

    Cambridge Chamber of     Lead Sponsorship                      $7,500.00
     Commerce

    Cambridge Health         Volunteer Match                       $1,000.00
     Alliance Foundation,
     Inc.

    Cambridge School         Volunteer Match                       $1,000.00
     Volunteers, Inc.

    Cambridgeport            2017 Summer Programs for              $5,000.00
     Neighborhood             Magazine Beach Park Support
     Association, Inc.

    Can Do Multiple          2018 SKI for MS                      $40,000.00
     Sclerosis

    Can Do Multiple          2017 MS Global                       $10,000.00
     Sclerosis

    Can Do Multiple          2017 TAKE CHARGE Program             $40,000.00
     Sclerosis

    Can Do Multiple          8th Annual Can Do Day                $10,000.00
     Sclerosis

    Can Do Multiple          2017 CAN DO Programs                 $50,000.00
     Sclerosis

    Can Do Multiple          Can Do On Demand Program             $60,000.00
     Sclerosis

    Can Do Multiple          2017 TAKE CHARGE and                 $16,500.00
     Sclerosis                JUMPSTART Programs

    Can Do Multiple          2017 JUMPSTART Programs              $80,000.00
     Sclerosis

    Can Do Multiple          2017 Ski for MS                      $30,000.00
     Sclerosis

    Can Do Multiple          2017 Online Programs                 $45,000.00
     Sclerosis

    Can Do Multiple          Can Do MS eNews: Your Best            $5,000.00
     Sclerosis                Life Update

    Case Management Society  Annual Corporate Partnership          $5,500.00
     of America

    Case Management Society  CMSA 2017 Conference                 $14,000.00
     of America

    Case Management Society  CMSA 27th Annual Conference &         $1,725.00
     of America               Expo

    Case Management Society  Focus on the Future--Keeping          $1,050.00
     of New England           a Keen Eye on Tomorrow
                              Program

    Case Management Society  Corporate Sponsorship                 $1,250.00
     of New England

    Case Management Society  Case Management Society of            $1,000.00
     of New England           New England Conference

    Charles River Community  Mom and Baby Program                 $15,000.00
     Health

    CheckOrphan              Rare Disease Page Sponsorship        $40,000.00

    Chicago Rheumatism       Congress Sponsorship                  $4,500.00
     Society

    Childrens Gaucher        Research Grant                       $75,000.00
     Research Fund

    Children's Hospital      Milagros para Ninos 2017 Gala         $5,000.00
     Corporation

    Chronic Disease Fund,    Patient Assistance Program          $350,000.00
     Inc. DBA Good Days
     from CDF

    Cincinnati Children's    Congress Sponsorship                 $10,000.00
     Hospital Medical
     Center

    Cleveland Clinic         Congress Sponsorship                 $15,000.00
     Educational Institute

    Cleveland Clinic         5th Annual Basic & Clinical           $3,500.00
     Educational Institute    Immunology for the Busy
                              Clinician

    Clevleand Clinic         Scott Hamilton and Friends            $5,000.00
                              Ice Show and Gala

    Coalition of State       CSRO State Society Key               $37,500.00
     Rheumatology             Legislator Education Program
     Organizations

    Coalition of State       Coalition of State                  $100,000.00
     Rheumatology             Rheumatology Organizations
     Organizations            Support

    Community Boating, Inc.  Universal Access Program 2017        $15,000.00

    Community Farms          Fresh Food Access                    $15,000.00
     Outreach

    Community Farms          Volunteer Match                       $1,000.00
     Outreach

    Community Oncology       Congress Sponsorship                 $33,000.00
     Alliance

    Community Servings,      25th Anniversary Pie in the          $10,000.00
     Inc.                     Sky Fundraiser

    Consortium of Multiple   North American Registry for         $200,000.00
     Sclerosis Centers        Care and Research in
                              Multiple Sclerosis Support

    Consortium of Multiple   2017 CMSC Annual Meeting            $100,000.00
     Sclerosis Centers

    Courageous Parents       Empowering parents and               $26,250.00
     Network                  caregivers of children with
                              MPS, Gaucher, Nieman-Pick

    Cradles to Crayons       Ready for School Program             $20,000.00
                              Support

    Cradles to Crayons       Volunteer Match                       $2,000.00

    Cure GM1 Incorporated    TORCH Award                           $5,000.00

    Cure Sanfilippo          TORCH Award                           $5,000.00
     Foundation

    Cystic Fibrosis          Uncork the Cure                      $15,000.00
     Foundation

    Cystic Fibrosis          Massachusetts CF Cycle for            $4,000.00
     Foundation               Life Fundraiser

    DEAF, Inc.--             Deaf-Accessible Medical Case         $10,000.00
     Developmental            Management and Access to
     Evaluation and           Health Program
     Adjustment Facilities,
     Inc.

    Department of            Congress Sponsorship                  $5,878.75
     Pediatrics, Tufts
     Medical Center

    Dimock Community         Volunteer Match                       $1,000.00
     Foundation Inc.

    Dimock Community         30th Anniversary Steppin' Out       $100,000.00
     Foundation Inc.          for The Dimock Center

    DPC Education Center     Fabry Disease Education              $27,500.00
                              Program

    Eastern Allergy          Congress Sponsorship                 $39,000.00
     Conference

    Emerald Necklace         14th Anniversary Party in the         $6,500.00
     Conservancy, Inc.        Park

    Emory University         JScreen Jewish Genetic              $216,089.00
                              Disease Education Initiative

    Endocrine Society        Congress Sponsorship                 $24,500.00

    EveryLife Foundation     2017 RareVoice Awards                $30,000.00
     for Rare Diseases

    EveryLife Foundation     Emerging Technologies for            $15,000.00
     for Rare Diseases        Rare Diseases: Clinical &
                              Regulatory Case Studies and
                              Approval Pathways

    EveryLife Foundation     Rare on the Road Leadership          $30,000.00
     for Rare Diseases        Tour

    EveryLife Foundation     TORCH Award Donations                 $5,000.00
     for Rare Diseases

    Fabry Support &          FSIG Fun Run/Walk                     $1,500.00
     Information Group

    Fabry Support &          General Operating Support           $100,000.00
     Information Group

    Fabry Support &          FSIG Annual Family Conference         $1,000.00
     Information Group

    Fabry Support &          2017 FSIG Expert Fabry               $50,000.00
     Information Group        Conference

    Family Promise           Fundraising Event                     $2,500.00
     Metrowest, Inc.

    Florida Society of       Congress Sponsorship                 $35,000.00
     Rheumatology

    Food For Free            A Nutrition Program for               $5,000.00
     Committee, Inc.          Seniors and People with
                              Disabilities

    Foundation of the        Newsletter Support                    $6,500.00
     Consortium of MS
     Centers

    Foundation of the        Annual Meeting                        $5,450.00
     Consortium of MS
     Centers

    Foundation of the        Research Grant                       $42,000.00
     Consortium of MS
     Centers

    Foundation of the        Multiple Sclerosis Workforce         $32,000.00
     Consortium of MS         of the Future 2018:Medical
     Centers                  Student Research
                              Scholarships

    Foundation of the        NARCOMS NOW Patient Quarterly        $33,583.00
     Consortium of MS         Magazine
     Centers

    Foundation of the        Congress Sponsorship                $432,000.00
     Consortium of MS
     Centers

    Framingham Townwide Pto  Volunteer Match                       $1,000.00
     Council

    Franciscan Hospital For  Adaptive Sports Program              $15,000.00
     Children, Inc.

    Friends of Children      Celebrating Fatherhood Brunch         $2,500.00
     Trust Fund, Inc.

    Friends of Resiliency    Resiliency's Academic Support        $10,000.00
     For Life, Inc.

    Fundacion de Esclerosis  Hurricane Relief                      $3,334.00
     Multiple de Puerto
     Rico

    Generation Citizen,      Massachusetts Spring 2017             $6,000.00
     Inc.                     Civics Day

    Genetic Alliance, Inc.   30th Anniversary Conference          $30,000.00
                              and Celebration

    Genetic Alliance, Inc.   30th Anniversary Conference          $30,000.00
                              and Celebration

    Genetic Disease          Fabry disease (dbFGP) Support       $100,000.00
     Foundation

    Georgia Chapter of the   Georgia AAP: Pediatrics on            $5,000.00
     American Academy of      the Parkway
     Pediatrics

    Georgia Society of       Congress Sponsorship                  $2,000.00
     Rheumatology

    Georgia Society of       Congress Sponsorship                  $8,000.00
     Rheumatology

    Girl Scouts of Eastern   Girls Building Self-eSTeEM           $15,000.00
     Massachusetts Inc.       Program

    Global Academy For       Congress Sponsorship                 $55,000.00
     Medical Education,
     Inc.

    Global Alliance for      Membership                           $50,000.00
     Patient Access

    Global Genes             RARE Tribute to Champions of         $25,000.00
                              Hope

    Global Genes             RARE Patient Advocacy Summit         $25,000.00

    Global Genes             Membership                           $25,000.00

    Greater Boston Chamber   2017 Annual Meeting                  $10,000.00
     of Commerce

    Habitat For Humanity     High Heels and Hard Hats             $10,000.00
     Metrowest--Greater       Auction and Gala
     Worcester, Inc.

    Habitat For Humanity     Home Renovation Build Support        $20,000.00
     Metrowest--Greater
     Worcester, Inc.

    Hadassah Greater         Our Heritage and Our Health--           $900.00
     Detroit                  Jewish Genetic Disorders and
                              Founder Effect Program

    Health Care For All,     Public Education Campaign            $15,000.00
     Inc.

    Health Literacy Media    MTC Educational Program              $50,000.00

    Hearts & Noses Hospital  Ongoing Bedside Hospital             $15,000.00
     Clown Troupe, Inc.       Clown Visits Program

    Hematology Oncology      Congress Sponsorship                  $7,500.00
     Managers of New York,
     Inc.

    Holy Name Health Care    2017 MS Awards Reception              $2,500.00
     MS Center

    Holy Name Medical        20th Annual Spring Fling to           $2,500.00
     Center                   Benefit MS

    Hope and Comfort, Inc.   Hope and Comfort Program              $5,000.00
                              Support

    Horizons for Homeless    19th Annual Women's Breakfast         $5,000.00
     Children

    Houston Food Bank        Volunteer Match                       $1,000.00

    Imedex, LLC              Congress Sponsorship                 $94,778.35

    International Institute  Healthcare Navigation for            $15,000.00
     of New England           Refugees Program

    International Institute  2017 Golden Door Award Gala          $10,000.00
     of New England

    International Institute  Transport Costs for Bicycles            $100.00
     of New England           for Refugee Families

    International            20th Anniversary IOMSN Dinner        $30,000.00
     Organization of
     Multiple Sclerosis
     Nurses

    International            2017 MS Perspectives Digital         $40,000.00
     Organization of          Magazine
     Multiple Sclerosis
     Nurses

    International Society    5th Glycoproteinoses                 $16,650.00
     For Mannosidosis &       International Conference
     Related Disease Inc.

    Jewish Genetic Disease   General Operating Support             $5,000.00
     Consortium

    Knect365 US, Inc.        Battle of the Biotech Bands           $5,000.00
                              Fundraiser

    Kometa Serbian           Volunteer Match                       $1,000.00
     Childrens Program Inc.

    Life Science Cares,      Life Science Cares Impact            $10,000.00
     Inc.                     Breakfast

    Light of Life            Light of Life Foundation 2017        $40,000.00
     Foundation               Activities

    Little Brothers/Friends  Medical Escort/Transportation         $7,500.00
     of the Elderly           Program

    Little Miss Hannah       Vegas Cares About Rare Kids           $5,000.00
     Foundation               5K

    Little Miss Hannah       Vegas Cares About Rare Kids           $2,500.00
     Foundation               5K

    LUGPA                    LUGPA Annual Meeting                 $10,000.00

    Lycee International De   ISB Benefit Gala                      $8,000.00
     Boston International
     School of Boston Inc.

    MagellanRx Management    Congress Sponsorship                  $7,500.00

    March of Dimes           Volunteer Match                       $2,000.00
     Foundation

    March of Dimes           Boston March for Babies              $25,000.00
     Foundation               Fundraiser

    March of Dimes           Volunteer Match                       $1,000.00
     Foundation

    Margaret Fuller          Youth Development Programs           $15,000.00
     Neighborhood House

    Mass Insight Education   STEM and English Program             $15,000.00
     and Research Institute
     Inc.

    Massachusetts Bay        STEM Mentor Program                  $40,000.00
     Community College
     Foundation

    Massachusetts            Patient Advocacy Summit              $10,000.00
     Biotechnology Council

    Massachusetts            Congress Sponsorship                 $25,000.00
     Biotechnology Council

    Massachusetts            MassBio Annual Meeting               $10,000.00
     Biotechnology Council

    Massachusetts            Rare Disease Day 2017                 $1,000.00
     Biotechnology Council

    Massachusetts            2017 Champions for                    $3,500.00
     Biotechnology            Biotechnology Awards
     Education Foundation,
     Inc.

    Massachusetts            BioTeach Program                     $50,000.00
     Biotechnology
     Education Foundation,
     Inc.

    Massachusetts            Life Sciences Workforce 2017,         $3,500.00
     Biotechnology            2nd Annual Conference
     Education Foundation,
     Inc.

    Massachusetts College    Sanofi Genzyme Biotchnology           $7,000.00
     of Pharmacy and Health   College Scholarship
     Sciences

    Massachusetts State      Advancing Science & Health           $50,000.00
     Science and              Education Programs
     Engineering Fair, Inc.

    Mayo Clinic              Congress Sponsorship                  $2,000.00

    MedImpact Healthcare     Congress Sponsorship                  $8,000.00
     Systems, Inc.

    MetroWest Chamber of     Board of Directors Luncheon             $250.00
     Commerce

    Metrowest Free Medical   Access to Women's Health Care        $15,000.00
     Program Inc.             for the Uninsured

    Mid America MS           Eat Bid Laugh 6 Event                $10,000.00
     Achievement Center

    Mid America MS           Race to Nowhere 19                    $5,000.00
     Achievement Center

    Milwaukee Synagogue for  Education Program                     $5,000.00
     Russian Jews:
     Congregation Moshiach
     Now Inc.

    Milwaukee Synagogue for  Education Program                     $5,000.00
     Russian Jews:
     Congregation Moshiach
     Now Inc.

    MS Bright Spots of Hope  MS Evening of Hope                    $2,500.00

    MS Cure Fund             Patient Education Programs           $25,000.00

    MS Cure Fund             Late Summer Education                $25,000.00
                              Programs

    MS Cure Fund             Lifestyle Management Programs        $15,000.00
                              Spring 2017

    MS Cure Fund             2017 Spring MS Health Fair            $1,500.00

    MS HOPE FOR A CURE INC.  2017 MS Hope Day                     $10,000.00

    MS Views And News Inc.   MS Neuro TV                          $35,000.00

    MS Views And News Inc.   Living Beyond MS--Effective          $20,000.00
                              Communication with Your
                              Healthcare Team

    MS Views And News Inc.   The Compass To Care Program          $73,550.00

    MS Views And News Inc.   2017 Display Sponsorship             $10,000.00
                              request

    MS Views And News Inc.   Educational Programs                 $23,825.00

    MS Views And News Inc.   Educational Programs                 $25,000.00

    MS Views And News Inc.   2nd Annual Champions Tackling        $10,000.00
                              MS Awards Dinner Gala

    MS Views And News Inc.   MS Views and News 2017                $1,000.00
                              Bowlathon

    Multiple Myeloma Cure    Defeat Multiple Myeloma run/          $5,000.00
     Seeker Society           walk

    Multiple Sclerosis       Navigating MS: Optimizing            $73,125.00
     Association of America

    Multiple Sclerosis       MSAA MRI Access Fund                $125,000.00
     Association of America

    Multiple Sclerosis       MSAA Improving Lives Benefit          $2,500.00
     Association of America   2017

    Multiple Sclerosis       Educational Programs                 $60,000.00
     Association of America

    Multiple Sclerosis       Understanding MS Progression         $39,000.00
     Association of America

    Multiple Sclerosis       MS Fest                              $10,000.00
     Center of Georgia

    Multiple Sclerosis       Health, Hope & Hops                   $7,000.00
     Center of Georgia

    Multiple Sclerosis       MS Focus' EmpowerSource              $35,000.00
     Foundation               Newsleter

    Multiple Sclerosis       Mind & Mobility                       $5,000.00
     Foundation

    Multiple Sclerosis       Homecare Assistance Grant            $20,000.00
     Foundation               Program

    Multiple Sclerosis       Assistive Technology Program         $30,000.00
     Foundation

    Multiple Sclerosis       2017 National MS Education           $30,000.00
     Foundation               and Awareness Month

    Multiple Sclerosis       30th Anniversary Gala                 $5,000.00
     Foundation               ``Bourbon & Blues''

    Multiple Sclerosis       2017 Mission Steps Walks & MS         $8,000.00
     Resources of Central     Awareness Days
     New York, Inc.

    Multiple Sclerosis       MS Awareness Expo                     $1,000.00
     Society of Colorado
     Springs, Inc.

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Pittsburg
     h, PA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Denver,
     CO

    Muscular Dystrophy       5th Annual Muscle Summit              $6,000.00
     Association--Harrisbur
     g, PA

    Muscular Dystrophy       MDA Muscle Summit                     $8,000.00
     Association--Broomall,
     PA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Shrevepor
     t, LA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Deerfield
     Beach, FL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Tallahass
     ee, FL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Grand
     Rapids, MI

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Fort
     Wayne, IN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Metairie,
     LA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Deerfield
     Beach, FL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Los
     Angeles, CA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Shrevepor
     t, LA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Harrisbur
     g, PA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Allentown
     , PA

    Muscular Dystrophy       Muscle Walk                           $2,000.00
     Association--Urbana,
     IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Billings,
     MT

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--San
     Diego, CA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Cincinnat
     i, OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Portland,
     MA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Spokane,
     WA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Salt Lake
     City, UT

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Louisvill
     e, KY

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Wilmingto
     n, NC

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Worthingt
     on, OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Dallas,
     TX

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Albany,
     NY

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Greensbor
     o, NC

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Columbus,
     OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Albany,
     NY

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Cincinnat
     i, OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Portland,
     OR

    Muscular Dystrophy       Muscular Dystrophy Summer             $2,000.00
     Association--North       Camp Program
     Haven, CT

    Muscular Dystrophy       Montana Muscular Dystrophy            $2,000.00
     Association--Billings,   Association Summer Camp 2017
     MT

    Muscular Dystrophy       MDA Limb Girdle Muscular            $900,000.00
     Association--Chicago,    Dystrophy (LGMD) Genetic
     IL                       Testing Program

    Muscular Dystrophy       2017 Summer Camp                      $2,500.00
     Association--Spokane,
     WA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Okemos,
     MI

    Muscular Dystrophy       2017 MDA Summer Camp of               $2,500.00
     Association--Tulsa, OK   Oklahoma

    Muscular Dystrophy       National Education and Impact       $400,000.00
     Association - Chicago,   Partner
     IL

    Muscular Dystrophy       MDA Summer Newsletter                 $2,000.00
     Association--Columbia,
     SC

    Muscular Dystrophy       2017 MDA Summer Camp                  $2,500.00
     Association--Cincinnat
     i, OH

    Muscular Dystrophy       MDA Summer Camp                       $5,000.00
     Association--Mountlake
     Terrace, WA

    Muscular Dystrophy       MDA Summer Camp                       $5,000.00
     Association--Denver,
     CO

    Muscular Dystrophy       2017 MDA Summer Camp                  $2,500.00
     Association--Shrevepor
     t, LA

    Muscular Dystrophy       2017 MDA Summer Camp                  $8,000.00
     Association--Dallas,
     TX

    Muscular Dystrophy       MDA Summer Camp                       $2,500.00
     Association--Bolingbro
     ok, IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Denver,
     CO

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Denver,
     CO

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--North
     Haven, CT

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Maywood,
     NJ

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Indianapo
     lis, IN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Urbana,
     IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Louisvill
     e, KY

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Chicago,
     IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Edina, MN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Metairie,
     LA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Reston,
     VA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Little
     Rock, AR

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Springfie
     ld, MO

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Fort
     Myers, FL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Bolingbro
     ok, IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Green
     Bay, WI

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Edina, MN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Dallas,
     TX

    Muscular Dystrophy       Quarterly Newsletter                  $3,000.00
     Association--Westbrook
     , ME

    Muscular Dystrophy       TORCH Award                           $5,000.00
     Association--Midland,
     TX

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--St.
     Petersburg, FL

    Muscular Dystrophy       2017 MDA Muscle Walk of               $1,000.00
     Association--Jacksonvi   Jacksonville
     lle, FL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Charlotte
     , NC

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Towson,
     MD

    Muscular Dystrophy       Muscle Walk                           $1,500.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk & Fire Truck Pull         $1,000.00
     Association--Austin,
     TX

    Muscular Dystrophy       Muscle Walk                           $1,500.00
     Association--Sacrament
     o, CA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Fort
     Wayne, IN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Birmingha
     m, AL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Edina, MN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Salt Lake
     City, UT

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Lafayette
     , LA

    Muscular Dystrophy       Spring Newsletter                     $1,500.00
     Association--Columbia,
     SC

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Memphis,
     TN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Allentown
     , PA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Cedar
     Rapids, IA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Lafayette
     , LA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Maryland
     Heights, MO

    Muscular Dystrophy       1st Quarter Newsletter                $1,000.00
     Association--North
     Haven, CT

    Muscular Dystrophy       Second Quarter Newsletter             $1,500.00
     Association--Chicago,
     IL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Cleveland
     , OH

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Oklahoma
     City, OK

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Wilmingto
     n, NC

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--San
     Antonio, TX

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Scottsdal
     e, AZ

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Montgomer
     y, AL

    Muscular Dystrophy       First Quarter Newsletter              $2,500.00
     Association--Chicago,
     IL

    Muscular Dystrophy       4th Quarter Newsletter                $1,500.00
     Association--North
     Haven, CT

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--El Paso,
     TX

    Muscular Dystrophy       Summer Camp 2017                      $8,000.00
     Association--Cypress,
     CA

    Muscular Dystrophy       1st Quarter Newsletter                $3,000.00
     Association--North
     Haven, CT

    Muscular Dystrophy       Kids Art Auction                      $2,000.00
     Association--Lake
     Mary, FL

    Muscular Dystrophy       Muscle Walk                           $2,000.00
     Association--Westborou
     gh, MA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Westborou
     gh, MA

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Brentwood
     , TN

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Lake
     Mary, FL

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Brookfiel
     d, WI

    Muscular Dystrophy       Muscle Walk                           $1,000.00
     Association--Wichita,
     KS

    Muscular Dystrophy       MA and RI Newsletters                $10,000.00
     Association--Westborou
     gh, MA

    Museum of Fine Arts      Membership                           $20,000.00

    Museum of Science        Sanofi Genzyme Teacher               $66,980.00
                              Sabbatical Program 2017-2018

    Museum of Science        Stars of STEM 2017                   $10,000.00

    National Bone Marrow     Caregiver Webinar Series              $2,500.00
     Transplant Link

    National Comprehensive   Membership                          $210,000.00
     Cancer Network

    National Eczema          Be Well, Mind + Body, Eczema        $100,000.00
     Association              Awareness Month Campaign

    National Eczema          NEA Educational Webcast for          $15,000.00
     Association              Patients & Caregivers

    National Eczema          Leaders in Eczema Forum             $100,000.00
     Association              Series

    National Eczema          Health Care Provider                 $85,000.00
     Association              Engagement Program

    National Eczema          Patient Engagement Program          $150,000.00
     Association

    National Eczema          Ambassadors Program                 $100,000.00
     Association

    National Fabry Disease   Fabry Family Conference               $6,500.00
     Foundation

    National Fabry Disease   2017 Urgent and Unmet Needs          $40,000.00
     Foundation               Program

    National Fabry Disease   2017 Annual Educational              $50,000.00
     Foundation               Conference and Fabry Family
                              Camp

    National Fabry Disease   Annual Conference                    $70,000.00
     Foundation

    National Fabry Disease   2018 NFDF Core Program Grant        $100,000.00
     Foundation

    National Fabry Disease   Fabry Family Meeting                  $3,000.00
     Foundation

    National Fabry Disease   Family Meeting                        $5,000.00
     Foundation

    National Fabry Disease   2017 Family Assistance               $10,000.00
     Foundation               Program

    National Gaucher         CARE Programs                       $800,000.00
     Foundation

    National Gaucher         Optimal Health Initiative &         $900,000.00
     Foundation               Education and Awareness

    National Gaucher         CARE Programs                     $1,500,000.00
     Foundation

    National Gaucher         Optimal Health Initiative &         $400,000.00
     Foundation               Education and Awareness

    National Kidney          Kidney Walk                          $25,000.00
     Foundation

    National Kidney          Spring Clinical Meeting               $3,500.00
     Foundation

    National Kidney          Kidney Health Risk Assessment         $1,500.00
     Foundation of Indiana    Program

    National Kidney          Kidney Health Risk Assessment         $1,500.00
     Foundation of Indiana    Program

    National Kidney          Kidney Health Risk Assessment         $1,500.00
     Foundation of Indiana    Program

    National Kidney          Kidney Health Risk Assessment         $1,500.00
     Foundation of Indiana    Program

    National Kidney          Kidney Walk                           $1,000.00
     Foundation of Michigan

    National Kidney          31st Annual Gift of Life Gala         $2,500.00
     Foundation of Eastern
     Missouri, Metro East

    National MPS Society     2018 International MPS              $100,000.00
                              Symposium

    National MPS Society     National MPS Society Gala               $134.00
                              Silent Auction

    National MPS Society     National MPS Society Family           $7,500.00
                              Conference Scholarships

    National MPS Society     31st Annual Family Conference        $35,000.00

    National MPS Society     National MPS Society 2017 Run/       $20,000.00
                              Walk Program

    National Multiple        Free From Falls                       $1,150.00
     Sclerosis Society--
     Southern California &
     Nevada Chapter

    National Multiple        Champions on the Move                 $5,000.00
     Sclerosis Society--
     Upstate New York
     Chapter

    National Multiple        Spellbound In the Vineyard            $2,500.00
     Sclerosis Society--
     Upstate New York
     Chapter

    National Multiple        2016 Annual Meeting                   $2,500.00
     Sclerosis Society--
     Greater Delaware
     Valley Chapter

    National Multiple        Women on the Move Luncheon            $2,500.00
     Sclerosis Society--
     Greater Illinois
     Chapter

    National Multiple        Life-Changing Breakthroughs:         $65,000.00
     Sclerosis Society--      MS Society Impact Series
     Colorado-Wyoming
     Chapter

    National Multiple        Leadership Conference 2017           $15,000.00
     Sclerosis Society--
     Colorado-Wyoming
     Chapter

    National Multiple        The Tykeson Fellows                  $15,000.00
     Sclerosis Society--      Conference
     Colorado-Wyoming
     Chapter

    National Multiple        Moving Mountains for MS:             $10,000.00
     Sclerosis Society--      Family Weekend Retreat
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Crystal Boots and Silver              $3,000.00
     Sclerosis Society--      Spurs
     Kentucky-Southeast
     Indiana Chapter

    National Multiple        Nationwide MS Navigator              $50,000.00
     Sclerosis Society--      Services
     Colorado-Wyoming
     Chapter

    National Multiple        On the Move Luncheon                  $2,500.00
     Sclerosis Society--
     Gateway Area Chapter

    National Multiple        Walk MS--Lanyard Sponsorship         $10,000.00
     Sclerosis Society--New
     Jersey Metro Chapter

    National Multiple        On the Move Luncheon                  $2,500.00
     Sclerosis Society--
     South Central Chapter

    National Multiple        Annual Meeting & Day of               $7,500.00
     Sclerosis Society--Mid   Discovery
     Florida Chapter

    National Multiple        Volunteer Program                    $10,000.00
     Sclerosis Society--New
     Jersey Metro Chapter

    National Multiple        Fall Crush Knoxville                  $2,500.00
     Sclerosis Society--Mid
     South Chapter

    National Multiple        Fall Crush Knoxville                  $2,500.00
     Sclerosis Society--Mid
     South Chapter

    National Multiple        Women Against MS Luncheon             $3,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        Challenge Walk MS                     $5,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        On the Move Baltimore                 $3,500.00
     Sclerosis Society--New
     York City Chapter

    National Multiple         Ambassadors Ball                    $10,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        Hispanic Outreach Initiative         $10,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        MS Scholarship Program               $15,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        2017 Weekend Escape                   $5,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        2017 Dinner of Champions              $2,500.00
     Sclerosis Society--
     Reno Chapter

    National Multiple        Everyday Matters: Living Your        $20,000.00
     Sclerosis Society--New   Best Life with MS
     York City Chapter

    National Multiple        International Progressive MS        $122,249.00
     Sclerosis Society--New   Alliance Industry Forum
     York City Chapter

    National Multiple        2017 On The Move Luncheon             $2,500.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        Books for a Better Life              $20,000.00
     Sclerosis Society--New   Awards
     York City Chapter

    National Multiple        Women on the Move Luncheon            $6,000.00
     Sclerosis Society--New
     York City Chapter

    National Multiple        National ``Living with MS''         $600,000.00
     Sclerosis Society--New   Event
     York City Chapter

    National Multiple        Walk MS 2017                         $25,000.00
     Sclerosis Society--
     South Florida Chapter

    National Multiple        Festival Hispano                      $1,500.00
     Sclerosis Society--
     South Florida Chapter

    National Multiple        MS Gala Luncheon 2017                 $2,500.00
     Sclerosis Society--
     South Florida Chapter

    National Multiple        MS Walk West Virginia                 $7,500.00
     Sclerosis Society--
     Central Virginia
     Chapter

    National Multiple        Patient Assistance Program            $5,000.00
     Sclerosis Society--
     Indiana State Chapter

    National Multiple        Walk MS                               $5,000.00
     Sclerosis Society--
     Long Island Chapter

    National Multiple        Women on the Move Luncheon &          $1,250.00
     Sclerosis Society--      Fashion Show
     Ohio Valley Chapter

    National Multiple        2017 MS Neurology Dinner              $5,000.00
     Slcerosis Society--
     Pacific South Coast
     Chapter

    National Multiple        Challenge Walk MS                     $2,500.00
     Slcerosis Society--
     Pacific South Coast
     Chapter

    National Niemann-Pick    Reinvention of The National          $75,000.00
     Disease Foundation       Niemann Pick Disease
                              Foundation (NNPDF)

    National Organization    Rare Disease Day Fundraiser          $10,000.00
     for Rare Disorders

    National Organization    2017 Rare Diseases and Orphan        $50,000.00
     for Rare Disorders,      Product Breakthrough Summit
     Inc.

    National Organization    Running for Rare                      $5,000.00
     for Rare Disorders,
     Inc.

    National Organization    2017 Corporate Council               $25,000.00
     for Rare Disorders,
     Inc.

    National Organization    2017 Rare Impact Awards              $50,000.00
     for Rare Disorders,
     Inc.

    National Organization    Undiagnosed Diseases Network          $5,000.00
     for Rare Disorders,      Fund
     Inc.

    National Organization    Orphan Drug Act Advocacy             $75,000.00
     for Rare Disorders,
     Inc.

    National Parkinson       Moving Day--Boston 2016               $1,000.00
     Foundation

    National Society of      36th Annual Education                 $2,800.00
     Genetic Counselors       Conference

    National Tay-Sachs &     Imagine & Believe                    $20,000.00
     Allied Diseases
     Association, Inc.

    National Tay-Sachs &     Raising Awareness of                  $1,100.00
     Allied Diseases          Ashkenazi Jewish Genetic
     Association, Inc.        Diseases

    National Tay-Sachs &     39th Annual Family Conference        $10,000.00
     Allied Diseases
     Association, Inc.

    National Tay-Sachs &     Family Support Resource Video         $5,000.00
     Allied Diseases          Series and Podcasts
     Association, Inc.

    NEHI                     NEHI's Innovators in Health          $25,000.00
                              Awards

    NEHI                     The Nick Littlefield Health          $25,000.00
                              Policy Fellowship

    Neuroscience Centers of  How to Improve Physical and           $6,640.00
     Florida Foundation,      Psychological Health Program
     Inc.

    Neuroscience Centers of  Maintaining Intimacy with             $3,895.72
     Florida Foundation,      Multiple Sclerosis
     Inc.

    Next Step Fund, Inc.     Summer Campference Program           $10,000.00

    Northeastern University  Biotchnology College                  $1,000.00
                              Scholarship

    Northern California      Congress Sponsorship                 $10,000.00
     Rheumatology Society

    Northern New England     Congress Sponsorship                  $2,000.00
     Clinical Oncology
     Society

    Operation Warm, Inc.     Boston Coat Program                  $20,000.00

    Operation Warrior        Wounded Military Event                  $798.00
     Wishes

    Pan Massachusetts        Pan Mass Challenge                   $11,000.00
     Challenge

    Patient Access Network   Patient Assistance Program          $460,000.00
     Foundation

    Patient Access Network   Patient Assistance Program          $200,000.00
     Foundation

    Patient Services, Inc.   Patient Assistance Program          $481,250.00

    Patient Services, Inc.   Patient Assistance Program        $2,902,500.00

    Patient Services, Inc.   Patient Assistance Program          $237,500.00

    Patient Services, Inc.   Patient Assistance Program          $818,750.00

    Patient Services, Inc.   Patient Assistance Program          $650,000.00

    Patient Services, Inc.   Patient Assistance Program        $5,960,000.00

    PCMA Pharmaceutical      Congress Sponsorship                 $60,000.00
     Care Management
     Association

    Pediatric Endocinology   Congress Sponsorship                  $6,200.00
     Nursey Society

    Pediatric Endocrine      Congress Sponsorship                 $27,500.00
     Society

    Peer Health Exchange,    Peer Health Exchange Program          $5,000.00
     Inc.

    Pennsylvania             Congress Sponsorship                 $10,000.00
     Rheumatology Society

    Perkins School for the   Enhancing Accessible Science         $20,000.00
     Blind                    and Technology Education
                              eLearning Program

    Philadelphia Rheumatism  5th Annual Ralph Schumacher           $2,250.00
     Society                  Lecture

    Phillips Brooks House    Bridges Workshop                      $3,000.00
     Association
     Incorporated

    President and Fellows    The Family Van Health Clinic         $50,000.00
     of Harvard College

    Pro Player Foundation    Flavors of Austin Fundraiser          $5,000.00

    Project HOPE             Project Hope Gala                    $10,000.00

    Project Just Because,    211 Domestic Abuse/Emergency         $10,000.00
     Inc.                     Program & Keep A Family Warm
                              Program

    Prostate Cancer Academy  Proscate Cancer Academy 2017          $7,500.00

    Race to Erase MS         24th Annual Race to Erase MS         $15,000.00

    Race to Erase MS         Race to Erase MS                     $10,000.00

    Radiological Society of  103rd Scientific Assembly and         $3,500.00
     North America            Annual Meeting

    Rare Disease United      14th Annual World Symposium--        $20,000.00
     Foundation               Lysosomal Diseases

    Rare Genomics Institute  Patient Advoacy Leadership           $25,000.00
                              Awards and Rare Disease
                              Patient Advocate Teaching
                              Modules

    Rare New England, Inc.   Improving Health Care                 $3,000.00
                              Experiences in the Rare
                              Disease Community

    Read to a Child, Inc.    Read to a Child's Lunchtime           $5,000.00
                              Reading Program

    Resolve Community        Volunteer Match                       $1,000.00
     Counseling Center,
     Inc.

    Rheumatology             Congress Sponsorship                  $2,000.00
     Association of IOWA

    Rheumatology             Congress Sponsorship                 $20,000.00
     Association of
     Minnesota and the
     Dakotas

    Rheumatology             Congress Sponsorship                 $10,000.00
     Association of Nevada

    Rheumatology Nurses      Immunology Webinar                   $50,000.00
     Society

    Rheumatology Nurses      10th Rheumatology Nurses              $3,443.91
     Society                  Society Annual Conference

    Rise Against Hunger      Volunteer Match                       $2,944.08

    Rise Against Hunger      Volunteer Match                       $2,944.08

    Rocky Mountain Multiple  MS4MS Fundraising Program             $5,000.00
     Sclerosis Center

    Rocky Mountain Multiple  2017 Webinar Program Series           $5,000.00
     Sclerosis Center

    Rocky Mountain Multiple  2016 Fall Education Summit            $5,000.00
     Sclerosis Center

    Samaritans, Inc.         Youth Suicide Prevention             $25,000.00
                              Services

    Saunders Health          2017 Night of Lights                  $2,500.00
     Services Foundation

    Saunders Health          2016 Night of Lights                  $1,000.00
     Services Foundation

    Save One Life, Inc.      Panel Discussion Donation               $250.00

    Scholarship America,     TORCH Awards Program                 $11,600.00
     Inc.

    Scholarship America,     Scholarship Program                  $39,900.00
     Inc.

    Science Club For Girls,  10th Annual Catalyst Awards          $10,000.00
     Inc.

    Science Club For Girls,  STEMinistas Program Expansion        $10,000.00
     Inc.

    Society of Nuclear       Congress Sponsorship                  $1,250.00
     Medicine and Molecular
     Imaging

    Society of Nuclear       Congress Sponsorship                  $2,200.00
     Medicine and Molecular
     Imaging

    Society of Nuclear       Congress Sponsorship                  $7,790.00
     Medicine and Molecular
     Imaging

    Society of Nuclear       Congress Sponsorship                  $1,800.00
     Medicine and Molecular
     Imaging

    Special Olympics         Bio-Ball 2017                         $2,500.00
     Massachusetts Inc.

    Sportsmen's Tennis &     Academic Enrichment Program          $12,500.00
     Enrichment Center

    St. Francis House        Triage and Coordinated Care          $10,000.00
                              for the Poor and Homeless
                              Population

    St. Mary's Center for    Women@Work Plus Program              $15,000.00
     Women and Children

    State of Texas           Congress Sponsorships                $20,000.00
     Association of
     Rheumatologists

    Temple Beth Sholom [The  Jewish Genetic Disease                $7,000.00
     Tribe]                   Awareness Screening

    The American             Congress Sponsorship                 $20,000.00
     Association of
     Clinical
     Endocrinologists
     (AACE)

    The American Society of  Congress Sponsorship                 $10,000.00
     Hematology

    The Boston Home, Inc.    The Boston Home Arts Program          $5,000.00

    The Boston Home, Inc.    Socialization & Wellness              $9,000.00
                              Program

    The Boston Home, Inc.    Resident & Family 2017 Event         $10,000.00
                              Series

    The Boston Home, Inc.    135 Anniversary Event                $10,000.00

    The Community Art        Teen Media Program                   $15,000.00
     Center

    The Community Art        General Operating Support            $10,000.00
     Center

    The Forsyth Institute    Mobile Dental Program Service        $10,000.00

    The Greater Boston Food  Volunteer Match                       $1,000.00
     Bank, Inc.

    The Leukemia & Lymphoma  Light The Night Event                $10,000.00
     Society Eastern PA
     Chapter

    The Leukemia & Lymphoma  Light The Night Event                $20,000.00
     Society, Inc.

    The MAGIC Foundation     23rd Annual Convention                $5,000.00

    The McCourt Foundation   Tour de South Shore--Bike/            $7,500.00
                              Walk

    The McCourt Foundation   MS Educational Program Update        $20,000.00

    The Menkes Foundation    The Rare Disease Film                 $3,000.00
                              Festival

    The MS Center of St      12th Annual Trivia and               $15,000.00
     Louis                    Auction Benefit

    The Oak Clinic           Wellness Thursday Nutrition          $21,000.00
                              for MS Seminars

    The Oak Clinic           2017 Oak Clinic Acorn Run             $3,500.00

    The Oak Clinic           2017 Diamond Run for MS               $5,000.00

    The Oak Clinic           Wellness Wednesday Nutrition         $14,000.00
                              for MS Seminars

    The Posse Foundation     STEM Posse Program                   $25,000.00

    The Possible Project     Powering Possibilities Gala          $10,000.00

    The Regents of the       Rare Disease Symposium               $10,000.00
     University of
     California, San
     Francisco

    The University of Texas  Congress Sponsorship                 $10,000.00
     MD Anderson Cancer
     Center

    Thompson Island Outward  Connections--Science                 $15,000.00
     Bound Education          Education for Boston Public
     Center, Inc.             School Students

    Thompson Island Outward  Thompson Island 4K Trail Run          $5,000.00
     Bound Education
     Center, Inc.

    ThyCa: Thyroid Cancer    Production and Distribution          $15,000.00
     Survivors'               of Educational Handbooks and
     Association, Inc.        Materials

    ThyCa: Thyroid Cancer    20th International Thyroid           $35,000.00
     Survivors'               Cancer Survivors' Conference
     Association, Inc.

    Tisch Multiple           2017 Future Without MS Gala          $10,000.00
     Sclerosis Research
     Center of New York,
     Inc.

    Tisch Multiple           Healing MS: Online Newsletter         $8,000.00
     Sclerosis Research
     Center of New York,
     Inc.

    Tri-State Multiple       Owensboro Autumn Walk                 $2,500.00
     Sclerosis Association

    Tri-State Multiple       Evansville Autumn Walk                $2,500.00
     Sclerosis Association

    Tutoring Plus of         STEAM Enrichment Programs             $7,500.00
     Cambridge, Inc.

    UMASS Dartmouth          Allston Brighton College              $2,000.00
                              Scholarship

    United Arizona           Congress Sponsorship                 $45,000.00
     Rheumatology Alliance

    United Network For       Congress Sponsorship                  $8,400.00
     Organ Sharing

    United Pompe Foundation  Reception and Early Onset            $30,000.00
                              Pompe Patient Meeting

    United Pompe Foundation  Reception and Early Onset            $45,000.00
                              Pompe Patient Meeting

    United Pompe Foundation  General Operating Support            $50,000.00

    United Rheumatology      Congress Sponsorship                $130,000.00

    United Rheumatology      Congress Sponsorship                $140,000.00

    United States Bone and   General Program Support              $46,250.00
     Joint Initiative, NFP

    United States Bone and   The Burden of Musculoskeletal        $25,000.00
     Joint Initiative, NFP    Diseases in the United
                              States

    United States Bone and   Membership                           $20,000.00
     Joint Initiative, NFP

    United States Bone and   Patient Education Programs           $80,000.00
     Joint Initiative, NFP

    University Hospitals     40th Anniversary Bone Marrow          $5,000.00
     Health System, Inc.      Transplant Celebration

    University Neurology,    2017 NYSMSC Annual Meeting            $5,000.00
     Inc.

    University of            Sanofi Genzyme Biotchnology           $3,000.00
     Connecticut Foundation   College Scholarship

    University of            Student Success Program             $200,000.00
     Massachusetts
     Foundation, Inc.

    University of            Sanofi Genzyme Biotchnology           $4,000.00
     Massachusetts: Lowell    College Scholarship

    University of Miami      Sanofi Genzyme Biotchnology           $1,000.00
                              College Scholarship

    University of            Congress Sponsorship                 $23,500.00
     Minnesota--Department
     of Surgery

    University of New        Sanofi Genzyme Biotchnology           $4,000.00
     Hampshire                College Scholarship

    University of            Congress Sponsorship                  $2,500.00
     Pennsylvania

    Us TOO International     13th Annual SEA Blue Prostate         $5,000.00
                              Cancer Walk & Run

    VCU Hume-Lee Transplant  Congress Sponsorship                  $1,000.00
     Center

    Visiting Nurse           Heroes in Health Care Gala           $10,000.00
     Association of Boston
     & Affiliates

    VZW Sint-Aloysius Oud    Volunteer Match                       $2,000.00
     Scouts Geel

    Washington University    Washington University Fellows         $1,500.00
     in St. Louis; Siteman    Program
     Cancer Center

    Wentworth Institute of   Sanofi Genzyme Biotchnology             $500.00
     Technology               College Scholarship

    West End House Boys and  Volunteer Match                       $1,000.00
     Girls Club

    WGBH Educational         WGBH Pledge Night Event              $12,000.00
     Foundation

    Whitehead Institute for  Expedition: Bio 2018 Program         $10,000.00
     Biomedical Research

    Wisconsin Rheumatology   Congress Sponsorship                 $10,000.00
     Association

    Women's Lunch Place      2017 Spaghetti Dinner                $10,000.00

    Women's Lunch Place      Healthy Meals Program                $35,000.00

    WORLD Symposium          Congress Sponsorship                 $40,000.00

    WORLD Symposium          Congress Sponsorship                    $600.00

    WORLD Symposium          Congress Sponsorship                  $1,200.00

    WORLD Symposium          Congress Sponsorship                 $25,000.00

    WORLD Symposium          Congress Sponsorship                 $63,000.00

    WORLD Symposium          Congress Sponsorship                $210,000.00

    WORLD Symposium          Congress Sponsorship                $160,000.00

    WORLD Symposium          Congress Sponsorship                  $5,000.00

    WriteBoston              Chelsea and WriteBoston              $18,000.00
                              Educational Programs

    Wylder Nation            4th Annual Living Like a             $15,000.00
     Foundation               Warrior Gala

    YMCA of Greater Boston   Summer Day Camp Scholarships         $15,000.00
                              for Low-Income Youth

    Young Men's Christian    MS One Step Program                  $15,000.00
     Association of
     Montclair, NJ

    ziMS Foundation          8th Annual UVA MS Event               $5,000.00

    ziMS Foundation          7th Annual UVA MS Event               $5,000.00

         Sponsorships, Charitable Donations, Memberships and Fellowships
                            1st Jan 2018-31st Dec 2018
        Sanofi US and its affiliate Genzyme Corporation are committed to
       supporting sponsorships for specific activities and initiatives of
        healthcare organizations and institutions, independent medical or
    professional societies, trade organizations and organized patient groups
      to improve patient care and provide information to the medical and/or
      patient communities. The goal of our charitable giving approach is to
     fund general operational support for patient/disease organizations, or
    program support for community-based organizations. Sanofi US and Genzyme
        Corporation are part of the Sanofi Group, a global pharmaceutical
                                    company.
     Applicant names are provided by the requestor. If applicants apply as a
      group for a single activity; all applicants may be not be identified
     above. ``Funding Amount'' is the amount that the Company funded during
      2018 identified above. ``Funding Amount'' does not include funds that
       may have been provided by other affiliated Sanofi Company Entities
                             (e.g., Sanofi Pasteur).
    ------------------------------------------------------------------------
       Recipient Name(s)             Activity Title          Funding Amount
    ------------------------------------------------------------------------
    495 MetroWest            Membership                           $10,000.00
     Partnership
    ------------------------------------------------------------------------
    ACMG                     Congress Sponsorship                 $33,000.00
    ------------------------------------------------------------------------
    ACMG                     Congress Sponsorship                  $7,600.00
    ------------------------------------------------------------------------
    ACMG                     Congress Sponsorship                    $500.00
    ------------------------------------------------------------------------
    ACMG                     Congress Sponsorship                  $4,500.00
    ------------------------------------------------------------------------
    ACTRIMS                  Congress Sponsorship                 $42,500.00
    ------------------------------------------------------------------------
    Alabama Cancer Congress  Membership                            $4,000.00
    ------------------------------------------------------------------------
    Alliance for             Membership                          $100,000.00
     Regenerative Medicine
    ------------------------------------------------------------------------
    Allston Village Main     Community Event                       $1,000.00
     Streets Inc.
    ------------------------------------------------------------------------
    American Academy of      DataDerm Program                    $350,000.00
     Dermatology
    ------------------------------------------------------------------------
    American Academy of      Quality Innovation Center            $50,000.00
     Dermatology              (QIC) Program
    ------------------------------------------------------------------------
    American Academy of      AccessDerm Program                  $250,000.00
     Dermatology
    ------------------------------------------------------------------------
    American Academy of      2019 President's Fundraiser         $275,000.00
     Dermatology
    ------------------------------------------------------------------------
    American Academy of      Practice Management Center          $100,000.00
     Dermatology              Program
    ------------------------------------------------------------------------
    American Academy of      2018 President's Fundraiser         $275,000.00
     Dermatology
    ------------------------------------------------------------------------
    American Academy of      Congress Sponsorship                  $1,000.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Congress Sponsorship                    $500.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Congress Sponsorship                    $500.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Congress Sponsorship                 $15,000.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Congress Sponsorship                 $81,000.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Congress Sponsorship                $598,935.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Women Leading in Neurology           $20,000.00
     Neurology Institute      Program
    ------------------------------------------------------------------------
    American Academy of      Transforming Leaders Program         $25,000.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Palatucci Advocacy Leadership        $30,000.00
     Neurology Institute      Forum
    ------------------------------------------------------------------------
    American Academy of      2018 Industry Roundtable             $50,000.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Academy of      Diversity Leadership Program         $30,000.00
     Neurology Institute
    ------------------------------------------------------------------------
    American Association     Congress Sponsorship                 $26,500.00
     for Pediatric
     Ophthalmology &
     Strabismus
    ------------------------------------------------------------------------
    American Association of  Congress Sponsorship                    $100.00
     Clinical
     Endocrinologists
    ------------------------------------------------------------------------
    American Association of  Congress Sponsorship                 $50,000.00
     Neuromuscular &
     Electrodiagnostic
     Medicine
    ------------------------------------------------------------------------
    American Association of  Congress Sponsorship                  $2,100.00
     Neuromuscular &
     Electrodiagnostic
     Medicine
    ------------------------------------------------------------------------
    American Association of  Congress Sponsorship                    $990.00
     Neuromuscular &
     Electrodiagnostic
     Medicine
    ------------------------------------------------------------------------
    American City Business   Corporate Citizenship Awards          $5,500.00
     Journals, Inc.           2018
    ------------------------------------------------------------------------
    American College of      Industry Advisory Council            $60,000.00
     Chest Physicians         2018
    ------------------------------------------------------------------------
    American College of      Congress Sponsorship                  $7,600.00
     Medical Genetics and
     Genomics
    ------------------------------------------------------------------------
    American College of      Congress Sponsorship                 $17,500.00
     Medical Genetics and
     Genomics
    ------------------------------------------------------------------------
    American College of      Congress Sponsorship                 $10,000.00
     Medical Genetics and
     Genomics
    ------------------------------------------------------------------------
    American College of      Fellowship Program                   $75,000.00
     Medical Genetics
     Foundation
    ------------------------------------------------------------------------
    American College of      Fellowship Program                   $75,000.00
     Medical Genetics
     Foundation
    ------------------------------------------------------------------------
    American College of      Congress Sponsorship                 $10,000.00
     Rheumatology
    ------------------------------------------------------------------------
    American College of      Congress Sponsorship                 $15,000.00
     Rheumatology
    ------------------------------------------------------------------------
    American Society for     Conference Sponsorship               $10,000.00
     Blood and Marrow
     Transplant
    ------------------------------------------------------------------------
    American Society for     Sarah Cannon Blood Cancer            $10,000.00
     Blood and Marrow         Network Event
     Transplant
    ------------------------------------------------------------------------
    American Society for     ASBMT Website Sponsorship            $15,000.00
     Blood and Marrow
     Transplant
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                $118,000.00
     Clinical Oncology
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                $358,750.00
     Clinical Oncology
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                $285,500.00
     Hematology
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                 $75,000.00
     Hematology
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                  $3,000.00
     Human Genetics
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                  $5,000.00
     Nephrology
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                  $3,600.00
     Nephrology
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                 $25,000.00
     Transplant Surgeons
    ------------------------------------------------------------------------
    American Society of      Congress Sponsorship                 $36,750.00
     Transplant Surgeons
    ------------------------------------------------------------------------
    American Thoracic        ATS 2018 Corporate Member            $50,000.00
     Society                  Program
    ------------------------------------------------------------------------
    American Thyroid         Congress Sponsorship                  $5,000.00
     Association
    ------------------------------------------------------------------------
    American Transplant      Congress Sponsorship                $153,000.00
     Congress
    ------------------------------------------------------------------------
    Americas Committee for   Congress Sponsorship                 $42,500.00
     Treatment and Research
     in Multiple Sclerosis,
     Inc.
    ------------------------------------------------------------------------
    Americas Committee for   Congress Sponsorship                 $12,480.00
     Treatment and Research
     in Multiple Sclerosis,
     Inc.
    ------------------------------------------------------------------------
    Americas Committee for   Congress Sponsorship                 $19,000.00
     Treatment and Research
     in Multiple Sclerosis,
     Inc.
    ------------------------------------------------------------------------
    America's Physician      Congress Sponsorship                  $4,500.00
     Groups
    ------------------------------------------------------------------------
    ANERA (American Near     Anera 50th Anniversary               $10,000.00
     East Refugee Aid)        Fundraiser
    ------------------------------------------------------------------------
    Ann & Robert H. Lurie    MPS Patient and Family Day            $2,500.00
     Children's Hospital of
     Chicago
    ------------------------------------------------------------------------
    Ann & Robert H. Lurie    Fellowship Program                   $75,000.00
     Children's Hospital of
     Chicago
    ------------------------------------------------------------------------
    Ann & Robert H. Lurie    Fellowship Program                   $75,000.00
     Children's Hospital of
     Chicago
    ------------------------------------------------------------------------
    Arthritis Foundation     Congress Sponsorship                  $7,500.00
     Northern California
     Office
    ------------------------------------------------------------------------
    Arts & Business Council  Battle of the Biotech Bands           $5,250.00
     of Greater Boston,
     Inc.
    ------------------------------------------------------------------------
    ASCO Exhibits            Congress Sponsorship                  $5,495.00
     Management
    ------------------------------------------------------------------------
    ASCO Exhibits            Congress Sponsorship                 $18,990.00
     Management
    ------------------------------------------------------------------------
    Asembia Specialty        Congress Sponsorship                 $20,000.00
     Pharmacy Summit LLC
    ------------------------------------------------------------------------
    Asembia Specialty        Congress Sponsorship                 $20,000.00
     Pharmacy Summit LLC
    ------------------------------------------------------------------------
    Asembia Specialty        Congress Sponsorship                 $20,000.00
     Pharmacy Summit LLC
    ------------------------------------------------------------------------
    ASN                      Congress Sponsorship                  $7,200.00
    ------------------------------------------------------------------------
    ASN                      Congress Sponsorship                 $72,500.00
    ------------------------------------------------------------------------
    ASPHO                    Congress Sponsorship                  $3,000.00
    ------------------------------------------------------------------------
    Association of Managed   Congress Sponsorship                 $20,000.00
     Care Pharmacy (AMCP)
    ------------------------------------------------------------------------
    Association of Northern  Membership                            $1,200.00
     California Oncologists
    ------------------------------------------------------------------------
    Association of VA        Congress Sponsorship                 $10,000.00
     Hematology/Oncology
    ------------------------------------------------------------------------
    Association of Women in  AWIR 2018 Corporate Program          $75,000.00
     Rheumatology
    ------------------------------------------------------------------------
    Bendcare                 Congress Sponsorship                $180,000.00
    ------------------------------------------------------------------------
    Bendcare                 Congress Sponsorship                $165,000.00
    ------------------------------------------------------------------------
    Big Brothers Big         Mentoring Youth in Science           $15,000.00
     Sisters of Central       Technology Engineering and
     Mass Metrowest Inc.      Math (MySTEM)
    ------------------------------------------------------------------------
    Biomedical Science       Evening of Hope 2018                 $75,000.00
     Careers Program
    ------------------------------------------------------------------------
    Biomedical Science       Hope Scholarship 2018-2019            $7,500.00
     Careers Program
    ------------------------------------------------------------------------
    Bleeding Disorders       Patient Education Program             $7,000.00
     Alliance Illinois
    ------------------------------------------------------------------------
    Blue Cross Blue Shield   Congress Sponsorship                 $17,500.00
     Association
    ------------------------------------------------------------------------
    Boston Area Rape Crisis  Medical Advocacy Program             $30,000.00
     Center
    ------------------------------------------------------------------------
    Boston Area Rape Crisis  Medical Advocacy (MedAd)             $30,000.00
     Center                   Program
    ------------------------------------------------------------------------
    Boston Children's        Fellowship Program                   $75,000.00
     Hospital Corporation
    ------------------------------------------------------------------------
    Boston College           Membership                           $10,000.00
    ------------------------------------------------------------------------
    Boston Educational       Boston Public Schools Science        $10,000.00
     Development              Fair
     Foundation, Inc.
    ------------------------------------------------------------------------
    Boston Health Care For   Life Essentials Fund                 $35,000.00
     The Homeless Program
     Inc.
    ------------------------------------------------------------------------
    Boston Partners in       Power Lunch, 2017-2018                $6,000.00
     Education, Inc.
    ------------------------------------------------------------------------
    Boston Plan for          Boston Teacher Residency:            $15,000.00
     Excellence in The        Building a Diverse Pipeline
     Public Schools           of STEM Educators for BPS
     Foundation
    ------------------------------------------------------------------------
    Boston Private Industry  2018 Corporate Contributions         $15,000.00
     Council                  Campaign
    ------------------------------------------------------------------------
    Boston University        Congress Sponsorship                  $1,500.00
     Continuing Medical
     Education
    ------------------------------------------------------------------------
    Bottom Line              Boston STEM Success Program          $15,000.00
    ------------------------------------------------------------------------
    Boys and Girls Clubs of  2018 Bids for Kids Auction &         $10,000.00
     MetroWest                fundraising event
    ------------------------------------------------------------------------
    Boys and Girls Clubs of  Operating Support                    $25,000.00
     MetroWest
    ------------------------------------------------------------------------
    Breakthrough Greater     Full STEAM Ahead Support             $15,000.00
     Boston
    ------------------------------------------------------------------------
    California Dermatology   Congress Sponsorship                 $15,000.00
     Physician Assistant
     Society
    ------------------------------------------------------------------------
    California Rheumatology  Congress Sponsorship                 $50,000.00
     Alliance
    ------------------------------------------------------------------------
    Cambridge Chamber of     Membership                            $7,250.00
     Commerce
    ------------------------------------------------------------------------
    Cambridge Chamber of     2018 Visionary Awards                 $3,250.00
     Commerce
    ------------------------------------------------------------------------
    Cambridge Chamber of     Community support program             $7,500.00
     Commerce
    ------------------------------------------------------------------------
    Cambridge School         Fundraiser for Cambridge             $10,000.00
     Volunteers, Inc.         Schools
    ------------------------------------------------------------------------
    Cambridge School         Fundraiser for Cambridge             $10,000.00
     Volunteers, Inc.         Schools
    ------------------------------------------------------------------------
    Cambridge School         Reading Buddies--Fletcher            $16,818.00
     Volunteers, Inc.         Maynard Academy Support
    ------------------------------------------------------------------------
    Cambridge School         Reading Buddies--Fletcher            $16,423.00
     Volunteers, Inc.         Maynard Academy Support
    ------------------------------------------------------------------------
    Cancer Research          CRI's Webinar Series: Cancer         $25,000.00
     Institute                Immunotherapy and You
    ------------------------------------------------------------------------
    Case Management Society  CMSA's 28th Annual Conference         $1,725.00
     of America               & Expo
    ------------------------------------------------------------------------
    Case Management Society  CMSA's 28th Annual Conference        $14,000.00
     of America               & Expo
    ------------------------------------------------------------------------
    Case Management Society  CMSA's 28th Annual Conference         $5,500.00
     of America               & Expo
    ------------------------------------------------------------------------
    Case Management Society  Corporate Sponsorship of              $1,250.00
     of New England           CMSNE
    ------------------------------------------------------------------------
    Case Management Society  Patient Education and                 $1,550.00
     of New England           Awareness Program
    ------------------------------------------------------------------------
    Case Management Society  Patient Education and                 $1,000.00
     of New England           Awareness Program
    ------------------------------------------------------------------------
    Center for               Congress Sponsorship                $133,900.00
     International Blood
     and Marrow Transplant
     Research
    ------------------------------------------------------------------------
    CEO Roundtable on        Membership                           $40,000.00
     Cancer
    ------------------------------------------------------------------------
    Charles River Community  Mom and Baby Program                 $15,000.00
     Health
    ------------------------------------------------------------------------
    CheckOrphan              Rare Disease Page Sponsorship        $11,000.00
    ------------------------------------------------------------------------
    Child Neurology Society  Congress Sponsorship                  $4,250.00
    ------------------------------------------------------------------------
    Children Health and      Fellowship Program                   $75,000.00
     Research Foundation,
     Inc.
    ------------------------------------------------------------------------
    Childrens Gaucher        Research: A novel iPSC-based         $75,000.00
     Research Fund            system to elucidate the
                              molecular mechanisms leading
                              to neuronopathic Gaucher
                              disease
    ------------------------------------------------------------------------
    Children's Hospital      Fellowship Program                   $75,000.00
     Corporation
    ------------------------------------------------------------------------
    Children's Hospital of   2019-2020 UCLA Intercampus           $75,000.00
     Orange County            Medical Biochemical Genetics
                              Training Program
    ------------------------------------------------------------------------
    Children's Hospital of   Fellowship Program                   $75,000.00
     Philadelphia
    ------------------------------------------------------------------------
    Citizen Schools          STEM Learning at Somerville's        $15,000.00
                              East Somerville Community
                              School
    ------------------------------------------------------------------------
    Citizen Schools          STEM Learning for High-Need          $15,000.00
                              Middle School Students in
                              Somerville
    ------------------------------------------------------------------------
    CitySprouts, Inc.        Middle School Program                 $8,000.00
    ------------------------------------------------------------------------
    CitySprouts, Inc.        Middle School Program                 $8,000.00
    ------------------------------------------------------------------------
    Cleveland Clinic         Congress Sponsorship                  $3,500.00
     Educational Foundation
    ------------------------------------------------------------------------
    Coalition of Hematology  Membership                            $6,000.00
     Oncology Practices
    ------------------------------------------------------------------------
    Collegium                32nd Symposium of the                $25,000.00
     Internationale           Collegium Internationale
     Allergologicum           Allergologicum
    ------------------------------------------------------------------------
    Community Boating, Inc.  Operating Support                    $15,000.00
    ------------------------------------------------------------------------
    Community Farms          Community Food Access                $15,000.00
     Outreach                 Programs
    ------------------------------------------------------------------------
    Community Servings,      Pie in the Sky                       $10,000.00
     Inc.
    ------------------------------------------------------------------------
    Community Servings,      General Operating Support            $30,000.00
     Inc.
    ------------------------------------------------------------------------
    Community Servings,      Volunteer Match                       $1,000.00
     Inc.
    ------------------------------------------------------------------------
    Community Servings,      Nutrition Program for                $30,000.00
     Inc.                     Individuals & Families
                              Affected by Multiple
                              Sclerosis and Other Acute
                              Life-Threatening Illnesses
    ------------------------------------------------------------------------
    Consortium of Multiple   Congress Sponsorship                  $8,000.00
     Sclerosis Centers
    ------------------------------------------------------------------------
    Consortium of Multiple   Congress Sponsorship                 $21,000.00
     Sclerosis Centers
    ------------------------------------------------------------------------
    Consortium of Multiple   Congress Sponsorship                 $22,200.00
     Sclerosis Centers
    ------------------------------------------------------------------------
    Consortium of Multiple   Congress Sponsorship                  $1,200.00
     Sclerosis Centers
    ------------------------------------------------------------------------
    Consortium of Multiple   Congress Sponsorship                  $6,000.00
     Sclerosis Centers
    ------------------------------------------------------------------------
    Consortium of Multiple   Congress Sponsorship                  $1,500.00
     Sclerosis Centers
    ------------------------------------------------------------------------
    Consortium of Multiple   North American Registry for         $200,000.00
     Sclerosis Centers        Care and Research in
                              Multiple Sclerosis (NARCRMS)
                              2018 Support
    ------------------------------------------------------------------------
    Cradles To Crayons Inc.  Ready for School Program             $20,000.00
    ------------------------------------------------------------------------
    Critical Path Institute  Transplant Therapeutics              $55,000.00
                              Consortium
    ------------------------------------------------------------------------
    DEAF, Inc.--             Deaf-Accessible Medical Case         $10,000.00
     Developmental            Management Program
     Evaluation and
     Adjustment Facilities,
     Inc.
    ------------------------------------------------------------------------
    Deep South Cancer        2018 Magic City Cycliad               $5,000.00
     Foundation
    ------------------------------------------------------------------------
    Dermatology Nurses       DNA 2018 Corporate Membership         $3,000.00
     Association
    ------------------------------------------------------------------------
    Dimock Community         4th Annual Road to Wellness           $1,000.00
     Foundation Inc.          5K Walk/Run
    ------------------------------------------------------------------------
    Dimock Community         31st Annual Fundraiser              $100,000.00
     Foundation Inc.
    ------------------------------------------------------------------------
    Duke University          Fellowship Program                   $75,000.00
    ------------------------------------------------------------------------
    East End House Inc.      Generating and Evaluating New        $20,000.00
                              Adventures in Science After
                              School (GENASAS)
    ------------------------------------------------------------------------
    East End House Inc.      Generating and Evaluating New        $20,000.00
                              Adventures in Science After
                              School (GENASAS)
    ------------------------------------------------------------------------
    Emory University         Fellowship Program                   $75,000.00
    ------------------------------------------------------------------------
    Emory University         JScreen Jewish Genetic              $100,000.00
                              Disease Education Initiative
    ------------------------------------------------------------------------
    Family Promise           Capital Campaign: A Place to         $25,000.00
     Metrowest Inc.           Call Home
    ------------------------------------------------------------------------
    Florida Society of       Membership                           $25,000.00
     Clinical Oncology
    ------------------------------------------------------------------------
    Florida Society of       Living with Prostate Cancer           $3,750.00
     Clinical Oncology
    ------------------------------------------------------------------------
    Florida Society of       Congress Sponsorship                 $35,600.00
     Rheumatology
    ------------------------------------------------------------------------
    Food For Free            Home Delivery--A Nutrition           $15,000.00
     Committee, Inc.          Program for Seniors and
                              People with Disabilities
    ------------------------------------------------------------------------
    Foundation of the        Multiple Sclerosis Workforce         $31,225.00
     Consortium of MS         of the Future: Medical
     Centers                  Student Research
                              Scholarships
    ------------------------------------------------------------------------
    Foundation of the        2018 FCMSC Neurology Resident        $10,000.00
     Consortium of MS         Annual Meeting Scientific
     Centers                  Scholarships
    ------------------------------------------------------------------------
    Foundation of the        NARCOMS NOW 2018                     $15,000.00
     Consortium of MS
     Centers
    ------------------------------------------------------------------------
    Foundation of the        Foundation of the Consortium         $10,000.00
     Consortium of MS         of Multiple Sclerosis
     Centers                  Centers 2018 Mission Support
    ------------------------------------------------------------------------
    Framingham Townwide Pto  Barbieri school holiday gift          $1,000.00
     Council                  drive
    ------------------------------------------------------------------------
    Franciscan Hospital For  Adaptive Sports Program              $15,000.00
     Children Inc.
    ------------------------------------------------------------------------
    Friends of Resiliency    Dropout Prevention Academic          $10,000.00
     for Life Inc.            Services
    ------------------------------------------------------------------------
    Generation Citizen Inc.  Generation Citizen                   $10,000.00
                              Massachusetts Civics Day
    ------------------------------------------------------------------------
    Generation Citizen Inc.  Volunteer Match                       $1,000.00
    ------------------------------------------------------------------------
    Georgia Dermatology of   Congress Sponsorship                 $35,000.00
     Physician Assistants
     (GDPA)
    ------------------------------------------------------------------------
    Georgia Society of       Membership                            $6,000.00
     Clinical Oncology
    ------------------------------------------------------------------------
    Georgia Society of       Congress Sponsorship                 $10,000.00
     Dermatology and
     Dermatologic Surgery
    ------------------------------------------------------------------------
    Georgia Society of       Congress Sponsorship                 $10,000.00
     Rheumatology
    ------------------------------------------------------------------------
    Georgia Society of       Congress Sponsorship                  $2,100.00
     Rheumatology
    ------------------------------------------------------------------------
    Girl Scouts of Eastern   Girls Building Self-eSTeEM           $15,000.00
     Massachusetts Inc.
    ------------------------------------------------------------------------
    Global Academy for       Congress Sponsorship                 $65,000.00
     Medical Education,
     Inc.
    ------------------------------------------------------------------------
    Global Academy for       Congress Sponsorship                 $40,037.50
     Medical Education,
     Inc.
    ------------------------------------------------------------------------
    Global Alliance for      Membership                           $50,000.00
     Patient Access
    ------------------------------------------------------------------------
    Global Genes             In-kind donation                     $11,128.38
    ------------------------------------------------------------------------
    Global Genes             Access Program                       $25,000.00
    ------------------------------------------------------------------------
    Global Genes             2018 Patient Advocacy Summit:         $2,500.00
                              Advocacy Support
    ------------------------------------------------------------------------
    Global Genes             2018 RARE Corporate Alliance         $25,000.00
    ------------------------------------------------------------------------
    Global Genes             2018 Patient Advocacy Summit         $50,000.00
    ------------------------------------------------------------------------
    Global Genes             RARE Global Advocacy                 $10,000.00
                              Leadership Symposium
    ------------------------------------------------------------------------
    Global Genes             2018 RARE Education Programs         $25,000.00
    ------------------------------------------------------------------------
    Global Genes             2018 Rare Disease Hub                 $5,000.00
    ------------------------------------------------------------------------
    Global Genes             2019 Corporate Alliance              $25,000.00
    ------------------------------------------------------------------------
    Gordon Research          Lysosomal storage diseases           $10,000.00
     Conferences              Program
    ------------------------------------------------------------------------
    Greater Boston Chamber   Membership                            $4,000.00
     of Commerce
    ------------------------------------------------------------------------
    Greenwood Genetic        Fellowship Program                   $74,764.00
     Center Inc.
    ------------------------------------------------------------------------
    Greenwood Genetic        Fellowship Program                   $74,991.00
     Center Inc.
    ------------------------------------------------------------------------
    Habitat For Humanity     Fundraiser Event                     $10,000.00
     Metrowest--Greater
     Worcester Inc.
    ------------------------------------------------------------------------
    Habitat For Humanity     Affordable Home Build Program        $20,000.00
     Metrowest--Greater
     Worcester Inc.
    ------------------------------------------------------------------------
    Habitat For Humanity of  Corporate Build Day                   $1,500.00
     North Central
     Massachusetts
    ------------------------------------------------------------------------
    Harvard Medical School   Congress Sponsorship                  $2,500.00
     Global and Continuing
     Education
    ------------------------------------------------------------------------
    Health Care For All      Framingham Area Health Care          $15,000.00
     Inc.                     Access Education and
                              Outreach Campaign
    ------------------------------------------------------------------------
    Health Resources in      The Leaders through                  $25,000.00
     Action Inc.              Education, Action and Hope
                              (LEAH) Project
    ------------------------------------------------------------------------
    Health Resources in      The Leaders through                     $866.75
     Action Inc.              Education, Action and Hope
                              (LEAH) Project
    ------------------------------------------------------------------------
    Hearts & Noses Hospital  Ongoing Bedside Hospital             $15,000.00
     Clown Troupe Inc.        Clown Visits to Ill and
                              Disabled Children in Greater
                              Boston
    ------------------------------------------------------------------------
    Hemostasis and           Membership                           $10,000.00
     Thrombosis Research
     Society
    ------------------------------------------------------------------------
    Hope and Comfort Inc.    Hope and Comfort: Personal           $10,000.00
                              Hygiene Products to Low-
                              Income Individuals and
                              Families
    ------------------------------------------------------------------------
    Horizons for Homeless    STEAM Education for Young            $10,000.00
     Children                 Homeless Children
    ------------------------------------------------------------------------
    Illinois Society of      Congress Sponsorship                 $25,000.00
     Dermatology Physicians
     Assistants
    ------------------------------------------------------------------------
    Imedex, LLC              Congress Sponsorship                 $99,900.00
    ------------------------------------------------------------------------
    Institute for Cancer     2018 In Vino Vita Fundraising        $10,000.00
     Research dba The         Event
     Research Institute of
     Fox Chase Cancer
     Center
    ------------------------------------------------------------------------
    International Eczema     Congress Sponsorship                $200,000.00
     Council
    ------------------------------------------------------------------------
    International Institute  2018 Golden Door Award               $10,000.00
     of New England           Fundraiser
    ------------------------------------------------------------------------
    International Institute  Healthcare Navigation for            $15,000.00
     of New England           Refugees in Boston
    ------------------------------------------------------------------------
    International Myeloma    Congress Sponsorship                $450,000.00
     Workshop, c/o SPARGO,
     Inc.
    ------------------------------------------------------------------------
    International            2018 MS Perspectives Program         $40,000.00
     Organization of
     Multiple Sclerosis
     Nurses
    ------------------------------------------------------------------------
    International            2018 IOMSN Mission Support           $10,000.00
     Organization of
     Multiple Sclerosis
     Nurses
    ------------------------------------------------------------------------
    International Society    Congress Sponsorship                 $11,799.99
     on Thrombosis and
     Haemostasis
    ------------------------------------------------------------------------
    Italian Home For         Volunteer Match                       $1,000.00
     Children Inc.
    ------------------------------------------------------------------------
    Italian Home For         Comprehensive Care for               $12,500.00
     Children Inc.            Children
    ------------------------------------------------------------------------
    Jewish Family Service    Patient Navigator/Enhanced           $20,000.00
     of Metrowest Inc.        Medical Escort Program
    ------------------------------------------------------------------------
    Jewish Genetic Disease   JGDC Website and Social Media         $5,000.00
     Consortium (JGDC)        Rebuild Phase Two and
                              Brochure Update
    ------------------------------------------------------------------------
    Jewish Genetic Diseases  Our Heritage and our Health--           $975.00
     Center of Greater        Ashkenazi Jewish Genetic
     Phoenix                  Disease and the Founder
                              Effect
    ------------------------------------------------------------------------
    Just-A-Start             Just-A-Start Biomedical              $25,000.00
     Corporation              Careers Program
    ------------------------------------------------------------------------
    Just-A-Start             Biomedical Careers Program (&        $25,000.00
     Corporation              Mass Bio Membership)
    ------------------------------------------------------------------------
    Kansas University        Fellowship Program                   $75,000.00
     Endowment Association
    ------------------------------------------------------------------------
    Knect365 US, Inc.        Selections from DISORDER the         $15,000.00
                              Rare Disease Film Festival
                              at Biotech Week Boston
    ------------------------------------------------------------------------
    Kometa Serbian           Volunteer Match                       $1,000.00
     Childrens Program Inc.
    ------------------------------------------------------------------------
    Life Science Cares Inc.  2018 Impact Breakfast                $10,000.00
    ------------------------------------------------------------------------
    Little Brothers/Friends  Medical Escort Program                $5,000.00
     of the Elderly
    ------------------------------------------------------------------------
    Louisiana Association    Congress Sponsorship                  $5,285.00
     of Health Plans
    ------------------------------------------------------------------------
    Lycee International De   Fundraiser Event                     $10,000.00
     Boston International
     School of Boston Inc.
    ------------------------------------------------------------------------
    Lysosomal and Rare       Fellowship Program                   $75,000.00
     Disorders Research and
     Treatment Center Inc.
    ------------------------------------------------------------------------
    Lysosomal and Rare       Fellowship Program                   $75,000.00
     Disorders Research and
     Treatment Center Inc.
    ------------------------------------------------------------------------
    Magellan Rx Management   Congress Sponsorship                  $7,500.00
     Inc.
    ------------------------------------------------------------------------
    Margaret Fuller          Margaret Fuller Neighborhood         $15,000.00
     Neighborhood House       House Youth Programs
    ------------------------------------------------------------------------
    Mass Insight Education   Mass Insight's Advanced              $15,000.00
     and Research Institute   Placement (AP) STEM &
     Inc                      English Program
    ------------------------------------------------------------------------
    Massachusetts Bay        STEM Mentor Program (SMP)            $43,000.00
     Community College
     Foundation
    ------------------------------------------------------------------------
    Massachusetts            Congress Sponsorship                $100,000.00
     Biotechnology Council
    ------------------------------------------------------------------------
    Massachusetts            Membership                           $30,800.00
     Biotechnology Council
    ------------------------------------------------------------------------
    Massachusetts            Patient Advocacy Summit              $10,000.00
     Biotechnology Council
    ------------------------------------------------------------------------
    Massachusetts            Conference Sponsorship                $5,000.00
     Biotechnology
     Education Foundation
     Inc.
    ------------------------------------------------------------------------
    Massachusetts            2018 Champions for                    $5,000.00
     Biotechnology            Biotechnology Education
     Education Foundation     Program
     Inc.
    ------------------------------------------------------------------------
    Massachusetts            Life Sciences Workforce 2018          $5,000.00
     Biotechnology
     Education Foundation
     Inc.
    ------------------------------------------------------------------------
    Massachusetts            MassBioEd Mission                    $50,000.00
     Biotechnology
     Education Foundation
     Inc.
    ------------------------------------------------------------------------
    Massachusetts Black      2018 Ida B. Wells Annual              $5,000.00
     Women Attorneys          Awards Event
     Foundation Inc.
    ------------------------------------------------------------------------
    Massachusetts College    Next Generation of Women             $10,000.00
     of Pharmacy and Health   Leaders in STEM
     Sciences
    ------------------------------------------------------------------------
    Massachusetts Life       Massachusetts Next Generation        $50,000.00
     Sciences Center          Initiative (MassNextGen)
    ------------------------------------------------------------------------
    Massachusetts State      2018 Fair Operations & Sanofi        $50,000.00
     Science and              Genzyme Science Award
     Engineering Fair, Inc.
    ------------------------------------------------------------------------
    Medical Oncology         Membership                           $10,000.00
     Association of
     Southern California,
     Inc.
    ------------------------------------------------------------------------
    MedStar Health           Congress Sponsorship                  $2,500.00
    ------------------------------------------------------------------------
    Metrowest Free Medical   Access to Women's Health Care        $15,000.00
     Program Inc.             Program
    ------------------------------------------------------------------------
    Michigan Society of      Membership                           $12,000.00
     Hematology & Oncology
    ------------------------------------------------------------------------
    Museum of Fine Arts      Membership                           $20,000.00
    ------------------------------------------------------------------------
    Museum of Science        Sanofi Genzyme Teacher               $71,520.00
                              Sabbatical at the Museum of
                              Science Cohort Year 2018/19
    ------------------------------------------------------------------------
    National Comprehensive   2019 NCCN Global Corporate           $15,000.00
     Cancer Network           Council Membership
    ------------------------------------------------------------------------
    National Comprehensive   NCCN 13th Annual Congress:           $10,000.00
     Cancer Network           Hematologic MalignanciesTM:
                              Patient Advocacy Pavilion
    ------------------------------------------------------------------------
    National Organization    Congress Sponsorship                  $3,000.00
     of Rheumatology
     Managers
    ------------------------------------------------------------------------
    National Organization    Corporate Membership                 $30,000.00
     of Rheumatology
     Managers
    ------------------------------------------------------------------------
    National Society of      Congress Sponsorship                  $2,500.00
     Genetic Counselors
    ------------------------------------------------------------------------
    National Society of      Congress Sponsorship                  $2,500.00
     Genetic Counselors
    ------------------------------------------------------------------------
    National Society of      Congress Sponsorship                    $375.00
     Genetic Counselors
    ------------------------------------------------------------------------
    NEHI                     NEHI's 2018 Innovators in            $10,000.00
                              Health Awards
    ------------------------------------------------------------------------
    New York University--    Fellowship Program                   $75,000.00
     Langone School of
     Medicine
    ------------------------------------------------------------------------
    NJ Sharing Network       Congress Sponsorship                  $5,000.00
    ------------------------------------------------------------------------
    NJ Society of Oncology   Membership                            $5,000.00
     Managers
    ------------------------------------------------------------------------
    Nora's Home              Congress Sponsorship                  $5,000.00
    ------------------------------------------------------------------------
    North Carolina Oncology  Membership                            $5,000.00
     Management Society
    ------------------------------------------------------------------------
    Northeastern University  Community Student Scholarship         $4,000.00
                              Program
    ------------------------------------------------------------------------
    Northern California      Congress Sponsorship                 $10,000.00
     Rheumatology Society
    ------------------------------------------------------------------------
    Norton Healthcare        2018 Neuroscience Expo                $5,000.00
     Foundation, Inc.
    ------------------------------------------------------------------------
    Norton Healthcare        2018 Celebrating MS                   $5,000.00
     Foundation, Inc.         Innovations
    ------------------------------------------------------------------------
    NSGC                     Congress Sponsorship                  $6,600.00
    ------------------------------------------------------------------------
    Ohio Hematology          Membership                            $5,000.00
     Oncology Society
    ------------------------------------------------------------------------
    Operation Warm Inc.      2018 Boston Coat Program             $20,000.00
    ------------------------------------------------------------------------
    Organ Donation &         2018 Corporate Sponsorship            $5,000.00
     Transplantation
     Alliance
    ------------------------------------------------------------------------
    Pan American League of   Congress Sponsorship                $131,750.00
     Associations for
     Rheumatology
    ------------------------------------------------------------------------
    PCMA Pharmaceutical      Congress Sponsorship                 $56,000.00
     Care Management
     Association
    ------------------------------------------------------------------------
    PCMA Pharmaceutical      Congress Sponsorship                 $50,000.00
     Care Management
     Association
    ------------------------------------------------------------------------
    PCMA Pharmaceutical      Congress Sponsorship                 $36,000.00
     Care Management
     Association
    ------------------------------------------------------------------------
    PCMA Pharmaceutical      Congress Sponsorship                 $50,000.00
     Care Management
     Association
    ------------------------------------------------------------------------
    Peer Health Exchange     Peer Health Exchange:                 $5,000.00
     Inc.                     Empowering Boston's Young
                              People to Make Healthy
                              Decisions
    ------------------------------------------------------------------------
    Pennsylvania             Congress Sponsorship                 $10,000.00
     Rheumatology Society
    ------------------------------------------------------------------------
    Perkins School for the   Technology for Success in            $20,000.00
     Blind                    STEM Learning
    ------------------------------------------------------------------------
    Philadelphia Rheumatism  Membership                            $1,000.00
     Society
    ------------------------------------------------------------------------
    Phillips Brooks House    Bridges Food Science and              $3,000.00
     Association              Physical Fitness Workshop
     Incorporated
    ------------------------------------------------------------------------
    Phoenix Rheumatology     Congress Sponsorship                 $10,000.00
     Association
    ------------------------------------------------------------------------
    Phoenix Rheumatology     Congress Sponsorship                 $30,000.00
     Association
    ------------------------------------------------------------------------
    Phoenix Rheumatology     Membership                           $10,000.00
     Association
    ------------------------------------------------------------------------
    Premier Oncology         Membership                            $5,000.00
     Hematology Management
     Society
    ------------------------------------------------------------------------
    Premier Oncology         Membership                            $5,000.00
     Hematology Management
     Society
    ------------------------------------------------------------------------
    Premier Specialty        Congress Sponsorship                 $15,000.00
     Network
    ------------------------------------------------------------------------
    President and Fellows    The Family Van: Culturally-          $50,000.00
     of Harvard College       Competent Care for All
    ------------------------------------------------------------------------
    President and Fellows    The Family Van: Increasing           $50,000.00
     of Harvard College       Healthcare Access to
                              Everyone
    ------------------------------------------------------------------------
    Pri-Med Institute        Congress Sponsorship                 $66,750.00
    ------------------------------------------------------------------------
    Pro Player Foundation    Patient Education and                 $5,000.00
                              Awareness Program
    ------------------------------------------------------------------------
    Pro Player Foundation    Patient Education and                 $5,000.00
                              Awareness Program
    ------------------------------------------------------------------------
    Project Just Because,    211 Domestic Abuse/Emergency         $10,000.00
     Inc.                     Program & Keep A Family Warm
                              Program
    ------------------------------------------------------------------------
    Prostate Cancer Academy  Congress Sponsorship                  $7,500.00
    ------------------------------------------------------------------------
    Read to a Child, Inc.    Read to a Child's Lunchtime           $5,000.00
                              Reading Program
    ------------------------------------------------------------------------
    Regents of the           Fellowship Program                   $75,000.00
     University of
     California
    ------------------------------------------------------------------------
    Regents of the           Lysosomal Storage Diseases           $57,059.40
     University of            Patient and Family
     California               Educational Grant
    ------------------------------------------------------------------------
    Regents of the           Fellowship Program                   $75,000.00
     University of Michigan
    ------------------------------------------------------------------------
    Regents of the           Fellowship Program                   $75,000.00
     University of
     Minnesota
    ------------------------------------------------------------------------
    Rheumatology             Congress Sponsorship                  $7,500.00
     Association of Iowa
    ------------------------------------------------------------------------
    Rheumatology             Congress Sponsorship                 $20,000.00
     Association of Iowa
    ------------------------------------------------------------------------
    Rheumatology             Congress Sponsorship                 $10,000.00
     Association of
     Minnesota and the
     Dakotas
    ------------------------------------------------------------------------
    Rheumatology             Congress Sponsorship                 $10,000.00
     Association of Nevada
    ------------------------------------------------------------------------
    Rheumatology Nurses      Congress Sponsorship                  $2,000.00
     Society
    ------------------------------------------------------------------------
    Rheumatology Nurses      Congress Sponsorship                 $45,000.00
     Society
    ------------------------------------------------------------------------
    Rheumatology Nurses      Congress Sponsorship                  $3,655.00
     Society
    ------------------------------------------------------------------------
    Rheumatology Nurses      Congress Sponsorship                 $33,575.00
     Society
    ------------------------------------------------------------------------
    Rheumatology Nurses      Congress Sponsorship                  $1,700.00
     Society
    ------------------------------------------------------------------------
    Rheumatology Nurses      National Advocacy Sponsorship        $50,000.00
     Society
    ------------------------------------------------------------------------
    Rheumatology Nurses      Speed Advocacy Session of the         $7,500.00
     Society                  RNS Advocacy Experience Day
    ------------------------------------------------------------------------
    Rheumatology Nurses      Corporate Sponsorship                $50,000.00
     Society
    ------------------------------------------------------------------------
    Rhode Island Diabetes &  Congress Sponsorship                    $750.00
     Endocrine Society
    ------------------------------------------------------------------------
    Run for Dad American     Run for Dad                           $3,000.00
     Cancer Society
    ------------------------------------------------------------------------
    S S Cosmas & Damian      92nd Annual Feast of S.S.             $2,500.00
     Society Inc.             Cosmas and Damian
    ------------------------------------------------------------------------
    Samaritans, Inc.         Youth Suicide Prevention             $25,000.00
                              Services
    ------------------------------------------------------------------------
    Scholarship America,     Chart Your Own Course                $32,250.00
     Inc.                     Scholarship Program
    ------------------------------------------------------------------------
    Scholarship America,     Sanofi Genzyme TORCH Awards          $11,600.00
     Inc.                     program
    ------------------------------------------------------------------------
    Science Club For Girls   Science Clubs and Junior             $10,000.00
     Inc.                     Mentors Program
    ------------------------------------------------------------------------
    Science From Scientists  In-School Module-Based (ISMB)        $30,000.00
     Inc.                     STEM Enrichment Program for
                              Boston Public Schools 2017-
                              18
    ------------------------------------------------------------------------
    Science From Scientists  In-School Module-Based (ISMB)        $30,000.00
     Inc.                     STEM Enrichment Program for
                              Boston Public Schools 2018-
                              19
    ------------------------------------------------------------------------
    Society for              Congress Sponsorship                 $20,000.00
     Investigative
     Dermatology
    ------------------------------------------------------------------------
    Southern Oncology        Membership                            $5,000.00
     Association of
     Practices
    ------------------------------------------------------------------------
    Southern Regional        Congress Sponsorship                  $2,000.00
     Genetics Group (SERGG)
    ------------------------------------------------------------------------
    Special Olympics         2018 Bio-Ball                         $2,500.00
     Massachusetts Inc.
    ------------------------------------------------------------------------
    Special Olympics         Special Olympics                      $7,500.00
     Massachusetts Inc.       Massachusetts Shrewsbury
                              Basketball Team to Compete
                              at Special Olympics World
                              Games in Abu Dhabi
    ------------------------------------------------------------------------
    Sportsmen's Tennis &     School to Sportsmen's Program        $15,000.00
     Enrichment Center
    ------------------------------------------------------------------------
    St. Francis House        Triage Program                       $10,000.00
    ------------------------------------------------------------------------
    St. Mary's Center for    Women@Work Plus                      $15,000.00
     Women and Children
    ------------------------------------------------------------------------
    State of Texas           Congress Sponsorship                 $40,000.00
     Association of
     Rheumatologists
    ------------------------------------------------------------------------
    State of Texas           Congress Sponsorship                 $40,000.00
     Association of
     Rheumatologists
    ------------------------------------------------------------------------
    The Administrators of    NOLA Bluedoo Run/Walk/                $7,500.00
     the Tulane Education     Celebration for Prostate
     Fund on behalf of        Cancer Research
     Tulane University
     Health Sciences
     Center, CCE
    ------------------------------------------------------------------------
    The American Society of  Congress Sponsorship                 $10,000.00
     Hematology
    ------------------------------------------------------------------------
    The American Society of  Congress Sponsorship                  $3,150.00
     Hematology
    ------------------------------------------------------------------------
    The Boston Home, Inc.    B.Fit! Socialization and             $18,000.00
                              Wellness Day Program
    ------------------------------------------------------------------------
    The Community Art        Community Art Center Youth           $15,000.00
     Center                   Programming
    ------------------------------------------------------------------------
    The Community Art        Community Art Center School          $15,000.00
     Center                   Age Child Care and Teen
                              Programs
    ------------------------------------------------------------------------
    The Discovery Museums    Sanofi Genzyme Discovery             $15,000.00
                              Science 2018
    ------------------------------------------------------------------------
    The Discovery Museums    Fundraiser Event                      $5,000.00
    ------------------------------------------------------------------------
    The Discovery Museums    Discovery Science: Framingham        $15,000.00
                              and Waltham
    ------------------------------------------------------------------------
    The Endocrine Society    Congress Sponsorship                  $3,995.00
    ------------------------------------------------------------------------
    The Forsyth Institute    Mobile Dental Program Service        $10,000.00
                              to the Youth on Fire Shelter
                              in Cambridge
    ------------------------------------------------------------------------
    The Greater Boston Food  General Operating Support            $30,000.00
     Bank Inc.
    ------------------------------------------------------------------------
    The Greater Boston Food  Volunteer Match                       $1,000.00
     Bank Inc.
    ------------------------------------------------------------------------
    The Greater Boston Food  Volunteer Match                       $1,000.00
     Bank Inc.
    ------------------------------------------------------------------------
    The Greater Boston Food  Emergency Food Distribution          $30,000.00
     Bank Inc.                Across Eastern Massachusetts
    ------------------------------------------------------------------------
    The Jewish P.O.C.E.T.    Congress Sponsorship                  $2,500.00
    ------------------------------------------------------------------------
    The Massachusetts        Everyday Amazing Race                 $5,000.00
     General Hospital
    ------------------------------------------------------------------------
    The McCourt Foundation   Educational Update                   $20,000.00
    ------------------------------------------------------------------------
    The McCourt Foundation   Tour de South Shore Athletic          $5,000.00
                              Festival
    ------------------------------------------------------------------------
    The McCourt Foundation   MS Educational Update for            $20,000.00
                              Patients, Caregivers and
                              Family Members
    ------------------------------------------------------------------------
    The Oak Clinic           2018 Oak Clinic Acorn Run             $4,500.00
    ------------------------------------------------------------------------
    The Oak Clinic           Oak Clinic's Marvelous               $15,000.00
                              Monday's Wellness Programs
    ------------------------------------------------------------------------
    The Oak Clinic           2018 Oak Clinic Diamond Run           $5,000.00
    ------------------------------------------------------------------------
    The Posse Foundation     Posse Boston                         $25,000.00
     Inc.
    ------------------------------------------------------------------------
    The Possible Project     The Possible Project 2018            $10,000.00
                              Event Series
    ------------------------------------------------------------------------
    The Regents of the       Fellowship Program                   $75,000.00
     University of
     California, Irvine
    ------------------------------------------------------------------------
    The Regents of the       Fellowship Program                   $75,000.00
     University of
     California, Los
     Angeles
    ------------------------------------------------------------------------
    The Salvation Army       Volunteer Match                       $2,000.00
    ------------------------------------------------------------------------
    The Salvation Army       Volunteer Match                       $6,000.00
    ------------------------------------------------------------------------
    The UCLA Foundation      The UCLA Fabry Disease                $2,500.00
                              Program
    ------------------------------------------------------------------------
    Thompson Island Outward  Connections Program                  $15,000.00
     Bound Education Center
     Inc.
    ------------------------------------------------------------------------
    Thompson Island Outward  2018 Thompson Island 4k Trail         $5,000.00
     Bound Education Center   Run
     Inc.
    ------------------------------------------------------------------------
    Trustees of Boston       Community Student Scholarship         $4,000.00
     University               Program
    ------------------------------------------------------------------------
    Trustees of Boston       Community Student Scholarship           $825.00
     University               Program
    ------------------------------------------------------------------------
    Trustees of the          The 19th International               $50,000.00
     University of            Vasculitis & ANCA Workshop
     Pennsylvania
    ------------------------------------------------------------------------
    Tutoring Plus of         STEAM Programming                     $5,000.00
     Cambridge, Inc.
    ------------------------------------------------------------------------
    Tutoring Plus of         Elementary and Middle School         $12,500.00
     Cambridge, Inc.          Programs
    ------------------------------------------------------------------------
    UAB Division of          Fellowship Program                   $75,000.00
     Nephrology Attn:
     Jennifer Clendenin
    ------------------------------------------------------------------------
    UConn Health             Congress Sponsorship                    $500.00
    ------------------------------------------------------------------------
    United Arizona           Congress Sponsorship                 $25,000.00
     Rheumatology Alliance
    ------------------------------------------------------------------------
    United Network For       Congress Sponsorship                  $9,100.00
     Organ Sharing
    ------------------------------------------------------------------------
    United Network For       Congress Sponsorship                  $6,000.00
     Organ Sharing
    ------------------------------------------------------------------------
    United Network For       Congress Sponsorship                  $8,000.00
     Organ Sharing
    ------------------------------------------------------------------------
    United Rheumatology LLC  Congress Sponsorship                $135,000.00
    ------------------------------------------------------------------------
    United Way of Tri-       Volunteer Match                       $1,000.00
     County
    ------------------------------------------------------------------------
    University of Alabama    Fellowship Program                   $75,000.00
     at Birmingham
    ------------------------------------------------------------------------
    University of Chicago    Congress Sponsorship                 $15,000.00
     Hospitals
    ------------------------------------------------------------------------
    University of Colorado   Congress Sponsorship                 $20,000.00
     Anschutz Medical
     Campus
    ------------------------------------------------------------------------
    University of Florida    Fellowship Program                   $75,000.00
     Foundation Inc.
    ------------------------------------------------------------------------
    University of Florida    Fellowship Program                   $74,900.00
     Foundation Inc.
    ------------------------------------------------------------------------
    University of Illinois   Congress Sponsorship                 $10,000.00
     at Chicago
    ------------------------------------------------------------------------
    University of            Congress Sponsorship                 $10,000.00
     Louisville
    ------------------------------------------------------------------------
    University of            Student Success Program,            $200,000.00
     Massachusetts            UMass Boston, College of
     Foundation Inc.          Science and Mathematics
    ------------------------------------------------------------------------
    University of            TORCH award donations                 $5,000.00
     Mississippi Foundation
    ------------------------------------------------------------------------
    Uplifting Athletes Inc.  Leadership Development               $38,000.00
                              Conference/Organizational
                              Support
    ------------------------------------------------------------------------
    Uplifting Athletes Inc.  2019 Uplifting Athletes Young        $20,000.00
                              Investigator Draft
    ------------------------------------------------------------------------
    Uplifting Athletes Inc.  Young Investigator Draft              $5,000.00
    ------------------------------------------------------------------------
    Vanderbilt University    Fellowship Program                   $75,000.00
     School of Medicine
    ------------------------------------------------------------------------
    VNA Care Hospice Inc.    Elizabeth Evarts de Rham              $5,000.00
                              Hospice Home at Chilton
                              Street
    ------------------------------------------------------------------------
    Wade Institute for       Summer Professional                  $20,000.00
     Science Education        Development STEM Institutes
                              for teachers
    ------------------------------------------------------------------------
    Wade Institute for       Summer Professional                  $20,000.00
     Science Education        Development Institutes for
                              Science Teachers 2019
    ------------------------------------------------------------------------
    Washington State         Membership                            $5,000.00
     Medical Oncology
     Society
    ------------------------------------------------------------------------
    Wentworth Institute of   Community Student Scholarship         $4,000.00
     Technology               Program
    ------------------------------------------------------------------------
    West End House Boys and  Volunteer Match                       $1,000.00
     Girls Club
    ------------------------------------------------------------------------
    West End House Boys and  Volunteer Match                       $1,000.00
     Girls Club
    ------------------------------------------------------------------------
    West End House Boys and  West End House Expect More           $24,609.00
     Girls Club               Campaign: MakerZone
    ------------------------------------------------------------------------
    West End House Boys and  West End House Annual                $25,000.00
     Girls Club               Celebration
    ------------------------------------------------------------------------
    West End House Boys and  West End House Annual                $50,000.00
     Girls Club               Celebration
    ------------------------------------------------------------------------
    Western States Regional  Congress Sponsorship                 $18,000.00
     Hemophilia Network
    ------------------------------------------------------------------------
    Wheelchairs 4 Kids       Let's Roll Program                   $10,000.00
    ------------------------------------------------------------------------
    Whitehead Institute for  Expedition: Bio 2019                 $10,000.00
     Biomedical Research
    ------------------------------------------------------------------------
    Wisconsin Rheumatology   Congress Sponsorship                 $10,000.00
     Association
    ------------------------------------------------------------------------
    Women's Dermatologic     Congress Sponsorship                  $2,500.00
     Society
    ------------------------------------------------------------------------
    Women's Lunch Place      Healthy Meals Program                $45,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                  $1,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                  $1,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                  $1,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $67,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                $110,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                  $5,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $50,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $60,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $35,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $35,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $50,000.00
    ------------------------------------------------------------------------
    WORLD Symposium          Congress Sponsorship                 $50,000.00
    ------------------------------------------------------------------------
    WORLDSymposia            Congress Sponsorship                  $5,250.00
    ------------------------------------------------------------------------
    WORLDSymposia            Congress Sponsorship                 $45,000.00
    ------------------------------------------------------------------------
    WriteBoston              Aligning and Elevating               $18,000.00
                              Literacy Instruction across
                              the Chelsea Public Schools
    ------------------------------------------------------------------------
    YMCA of Greater Boston   Scholarships for Low-Income          $15,000.00
                              Allston-Brighton Children
    ------------------------------------------------------------------------
    ziMS Foundation          2018 ZIMS Strike Down MS Bowl-        $5,000.00
                              A-Thon
    ------------------------------------------------------------------------

      Proposal Type      Project Name        Legal Name          Amount

    Corporate         Transplantation    Critical Path            $55,000.00
     Membership        Therapeutics       Institute
                       Membership

    Corporate         Corporate          Endocrine Society        $11,000.00
     Membership        Membership

    Corporate         Corporate          Colorado Business         $5,000.00
     Membership        Membership         Group on Health

    Corporate         Corporate          Rheumatology            $200,000.00
     Membership        Membership         Research
                                          Foundation

    Corporate         Corporate          National                 $25,000.00
     Membership        Membership         Governors
                                          Association

    Corporate         Corporate          National                  $5,000.00
     Membership        Membership         Conference of
                                          Insurance
                                          Legislato

    Corporate         CEVR Membership    Tufts Medical            $35,000.00
     Membership                           Center

    Corporate         Corporate          American                 $20,000.00
     Membership        Membership         Association for
                                          Cancer Research

    Corporate         Corporate          American                 $20,000.00
     Membership        Membership         Association for
                                          Cancer Research

    Corporate         Corporate          American                 $25,000.00
     Membership        Membership         Association of
                                          Diabetes
                                          Educator

    Corporate         Corporate          AMGA Foundation          $15,000.00
     Membership        Membership         Inc.

    Corporate         2018 NEHI          NEHI                     $75,000.00
     Membership        Membership

    Corporate         2018 Corporate     National Kidney          $10,000.00
     Membership        Membership         Foundation, Inc.

    Corporate         Corporate          The Partnership          $19,000.00
     Membership        Membership Dues    for Quality
                       2018               Medical Donati

    Corporate         STOP Obesity       George Washington        $25,000.00
     Membership        Alliance           University's
                                          STOP Obes

    Corporate         Premium            Texas Business           $15,000.00
     Membership        Membership         Group on Health

    Corporate         Health             University of            $50,000.00
     Membership        Organization       Louisville
                       Corporate          School of Public
                       Membership         Health

    Corporate         Corporate          American                 $20,000.00
     Membership        Membership         Association of
                                          Nurse
                                          Practitioner

    Corporate         Corporate          Georgia Chamber             $750.00
     Membership        Membership         of Commerce

    Corporate         Corporate          American                 $20,000.00
     Membership        Membership         Association of
                                          Clinical
                                          Endocrinol

    Corporate         Corporate          National Business        $16,500.00
     Membership        Membership         Group on Health

    Corporate         PBSM Corporate     National Business        $15,000.00
     Membership        Membership         Group on Health

    Corporate         Membership Dues    Florida Chamber           $2,000.00
     Membership                           of Commerce,
                                          Inc.

    Corporate         2018 Membership    Buyers Health            $10,000.00
     Membership                           Care Action
                                          Group

    Corporate         Chamber of         Montana Chamber             $280.00
     Membership        Commerce Dues      of Commerce

    Corporate         Corporate          Business for             $33,000.00
     Membership        Membership         Social
                                          Responsibility

    Corporate         2018 ACCP Annual   Association of            $6,250.00
     Membership        Membership         Corporate
                                          Contributions
                                          Pro

    Corporate         Corporate          Society of                $2,500.00
     Membership        Membership         Toxicologic
                                          Pathology

    Corporate         Corporate          Healthcare               $45,000.00
     Membership        Membership         Distribution
                                          Alliance HDA

    Corporate         Tufts CSDD         Tufts Center for         $15,000.00
     Membership                           the Study of
                                          Drug Developm

    Corporate         Affiliate          Massachusetts             $2,500.00
     Membership        Membership Dues    Association of
                                          Health Plans

    Corporate         Corporate          National Health          $32,000.00
     Membership        Membership         Council

    Corporate         Corporate          Illinois                  $2,500.00
     Membership        Membership         Manufacturers'
                                          Association

    Corporate         NASPA 2018         NASPA                     $5,000.00
     Membership        Associate Member
                       Dues

    Corporate         Corporate          National LGBT             $7,500.00
     Membership        Membership 2018    Chamber of
                                          Commerce

    Corporate         Corporate          National LGBT             $7,500.00
     Membership        Membership 2018    Chamber of
                                          Commerce

    Corporate         Corporate          International            $20,000.00
     Membership        Membership         Society for
                                          Medical
                                          Publicatio

    Corporate         ACPA Corporate     American Chronic         $10,000.00
     Membership        Membership         Pain Association

    Corporate         Corporate          Pharmaceutical          $397,832.00
     Membership        Membership         Research and
                                          Manufacture

    Corporate         Corporate          Pharmaceutical                    -
     Membership        Memberhsip         Research and
                                          Manufacture

    Corporate         Women's Heart      Tides Center             $75,000.00
     Membership        Alliance
                       Mebership

    Corporate         Corporate          College Diabetes         $25,000.00
     Membership        Membership         Network Inc.

    Corporate         Corp.              AIM--Associated          $10,000.00
     Membership                           Industries of
                                          Massachuset

    Corporate         NLGA Corporate     National Lt.             $10,000.00
     Membership        Membership         Governors
                                          Association

    Corporate         Corporate          Ohio Chamber of           $1,700.00
     Membership        Membership         Commerce

    Corporate         Corporate          Somerset Health           $2,500.00
     Membership        Membership         Care Foundation

    Corporate         Corporate          Academy of               $10,000.00
     Membership        Membership         Managed Care
                                          Pharmacy

    Corporate         Corporate          HealthCare                $5,000.00
     Membership        Membership         Institute of NJ

    Corporate         DA4S Corporate     Diversity                   $700.00
     Membership        Membership         Alliance for
                                          Science, Inc.

    Corporate         Corporate          Healthcare               $23,500.00
     Membership        Membership         Businesswomen's
                                          Association

    Corporate         National Quality   National Quality         $39,400.00
     Membership        Forum Membership   Forum

    Corporate         WPEO Corporate     Women President           $5,000.00
     Membership        Membership         Educational
                                          Organization

    Corporate         Corporate          Minnesota Society         $6,000.00
     Membership        Membership         of Health-System
                                          Pharm

    Corporate         Corporate          The Medical Alley         $2,000.00
     Membership        Membership         Association

    Corporate         2018 Membership    New York & New            $6,500.00
     Membership                           Jersey Minority
                                          Supplier D

    Corporate         Corporate          Pittsburgh                $3,450.00
     Membership        Membership         Business Group
                                          on Health

    Corporate         GDAHC Corporate    Greater Detroit           $7,000.00
     Membership        Membership         Area Health
                                          Council, Inc.

    Corporate         Ruby Annual        US Business               $7,500.00
     Membership        Membership         Leadership
                                          Network

    Corporate         Ruby Annual        US Business               $7,500.00
     Membership        Membership         Leadership
                                          Network

    Corporate         2018 Corporate     Physician                $20,000.00
     Membership        Dues               Assistant
                                          Foundation of
                                          the Americas

    Corporate         2018 Somerset      Somerset County          $15,000.00
     Membership        County Business    Business
                       Partnership dues   Partnership

    Corporate         Annual Membership  Women in                 $20,000.00
     Membership                           Government
                                          Foundation, Inc.

    Corporate         CLSA Sustaining    California Life          $76,000.00
     Membership        Membership         Sciences
                                          Association

    Corporate         NaVOBA corporate   NaVOBA--National         $15,000.00
     Membership        membership         Veteran Owned
                                          Busines

    Corporate         Corporate          Intellectual             $26,800.00
     Membership        Membership         Property Owners
                                          Association

    Corporate         Annual Membership  Michigan Primary          $5,000.00
     Membership                           Care Consortium

    Corporate         Annual Membership  National Alliance        $15,000.00
     Membership                           of Healthcare
                                          Purchaser

    Corporate         Annual Membership  ISPOR                    $15,000.00
     Membership

    Corporate         Corporate          The Antibody             $10,000.00
     Membership        Membership         Society

    Corporate         Corporate          Michigan                  $2,500.00
     Membership        Membership         Association of
                                          Health

    Corporate         Corporate          Life Science              $1,500.00
     Membership        Membership         Tennessee

    Corporate         2018 Corporate     Association of           $75,000.00
     Membership        Membership         Community Cancer
                                          Centers

    Corporate         Corporate          Texas Association         $5,000.00
     Membership        Membership         of Manufacturers

    Corporate         Annual Membership  JDRF                     $30,000.00
     Membership                           International

    Corporate         Corporate          AMDA--The Sociery         $2,584.00
     Membership        Membership         for Post-Acute
                                          and Long

    Corporate         Corporate          Texas Healthcare          $5,000.00
     Membership        Membership         and Bioscience
                                          Institute

    Corporate         Corporate          BioForward                $3,000.00
     Membership        Membership

    Corporate         Annual Membership  National                $224,000.00
     Membership                           Association of
                                          Manufacturers

    Corporate         2018 Business      The Health                  $450.00
     Membership        Partner            Collaborative
                       Membership

    Corporate         OFII 2018          Organization for         $17,500.00
     Membership        Membership Dues    International
                                          Investment

    Corporate         AMA Foundation     American Medical         $20,000.00
     Membership        dues               Association
                                          Foundation

    Corporate         Corporate          National                $200,000.00
     Membership        Membership Dues    Pharmaceutical
                                          Council

    Corporate         Corporate          National                $200,000.00
     Membership        Membership Dues    Pharmaceutical
                                          Council

    Corporate         Corporate          National                 $50,000.00
     Membership        Membership Dues    Pharmaceutical
                                          Council

    Corporate         Biocom Membership  Biocom                   $15,000.00
     Membership        Dues

    Corporate         2018 Preferred     BIONJ Inc.               $30,000.00
     Membership        Membership

    Corporate         2018 Membership    Healthcare              $200,000.00
     Membership        Dues               Leadership
                                          Council

    Corporate         Corporate          Oregon Business &         $1,500.00
     Membership        Membership         Industry
                                          Association

    Corporate         Membership Dues    American Society         $30,000.00
     Membership                           of
                                          Transplantation

    Corporate         Patients Count     Milken Institute         $50,000.00
     Membership        Membership Dues

    Corporate         Membership Dues    Rheumatology            $200,000.00
     Membership                           Research
                                          Foundation

    Corporate         Membership Dues    The Kansas                  $993.00
     Membership                           Chamber

    Corporate         Membership Dues    Lehigh Valley             $1,500.00
     Membership                           Business
                                          Coalition on
                                          Healthcare

    Corporate         2018 BIO           Biotechnology           $718,851.00
     Membership        Membership         Innovation
                                          Organization

    Corporate         2018 Membership    Northeast                $10,500.00
     Membership        Dues               Business Group
                                          on Health

    Corporate         Corporate          Indiana Chamber             $650.00
     Membership        Membership         of Commerce

    Corporate         Corporate          American Society         $35,000.00
     Membership        Membership Dues    of Hematology

    Corporate         Corporate          HealthCare 21             $2,750.00
     Membership        Membership         Business
                                          Coalition

    Corporate         MichiBio           Michigan                  $1,500.00
     Membership        Membership         Biosciences
                                          Industry
                                          Association

    Corporate         Membership Dues    Virginia Bio              $2,300.00
     Membership

    Corporate         Corporate          American                 $50,000.00
     Membership        Membership         Foundation for
                                          Women's Health

    Corporate         PSTC Corporate     Critical Path            $35,000.00
     Membership        Membership         Institute

    Corporate         Corporate          Research!America         $15,000.00
     Membership        Membership Dues

    Corporate         Membership Dues    ILSI Health and          $15,000.00
     Membership                           Environmental
                                          Health Instit

    Corporate         Membership Dues    ILSI Health and          $82,971.00
     Membership                           Environmental
                                          Health Instit

    Corporate         Membership Dues    Washington Health         $6,930.00
     Membership                           Alliance

    Corporate         Membership Dues    Employers Health          $1,000.00
     Membership                           Coalition, Inc.

    Corporate         Membership Dues    State Legislative        $35,000.00
     Membership                           Leaders
                                          Foundation, Inc.

    Corporate         Associate          Alliance for             $50,000.00
     Membership        Sustaining         Patient Access
                       Membership Dues

    Corporate         2018 NewYorkBIO    NewYorkBIO                $2,500.00
     Membership        Membership

    Corporate          Membership        Michigan Chamber          $1,950.00
     Membership        Renewal            of Commerce

    Corporate         CAHF Associate     CA Assn of Health         $1,200.00
     Membership        Membership         Facilities
                       Renewal

    Corporate         2018 Memebership   Alliance for a           $20,000.00
     Membership                           Stronger FDA

    Corporate         Industry Advisory  The Foundation           $25,000.00
     Membership        Board              for Post-Acute &
                                          Long-Term

    Corporate         DTA Membership     Digital                  $75,000.00
     Membership                           Therapeutics
                                          Alliance

    Corporate         Corporate          Public Affairs           $12,900.00
     Membership        Membership         Council
                       Renewal

    Corporate         2018 IPAC          Diabetes                 $15,000.00
     Membership        membership         Education and
                                          Camping
                                          Associatio

    Corporate         Annual Membership  Evidence for            $100,000.00
     Membership                           Health Care
                                          Improvement d/b

    Corporate         Consortium for     National Academy        $100,000.00
     Membership        Value and          of Sciences
                       Science
                       Membership

    Corporate         HRPA Membership    HR Policy                $15,000.00
     Membership                           Association

    Corporate         CPR Membership     International            $10,000.00
     Membership                           Institute for
                                          Conflict
                                          Preventio

    Corporate         Corporate          American                $100,000.00
     Membership        Membership         Enterprise
                                          Institute for
                                          Public Policy

    Corporate         Annual Membership  Louisiana                 $1,765.00
     Membership                           Association of
                                          Health Plans

    Corporate         Corporate          U.S. Capitol             $10,000.00
     Membership        Committee          Historical
                       Membership 2018    Society

    Corporate         2018 Memebership   Well-Being                $1,000.00
     Membership                           Collaborative of
                                          Ohio

    Corporate         2018 Council       Virginia Center           $5,000.00
     Membership        Membership         for Health
                                          Innovation

    Corporate         Corporate          Arkansas State            $1,000.00
     Membership        Membership         Chamber of
                                          Commerce/AIA

    Corporate         Corporate          International             $8,000.00
     Membership        Membership         Society for
                                          Pharmacoepidemi

    Corporate         AWB Membership     Association of            $2,500.00
     Membership                           Washington
                                          Business

    Corporate         Membership dues    Pharmaceutical                    -
     Membership                           Research and
                                          Manufacture

    Corporate         Annual Membership  Medical                   $5,000.00
     Membership                           Association of
                                          Georgia

    Corporate         Annual Membership  New Jersey                $5,000.00
     Membership                           Association of
                                          Health Plans

    Corporate         Annual Membership  CECP                     $15,000.00
     Membership

    Corporate         Corporate          Kentuckiana               $1,500.00
     Membership        Membership         Health
                                          Collaborative

    Corporate         2018 PQA           PQA, Inc.                $34,375.00
     Membership        Membership Dues

    Corporate         2018 CIBMTR        The Medical              $30,000.00
     Membership        Corporate          College of
                       Membership         Wisconsin, Inc.

    Corporate         Annual Membership  American                 $75,000.00
     Membership                           Thrombosis and
                                          Hemostasis
                                          Network

    Corporate         Annual Membership  Missouri Chamber          $1,500.00
     Membership                           of Commerce and
                                          Indust

    Corporate         Annual membership  Center Forward           $20,000.00
     Membership

    Corporate         PACH Associate     Partnership for         $125,000.00
     Membership        Membership         the Advancement
                                          of Cardio

    Corporate         HUBZone            HUBZone                   $2,495.00
     Membership        Contractors        Contractors
                       National Council   National
                                          Council, Inc.

    Corporate         Annual Membership  Greater Las Vegas         $1,499.50
     Membership                           Chamber of
                                          Commerce

    Corporate         GlobalWIN Annual   Global Women's           $20,000.00
     Membership        Support            Innovation
                                          Network

    Corporate         FDLI Membership    Food and Drug Law        $13,750.00
     Membership                           Institute

    Corporate         Annual Membership  Wisconsin                   $714.00
     Membership                           Manufacturers
                                          and Commerce

    Corporate         Annual Membership  Midwest Business          $8,000.00
     Membership                           Group on Health

    Corporate         Corporate          National                 $25,000.00
     Membership        Membership         Committee for
                                          Quality
                                          Assurance

    Corporate         Affiliate Partner  Central Florida           $1,800.00
     Membership        dues               Health Care
                                          Coalition

    Corporate         MRCT Clinical      Multi Regional           $50,000.00
     Membership        Trials             Clinical Trial
                       Membership         Center of Brigha

    Corporate         MRCT Bioethics     Multi Regional           $25,000.00
     Membership        Membership         Clinical Trial
                                          Center of Brigha

    Corporate         MOBIO Membership   Missouri                  $1,500.00
     Membership        2018               Biotechnology
                                          Association

    Corporate         Corporate          National Hispanic        $25,000.00
     Membership        Membership         Health
                                          Foundation

    Corporate         Annual Membership  West Virginia             $1,320.00
     Membership                           Chamber of
                                          Commerce, Inc.

    Corporate         Annual Membership  New Jersey                $3,000.00
     Membership                           Alliance for
                                          Action

    Corporate         Corporate          American College          $1,500.00
     Membership        Membership         of Toxicology

    Corporate         2018 Memebership   National                  $9,960.00
     Membership                           Association of
                                          Chain Drug
                                          Stores

    Corporate         Annual Membership  Business Council          $3,000.00
     Membership                           of Alabama

    Corporate         Corporate          US Pain                  $20,000.00
     Membership        Membership         Foundation Inc.

    Corporate         Corporate          South Carolina            $3,000.00
     Membership        Membership         Alliance of
                                          Health Plans

    Corporate         Corporate          The Oklahoma              $2,400.00
     Membership        Membership         State Chamber of
                                          Commerc

    Corporate         Corporate          American                  $5,000.00
     Membership        Membership         Legislative
                                          Exchange Council

    Corporate         Corporate          American                 $12,000.00
     Membership        Membership         Legislative
                                          Exchange Council

    Corporate         Corporate          American Society         $20,000.00
     Membership        Membership         of Nephrology

    Corporate         Corporate          American Society         $10,000.00
     Membership        Membership         of Nephrology

    Corporate         Annual Membership  Iowa                      $2,000.00
     Membership        Dues               Biotechnology
                                          Association

    Corporate         CHOT Annual        University of            $50,000.00
     Membership        Membership         Louisville
                                          School of Public
                                          Health

    Corporate         Corporate          Maryland Health           $5,000.00
     Membership        Membership         Care Coalition
                                          DBA MidAtlantic

    Corporate         Corporate          NCSL Foundation          $12,500.00
     Membership        Membership         for State
                                          Legislatures

    Corporate         Corporate          Associated                $3,865.00
     Membership        Membership         Industries of
                                          Missouri

    Corporate         Annual Associate   Derma Care Access       $100,000.00
     Membership        Membership         Network

    Corporate         Corporate          Wisconsin                 $3,750.00
     Membership        Membership         Collaborative
                                          for Healthcare
                                          Quality

    Corporate         Corporate          Academy of               $15,000.00
     Membership        Membership         Integrative Pain
                                          Management

    Corporate         Corporate          Association of            $3,000.00
     Membership        Membership         Military
                                          Surgeons of the
                                          Unit

    Corporate         DPAC Corporate     Diabetes Patient         $25,000.00
     Membership        Membership         Advocacy
                                          Coalition

    Corporate         HISCI Membership   Health Industry           $5,300.00
     Membership                           Distributors
                                          Association

    Corporate         CCCC Corporate     California                $5,000.00
     Membership        Membership         Chronic Care
                                          Coalition

    Corporate         Corporate          America's                $25,000.00
     Membership        Membership 2018-   Physician Groups
                       2019

    Corporate         Corporate          Integrated               $33,450.00
     Membership        Membership         Benefits
                                          Institute, Inc.

    Corporate         Corporate          Integrated                $7,814.00
     Membership        Membership         Benefits
                                          Institute, Inc.

    Corporate         Corporate          Integrated                $8,736.00
     Membership        Membership         Benefits
                                          Institute, Inc.

    Corporate         2019 Affiliate     Greater                   $5,000.00
     Membership        Membership Dues    Philadelphia
                                          Business
                                          Coalition on
                                          Health

    Corporate         Maryland Tech      Maryland Tech             $1,800.00
     Membership        Council            Council
                       Membership

    Corporate         Gender Parity      Healthcare               $30,000.00
     Membership        Collaborative      Businesswomen's
                       Membership         Association

    Donations         Adult Day Center   Visiting Nurse           $10,000.00
                       Expanded           Association of
                       Therapeutic        Somerset Hills
                       Programing
                       Request

    Donations         SARP Program       The Pennsylvania        $150,000.00
                       Support            State University

    Donations         Katy's Place       The Center For            $5,000.00
                       Child              Great
                       Development        Expectations
                       Center             Inc.

    Donations         Community          Operation Jersey            $600.00
                       Outreach to        Cares
                       Veterans

    Donations         Sanofi US          Seattle                   $5,000.00
                       Empowering Life    Children's
                       Photo Contest      Hospital
                                          Foundation

    Donations         Student Support    Drexel University         $5,000.00
                       for Drexel
                       Chemical and
                       Biological
                       Engineering

    Donations         XTL Youth          Affirmations              $2,500.00
                       Programming--Emp
                       owering Life
                       Winner

    Donations         COTA for CJ T--    COTA Children's           $2,500.00
                       Empowering Life    Organ Transplant
                       Winner             Associati

    Donations         General Mission    The Partnership          $10,000.00
                       Support            for Quality
                                          Medical Donati

    Donations         Research Training  Trustees of The          $20,000.00
                       in                 University of
                       Pharmacoepidemio   Pennsylvania
                       logy

    Donations         Friends of Cancer  Friends of Cancer        $50,000.00
                       Research Mission   Research
                       Support

    Donations         Cooley Landing     Grassroots               $25,000.00
                       Community-Based    Ecology
                       Baylands
                       Restoration
                       Project

    Donations         Green Printing     Arbor Day                 $4,944.00
                       Initiative         Foundation

    Donations         Veterans and       U.S. Naval                $1,000.00
                       Careers            Academy Alumni
                                          Association

    Donations         Fellowship         Pharmaceutical          $270,000.00
                       Support            Research and
                                          Manufacture

    Donations         General Mission    United Way of                $55.00
                       Support            Northern New
                                          Jersey

    Donations         2018 Warrior       Operation Warrior        $10,000.00
                       Wishes Program     Wishes
                                          Foundation

    Donations         General Mission    ASTS Foundation          $50,000.00
                       Support

    Donations         General Operating  American College          $2,500.00
                       Support            of Laboratory
                                          Animal Medicine

    Donations         Meals on Wheels    Midland Adult             $5,000.00
                                          Services Inc.

    Donations         General Operating  Washington Legal         $30,000.00
                       Support            Foundation

    Donations         Empowering young   Junior                   $50,000.00
                       people for         Achievement of
                       success in STEM    New Jersey, Inc.
                       careers

    Donations         Get Active and     College Diabetes         $12,000.00
                       Make a             Network Inc.
                       Difference
                       Challenge

    Donations         Get Active and     Junior                    $2,500.00
                       Make a             Achievement USA
                       Difference
                       Challenge

    Donations         Get Active & Make  Boys & Girls              $2,500.00
                       a Difference       Clubs of America
                       Challenge

    Donations         Residential        Safe + Sound             $10,000.00
                       Children's         Somerset
                       Program

    Donations         Get Active and     March of Dimes            $8,000.00
                       Make a             Foundation
                       Difference
                       Challenge

    Donations         Healthy Food       The Salvation            $10,000.00
                       Pantry Program     Army

    Donations         Responding to      Direct Relief            $25,000.00
                       California
                       Wildfires

    Donations         Vets4Warrios       Rutgers                   $2,000.00
                                          University
                                          Foundation

    Donations         MAP's Domestic     Map International        $10,000.00
                       Disaster Relief
                       Prepardness

    Donations         Midland Explores   Midland Adult             $5,000.00
                       Community          Services Inc.
                       Program

    Donations         MAS Employment     Midland Adult             $5,000.00
                       Program            Services Inc.

    Donations         Get Active and     Wounded Warrior          $40,000.00
                       Make a             Project, Inc.
                       Difference
                       Challenge

    Donations         Advancing          Students 2              $250,000.00
                       Authentic STEM     Science
                       Education

    Donations         Success By 6 with  United Way of            $37,000.00
                       Scholarship        Northern New
                       Support and STEM   Jersey
                       Enhancement

    Donations         Get Active and     National Alliance         $2,500.00
                       Make A             for Caregiving
                       Difference
                       Challenge

    Donations         General Operating  Food Bank of             $25,000.00
                       Support            Somerset County
                                          Inc.

    Donations         Corporate Work-    Cristo Rey Newark        $60,000.00
                       Study Program      High School
                                          Corp.

    Donations         U.S. Disaster      Americares               $25,000.00
                       Assitance

    Donations         LGBT Staff         Somerset Health           $7,000.00
                       Sensitivity        Care Foundation
                       Training

    Donations         US Disaster        Heart To Heart           $25,000.00
                       Readiness &        International
                       Response           Inc.

    Donations         U.S. Emergency     Direct Relief            $25,000.00
                       Preparedness and
                       Response

    Donations         Empowering Inner   Sheltered Yoga            $5,000.00
                       City Kids
                       Through Yoga &
                       Meditation

    Donations         Comprehensive      NJ Sharing                $5,000.00
                       Family Support     Network
                                          Foundation

    Donations         NCCN Foundation    NCCN Foundation          $25,000.00
                       Patient Advocacy
                       Collaboration

    Donations         Advocacy and       Deirdre O'Brien           $5,000.00
                       Forensic           Child Advocacy
                       Interviewing of    Center Inc.
                       Child Victims of
                       Abuse

    Donations         Genearl Operating  Camp Quality USA         $10,000.00
                       Support            dba Camp Quality
                                          NJ

    Donations         General Operating  Jersey Battered           $5,000.00
                                          Women's Service,
                                          Inc.

    Donations         Trainee            Society for              $25,000.00
                       Professional       Neuroscience
                       Development
                       Awards

    Donations         Project Self       Family Promise of        $10,000.00
                       Sufficiency--San   Monroe County
                       ofi in our
                       Communities

    Donations         Americares         Americares                $5,000.00
                       Airlift Benefit

    Donations         Get Active and     Dress for Success         $2,500.00
                       Make a             Northern New
                       Difference         Jersey--10
                       Challenge

    Donations         Young Scholars     NJ SEEDS                 $10,000.00
                       Program

    Donations         Vets4Warriors      Rutgers                  $10,000.00
                                          University
                                          Foundation

    Donations         Foundations of     Dress for Success        $10,000.00
                       Success            Northern New
                                          Jersey--10

    Donations         US Disaster        Heart To Heart           $25,000.00
                       Relief--Hurrican   International
                       e Michael          Inc.

    Donations         Hurricane Michael  Direct Relief            $50,000.00
                       Response

    Donations         Hunterdon County   Hunterdon                $10,000.00
                       Food Back Pack     Healthcare
                       Program            Foundation

    Donations         General Operating  Hyacinth                 $10,000.00
                       Support            Foundation: A
                                          New Jersey
                                          Nonprofit

    Donations         HSF General        Hispanic                  $5,000.00
                       Operating          Scholarship Fund
                       Support

    Donations         Hurricane Michael  Americares               $25,000.00
                       Response

    Donations         General Operating  Good Grief Inc.           $5,000.00
                       Support

    Donations         General Operating  Deirdre O'Brien           $5,000.00
                       Support            Child Advocacy
                                          Center Inc.

    Donations         Valhalla's Hope    Valhalla Veterans        $10,000.00
                                          Services

    Donations         Residential        Community Hope,          $25,000.00
                       Recovery           Inc.
                       Programs for
                       Homeless
                       Veterans and Dis

    Donations         Sanofi Corporate   Raritan Valley           $10,000.00
                       Mentor Program     Community
                       at RVCC            College Foundat

    Donations         PRIDE Connect      Hyacinth                  $3,500.00
                       Project Support    Foundation: A
                                          New Jersey
                                          Nonprofit

    Donations         Trevor's Life-     Trevor Project            $3,500.00
                       Saving Programs    Inc.
                       for LGBTQ Youth

    Donations         General Operating  Junior                    $5,000.00
                       Support            Achievement of
                                          Northeastern
                                          Pennsylvania

    Donations         Camp Nejeda:       Camp Nejeda              $10,000.00
                       Helping Kids       Foundation
                       with type 1
                       diabetes live
                       happier

    Donations         Advocacy Program   Deirdre O'Brien           $5,000.00
                       for Child          Child Advocacy
                       Victims of Abuse   Center Inc.
                       and or Neglect

    Donations         California         Direct Relief           $100,000.00
                       Wildfires

    Donations         SP 2018 UW         United Way of            $86,982.00
                       Campaign Match     Monroe County

    Donations         Vets4Warrios       Rutgers                   $4,000.00
                                          University
                                          Foundation

    Donations         Support4Families:  Cancer Support           $15,000.00
                       Teens Connect      Community
                       School-Based       Central
                       Support Group

    Donations         Supporting         Students 2               $25,000.00
                       Environmental      Science
                       Science for High
                       School Students

    Donations         Health for         Covenant House           $25,000.00
                       Homeless Youth     New Jersey Inc.

    Donations         Medical Home       Children's Health       $198,000.00
                       Initiative 2019    Fund

    Donations         Serving Local      Matheny School           $10,000.00
                       Patients With      and Hospital
                       Disabilities       Inc.

    Donations         Matheny School     Matheny School           $10,000.00
                       STEM program       and Hospital
                                          Inc.

    Donations         Support4Families:  Cancer Support            $5,000.00
                       Strengthening      Community
                       Our Schools        Central

    Donations         Food, Health and   The Community            $25,000.00
                       Hope: An Answer    Food Bank of New
                       to Diabetes (FHH   Jersey
                       Diabetes)

    Donations         Camp Quality USA   Camp Quality USA         $10,000.00
                       dba Camp Quality   dba Camp Quality
                       NJ                 NJ

    Donations         General Operating  Visiting Nurse           $10,000.00
                       Support            Association of
                                          Somerset Hills

    Donations         Steeple Chase      Somerset Health         $100,000.00
                       Cancer Center      Care Foundation
                       Patient
                       Assistance Fund

    Donations         General            Hyacinth                 $10,000.00
                       Operational        Foundation: A
                       Support            New Jersey
                                          Nonprofit

    Donations         Healthier          Somerset Health          $10,000.00
                       Somerset           Care Foundation

    Donations         HSF STEM Summit    Hispanic                 $50,000.00
                                          Scholarship Fund

    Donations         Nights of Support  Good Grief Inc.          $10,000.00
                       Program

    Donations         General Operating  Dress for Success        $10,000.00
                       Support            Northern New
                                          Jersey--10

    Donations         Trevor's Life-     Boys & Girls             $10,000.00
                       Saving Programs    Clubs of Union
                       for LGBTQ Youth    County

    Donations         Camp Nejeda:       Camp Nejeda              $10,000.00
                       Education and      Foundation
                       Empowerment for
                       Children

    Donations         Vets4Warriors      Rutgers                  $10,000.00
                                          University
                                          Foundation

    Donations         HSF Scholarship    Hispanic                 $50,000.00
                       Fund               Scholarship Fund

    Donations         General Operating  NJ SEEDS                 $10,000.00
                       Support for NJ
                       SEEDS

    Donations         Banco de           Banco de                 $25,000.00
                       ALimentos de       Alimentos de
                       Puerto Rico        Puerto Rico

    LOR               BCCNS Patient      BCCNS Alliance           $25,000.00
                       Project

    LOR               Patient            Patients Rising,         $10,000.00
                       Engagement         Inc.
                       Sponsorship

    LOR               Patient Education  Taking Control of        $40,000.00
                       Diabetes           Your Diabetes
                       Conferences and
                       Health Fairs

    LOR               Biological         California               $15,000.00
                       Research           Institute of
                       Symposium          Technology

    LOR               Patient Skin       American Cancer         $200,000.00
                       Cancer Education   Society
                       and Awareness

    LOR               Populatoin Health  Thomas Jefferson         $60,000.00
                       Leadership         University
                       Series

    LOR               nPOD Annual        University of            $15,000.00
                       Meeting            Florida

    LOR               Diabetes Scholars  Diabetes Scholars        $10,000.00
                       Foundation         Foundation
                       College
                       Scholarships

    LOR               2018 Annual        Health Action             $4,700.00
                       Symposium and      Council
                       Conference

    LOR               Western Atrial     University of            $50,000.00
                       Fibrillation       Utah
                       Symposium 2018

    LOR               Gordon Research    Gordon Research           $5,000.00
                       Conference on      Conferences
                       Myelin

    LOR               Cell Culture       Engineering               $5,000.00
                       Engineering XVI    Conferences
                       Conference         International

    LOR               2018 Alliance      Alliance for             $20,000.00
                       Industry Summitt   Continuing
                                          Education in the
                                          Health Sciences

    LOR               Symposium on Drug  Massachusetts             $8,000.00
                       Delivery Systems   Institute of
                                          Technology

    LOR               2nd Annual EPIC    Children's               $10,000.00
                       Diabetes           Diabetes
                       Conference         Foundation

    LOR               ASN 48th Annual    American Society          $2,500.00
                       Meeting            for
                                          Neurochemistry

    LOR               2018 BIO           Biotechnology           $334,500.00
                       International      Innovation
                       Convention         Organization

    LOR               FOCIS 2018 Annual  Federation of            $25,000.00
                       Meeting            Clinical
                                          Immunology
                                          Societies

    LOR               2018 BIO Europe    Biotechnology            $22,500.00
                       Spring             Innovation
                                          Organization

    LOR               2018 BIO Europe    Biotechnology            $22,500.00
                       Fall               Innovation
                                          Organization

    LOR               Annual Healthcare  MIT Sloan                 $5,000.00
                       Conference         Healthcare
                                          Conference and
                                          Club

    LOR               SOT 2018 Annual    Society of               $10,000.00
                       Meeting            Toxicology

    LOR               2018 Public        American                 $20,000.00
                       Policy Forum       Association of
                                          Diabetes
                                          Educator

    LOR               Annual Gala        Asian American           $20,000.00
                       Dinner             Legal Defense
                                          and Educatio

    LOR               JDRF Imagine Gala  JDRF                     $10,000.00

    LOR               2018 Advocacy      Research!America         $25,000.00
                       Awards Dinner

    LOR               JDRF Government    JDRF                     $50,000.00
                       Day                International

    LOR               Immune Tolerance   Parker Institute         $10,000.00
                       Symposium          for Cancer
                                          Immunotherapy

    LOR               Annual Forum on    National Academy         $85,000.00
                       Drug Discovery     of Sciences
                       and Development

    LOR               Biomedical         Foundation for           $25,000.00
                       Research Program   Biomedical
                                          Research

    LOR               Annual Symposium   CASSS                     $2,500.00
                       of Regulatory
                       and Analytical
                       Science

    LOR               Analytical         CASSS                     $2,500.00
                       Technologies
                       Symposium

    LOR               2018 Gordon        Gordon Research           $3,000.00
                       Research           Conferences
                       Conference on
                       Medicinal
                       Chemistry

    LOR               2018 AMSSM         American Medical         $50,000.00
                       Foundation         Society for
                       Research Grant     Sports Medicine
                       Award Program

    LOR               Patient            National Health         $130,000.00
                       Perspective        Council
                       Program

    LOR               Annual Business    Waltham Chamber           $6,000.00
                       Meeting            of Commerce

    LOR               Barriers of the    Gordon Research           $5,000.00
                       CNS Conference     Conferences

    LOR               FARE Patient       Food Allergy             $50,000.00
                       Registry           Research &
                                          Education, Inc.

    LOR               Wonder Women:      Center for Talent        $40,000.00
                       Flourishing and    Innovation
                       Thriving on the
                       Frontiers

    LOR               Early              American                 $55,000.00
                       Osteoarthritis     Orthopaedic
                       and Prevention     Society for
                       of OA              Sports Medicine
                       Progression

    LOR               Pharmacy           Iowa Pharmacy            $10,000.00
                       Leadership         Association
                       Training Program   Foundation

    LOR               FIU Global Health  Florida                  $95,000.00
                       Conference         International
                                          University Board
                                          of Trustees

    LOR               2018 Statewide     Florida Health           $15,000.00
                       Cardiac            Care Coalition
                       Collaborative

    LOR               36 Annual JDRF     JDRF                      $2,500.00
                       Boston Gala        International

    LOR               Innovative         Preventive              $150,000.00
                       Medicine           Cardiovascular
                       Campaign           Nurses
                                          Association

    LOR               Women and Heart    WomenHeart: The          $50,000.00
                       Disease Program    National
                                          Coalition for
                                          Women With Heart
                                          Disease

    LOR               Off to College     College Diabetes         $50,000.00
                       Sponsorship 2018   Network Inc.

    LOR               Patient Education  Diabetes                  $2,000.00
                       Diabetes           Foundation of
                       Conference         Mississippi

    LOR               Division of        ACS Division of           $3,000.00
                       Medicinal          Medicinal
                       Chemistry          Chemistry
                       Program ACS
                       National Meeting

    LOR               Patient Centered   National Lipid           $16,060.00
                       Management of      Association
                       Dyslipidemia

    LOR               2018 Annual SMA    Families of SMA           $5,000.00
                       Conference         DBA Cure SMA

    LOR               2018 ZERO          ZERO--The End of          $2,000.00
                       Prostate Cancer    Prostate Cancer
                       Summit

    LOR               DA4S West Coast    Diversity                 $3,000.00
                       2018               Alliance for
                                          Science, Inc.

    LOR               Economic           Greater New               $4,000.00
                       Development =      England Minority
                       Corporate          Supplier
                       Sponsorship        Development
                       Renewal

    LOR               2018 V-BID         Regents of the           $50,000.00
                       Summit: V-BID at   University of
                       the Big House      Michigan

    LOR               AUTM 2018 Annual   Association of            $5,000.00
                       Meeting            University
                                          Technology Mana

    LOR               2018 Annual        BIONJ Inc.               $10,000.00
                       Dinner Meeting

    LOR               SOT Annual         Society of                $2,500.00
                       meeting            Toxicology

    LOR               Forum Group on     George Washington        $70,000.00
                       Arbovirus          University
                       Infections

    LOR               World Vitiligo     The Umass                 $2,500.00
                       Day 2018           Memorial
                       Conference         Foundation Inc.

    LOR               Men's Health       Men's Health             $30,000.00
                       Month              Network
                       Sponsorship

    LOR               OSU Pharmacy       Oregon State              $7,500.00
                       Partners Program   University
                                          Foundation

    LOR               2018 Global        International             $5,000.00
                       Doctoral           Biomedical
                       Partnerships       Research
                       Annual Workshop    Alliance

    LOR               2018 AAAS Annual   American                 $25,000.00
                       Meeting            Association for
                       Sponsorship        the Advancement

    LOR               Cold Spring        Cold Spring              $15,000.00
                       Harbor Meetings    Harbor
                       and Courses        Laboratory
                       Program

    LOR               2018 Annual Event  New York & New           $10,000.00
                       Sponsorship        Jersey Minority
                                          Supplier
                                          Development

    LOR               2018 Greater New   American Diabetes        $10,000.00
                       York Tour de       Association
                       Cure & Wellness
                       Expo

    LOR               National Minority  Make Well Known          $25,000.00
                       Cardiovascular     Foundation
                       Alliance

    LOR               OASC Annual        Ohio Association          $1,000.00
                       Conference         of Senior
                                          Centers

    LOR               2018 Flu Podcast   Women In                  $5,000.00
                       Campaign           Government
                                          Foundation, Inc.

    LOR               25th Annual        Florida Health            $5,000.00
                       National           Care Coalition
                       Conference

    LOR               State Lung Health  Respiratory                 $500.00
                       Education          Health
                       Program            Association

    LOR               CWAG 2018 Annual   Conference of             $5,000.00
                       Meeting            Western
                                          Attorneys
                                          General

    LOR               2018 Town Hall     American Society        $203,900.00
                       Meeting Support    for Preventive
                                          Cardiology

    LOR               Get in Rhythm      American                 $25,000.00
                       Stay in Rhythm--   Foundation for
                       Afib Patient       Women's Health
                       Conference

    LOR               PRISMS 10th Smith- PRISMS, Inc.              $2,500.00
                       Magenis Syndrome
                       Conference

    LOR               Guidelines for     Florida                  $50,000.00
                       Antimicrobial      International
                       Stewardship        University
                                          Foundation

    LOR               Latin American     Florida                  $70,000.00
                       and Caribbean      International
                       Diabetes           University
                       Network: A         Foundation
                       framework

    LOR               Assesment of       Florida                  $60,000.00
                       acellular          International
                       vaccination        University
                       programs in        Foundation
                       Mexico, Costa

    LOR               Bioorganic         Gordon Research           $1,000.00
                       Research           Conferences
                       Conference

    LOR               National           Trustees of             $150,000.00
                       Community Health   Boston
                       Workers Project    University

    LOR               Health Innovation  Springboard 2000         $25,000.00
                       Hub 2018           Enterprises,
                                          Inc.

    LOR               Bill Foege Event   Map International        $10,000.00
                       Sponsorship

    LOR               SDHB Pheo-Para     SDHB Pheo-Para           $10,000.00
                       Coalition Gala     Coalition, Inc.

    LOR               9th International  University of             $2,000.00
                       Conference on      Florida
                       Unstable           Foundation, Inc.
                       Microsatellites
                       and Human
                       Disease

    LOR               21st Annual        HealthCare 21             $3,000.00
                       Health &           Business
                       Productivity       Coalition
                       Forum

    LOR               2018 Celebrating   Blood and Marrow         $25,000.00
                       a Second Chance    Transplant
                       at Life            Information
                       Survivorship
                       Sympos

    LOR               Patient Education  Taking Control of        $40,000.00
                       Diabetes           Your Diabetes
                       Conferences and
                       Health Fairs

    LOR               Patient Education  Taking Control of        $60,000.00
                       Diabetes           Your Diabetes
                       Conferences and
                       Health Fairs

    LOR               2018 FH Global     The FH Foundation        $75,000.00
                       Summit

    LOR               Chemical Biology   Northeastern              $1,000.00
                       in the Hub         Section of the
                       Symposium          American
                                          Chemical Society

    LOR               2018 Champion of   National Kidney           $1,000.00
                       Hope Tribute       Foundation of
                       Dinner             Michigan

    LOR               7th International  CASSS                     $2,500.00
                       Symposium on
                       Higher Order
                       Structure of
                       Protein
                       Therapeutics

    LOR               Bioassays 2018:    CASSS                     $2,500.00
                       Scientific
                       Approaches &
                       Regulatory
                       Strategies

    LOR               A Taste of Ginger  Joslin Diabetes          $10,000.00
                       Gala               Center, Inc.

    LOR               2018 Annual        Western                  $10,000.00
                       Meeting            Governors'
                       Sponsorship        Foundation

    LOR               Community Hope     Community Hope,          $10,000.00
                       Annual Dinner      Inc.

    LOR               8th International  Florida                 $150,000.00
                       Conference on      International
                       Global Health      University
                                          Foundation

    LOR               8th International  Florida                  $14,000.00
                       Conference on      International
                       Global Health      University
                                          Foundation

    LOR               2018 Machestic     Machestic Dragons         $5,500.00
                       Dragons ``Paddle
                       for Pink''
                       Community Dragon

    LOR               ``Visions of       Diabetes                  $2,500.00
                       Hope'' Awards      Foundation Inc.
                       Dinner

    LOR               Stick It to        Mercy Health              $2,000.00
                       Diabetes           Foundation
                                          Joplin

    LOR               2018               FSH Society               $2,000.00
                       International
                       Research
                       Conference

    LOR               Teratology         Teratology                $1,500.00
                       Society 58th       Society
                       Annual Meeting

    LOR               255th ACS          ACS Division of           $5,000.00
                       National Meeting   Biochemical
                       and Exposition     Technology
                       (BIOT Division)

    LOR               Forum on           National Academy         $50,000.00
                       Neuroscience and   of Sciences
                       Nervous System
                       Disorders

    LOR               2018 National      ACS Division of           $3,000.00
                       Medicinal          Medicinal
                       Chemistry          Chemistry
                       Symposium

    LOR               Giving Diabetes    The Diabetes              $2,500.00
                       the Blues          Coalition of
                       Conference         Mississippi

    LOR               Diabetes Care and  Academy of               $10,000.00
                       Dietetic           Nutrition and
                       Education          Dietetics
                       Program

    LOR               2018 Heart &       The American             $25,000.00
                       Stroke Ball        Heart
                                          Association

    LOR               RNA Therapeutics:  The Umass                $10,000.00
                       From Base Pairs    Memorial
                       to Bedsides        Foundation Inc.

    LOR               2nd Annual Heart   Metabolic               $100,000.00
                       in Diabetes--HiD   Endocrine
                                          Education
                                          Foundation

    LOR               Immuno-Therapy     The University of        $50,000.00
                       Scientific         Texas Foundation
                       Workshop

    LOR               Cell Culture       Engineering               $2,500.00
                       Engineering XVI    Conferences
                       Conference         International

    LOR               2018 LVBCH Annual  Lehigh Valley             $1,000.00
                       Conference         Business
                                          Coalition on
                                          Healthcare

    LOR               Bowhay Institute   The Council of            $5,000.00
                                          State
                                          Government, Ltd.

    LOR               2018 Lysosomes     Gordon Research           $2,000.00
                       and Endocytosis    Conferences
                       Gordon Research
                       Conference

    LOR               South Sound JDRF   JDRF                      $1,000.00
                       One Walk           International--N
                                          orthwest Chapter

    LOR               36th Annual        JDRF                      $2,500.00
                       Nordstrom Beat
                       the Bridge

    LOR               Diabetes Under     American Diabetes         $1,000.00
                       the Dome Event     Association

    LOR               2018 Wenger        WomenHeart: The          $25,000.00
                       Awards Dinner      National
                                          Coalition for
                                          Women With Heart
                                          Disease

    LOR               CRI's              Cancer Research          $25,000.00
                       Immunotherapy      Institute Inc.
                       Patient Summit
                       Series

    LOR               2018 HBA Woman of  Healthcare               $15,000.00
                       the Year Event     Businesswomen's
                                          Association

    LOR               Transforming       Dress for Success        $15,000.00
                       Lives 20th year    Northern New
                       Celebration        Jersey--10

    LOR               Recovery of        American Chemical        $10,000.00
                       Biological         Society,
                       Products XVIII     Division of
                       Conference         Biochemistry

    LOR               Friends for Life   Children with            $25,000.00
                       Orlando 2018       Diabetes
                       Patient
                       Conference

    LOR               2018 Orlando       Children with            $10,000.00
                       Fellows Program    Diabetes

    LOR               Hypoglycemia       Endocrine Society       $150,000.00
                       Quality
                       Improvement/
                       Prevention
                       Project

    LOR               2018 Annual Henry  The Henry Kunkel          $2,000.00
                       Kunkel Society     Society c/o The
                       Meeting            Rockefeller

    LOR               GPEN 2018          Globalization of          $1,500.00
                       Scientific         Pharmaceutics
                       Meeting            Education

    LOR               2018 Conference    Employers Health          $7,500.00
                       Sponsorship        Coalition, Inc.

    LOR               RVCC's 50th        Raritan Valley           $25,000.00
                       Anniversary        Community
                       Golden Harvest     College Foundat
                       Gala

    LOR               2018 PQA Annual    Healthcare                $6,100.00
                       Meeting            Businesswomen's
                                          Association

    LOR               2018 PQA Annual    PQA, Inc.                $12,500.00
                       Meeting

    LOR               eValue8 Project    Northeast                 $2,500.00
                                          Business Group
                                          on Health

    LOR               Annual Good Grief  Good Grief Inc.           $3,500.00
                       Gala

    LOR               8th Annual         Center for               $10,000.00
                       Diversity,         Healthcare
                       Inclusion, &       Innovation
                       Health Equity
                       Symposium

    LOR               Real World         American Diabetes       $210,000.00
                       Evidence           Association
                       Generation and
                       Analysis
                       Research
                       Symposium

    LOR               From Rare to       Keystone Symposia         $3,000.00
                       Care: Discovery,   on Molecular and
                       Modeling and       Cellular
                       Translation of
                       Rare Diseases

    LOR               6th Annual         International            $15,000.00
                       Meeting of the     Cytokine and
                       International      Interferon
                       Cytokine &         Society
                       Interferon

    LOR               Diabetes and CV    Icahn School of          $30,000.00
                       Risk Factors       Medicine at
                       Program            Mount Sinai

    LOR               Prix Galien USA    The Galien               $15,000.00
                       Forum              Foundation

    LOR               Learning Sessions  The Health                $5,000.00
                       Program            Collaborative

    LOR               Horton's Kids      Horton's Kids,           $15,000.00
                       Comprehensive      Inc.
                       Programming for
                       At-Risk Children

    LOR               Children's Health  Children's Health        $30,000.00
                       Fund 2018 Annual   Fund
                       Benefit

    LOR               60th Anniversary   Project Hope The         $10,000.00
                       Project HOPE       People To People
                       Gala               Health

    LOR               Structural         Harvard Medical           $2,500.00
                       Biology Meeting    School

    LOR               PROMIS: Global     Harvard Medical           $2,500.00
                       Advances in        School
                       Methodology and
                       Clinical Science

    LOR               68th Annual        Somerset County           $2,500.00
                       Outstanding        Business
                       Citizen of the     Partnership
                       Year Awards
                       Dinner

    LOR               Annual Meeting     Somerset County           $2,500.00
                       Awards Luncheon    Business
                       2018               Partnership

    LOR               Illinois Diabetes  Illinois Diabetes           $250.00
                       Caucus             Caucus
                       Fundraiser         Foundation

    LOR               18th annual        The Virginia                $700.00
                       luncheon           Public Access
                                          Project

    LOR               Grand Tastings     Jersey Battered          $15,000.00
                       XXIV               Women's Service,
                                          Inc.

    LOR               d18 Executive      The diaTribe            $250,000.00
                       Innovation Lab     Foundation
                       on Diabetes and
                       Prediabetes

    LOR               2018 Scientific    Children's               $10,000.00
                       Program in         Hospital
                       Cellular and       Corporation
                       Molecular
                       Medicine

    LOR               JDRF One Walk,     JDRF                      $2,500.00
                       Washington, DC

    LOR               WOCIP 2018-2019    Women of Color in        $20,000.00
                       Annual Meeting     Pharma

    LOR               WOCIP 2018-2019    Women of Color in        $20,000.00
                       Annual Meeting     Pharma

    LOR               Koch Institute     Massachusetts             $5,000.00
                       2018 Summer        Institute of
                       Symposium          Technology

    LOR               Koch Institute     Massachusetts             $5,000.00
                       2018 Summer        Institute of
                       Symposium          Technology

    LOR               Event Sponsorship- Discovering              $10,000.00
                       Discovering        Justice
                       Justice 20th
                       Anniversary Gala

    LOR               Boston             Children's                $3,000.00
                       Postdoctoral       Hospital
                       Association        Corporation
                       Symposium on
                       Careers and
                       Collaboration in
                       Science

    LOR               ONE: The Ultimate  Taking Control of        $20,000.00
                       Conference for     Your Diabetes
                       Adult Type 1

    LOR               2018 Gordon        Gordon Research           $3,000.00
                       Research           Conferences
                       Conference on
                       Heterocycles

    LOR               PDAF Fundraiser    Prescription Drug         $1,250.00
                       Sponsorship        Assistance
                                          Foundation

    LOR               Generations Gala   Adult Day Center          $3,000.00
                       Event              of Somerset
                                          County

    LOR               12th Annual        The diaTribe             $10,000.00
                       Diabetes Forum     Foundation

    LOR               2018 Triangle      JDRF                     $10,000.00
                       Hope Glala

    LOR               Lecture Series     The New York             $25,000.00
                       Program            Academy of
                                          Sciences

    LOR               Division of        ACS Division of           $3,000.00
                       Medicinal          Medicinal
                       Chemistry          Chemistry
                       Program ACS
                       National Meeting

    LOR               11th Annual        Brigham and               $2,000.00
                       Polycystic         Women's Hospital
                       Kidney Disease
                       Symposium

    LOR               DA4S East Coast    Diversity                 $7,500.00
                       2018               Alliance for
                                          Science, Inc.

    LOR               The Jessica        Dana Farber               $5,000.00
                       Ingram Lecture     Cancer Institute
                       Series

    LOR               The Jessica        Dana Farber               $5,000.00
                       Ingram Lecture     Cancer Institute
                       Series

    LOR               Key Initiatives    Prostate Cancer          $30,000.00
                       Program            Education
                                          Council

    LOR               NEQCA Annual       New England               $5,000.00
                       Forum              Quality Care
                                          Alliance

    LOR               MMRF 2018 Myeloma  Multiple Myeloma        $100,000.00
                       Patient and        Research
                       Caregiver          Foundation
                       Education
                       Program

    LOR               National Forum     National Forum          $200,000.00
                       for Heart          for Heart
                       Disease            Disease and
                                          Stroke

    LOR               TB Survivors for   National TB               $5,000.00
                       Patient            Controllers
                       Education          Association

    LOR               9th Annual Spirit  Association of           $50,000.00
                       of the Heart       Black
                       Awards Dinner      Cardiologists

    LOR               Change for Women   Catalyst Inc.            $15,000.00
                       in the Workplace
                       Program

    LOR               2018 Annual        Washington Policy         $3,500.00
                       Dinner             Center

    LOR               National           The Mended               $25,000.00
                       Education &        Hearts, Inc.
                       Training
                       Conference 2018

    LOR               2018 ICSA          International             $3,000.00
                       Symposium          Chinese
                                          Statistical
                                          Association

    LOR               BMT InfoNet        Blood and Marrow         $10,000.00
                       Patient Guide      Transplant
                       Reprint            Information

    LOR               Research on        Harvard T.H. Chan       $200,000.00
                       Health             School of Public
                       Technology         Health
                       Assessment

    LOR               DIA Inspires       Drug Information          $4,500.00
                       Award Dinner       Asssociation
                                          (DIA)

    LOR               Diabetes           Fundacion Centro          $7,000.00
                       Education          Pediatrico de
                       Program for        Diabetes
                       School Personnel
                       and T1D Students

    LOR               NCCN Guidelines    NCCN Foundation          $25,000.00
                       for Patients
                       guide

    LOR               Fall Meeting       Middle Atlantic           $1,000.00
                       Sponsorship        Reproduction and
                                          Teratolog

    LOR               PROMIS: Global     PROMIS Health            $15,000.00
                       Advances in        Organization
                       Methodology and    (PHO)
                       Clinical Science

    LOR               Immunization       Idaho                     $2,500.00
                       Summit 2018        Immunization
                                          Coalition

    LOR               Bob Langer 70th    Rutgers                  $20,000.00
                       Birthday Gala      University
                       and Symposium      Foundation

    LOR               TMA Group Annual   Texas Medical             $1,200.00
                       Meeting            Association

    LOR               Clinical Inertia   American Diabetes       $300,000.00
                       Campaign           Association

    LOR               Life Sciences      Life Sciences PA            $250.00
                       Event June 2018

    LOR               CE in the          CASSS                     $2,500.00
                       Biotechnology &
                       Pharmaceutical
                       Industries: 20th
                       Symposium

    LOR               15th Symposium on  CASSS                     $2,500.00
                       the Practical
                       Applications of
                       Mass
                       Spectrometry

    LOR               NCQA's Quality     National                 $10,000.00
                       Talks 2018         Committee for
                                          Quality
                                          Assurance

    LOR               Gala of Giving     Operation Jersey          $3,000.00
                       Country Style      Cares
                       2018

    LOR               Cell & Gene        CASSS                     $5,000.00
                       Therapy Products
                       (CGTP):
                       Manufacturing,
                       Quality

    LOR               Newletter Funding  Skin Cancer             $100,000.00
                                          Foundation

    LOR               Advocating for     Lupus Foundation          $5,000.00
                       Chronic Disease    of America Inc.
                       Patients

    LOR               Inspiring Hope     Cancer Support            $2,500.00
                       Gala               Community
                                          Central

    LOR               2018 National      Lung Cancer              $10,000.00
                       Advocacy Summit    Alliance

    LOR               Bastille Day       Resources USA             $5,000.00
                       Boston 2018        Inc.

    LOR               Bastille Day       Resources USA            $10,000.00
                       Washington DC      Inc.
                       2018

    LOR               The Lancet Women   Icahn School of         $100,000.00
                       and                Medicine at
                       Cardiovascular     Mount Sinai
                       Disease
                       Commission

    LOR               Northeast          CASSS                     $2,500.00
                       Regional Forum
                       October 2018

    LOR               2018 National      Research!America         $25,000.00
                       Health Research
                       Forum

    LOR               Promoting Nurses   Preventive               $25,000.00
                       as Leaders in      Cardiovascular
                       Prevention         Nurses
                       Program            Association

    LOR               ACCC educational   Association of          $144,000.00
                       program funding    Community Cancer
                                          Centers

    LOR               Patient Access     Alliance for             $75,000.00
                       Collaborative      Patient Access

    LOR               NJMLA 2018 Annual  New Jersey Muslim         $1,250.00
                       Eid Gala           Lawyer
                                          Association

    LOR               2018 Biomarkers    Foundation for            $2,500.00
                       Consortium         the National
                       meeting            Institutes of
                                          Health

    LOR               Pro Bono           Pro Bono                 $25,000.00
                       Partnership 2018   Partnership
                       Gala

    LOR               Tour de Cure       American Diabetes         $2,500.00
                       Hawaii             Association

    LOR               19th Annual        Patient Advocate         $10,000.00
                       Patient Congress   Foundation

    LOR               Patient Education  ZERO--The End of          $8,000.00
                       Webinar Funding    Prostate Cancer

    LOR               2018 Diabetes      Joslin Diabetes           $5,000.00
                       Coalition          Center, Inc.
                       Conference

    LOR               Mary's Center      Mary's Center            $30,000.00
                       2018 Symposium

    LOR               2018 Safety        Safety                    $2,500.00
                       Pharmacology       Pharmacology
                       Society Annual     Society
                       meeting

    LOR               Drugs for          Drugs for                $50,000.00
                       Neglected          Neglected
                       Diseases           Diseases
                       initiative         Initiative,
                       (DNDi)'s Making    North American
                       Medical History    Inc.

    LOR               Drugs for          Drugs for                $25,000.00
                       Neglected          Neglected
                       Diseases           Diseases
                       initiative         Initiative North
                       (DNDi)'s Making    American Inc.
                       Medical History

    LOR               Drugs for          Drugs for                $25,000.00
                       Neglected          Neglected
                       Diseases           Diseases
                       initiative         Initiative North
                       (DNDi)'s Making    American Inc.
                       Medical History

    LOR               Pharmacy Alumni    The Ohio State            $1,000.00
                       Society            University
                       Pharmathon 5k      Foundation
                       Sponsorship

    LOR               Diabetes Policy    Alliance for            $150,000.00
                       Advocacy           Patient Access
                       Initiatives

    LOR               Yale               Yale University           $2,000.00
                       Immunobiology
                       Student
                       Symposium 2018

    LOR               ConnecT1D Family   ConnecT1D                 $5,000.00
                       Camp 2018

    LOR               2018 Alumni Hall   Hispanic                 $25,000.00
                       of Fame Gala       Scholarship Fund
                       Dinner

    LOR               JDRF One Walk      JDRF                      $5,000.00

    LOR               ACS CAN National   American Cancer          $35,000.00
                       Advocacy           Society Cancer
                       Activities         Action Network

    LOR               American College   American College          $2,500.00
                       of Toxicology      of Toxicology
                       39th Annual
                       Meeting

    LOR               Fall Advocacy Day  ASTS Foundation          $15,000.00

    LOR               2018 OFII Annual   Organization for         $15,000.00
                       Dinner             International
                                          Investment

    LOR               2018 Patient &     Biotechnology            $10,000.00
                       Health Advocacy    Innovation
                       Summit             Organization

    LOR               2018 Indiana Tour  American Diabetes         $2,500.00
                       de Cure            Association,
                                          Indiana

    LOR               2018 JDRF One      JDRF                      $5,000.00
                       Walk Syracuse      International

    LOR               12th Annual Gala   International            $10,000.00
                       Celebration        Myeloma
                                          Foundation

    LOR               14th Annual        National Alliance         $2,500.00
                       Meeting of         of State
                       NASPCC             Prostate Cancer

    LOR               Translational      American                 $25,000.00
                       Cancer Research    Association for
                       for Basic          Cancer Research
                       Scientists
                       Workshop

    LOR               Boston Heart Walk  American Heart            $5,000.00
                                          Association

    LOR               JDRF One Walk      JDRF                      $5,000.00
                       2018               International

    LOR               Airline Benefit    Americares               $12,000.00
                       Gala

    LOR               Improving          National Minority       $125,000.00
                       Diabetes and       Quality Forum
                       Cardiovasular
                       Disease
                       Management

    LOR               Digital Health     MassChallenge,          $100,000.00
                       Accellerator       Inc.
                       Program

    LOR               Multiple Myeloma   Blood and Marrow          $3,750.00
                       Patient Survival   Transplant
                       Guide              Information

    LOR               2018 ACS CAN       American Cancer          $25,000.00
                       State Events       Society Cancer
                       Program            Action Network

    LOR               Healthcare         American College          $1,000.00
                       Leaders            of Healthcare
                       Educational        Executives
                       Events

    LOR               36th Annual        President and            $10,000.00
                       Retreat for the    Fellows of
                       Harvard/MIT MD-    Harvard College
                       PhD Program

    LOR               Moving the Needle  Healthcare                $1,000.00
                       on Gender Parity   Businesswomen's
                                          Association

    LOR               Employer's Guide   Northeast                $17,500.00
                       to Digital         Business Group
                       Diabetes           on Health
                       Prevention and
                       Management

    LOR               10th Annual        Prevent Cancer            $5,000.00
                       Health Fair and    Foundation
                       5k Walk/Run

    LOR               16th Annual Gala   Fundacion Centro          $3,500.00
                       Dinner             Pediatrico de
                                          Diabetes

    LOR               Advancement and    Cross-Company             $2,500.00
                       Challenges         Abuse Liability
                       Meeting            Council

    LOR               Respiraory         Alliance for             $50,000.00
                       Therapy Access     Patient Access
                       Working Group

    LOR               The Champions For  Skin Cancer              $25,000.00
                       Change Gala        Foundation

    LOR               High Hopes Gala    Joslin Diabetes          $25,000.00
                                          Center, Inc.

    LOR               Friends Annual     Friends of Cancer        $10,000.00
                       Cancer Research    Research
                       Leadership
                       Awards

    LOR               Women Building     Virginia Bio              $3,000.00
                       Bio Sponsorship

    LOR               NACHW              Trustees of              $20,000.00
                       Organizational     Boston
                       Launch             University
                       Announcement
                       Event

    LOR               2018 PQA           PQA, Inc.                 $7,500.00
                       Leadership
                       Summit

    LOR               High Level         Speak Up Africa d/       $25,000.00
                       Conference and     b/a The Access
                       Awards Event       Challenge

    LOR               International      International            $90,000.00
                       Myeloma            Myeloma
                       Foundation         Foundation
                       Patient
                       Initiative
                       Programs

    LOR               NCCN Innovation    National                 $40,000.00
                       Pilot Program      Comprehensive
                                          Cancer Network

    LOR               Annual AMCP        Academy of               $18,000.00
                       meeting            Managed Care
                                          Pharmacy

    LOR               Solvable Problems  The diaTribe             $48,000.00
                       in Diabetes        Foundation
                       Program

    LOR               NESOT Annual       Society of                $1,500.00
                       Meeting            Toxicology

    LOR               Patient Advocacy   Cancer Support           $75,000.00
                       Kit for Multiple   Community
                       Myeloma

    LOR               Patient Education  National Kidney           $7,500.00
                       Brochure Big Ask   Foundation, Inc.
                       Big Give

    LOR               Patient Awareness  National Hispanic        $25,000.00
                       and Education      Medical
                       Program for        Association
                       Hispanic Patient

    LOR               Diabetes Family    Fundacion Centro          $5,000.00
                       Day Sponsorship    Pediatrico de
                                          Diabetes

    LOR               Annual Promise     JDRF                     $20,000.00
                       Ball               International

    LOR               Congress           American Society         $10,000.00
                       Sponsorship        of Hematology

    LOR               Scientific Annual  Lupus Research           $10,000.00
                       Conference         Alliance

    LOR               R3 Annual Forum    Multi Regional            $7,500.00
                                          Clinical Trial
                                          Center of
                                          Brigham

    LOR               Diabetes           Public Health            $10,000.00
                       Prevention on      Advocates
                       the Ground in
                       California
                       Sponsorship

    LOR               Northcrest Annual  NorthCrest                $2,500.00
                       Gala               Medical Center
                                          Foundation

    LOR               19th Annual        GLBTQ Legal               $3,000.00
                       Spirit of          Advocates &
                       Justice Award      Defenders (GLAD)
                       Dinner

    LOR               AUTM Annual        Association of            $5,000.00
                       Meeting            University
                                          Technology Mana

    LOR               TCYOD Patient      Taking Control of        $75,000.00
                       Conferences and    Your Diabetes
                       Health Fairs

    LOR               New Jersey Smart   RideWise, Inc.            $1,000.00
                       Workplace Annual
                       recognition
                       event

    LOR               Breakfast          Women In                  $7,500.00
                       Sponsorship        Government
                                          Foundation, Inc.

    LOR               Patient Education  Malecare                 $20,000.00
                       African American
                       Men with
                       Prostate Cancer

    LOR               Patient Education  Malecare                 $15,000.00
                       Brochure: Simple
                       Cancer

    LOR               ONE: The           Taking Control of        $75,000.00
                       Ultimaite          Your Diabetes
                       Conference and
                       Retreate for
                       Adults with Type
                       I

    LOR               Women in           All in Together          $40,000.00
                       Healthcare         Campaign Inc.
                       Policy Forum

    LOR               Innovation Labs    The diaTribe            $100,000.00
                       on Diabetes and    Foundation
                       Prediabetes

    LOR               Annual Joe         Joe Andruzzi              $5,000.00
                       Andruzzi           Foundation Inc.
                       Foundation Gala

    LOR               Corporate          AMGA                     $25,000.00
                       Sponsorship for
                       Institute for
                       Quality
                       Leadership

    LOR               Patient Awareness  ZERO--The End of         $10,000.00
                       and Education      Prostate Cancer
                       Program

    LOR               Congress           Metabolic                $50,000.00
                       Sponsorship        Endocrine
                                          Education
                                          Foundation

    LOR               2018 Annual        PCMA                     $95,000.00
                       Meeting
                       Sponsorship

    LOR               PCMA Business      PCMA                     $80,000.00
                       Forum
                       Sponsorship

    LOR               Cardiovascular     Association of           $30,000.00
                       Risk Reduction     Black
                       Project            Cardiologists

    LOR               Corporate          California Life           $8,500.00
                       Sponsorship for    Sciences
                       Institute for      Association
                       Life Sciences
                       Academy

    LOR               Friends            Friends of Cancer        $50,000.00
                       ImmunoOncology     Research
                       Programs

    LOR               Patient Education  Prostate Cancer          $20,000.00
                       Brochure:          Education
                       Chemotherary in    Council
                       Prosate Cancer

    LOR               2018 Patient       BIONJ Inc.                $1,000.00
                       Advocacy Summit
                       Sponsorship

    LOR               Patient Guide      Arizona Myeloma          $10,000.00
                       Living with        Network (AZMN)
                       Myeloma

    LOR               Yellow Fever       Fondation Merieux        $10,000.00
                       Symposium          USA, Inc.

    LOR               Patient Education  Blood and Marrow         $40,000.00
                       Brochure on        Transplant
                       Transplantation    Information

    LOR               MBGH Sponsorship   Midwest Business         $20,000.00
                       Request            Group on Health

    LOR               Patient Education  American Academy         $30,000.00
                       Brochure on SCC    of Dermatology
                                          Inc.

    LOR               HBA Woman of the   Healthcare               $22,250.00
                       Year Luncheon      Businesswomen's
                                          Association

    LOR               Corporate          Midwest Business         $30,000.00
                       Sponsorship        Group on Health

    ------------------------------------------------------------------------
      Date of                   Primary       Primary     Physician/Teaching
      Payment       Amount      Purpose       Nature     Hospital Name (NPI)
    ------------------------------------------------------------------------
    11/10/2015    $75,000.00  Fellowship   Cash or Cash  Vanderbilt
                                            Equivalent    University
                                                          Hospital
    ------------------------------------------------------------------------
    06/15/2015    $74,987.00  Fellowship   Cash or Cash  Childrens Hospital
                                            Equivalent    Medical Center
    ------------------------------------------------------------------------
    02/24/2015    $75,000.00  Fellowship   Cash or Cash  Langley Porter
                                            Equivalent    Psychiatric
                                                          Hospital
    ------------------------------------------------------------------------
    08/01/2015    $75,000.00  Fellowship   Cash or Cash  Emory University
                                            Equivalent    Hospital
    ------------------------------------------------------------------------
    07/01/2015    $75,000.00  Fellowship   Cash or Cash  Uci Medical Center
                                            Equivalent    (.)
    ------------------------------------------------------------------------
    05/26/2015    $75,000.00  Fellowship   Cash or Cash  Uci Medical Center
                                            Equivalent    (.)
    ------------------------------------------------------------------------
    04/07/2015    $43,494.57  Fellowship   Cash or Cash  University of
                                            Equivalent    Alabama Hospital
    ------------------------------------------------------------------------
    05/17/2016    $75,000.00  Fellowship   Cash or Cash  Vanderbilt
                                            Equivalent    University
                                                          Hospitals & Cl (.)
    ------------------------------------------------------------------------
    06/21/2016    $75,000.00  Fellowship   Cash or Cash  Emory University
                                            Equivalent    Hospital (.)
    ------------------------------------------------------------------------
    03/09/2016    $77,537.90  Fellowship   Cash or Cash  Emory University
                                            Equivalent    Hospital (.)
    ------------------------------------------------------------------------
    06/07/2016    $77,317.00  Fellowship   Cash or Cash  Ann & Robert H.
                                            Equivalent    Lurie Childrens
                                                          Hos (.)
    ------------------------------------------------------------------------
    03/01/2016    $63,000.00  Fellowship   Cash or Cash  Resnick
                                            Equivalent    Neuropsychiatric
                                                          Hospital At (.)
    ------------------------------------------------------------------------
    06/07/2016    $75,000.00  Fellowship   Cash or Cash  University Of
                                            Equivalent    Alabama Hospital
                                                          (.)
    ------------------------------------------------------------------------
    06/27/2017    $75,000.00  Fellowship   Cash or Cash  Ann & Robert H.
                                            Equivalent    Lurie Childrens
                                                          Hos (1497018154)
    ------------------------------------------------------------------------
    03/02/2017    $75,000.00  Fellowship   Cash or Cash  Hospital Of The
                                            Equivalent    Univ Of Penna
                                                          (1003946153)
    ------------------------------------------------------------------------
    07/01/2017    $75,000.00  Fellowship   Cash or Cash  Cooper University
                                            Equivalent    Hospital
                                                          (1053654749)
    ------------------------------------------------------------------------
    07/01/2017    $75,000.00  Fellowship   Cash or Cash  Childrens Hospital
                                            Equivalent    Medical Center
                                                          (1083665137)
    ------------------------------------------------------------------------
    07/01/2017    $75,000.00  Fellowship   Cash or Cash  Uci Medical Center
                                            Equivalent    (.)
    ------------------------------------------------------------------------
    07/01/2017    $63,000.00  Fellowship   Cash or Cash  Resnick
                                            Equivalent    Neuropsychiatric
                                                          Hospital At
                                                          (1124327853)
    ------------------------------------------------------------------------
    12/12/2017    $75,000.00  Fellowship   Cash or Cash  Emory University
                                            Equivalent    Hospital (.)
    ------------------------------------------------------------------------
    12/12/2017    $63,000.00  Fellowship   Cash or Cash  Resnick
                                            Equivalent    Neuropsychiatric
                                                          Hospital At
                                                          (1124327853)
    ------------------------------------------------------------------------
    12/17/2017    $75,000.00  Fellowship   Cash or Cash  Uci Medical Center
                                            Equivalent    (.)
    ------------------------------------------------------------------------
    12/06/2017    $75,000.00  Fellowship   Cash or Cash  Vanderbilt
                                            Equivalent    University Medical
                                                          Center
                                                          (1104202761)
    ------------------------------------------------------------------------
    03/02/2017    $75,000.00  Fellowship   Cash or Cash  Emory University
                                            Equivalent    Hospital (.)
    ------------------------------------------------------------------------
    03/14/2017    $73,714.12  Fellowship   Cash or Cash  University Of
                                            Equivalent    Alabama Hospital
                                                          (.)
    ------------------------------------------------------------------------

    ------------------------------------------------------------------------
      Payment Report
      Recipient Type    Address Line 1       City          State       ZIP
    ------------------------------------------------------------------------
    Teaching hospital  1211 MEDICAL      NASHVILLE     TN              37232
                        CENTER DRIVE
    ------------------------------------------------------------------------
    Teaching hospital  3333 BURNET       CINCINNATI    OH              45229
                        AVENUE MLC
                        #4900
    ------------------------------------------------------------------------
    Teaching hospital  405 PARNASUS      SAN           CA              94143
                                          FRANCISCO
    ------------------------------------------------------------------------
    Teaching hospital  1364 CLIFTON      ATLANTA       GA              30302
                        ROAD
    ------------------------------------------------------------------------
    Teaching hospital  101 CITY DRIVE    ORANGE        CA              92868
                        SOUTH
    ------------------------------------------------------------------------
    Teaching hospital  101 CITY DRIVE    ORANGE        CA              92868
                        SOUTH
    ------------------------------------------------------------------------
    Teaching hospital  619 SOUTH 19TH    BIRMINGHAM    AL              35233
                        STREET
    ------------------------------------------------------------------------
    Teaching hospital  1211 MEDICAL      NASHVILLE     TN              37232
                        CENTER DRIVE
    ------------------------------------------------------------------------
    Teaching hospital  1364 CLIFTON      ATLANTA       GA              30302
                        ROAD
    ------------------------------------------------------------------------
    Teaching hospital  1364 CLIFTON      ATLANTA       GA              30302
                        ROAD
    ------------------------------------------------------------------------
    Teaching hospital  225 EAST CHICAGO  CHICAGO       IL              60611
                        AVENUE
    ------------------------------------------------------------------------
    Teaching hospital  150 UCLA MEDICAL  LOS ANGELES   CA              90095
                        PLAZA
    ------------------------------------------------------------------------
    Teaching hospital  619 SOUTH 19TH    BIRMINGHAM    AL              35233
                        STREET
    ------------------------------------------------------------------------
    Teaching hospital  225 EAST CHICAGO  CHICAGO       IL              60611
                        AVENUE
    ------------------------------------------------------------------------
    Teaching hospital  3400 SPRUCE       PHILADELPHIA  PA              19104
                        STREET
    ------------------------------------------------------------------------
    Teaching hospital  ONE COOPER PLAZA  CAMDEN        NJ              08103
    ------------------------------------------------------------------------
    Teaching hospital  3333 BURNET       CINCINNATI    OH              45229
                        AVENUE MLC
                        #4900
    ------------------------------------------------------------------------
    Teaching hospital  101 CITY DRIVE    ORANGE        CA              92868
                        SOUTH
    ------------------------------------------------------------------------
    Teaching hospital  150 UCLA MEDICAL  LOS ANGELES   CA              90095
                        PLAZA
    ------------------------------------------------------------------------
    Teaching hospital  1364 CLIFTON      ATLANTA       GA              30302
                        ROAD
    ------------------------------------------------------------------------
    Teaching hospital  150 UCLA MEDICAL  LOS ANGELES   CA              90095
                        PLAZA
    ------------------------------------------------------------------------
    Teaching hospital  101 CITY DRIVE    ORANGE        CA              92868
                        SOUTH
    ------------------------------------------------------------------------
    Teaching hospital  1211 MEDICAL      NASHVILLE     TN              37232
                        CENTER DRIVE
    ------------------------------------------------------------------------
    Teaching hospital  1364 CLIFTON      ATLANTA       GA              30302
                        ROAD
    ------------------------------------------------------------------------
    Teaching hospital  619 SOUTH 19TH    BIRMINGHAM    AL              35233
                        STREET
    ------------------------------------------------------------------------

    ------------------------------------------------------------------------
       Date of
       Payment         Amount         Primary Purpose       Primary Nature
    ------------------------------------------------------------------------
    08/11/2015        $124,572.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    12/15/2015         $74,327.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/20/2015        $174,088.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $5,648.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $7,060.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $7,060.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $5,648.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $4,236.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015            $350.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $1,250.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $1,086.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $5,648.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $2,824.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $2,824.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $9,775.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015            $750.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/27/2015          $7,234.45  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    12/08/2015         $11,074.80  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $6,698.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $1,551.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/06/2015        $127,160.70  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/06/2015        $385,403.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/27/2015        $137,506.80  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/24/2015         $35,672.06  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/17/2015         $36,130.95  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/15/2015          $7,226.19  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/10/2015        $325,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/20/2015          $5,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/21/2015          $5,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/07/2015         $49,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/21/2015         $16,089.68  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/02/2015         $14,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/10/2015          $5,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/06/2015         $20,100.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $1,412.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $1,412.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015          $1,412.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/14/2015          $8,363.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/08/2015          $7,760.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/03/2015          $4,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/27/2015         $28,585.85  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/14/2015         $85,757.55  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/20/2015         $28,585.85  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/03/2015         $61,725.52  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/03/2015         $11,176.62  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/03/2015         $24,246.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/13/2015        $125,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    12/15/2015        $200,000.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/13/2015         $39,771.64  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/05/2015         $39,771.64  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/09/2015         $39,771.65  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/19/2015        $119,166.66  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/26/2015        $185,900.01  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/02/2015         $61,966.67  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/28/2015         $61,966.66  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/17/2015        $126,059.09  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/17/2015        $126,059.09  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/07/2015        $174,088.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/06/2015         $59,187.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/19/2015         $59,187.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/14/2015         $11,120.67  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/26/2015         $28,612.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/16/2015         $28,612.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/11/2015          $7,234.45  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/24/2015         $28,830.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/17/2015         $30,167.85  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/17/2015         $24,228.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/11/2015        $355,830.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/26/2015         $28,777.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/17/2015          $8,329.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/14/2015          $9,229.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/19/2015         $53,400.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/10/2015        $214,706.70  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/17/2015          $7,425.18  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/23/2015         $12,375.30  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/07/2015        $160,228.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/23/2015         $14,850.36  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/26/2016        $114,107.36  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/12/2016        $250,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/26/2016         $54,115.17  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/17/2016        $174,088.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/26/2016         $35,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/02/2016         $18,334.48  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/13/2016        $174,088.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/28/2016        $224,593.02  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/13/2016         $22,950.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/09/2016         $50,279.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/19/2016         $28,830.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/12/2016         $24,228.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/19/2016         $24,228.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/26/2016         $33,332.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/08/2016         $30,589.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/19/2016          $7,234.45  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/28/2016         $15,750.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/27/2016         $42,502.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/07/2016         $38,530.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/15/2016         $22,106.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/16/2016          $3,103.89  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/22/2016        $114,600.84  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/23/2016         $88,057.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/27/2016         $12,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/13/2016         $18,768.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016         $88,057.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016            $959.62  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016          $3,047.08  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016          $1,556.04  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016          $3,941.70  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/14/2016            $661.42  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/27/2016        $293,490.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/09/2016         $12,505.30  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/12/2016         $76,515.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/16/2016         $36,067.85  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/18/2016         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/29/2016         $12,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/29/2016         $64,130.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/29/2016         $25,730.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/31/2016          $3,103.89  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/04/2016         $76,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/13/2016         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/19/2016        $152,796.13  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/28/2016         $12,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/05/2016         $12,505.30  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/09/2016        $153,730.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/09/2016         $51,015.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/24/2016        $576,860.60  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/25/2016        $117,405.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/06/2016        $117,405.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/13/2016        $352,185.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/13/2016         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2016         $11,312.95  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/26/2016         $15,040.60  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/26/2016         $21,998.88  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/26/2016         $27,466.10  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/26/2016         $24,981.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/27/2016          $7,585.30  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/27/2016         $27,963.12  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/28/2016         $12,505.30  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/31/2016         $12,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/01/2016         $22,106.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/14/2016          $3,103.89  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/27/2016         $88,057.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/10/2016         $72,120.70  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/19/2016         $22,106.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/24/2016         $12,505.30  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/31/2016        $293,760.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/31/2016         $58,764.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/31/2016         $12,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/31/2016         $58,764.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/01/2016         $29,389.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/15/2016         $77,933.40  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/17/2016         $58,764.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/21/2016         $19,265.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/21/2016        $134,465.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/14/2016         $88,138.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/19/2016        $293,760.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/05/2016            $382.26  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/17/2016            $449.71  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/09/2016      $1,122,210.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/08/2016      $1,122,209.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/16/2016         $59,187.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/18/2016         $67,970.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/26/2016         $19,474.93  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/02/2016         $47,400.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    12/13/2016         $47,400.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/04/2017            $862.56  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/10/2017         $12,930.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/11/2017          $6,317.65  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/16/2017            $862.56  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/18/2017         $29,362.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017         $11,247.95  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017            $288.66  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017         $11,247.95  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017          $1,108.73  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017         $19,945.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017          $4,538.12  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017         $13,549.36  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017          $3,112.08  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017         $24,916.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/24/2017            $810.52  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/08/2017            $884.54  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/01/2017            $884.54  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/13/2017         $25,730.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/16/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/29/2017          $6,317.65  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/30/2017        $145,308.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/06/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/01/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/08/2017         $45,402.40  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/18/2017         $29,362.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/25/2017         $29,362.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/08/2017         $22,766.20  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/12/2017         $22,766.20  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/15/2017         $29,362.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/15/2017         $29,362.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    06/29/2017         $14,980.36  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/05/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/13/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/17/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2017         $19,945.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2017         $10,129.40  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2017         $10,194.40  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2017         $24,916.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/25/2017          $2,413.36  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/02/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/15/2017         $15,220.80  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/24/2017        $440,227.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/20/2017         $30,311.60  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/21/2017         $14,980.36  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/18/2017         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/30/2017        $305,489.41  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/29/2017          $6,855.86  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/29/2017         $40,810.16  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/18/2017        $162,934.69  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/20/2017      $1,163,061.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    12/20/2017        $831,459.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/12/2017        $140,654.12  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/01/2017         $75,158.78  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/25/2017         $53,668.90  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/20/2017        $391,759.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/21/2017         $76,900.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/12/2017         $55,768.59  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/18/2017         $77,522.30  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/02/2017          $7,955.33  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/06/2017         $43,280.58  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/17/2017        $244,633.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/17/2017         $37,134.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/21/2017          $6,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/04/2017          $7,234.45  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/23/2017         $50,279.75  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/15/2017         $92,654.93  Investigator          ...................
                                    Sponsored Trial
                                    Cash or Cash
                                    Equivalent
    ------------------------------------------------------------------------
    04/25/2017        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/18/2017        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/05/2017        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/07/2017        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/09/2017         $66,562.62  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/06/2017         $66,562.62  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/03/2017         $66,562.62  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/02/2017         $80,715.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/04/2017         $47,400.50  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/04/2017         $47,400.97  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/17/2017        $100,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/02/2017         $26,701.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/18/2017        $190,471.20  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/15/2017          $2,100.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/14/2017         $23,348.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/30/2017        $140,654.12  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/19/2017        $188,832.43  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    12/05/2017          $2,835.71  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/22/2018         $16,681.38  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/22/2018            $427.27  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/22/2018            $750.53  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/23/2018         $15,679.17  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/23/2018          $3,904.40  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/23/2018         $12,928.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/25/2018         $25,640.33  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/25/2018          $1,118.37  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/25/2018          $2,872.13  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    01/29/2018        $712,788.63  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    02/20/2018        $152,752.20  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/11/2018        $314,348.09  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/17/2018         $19,930.48  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/22/2018        $261,959.23  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    05/29/2018        $157,181.55  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/10/2018         $16,302.40  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/10/2018         $13,607.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/12/2018         $17,650.10  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/12/2018         $27,084.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/17/2018        $209,570.39  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    07/19/2018         $88,057.50  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/14/2018         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/20/2018         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/23/2018        $117,405.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/17/2018        $157,181.55  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/27/2018        $157,181.55  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/29/2018        $261,959.23  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/28/2018         $58,710.00  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/29/2018        $104,792.70  Investigator          Product
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/26/2018            $348.48  Investigator          Supplies
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/26/2018             $28.32  Investigator          Supplies
                                    Sponsored Trial
    ------------------------------------------------------------------------
    04/25/2018             $67.25  Investigator          Supplies
                                    Sponsored Trial
    ------------------------------------------------------------------------
    08/28/2018            $281.36  Investigator          Supplies
                                    Sponsored Trial
    ------------------------------------------------------------------------
    11/27/2018        $793,755.00  Investigator          Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    09/24/2018        $277,130.00  Investigator          Investigator Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    10/19/2018        $207,848.00  Investigator          Investigator Fees
                                    Sponsored Trial
    ------------------------------------------------------------------------
    03/20/2018         $26,125.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/30/2018         $76,900.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/12/2018         $29,796.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/20/2018        $178,970.30  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/16/2018        $244,633.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    02/06/2018        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/06/2018        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    09/06/2018        $128,325.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/19/2018         $66,562.62  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/15/2018         $35,581.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/15/2018         $30,030.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    06/19/2018         $52,087.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    07/23/2018         $31,131.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/30/2018         $14,223.80  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/03/2018        $144,601.03  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/02/2018         $47,500.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/02/2018        $148,734.45  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    03/29/2018        $238,670.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    04/05/2018        $104,418.67  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/10/2018          $7,939.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/26/2018         $14,624.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/09/2018        $100,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/02/2018         $53,668.90  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    01/05/2018        $391,759.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    05/08/2018         $28,610.89  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    10/29/2018         $78,100.80  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    08/21/2018         $29,796.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/19/2018        $103,543.60  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/19/2018         $97,510.18  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    12/10/2018         $48,814.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------
    11/19/2018         $72,000.00  Investigator          Cash or Cash
                                    Sponsored Trial       Equivalent
    ------------------------------------------------------------------------

    ------------------------------------------------------------------------
      Physician/
       Teaching       Address
     Hospital Name    Line 1       City    State      ZIP     Name of Study
         (NPI)
    ------------------------------------------------------------------------
    Montefiore      111 EAST     BRONX    NY         10467  A roadmap for
     Medical         210TH                                   the conversion
     Center          STREET                                  from sliding
                                                             scale to basal
                                                             insulin in the
                                                             long term care
                                                             setting.
    ------------------------------------------------------------------------
    Langley Porter  405          SAN      CA         94143  A Phase I Study
     Psychiatric     PARNASUS     FRANCI                     of Cabazitaxel,
                                  SCO                        Mitoxanthrone,
                                                             and Prednison
                                                             (CAMP) for
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
                                                             and no Prior
                                                             Chemotherapy
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  An Exploratory
     Hospital for    AVENUE       YORK                       Randomized
     Cancer and                                              Phase II
     Allied                                                  Multicenter
     Diseases                                                Trial of
                                                             Abiraterone
                                                             Acetate with or
                                                             without
                                                             Cabazitaxel in
                                                             Treatment of
                                                             Metastatic
                                                             Castration
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    Keck Hospital   1500 SAN     LOS      CA         90033  Detection of
     of USC          PABLO        ANGELE                     early end-organ
                     STREET       S                          damage by
                                                             endothelial
                                                             dysfunction
                                                             with reactive
                                                             hyperemia-
                                                             digital
                                                             peripheral
                                                             arterial
                                                             tonometry in
                                                             patients with
                                                             Fabry disease
    ------------------------------------------------------------------------
    University of   619 SOUTH    BIRMING  AL         35233  Improved
     Alabama         19TH         HAM                        Detection,
     Hospital        STREET                                  Diagnosis, and
                                                             Management of
                                                             Fabry Disease
                                                             through Serial
                                                             Ophthalmic
                                                             Documentation
                                                             and Tear Fluid
                                                             Analysis
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    Brigham and     75 FRANCIS   BOSTON   MA         02115  Effects of an
     Womens          STREET                                  Intensive
     Hospital                                                Intervention on
                                                             Medication
                                                             Adherence,
                                                             Glycemic
                                                             Control, and
                                                             Readmission
                                                             Rates in
                                                             Patients with
                                                             Type 2 Diabetes
    ------------------------------------------------------------------------
    University of   2            SEATTLE  WA         98195  FLuctuation
     Washington                                              Reduction With
                                                             Insulin and GLP-
                                                             1 Added
                                                             Together (FLAT-
                                                             SUGAR)
    ------------------------------------------------------------------------
    Beth Israel     330          BOSTON   MA         02215  Simplification
     Deaconess       BROOKLINE                               of diabetes
     Medical         AVENUE                                  regimen in
     Center                                                  elderly
                                                             patients using
                                                             glargine
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase I Study of
     Cancer          BROOKLINE                               Plerixafor
     Institute       AVE                                     (AMD3100) and
                                                             Bevacizumab for
                                                             recurrent high-
                                                             grade glioma
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase I/II Trial
     Cancer          BROOKLINE                               of Combination
     Institute       AVE                                     AMD3100 and
                                                             Bortezomib in
                                                             Relapsed or
                                                             Relapsed/
                                                             Refractory
                                                             Multiple
                                                             Myeloma
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase I/II Trial
     Cancer          BROOKLINE                               of Combination
     Institute       AVE                                     AMD3100 and
                                                             Bortezomib in
                                                             Relapsed or
                                                             Relapsed/
                                                             Refractory
                                                             Multiple
                                                             Myeloma
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Taxotere Plus
     Cancer          BROOKLINE                               Six-Month
     Institute       AVE                                     Androgen
                                                             Suppression and
                                                             Radiation
                                                             Therapy vs Six-
                                                             Month Androgen
                                                             Suppression and
                                                             Radiation
                                                             Therapy for
                                                             Patients with
                                                             High-Risk
                                                             Localized or
                                                             Locally
                                                             Advanced
                                                             Prostate
                                                             Cancer: A
                                                             Randomized
                                                             Controlled
                                                             Trial
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  Phase I/II Study
     Cancer Center   HOLCOMBE                                of Plerixafor
                     BLVD                                    and Clofarabine
                                                             in Previously
                                                             Untreated Older
                                                             (>= 60 years)
                                                             Adult Patients
                                                             with Acute
                                                             Myelogenous
                                                             Leukemia (AML)
                                                             for Whom
                                                             Standard
                                                             Induction
                                                             Chemotherapy is
                                                             Unlikely to be
                                                             of Benefit
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  G-CSF and
     Cancer Center   HOLCOMBE                                Plerixafor with
                     BLVD                                    Sorafenib for
                                                             Acute
                                                             Myelogenous
                                                             Leukemia with
                                                             FLT3(ITD)
                                                             mutations
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  Phase I/II Study
     Cancer Center   HOLCOMBE                                of Plerixafor
                     BLVD                                    and Clofarabine
                                                             in Previously
                                                             Untreated Older
                                                             (>= 60 years)
                                                             Adult Patients
                                                             with Acute
                                                             Myelogenous
                                                             Leukemia (AML)
                                                             for Whom
                                                             Standard
                                                             Induction
                                                             Chemotherapy is
                                                             Unlikely to be
                                                             of Benefit
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  G-CSF and
     Cancer Center   HOLCOMBE                                Plerixafor with
                     BLVD                                    Sorafenib for
                                                             Acute
                                                             Myelogenous
                                                             Leukemia with
                                                             FLT3(ITD)
                                                             mutations
    ------------------------------------------------------------------------
    Langley Porter  405          SAN      CA         94143  A Phase III
     Psychiatric     PARNASUS     FRANCI                     Trial of
     Institute                    SCO                        Irinotecan/5-FU/
                                                             Leucovorin or
                                                             Oxaliplatin/5-
                                                             FU/leucovorin
                                                             with
                                                             Bevacizumab, or
                                                             Cetuximab
                                                             (C225) or with
                                                             the Combination
                                                             of Bevacizumab
                                                             and Cetuximab
                                                             for Patients
                                                             with Untreated
                                                             Metastatic
                                                             Adenocarcinoma
                                                             of the Colon or
                                                             Rectum
    ------------------------------------------------------------------------
    U of U          50 NORTH     SALT     UT         84132  Phase I/II Study
     Hospitals &     MEDICAL      LAKE                       of Low-Dose
     Clinic          DRIVE        CITY                       Oral
                                                             Clofarabine for
                                                             the treatment
                                                             of IPSS INT-1,
                                                             INT-2 or HIGH
                                                             Myelodysplastic
                                                             Syndromes
                                                             (dysplastic
                                                             type) Patients
                                                             who have failed
                                                             Hypomethylating
                                                             Therapy
    ------------------------------------------------------------------------
    Lehigh Valley   2100 MACK    ALLENTO  PA         18105  A Multicenter,
     (.)             BLVD. 4TH    WN                         Randomized,
                     FLOOR                                   Controlled
                     FINANCE                                 Trial
                                                             Evaluating the
                                                             Safety,
                                                             Efficacy and
                                                             Cost-
                                                             Effectiveness
                                                             of Seprafilm
                                                             Adhesion
                                                             Barrier
                                                             Following
                                                             Cesarean
                                                             Section
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University of   5841 SOUTH   CHICAGO  IL         60637  A study of the
     Chicago         MARYLAND                                effects of
     Hospital        AVENUE                                  Alemtuzumab on
                                                             Surrogate
                                                             Markers of
                                                             Disease
                                                             Activity and
                                                             Repair using
                                                             Advanced MRI
                                                             measures in
                                                             Subjects with
                                                             Relapsing
                                                             Remitting
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Do the Benefits
     University      CLIFTON                                 Outweigh the
     Hospital        ROAD                                    Risks?
                                                             Assessing
                                                             Patients'
                                                             Perceptions of
                                                             Newborn
                                                             Screening for
                                                             Lysosomal
                                                             Storage
                                                             Diseases
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Neuroimaging
     General         STREET                                  Characteristics
     Hospital                                                in Fabry
                                                             Disease:
                                                             Quantitation of
                                                             CNS White
                                                             Matter Lesions
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Neuroimaging
     General         STREET                                  Characteristics
     Hospital                                                in Fabry
                                                             Disease:
                                                             Quantitation of
                                                             CNS White
                                                             Matter Lesions
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Neuroimaging
     General         STREET                                  Characteristics
     Hospital                                                in Fabry
                                                             Disease:
                                                             Quantitation of
                                                             CNS White
                                                             Matter Lesions
    ------------------------------------------------------------------------
    University of   2            SEATTLE  WA         98195  Podocyturia: A
     Washington                                              Non-Invasive
                                                             Biomarker of
                                                             Fabry
                                                             Nephropathy
    ------------------------------------------------------------------------
    University of   2            SEATTLE  WA         98195  Podocyturia: A
     Washington                                              Non-Invasive
                                                             Biomarker of
                                                             Fabry
                                                             Nephropathy
    ------------------------------------------------------------------------
    University of   619 SOUTH    BIRMING  AL         35233  Cognitive
     Alabama         19TH         HAM                        Function
     Hospital        STREET                                  Assessment in
                                                             Fabry Disease:
                                                             A Pilot
                                                             Feasibility
                                                             Study
    ------------------------------------------------------------------------
    University of   619 SOUTH    BIRMING  AL         35233  Multi-center,
     Alabama         19TH         HAM                        Open-label
     Hospital        STREET                                  Study of the
                                                             Safety and
                                                             Efficacy of
                                                             Control of
                                                             Proteinuria
                                                             with ACE
                                                             Inhibitors and
                                                             ARBS in
                                                             Patients with
                                                             Fabry Disease
                                                             Who Are
                                                             Receiving
                                                             Fabrazyme?: The
                                                             Fabrazyme? +
                                                             Arbs + ACE
                                                             inhibitors
                                                             Treatments
                                                             (FAACET) Study:
                                                             The FAACET
                                                             Study.
    ------------------------------------------------------------------------
    Rochester       1425         ROCHEST  NY         14621  A Study
     General         PORTLAND     ER                         Evaluating
     Hospital        AVENUE                                  Acute Otitis
                                                             Media and
                                                             Nasopharyngeal
                                                             Colonization
                                                             Caused by
                                                             Streptococcus
                                                             pneumoniae in
                                                             Healthy
                                                             Children
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Randomized Phase
     Cancer          BROOKLINE                               II Study of
     Institute       AVE                                     FOLFOX +/-
                                                             Aflibercept in
                                                             metastatic
                                                             esophagogastric
                                                             cancer
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Randomized Phase
     Cancer          BROOKLINE                               II Study of
     Institute       AVE                                     FOLFOX +/-
                                                             Aflibercept in
                                                             metastatic
                                                             esophagogastric
                                                             cancer
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Randomized Phase
     Cancer          BROOKLINE                               II Study of
     Institute       AVE                                     FOLFOX +/-
                                                             Aflibercept in
                                                             metastatic
                                                             esophagogastric
                                                             cancer
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Randomized
     Cancer Center   HOLCOMBE                                Study of Once
                     BLVD                                    Daily
                                                             Fludarabine-
                                                             Clofarabine vs
                                                             Fludarabine
                                                             Alone Combined
                                                             with IV
                                                             Busulfan
                                                             Followed by
                                                             Allogeneic
                                                             Hemopoietic
                                                             Stem Cell
                                                             Transplantation
                                                             for AML and MDS
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Randomized
     Cancer Center   HOLCOMBE                                Study of Once
                     BLVD                                    Daily
                                                             Fludarabine-
                                                             Clofarabine vs
                                                             Fludarabine
                                                             Alone Combined
                                                             with IV
                                                             Busulfan
                                                             Followed by
                                                             Allogeneic
                                                             Hemopoietic
                                                             Stem Cell
                                                             Transplantation
                                                             for AML and MDS
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Randomized
     Cancer Center   HOLCOMBE                                Study of Once
                     BLVD                                    Daily
                                                             Fludarabine-
                                                             Clofarabine vs
                                                             Fludarabine
                                                             Alone Combined
                                                             with IV
                                                             Busulfan
                                                             Followed by
                                                             Allogeneic
                                                             Hemopoietic
                                                             Stem Cell
                                                             Transplantation
                                                             for AML and MDS
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Randomized
     Cancer Center   HOLCOMBE                                Study of Once
                     BLVD                                    Daily
                                                             Fludarabine-
                                                             Clofarabine vs
                                                             Fludarabine
                                                             Alone Combined
                                                             with IV
                                                             Busulfan
                                                             Followed by
                                                             Allogeneic
                                                             Hemopoie
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A phase II study
     Cancer Center   HOLCOMBE                                of cabazitaxel
                     BLVD                                    with or without
                                                             carboplatin in
                                                             patients with
                                                             metastatic
                                                             castration-
                                                             resistant
                                                             prostate cancer
                                                             previously
                                                             treated with
                                                             docetaxel-based
                                                             therapy.
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A phase II study
     Cancer Center   HOLCOMBE                                of cabazitaxel
                     BLVD                                    with or without
                                                             carboplatin in
                                                             patients with
                                                             metastatic
                                                             castration-
                                                             resistant
                                                             prostate cancer
                                                             previously
                                                             treated with
                                                             docetaxel-based
                                                             therapy.
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  An Exploratory
     Hospital For    AVENUE       YORK                       Randomized
     Center                                                  Phase II
                                                             Multicenter
                                                             Trial of
                                                             Abiraterone
                                                             Acetate with or
                                                             without
                                                             Cabazitaxel in
                                                             Treatment of
                                                             Metastatic
                                                             Castration
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Assessment of
     Womens          STREET                                  Aubagio?s
     Hospital                                                neuroprotective
                                                             effect on the
                                                             development of
                                                             T1 black holes
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Assessment of
     Womens Hosp     STREET                                  Aubagio?s
                                                             neuroprotective
                                                             effect on the
                                                             development of
                                                             T1 black holes
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Post-partum MRI
     Womens Hosp     STREET                                  Changes in
                                                             Women with
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Post-partum MRI
     Womens Hosp     STREET                                  Changes in
                                                             Women with
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Post-partum MRI
     Womens Hosp     STREET                                  Changes in
                                                             Women with
                                                             Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    Keck Hospital   1500 SAN     LOS      CA         90033  Detection of
     of USC          PABLO        ANGELE                     early end-organ
                     STREET       S                          damage by
                                                             endothelial
                                                             dysfunction
                                                             with reactive
                                                             hyperemia-
                                                             digital
                                                             peripheral
                                                             arterial
                                                             tonometry in
                                                             patients with
                                                             Fabry Disease
    ------------------------------------------------------------------------
    Vanderbilt      1211         NASHVIL  TN         37232  Innovation in
     University      MEDICAL      LE                         the timely
     Hospital        CENTER                                  diagnosis and
                     DRIVE                                   multidiscipinar
                                                             y treatment of
                                                             Fabry disease
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  A Prospective,
     University      CLIFTON                                 Multicenter
     Hospital        ROAD                                    Study Of Fabry
                                                             Disease
                                                             Clinical and
                                                             Biochemical
                                                             Findings in
                                                             Young Pediatric
                                                             Patients (The
                                                             MOPPET Study)
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Reproductive
     University      CLIFTON                                 Fitness in
     Hospital        ROAD                                    Individuals
                                                             Affected by
                                                             Fabry Disease
                                                             (FIT)
    ------------------------------------------------------------------------
    UCI Medical     101 CITY     ORANGE   CA         92868  Investigating
     Center (.)      DRIVE                                   Pompe
                     SOUTH                                   Prevalence in
                                                             NEuromuscular
                                                             Medicine
                                                             Academic
                                                             Practices
                                                             (IPANEMA Study)
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  The Fabry Pain
     General         STREET                                  Inventory:
     Hospital                                                Validation of a
                                                             New Clinical
                                                             Tool to
                                                             Comprehensively
                                                             Capture the
                                                             Fabry Pain
                                                             Experience
    ------------------------------------------------------------------------
    University of   2            SEATTLE  WA         98195  Effects of Fabry
     Washington                                              Disease on
                                                             Myelination in
                                                             the In Vivo
                                                             Adult Human
                                                             Brain
    ------------------------------------------------------------------------
    University of   619 SOUTH    BIRMING  AL         35233  Improved
     Alabama         19TH         HAM                        Detection,
     Hospital        STREET                                  Diagnosis, and
                                                             Management of
                                                             Fabry Disease
                                                             through Serial
                                                             Ophthalmic
                                                             Documentation
                                                             and Tear Fluid
                                                             Analysis
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase II Study
     Cancer          BROOKLINE                               of Clofarabine
     Institute       AVE                                     in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase I/II Trial
     Cancer          BROOKLINE                               of Combination
     Institute       AVE                                     AMD3100 and
                                                             Bortezomib in
                                                             Relapsed or
                                                             Relapsed/
                                                             Refractory
                                                             Multiple
                                                             Myeloma
    ------------------------------------------------------------------------
    The Nebraska    DEWEY        OMAHA    NE         68198  Leukine
     Medical         AVENUE AT                               (sargramostim)
     Center          42ND                                    for Parkinson's
                                                             disease
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
                                                             Protein plus
                                                             Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    City of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
                                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    The Christ      2139 AUBURN  CINCINN  OH         45219  A Phase II Trial
     Hospital        AVENUE       ATI                        of GM-CSF
                                                             Protein plus
                                                             Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Ohsu Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     and Clinics     JACKSON      D                          Trial of
     (.)             PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  Creation of a
     Hospital for    AVENUE       YORK                       registry of
     Cancer and                                              patients
     Allied                                                  treated on
     Diseases                                                TAX3503
     (101317743)
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase I/II Trial
     Cancer          BROOKLINE                               of Combination
     Institute (.)   AVE                                     AMD3100 and
                                                             Bortezomib in
                                                             Relapsed or
                                                             Relapsed/
                                                             Refractory
                                                             Multiple
                                                             Myeloma
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  An Exploratory
     Hospital for    AVENUE       YORK                       Randomized
     Cancer and                                              Phase II
     Allied                                                  Multicenter
     Diseases                                                Trial of
     (101317743)                                             Abiraterone
                                                             Acetate with or
                                                             without
                                                             Cabazitaxel in
                                                             Treatment of
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Randomized
     Cancer Center   HOLCOMBE                                Phase 2 study
     (1083730964)    BLVD                                    to Evaluate the
                                                             Efficacy of
                                                             Rasburicase in
                                                             Patients at
                                                             Risk for TLS
                                                             During Two
                                                             Cycles of
                                                             Chemotherapy
    ------------------------------------------------------------------------
    The Miriam      164 SUMMIT   PROVIDE  RI         02906  Aflibercept
     Hospital (.)    AVENUE       NCE                        Maintenance for
                                                             patients with
                                                             resected or
                                                             ablated
                                                             metastatic
                                                             colorectal
                                                             cancer
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  An Exploratory
     Hospital for    AVENUE       YORK                       Randomized
     Cancer and                                              Phase II
     Allied                                                  Multicenter
     Diseases                                                Trial of
     (101317743)                                             Abiraterone
                                                             Acetate with or
                                                             without
                                                             Cabazitaxel in
                                                             Treatment of
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  A Multi-center
     Hospital for    AVENUE       YORK                       Randomized
     Cancer and                                              Phase II Study
     Allied                                                  of the Impact
     Diseases                                                of CD34+ Cell
     (101317743)                                             Dose on
                                                             Progression-
                                                             free Survival
                                                             Following High-
                                                             Dose Therapy
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase I Study of
     Cancer          BROOKLINE                               Plerixafor
     Institute (.)   AVE                                     (AMD3100) and
                                                             Bevacizumab for
                                                             Recurrent High-
                                                             grade Glioma
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  A Prospective,
     University      CLIFTON                                 Multicenter
     Hospital        ROAD                                    Study Of Fabry
     (1073592747)                                            Disease
                                                             Clinical and
                                                             Biochemical
                                                             Findings in
                                                             Young Pediatric
                                                             Patients (The
                                                             MOPPET Study)
    ------------------------------------------------------------------------
    Vanderbilt      1211         NASHVIL  TN         37232  Innovation in
     University      MEDICAL      LE                         the timely
     Hospitals &     CENTER                                  diagnosis and
     Clinic (.)      DRIVE                                   multidiscipinar
                                                             y treatment of
                                                             Fabry disease
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Reproductive
     University      CLIFTON                                 Fitness in
     Hospital        ROAD                                    Individuals
     (1073592747)                                            Affected by
                                                             Fabry Disease
                                                             (FIT)
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Reproductive
     University      CLIFTON                                 Fitness in
     Hospital        ROAD                                    Individuals
     (1073592747)                                            Affected by
                                                             Fabry Disease
                                                             (FIT)
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  MGH Fabry
     General         STREET                                  Screening
     Hospital (.)                                            Initiative
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  A Comparison of
     University      CLIFTON                                 Pharmacological
     Hospital        ROAD                                    vs.
     (1073592747)                                            Psychological
                                                             Interventions
                                                             to Improve
                                                             Adaptive
                                                             Function in
                                                             Fabry Patients
                                                             Undergoing
                                                             Enzyme Replace
    ------------------------------------------------------------------------
    USC Norris      1441         LOS      CA         90033  Detection of
     Cancer          EASTLAKE     ANGELE                     early end-organ
     Hospital (.)    AVE          S                          damage by
                                                             endothelial
                                                             dysfunction
                                                             with reactive
                                                             hyperemia-
                                                             digital
                                                             peripheral
                                                             arterial
                                                             tonometry in
                                                             patients with
                                                             Fabry Disease.
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Online Social
     University      CLIFTON                                 Networking Use
     Hospital (.)    ROAD                                    Among
                                                             Individuals
                                                             Affected with
                                                             Lysosomal
                                                             Storage
                                                             Diseases:
                                                             ``Friend'' or
                                                             Foe?
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Characterization
     General         STREET                                  and analysis of
     Hospital                                                pathophysiology
     (1114196961)                                            of the
                                                             gastrointestina
                                                             l complications
                                                             of Fabry
                                                             disease.
    ------------------------------------------------------------------------
    Univ of MI      2301         ANN      MI         48105  A Phase II Study
     Hospitals &     COMMONWEAL   ARBOR                      of VEGF-Trap
     Hlth Ctrs       TH BLVD                                 plus Modified
     (1043488760)                                            FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital (.)                                            open-labeled
                                                             Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Rena
    ------------------------------------------------------------------------
    Washington      110 IRVING   WASHING  DC         20010  Comparison of I-
     Hospital        STREET NW    TON                        124 and I-131
     Center                                                  Radiopharmacoki
     (1184638959)                                            netics in
                                                             Patients who
                                                             have Well-
                                                             differentiated
                                                             Thyroid Cancer
                                                             and have been
                                                             Prepared with
                                                             Radioactive
                                                             Iodine 124
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (.)             PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Aflibercept
     Hospital (.)                                            in Patients
                                                             with Advanced,
                                                             Progressive
                                                             Carcinoid
                                                             Tumors
    ------------------------------------------------------------------------
    Vanderbilt      1211         NASHVIL  TN         37232  Epidemiology of
     University      MEDICAL      LE                         Diabetes
     Hospitals &     CENTER                                  Interventions
     Clinic          DRIVE                                   and
     (1104202761)                                            Complications
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase II Study
     Cancer          BROOKLINE                               of Clofarabine
     Institute (.)   AVE                                     in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Univ Of Iowa    200 HAWKINS  IOWA     IA         52242  Epidemiology of
     Hosp & Clinic   DRIVE 1353   CITY                       Diabetes
     (.)             JCP                                     Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    Univ of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Epidemiology of
     Washington      PACIFIC ST                              Diabetes
     Med Ctr (.)                                             Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Epidemiology of
     Hospital (.)    STREET       HAVEN                      Diabetes
                                                             Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Eliglustat
     Hospital        STREET       HAVEN                      Tatrate Named
     (1003142225)                                            Patient Program
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  Safety and
     Hospital For    AVENUE       YORK                       Efficacy Trial
     Cancer And                                              of Escalation
     Allied                                                  of Plerixafor
     Diseases                                                for
     (101317743)                                             Mobilization of
                                                             CD34+
                                                             Hematopoietic
                                                             Progenitor
                                                             Cells and
                                                             Evaluation of
                                                             Globin Gene
                                                             Traits
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase II Study
     Cancer          BROOKLINE                               of Clofarabine
     Institute (.)   AVE                                     in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Aflibercept
     Hospital (.)                                            in Patients
                                                             with Advanced,
                                                             Progressive
                                                             Carcinoid
                                                             Tumors
    ------------------------------------------------------------------------
    Univ Of MI      2301         ANN      MI         48105  A Phase II Study
     Hospitals &     COMMONWEAL   ARBOR                      of VEGF-Trap
     Hlth Ctrs       TH BLVD                                 plus Modified
     (1043488760)                                            FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    University      445 LENOX    BROOKLY  NY         11203  A Phase II Study
     Hospital Of     ROAD         N                          of VEGF-Trap
     Brooklyn (.)                                            plus Modified
                                                             FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Washington      110 IRVING   WASHING  DC         20010  Comparison of I-
     Hospital        STREET NW    TON                        124 and I-131
     Center                                                  Radiopharmacoki
     (1184638959)                                            netics in
                                                             Patients who
                                                             have Well-
                                                             differentiated
                                                             Thyroid Cancer
                                                             and have been
                                                             Prepared with
                                                             Radioactive
                                                             Iodine 124
    ------------------------------------------------------------------------
    University      445 LENOX    BROOKLY  NY         11203  A Phase II Study
     Hospital Of     ROAD         N                          of VEGF-Trap
     Brooklyn (.)                                            plus Modified
                                                             FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Dana-Farber     450          BOSTON   MA         02215  Phase II Study
     Cancer          BROOKLINE                               of Clofarabine
     Institute (.)   AVE                                     in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (.)             PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    Univ Of MI      2301         ANN      MI         48105  A Phase II Study
     Hospitals &     COMMONWEAL   ARBOR                      of VEGF-Trap
     Hlth Ctrs       TH BLVD                                 plus Modified
     (1043488760)                                            FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Univ Of MI      2301         ANN      MI         48105  A Phase II Study
     Hospitals &     COMMONWEAL   ARBOR                      of VEGF-Trap
     Hlth Ctrs       TH BLVD                                 plus Modified
     (1043488760)                                            FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Eliglustat
     Hospital        STREET       HAVEN                      Tatrate Named
     (1003142225)                                            Patient Program
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  A Multi-center
     Hospital For    AVENUE       YORK                       Randomized
     Cancer And                                              Phase II Study
     Allied                                                  of the Impact
     Diseases                                                of CD34+ Cell
     (101317743)                                             Dose on
                                                             Progression-
                                                             free Survival
                                                             Following High-
                                                             Dose Therapy
                                                             and Autologous
                                                             Stem-cell
                                                             Rescue
    ------------------------------------------------------------------------
     Lucile         725 WELCH    PALO     CA         94304  AML08: A Phase
     Packard         ROAD         ALTO                       III randomized
     Childrens                                               trial of
     Hospital                                                clofarabine
     (1003929852)                                            plus cytarabine
                                                             versus
                                                             conventional
                                                             induction
                                                             therapy and of
                                                             natural killer
                                                             cell
                                                             transplantation
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital (.)                                            in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Univ Of Iowa    200 HAWKINS  IOWA     IA         52242  Epidemiology of
     Hosp & Clinic   DRIVE 1353   CITY                       Diabetes
     (.)             JCP                                     Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    Rainbow Babies  11100        CLEVELA  OH         44106  Epidemiology of
     & Childrens     EUCLID       ND                         Diabetes
     Hospital        AVENUE                                  Interventions
     (1013954395)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Epidemiology of
     Washington      PACIFIC ST                              Diabetes
     Med Ctr (.)                                             Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Epidemiology of
     Hospital (.)    STREET       HAVEN                      Diabetes
                                                             Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    Mayo Clinic     1216 SECOND  ROCHEST  MN         55905  Epidemiology of
     Hospital        STREET SW    ER                         Diabetes
     Rochester (.)                                           Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Aflibercept
     Hospital (.)                                            in Patients
                                                             with Advanced,
                                                             Progressive
                                                             Carcinoid
                                                             Tumors
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital (.)                                            open-labeled
                                                             Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Washington      110 IRVING   WASHING  DC         20010  Comparison of I-
     Hospital        STREET NW    TON                        124 and I-131
     Center                                                  Radiopharmacoki
     (1184638959)                                            netics in
                                                             Patients who
                                                             have Well-
                                                             differentiated
                                                             Thyroid Cancer
                                                             and have been
                                                             Prepared with
                                                             Radioactive
                                                             Iodine 124
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Memorial        1275 YORK    NEW      NY         10065  Safety and
     Hospital For    AVENUE       YORK                       Efficacy Trial
     Cancer And                                              of Escalation
     Allied                                                  of Plerixafor
     Diseases                                                for
     (101317743)                                             Mobilization of
                                                             CD34+
                                                             Hematopoietic
                                                             Progenitor
                                                             Cells and
                                                             Evaluation of
                                                             Globin Gene
                                                             Traits
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital (.)                                            open-labeled
                                                             Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital (.)                                            in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Aflibercept
     Hospital (.)                                            in Patients
                                                             with Advanced,
                                                             Progressive
                                                             Carcinoid
                                                             Tumors
    ------------------------------------------------------------------------
    Cook Childrens  901 SEVENTH  FORT     TX         76104  AML08: A Phase
     Medical         AVENUE       WORTH                      III randomized
     Center                                                  trial of
     (1215907530)                                            clofarabine
                                                             plus cytarabine
                                                             versus
                                                             conventional
                                                             induction
                                                             therapy and of
                                                             natural killer
                                                             cell
                                                             transplantation
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital (.)                                            in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Ohsu Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (.)             PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital (.)                                            in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Univ Of Mi      2301         ANN      MI         48105  A Phase II Study
     Hospitals &     COMMONWEAL   ARBOR                      of VEGF-Trap
     Hlth Ctrs       TH BLVD                                 plus Modified
     (1043488760)                                            FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Univ Of MI      2301         ANN      MI         48105  A Phase II Study
     Hospitals &     COMMONWEAL   ARBOR                      of VEGF-Trap
     Hlth Ctrs       TH BLVD                                 plus Modified
     (1043488760)                                            FOLFOX 6 in
                                                             Previously
                                                             Untreated
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer
    ------------------------------------------------------------------------
    Lucile Packard  725 WELCH    PALO     CA         94304  AML08: A Phase
     Childrens       ROAD         ALTO                       III randomized
     Hospital                                                trial of
     (1003929852)                                            clofarabine
                                                             plus cytarabine
                                                             versus
                                                             conventional
                                                             induction
                                                             therapy and of
                                                             natural killer
                                                             cell
                                                             transplantation
    ------------------------------------------------------------------------
    City Of Hope    1500 EAST    DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical         ROAD                                    and High-Dose
     Center                                                  Melphalan
     (103343529)                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Enhancing Anti-
     University      CLIFTON                                 Myeloma Vaccine
     Hospital        ROAD                                    Response after
     (1073837167)                                            Autologous Stem
                                                             Cell
                                                             Transplantation
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  MTA for :
     University      CLIFTON                                 Enhancing Anti-
     Hospital (.)    ROAD                                    Myeloma Vaccine
                                                             Response after
                                                             Autologous Stem
                                                             Cell Transplant
    ------------------------------------------------------------------------
    Rochester       1425         ROCHEST  NY         14621  A Study
     General         PORTLAND     ER                         Evaluating
     Hospital (.)    AVENUE                                  Acute Otitis
                                                             Media and
                                                             Nasopharyngeal
                                                             Colonization
                                                             Caused by
                                                             Streptococcus
                                                             pneumoniae in
                                                             Healthy
                                                             Children
    ------------------------------------------------------------------------
    Rochester       1425         ROCHEST  NY         14621  A Study
     General         PORTLAND     ER                         Evaluating
     Hospital (.)    AVENUE                                  Acute Otitis
                                                             Media and
                                                             Nasopharyngeal
                                                             Colonization
                                                             Caused by
                                                             Streptococcus
                                                             pneumoniae in
                                                             Healthy
                                                             Children
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Assessment of
     Womens          STREET                                  Aubagio?s
     Hospital (.)                                            neuroprotective
                                                             effect on the
                                                             development of
                                                             T1 black holes
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  miRNA profiling
     Womens          STREET                                  in
     Hospital                                                Teriflunomide
     (1013935550)                                            (Aubagio)
                                                             treated
                                                             patients
    ------------------------------------------------------------------------
    Langley Porter  405          SAN      CA         94143  Long-term
     Psychiatric     PARNASUS     FRANCI                     Management of
     Hosptial (.)                 SCO                        ?Younger,
                                                             Active?
                                                             Patients with
                                                             Pain from Early
                                                             Knee
                                                             Osteoarthritis
                                                             with Synvisc-
                                                             One (hylan G-F
                                                             20)
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Fluctuation
     Washington      PACIFIC ST                              Reduction With
     Med Ctr (.)                                             Insulin and GLP-
                                                             1 Added
                                                             Together (FLAT-
                                                             SUGAR)
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Fluctuation
     Washington      PACIFIC ST                              Reduction With
     Med Ctr (.)                                             Insulin and GLP-
                                                             1 Added
                                                             Together (FLAT-
                                                             UGAR)
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1043549397)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Aflibercept
     Hospital                                                in Patients
     (1114196961)                                            with Advanced,
                                                             Progressive
                                                             Carcinoid
                                                             Tumors
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1043549397)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Mount Sinai     ONE GUSTAVE  NEW      NY         10029  Phase II Study
     Hospital        L. LEVY      YORK                       of Clofarabine
     (1003063280)    PLACE                                   in Patients
                                                             with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Mayo Clinic     1216 SECOND  ROCHEST  MN         55905  Epidemiology of
     Hospital        STREET SW    ER                         Diabetes
     Rochester (.)                                           Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    Mayo Clinic     1216 SECOND  ROCHEST  MN         55905  Epidemiology of
     Hospital        STREET SW    ER                         Diabetes
     Rochester (.)                                           Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   200 HAWKINS  IOWA     IA         52242  Epidemiology of
     Iowa Hosp &     DRIVE 1353   CITY                       Diabetes
     Clinics         JCP                                     Interventions
     (1326474149)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   200 HAWKINS  IOWA     IA         52242  Epidemiology of
     Iowa Hosp &     DRIVE 1353   CITY                       Diabetes
     Clinics         JCP                                     Interventions
     (1326474149)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Vanderbilt      1211         NASHVIL  TN         37232  Epidemiology of
     University      MEDICAL      LE                         Diabetes
     Medical         CENTER                                  Interventions
     Center          DRIVE                                   and
     (1104202761)                                            Complications
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Epidemiology of
     Hospital        STREET       HAVEN                      Diabetes
     (1003142225)                                            Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1043549397)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1043549397)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Aflibercept
     Hospital                                                in Patients
     (1114196961)                                            with Advanced,
                                                             Progressive
                                                             Carcinoid
                                                             Tumors
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Methodist       7700 FLOYD   SAN      TX         78229  A Multi-center
     Hospital        CURL DRIVE   ANTONI                     Randomized
     (1124074273)                 O                          Phase II Study
                                                             of the Impact
                                                             of CD34+ Cell
                                                             Dose on
                                                             Progression-
                                                             free Survival
                                                             Following High-
                                                             Dose Therapy
                                                             and Autologous
                                                             Stem-cell
                                                             Rescue
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Clofarabine
     Hospital                                                in Patients
     (1114196961)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Arkansas        1 CHILDRENS  LITTLE   AR         72202  Phase II Study
     Childrens       WAY          ROCK                       of Clofarabine
     Hospital                                                in Patients
     (1134155831)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Phoenix         1919 E.      PHOENIX  AZ         85016  Phase II Study
     Childrens       THOMAS                                  of Clofarabine
     Hospital        ROAD                                    in Patients
     (1023475506)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Epidemiology of
     Hospital        STREET       HAVEN                      Diabetes
     (1003142225)                                            Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Clofarabine
     Hospital                                                in Patients
     (1114196961)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    City Of Hope    1500 E.      DUARTE   CA         91010  Phase II Study
     National        DUARTE                                  of Clofarabine
     Medical Cnt     ROAD                                    and High-Dose
     (1033435292)                                            Melphalan
                                                             Conditioning
                                                             Prior to
                                                             Allogeneic
                                                             Heamtopoietic
                                                             Cell
                                                             Transplantation
                                                             for
                                                             Myelodysplasia
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    Phoenix         1919 E.      PHOENIX  AZ         85016  Phase II Study
     Childrens       THOMAS                                  of Clofarabine
     Hospital        ROAD                                    in Patients
     (1023475506)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Mount Sinai     ONE GUSTAVE  NEW      NY         10029  Clinical Trial
     Hospital (.)    L. LEVY      YORK                       of a Rapidly
                     PLACE                                   Cycling, Non-
                                                             Cross Reactive
                                                             Regimen of
                                                             Approved
                                                             Therapeutic
                                                             Agents to Treat
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Ohsu Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (.)             PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    Rochester       1425         ROCHEST  NY         14621  A Study
     General         PORTLAND     ER                         Evaluating
     Hospital        AVENUE                                  Acute Otitis
     (1023105376)                                            Media and
                                                             Nasopharyngeal
                                                             Colonization
                                                             Caused by
                                                             Streptococcus
                                                             pneumoniae in
                                                             Healthy
                                                             Children
    ------------------------------------------------------------------------
    Rochester       1425         ROCHEST  NY         14621  A Study
     General         PORTLAND     ER                         Evaluating
     Hospital        AVENUE                                  Acute Otitis
     (1023105376)                                            Media and
                                                             Nasopharyngeal
                                                             Colonization
                                                             Caused by
                                                             Streptococcus
                                                             pneumoniae in
                                                             Healthy
                                                             Children
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Glargine U300
     University      CLIFTON                                 Hospital Trial:
     Hospital (.)    ROAD                                    A Randomized
                                                             Controlled
                                                             Trial Comparing
                                                             Glargine U300
                                                             and Glargine
                                                             U100 for the
                                                             Inpatient and
                                                             Post-Hospital
                                                             Discharge
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  Investigating
     Clinic          AVENUE       ND                         the efficacy of
     Hospital (.)                                            Synvisc-One
                                                             (Hylan-GF 20
                                                             6ml ) as
                                                             adjunctive
                                                             therapy for
                                                             patients with
                                                             knee osteo-
                                                             arthritis or
                                                             requiring
                                                             physical
                                                             therapy
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Enzyme
     General         STREET                                  Replacement
     Hospital                                                Therapy and
     (1114196961)                                            Podocyte
                                                             Function
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  KINDRED--Kidney
     General         STREET                                  Information
     Hospital                                                Network for
     (1114196961)                                            Disease
                                                             Research and
                                                             Education
    ------------------------------------------------------------------------
    Tufts Medical   800          BOSTON   MA         02111  The Prevalence,
     Center (.)      WASHINGTON                              Morphology,
                     ST                                      Clinical Course
                                                             and Management
                                                             of Patients
                                                             with Anderson-
                                                             Fabry Disease
                                                             Identified
                                                             Among a Large
                                                             Adult
                                                             Population
    ------------------------------------------------------------------------
    University Of   619 SOUTH    BIRMING  AL         35233  Teriflunomide as
     Alabama         19TH         HAM                        a disease
     Hospital (.)    STREET                                  modifying anti-
                                                             inflammatory
                                                             therapy for a
                                                             severe animal
                                                             model of
                                                             chronic
                                                             inflammatory
                                                             demyelinating
                                                             polyneuropathy
    ------------------------------------------------------------------------
    Langley Porter  405          SAN      CA         94143  A Phase I Study
     Psychiatric     PARNASUS     FRANCI                     of Cabazitaxel,
     Hosptial                     SCO                        Mitoxanthrone,
     (1417115031)                                            and Prednisone
                                                             (CAMP) for
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  Post-partum MRI
     Womens          STREET                                  Changes in
     Hospital                                                Women with
     (1013935550)                                            Multiple
                                                             Sclerosis.
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Establishing an
     Washington      PACIFIC ST                              in-vitro Model
     Med Ctr (.)                                             of Fabry
                                                             Podocytopathy
    ------------------------------------------------------------------------
    UCI Medical     101 CITY     ORANGE   CA         92868  Investigating
     Center (.)      DRIVE                                   Pompe
                     SOUTH                                   Prevalence in
                                                             NEuromuscular
                                                             Medicine
                                                             Academic
                                                             Practices
                                                             (IPANEMA Study)
    ------------------------------------------------------------------------
    UCI Medical     101 CITY     ORANGE   CA         92868  Safety and
     Center (.)      DRIVE                                   Effectiveness
                     SOUTH                                   of Resistance
                                                             exercise
                                                             training in
                                                             late onset
                                                             Pompe disease
                                                             patients--a
                                                             pilot study
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Do the Benefits
     University      CLIFTON                                 Outweigh the
     Hospital (.)    ROAD                                    Risks?
                                                             Assessing
                                                             Patients'
                                                             Perceptions of
                                                             Newborn
                                                             Screening for
                                                             Lysosomal
                                                             Storage
                                                             Diseases
    ------------------------------------------------------------------------
    USC Norris      1441         LOS      CA         90033  Detection of
     Cancer          EASTLAKE     ANGELE                     early end-organ
     Hospital        AVE          S                          damage by
     (1104096577)                                            endothelial
                                                             dysfunction
                                                             with reactive
                                                             hyperemia-
                                                             digital
                                                             peripheral
                                                             arterial
                                                             tonometry in
                                                             patients with
                                                             Fabry Disease
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  A Prospective,
     University      CLIFTON                                 Multicenter
     Hospital (.)    ROAD                                    Study Of Fabry
                                                             Disease
                                                             Clinical and
                                                             Biochemical
                                                             Findings in
                                                             Young Pediatric
                                                             Patients (The
                                                             MOPPET Study)
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Establishing an
     Washington      PACIFIC ST                              in-vitro Model
     Med Ctr (.)                                             of Fabry
                                                             Podocytopathy
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal
                                                             Protection
                                                             after Liver
                                                             Transplantation
                                                             A Multi-Center
                                                             Study
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal
                                                             Protection
                                                             after Liver
                                                             Transplantation
                                                             A Multi-Center
                                                             Study
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal
                                                             Protection
                                                             after Liver
                                                             Transplantation
                                                             A Multi-Center
                                                             Study
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal
                                                             Protection
                                                             after Liver
                                                             Transplantation
                                                             A Multi-Center
                                                             Study
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     and Clinics     JACKSON      D                          Trial of
     (1053454645)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     and Clinics     JACKSON      D                          Trial of
     (1053454645)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     and Clinics     JACKSON      D                          Trial of
     (1053454645)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Mount Sinai     FIRST        NEW      NY         10003  Gaucher
     Beth Israel     AVENUE AT    YORK                       Generation--Cog
     (1003052200)    16 STREET                               nition, Motor
                                                             Control,
                                                             Imaging and
                                                             Pathologic
                                                             Biomarkers in
                                                             GBA1 Mutation
                                                             Carriers
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Fluctuation
     Washington      PACIFIC ST                              Reduction with
     Med Ctr (.)                                             Insulin and
                                                             GLP--1 Added
                                                             Together (FLAT-
                                                             SUGAR)
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Fluctuation
     Washington      PACIFIC ST                              Reduction with
     Med Ctr (.)                                             Insulin and GLP-
                                                             1 Added
                                                             Together (FLAT-
                                                             SUGAR)
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  miRNA profiling
     Womens          STREET                                  in
     Hospital                                                Teriflunomide
     (1013935550)                                            (Aubagio)
                                                             treated
                                                             patients
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Factors
     General         STREET                                  influencing
     Hospital                                                patient
     (1114196961)                                            preferences for
                                                             oral versus
                                                             intravenous
                                                             (IV) enzyme
                                                             replacement
                                                             medication.
    ------------------------------------------------------------------------
    University Of   1959 NE      SEATTLE  WA         98195  Localization of
     Washington      PACIFIC ST                              Globotriaosylce
     Med Ctr (.)                                             ramide (GL3)
                                                             Inclusions in
                                                             Fabry Podocytes
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Online Social
     University      CLIFTON                                 Networking Use
     Hospital (.)    ROAD                                    Among
                                                             Individuals
                                                             Affected with
                                                             Lysosomal
                                                             Storage
                                                             Diseases:
                                                             ``Friend'' or
                                                             Foe?
    ------------------------------------------------------------------------
    University Of   619 SOUTH    BIRMING  AL         35233  Comparative
     Alabama         19TH         HAM                        Proteomics and
     Hospital (.)    STREET                                  Lipidomics of
                                                             Exosomes
                                                             Isolated from
                                                             Serum and Urine
                                                             in Fabry
                                                             Disease
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Glargine U300
     University      CLIFTON                                 Hospital Trial:
     Hospital (.)    ROAD                                    A Randomized
                                                             Controlled
                                                             Trial Comparing
                                                             Glargine U300
                                                             and Glargine
                                                             U100 for the
                                                             Inpatient and
                                                             Post-Hospital
                                                             Discharge
                                                             Management of
                                                             Medicine and
                                                             Surgery
                                                             Patients with
                                                             Type 2 Diabetes
    ------------------------------------------------------------------------
    UC Davis        2315         SACRAME  CA         95817  A Selective
     Medical         STOCKTON     NTO                        Frontline
     Center (.)      BLVD                                    Jevtana
                                                             Therapeutic
                                                             Pathway for
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
                                                             with Integrated
                                                             Biomarkers
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Study of
     Clinic          AVENUE       ND                         Hematopoietic
     Hospital                                                Stem Cell
     (1013392125)                                            Supermobilizati
                                                             on in Patients
                                                             with Lymphoma
    ------------------------------------------------------------------------
    UH Cleveland    11100        CLEVELA  OH         44106  Epidemiology of
     Medical         EUCLID       ND                         Diabetes
     Center          AVENUE                                  Interventions
     (1013954395)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    UH Cleveland    11100        CLEVELA  OH         44106  Epidemiology of
     Medical         EUCLID       ND                         Diabetes
     Center          AVENUE                                  Interventions
     (1013954395)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    UH Cleveland    11100        CLEVELA  OH         44106  Epidemiology of
     Medical         EUCLID       ND                         Diabetes
     Center          AVENUE                                  Interventions
     (1013954395)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Epidemiology of
     Hospital        STREET       HAVEN                      Diabetes
     (1003142225)                                            Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Dynamic
     Cancer Center   HOLCOMBE                                Allocation
     (1053755272)    BLVD                                    Modular
                                                             Sequential
                                                             Trial of
                                                             Approved and
                                                             Promising
                                                             Therapies in
                                                             Men with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (1033650353)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Dynamic
     Cancer Center   HOLCOMBE                                Allocation
     (1053755272)    BLVD                                    Modular
                                                             Sequential
                                                             Trial of
                                                             Approved And
                                                             Promising
                                                             Therapies in
                                                             Men with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Charleston      501 MORRIS   CHARLES  WV         25326  A Phase II Trial
     Area Medical    STREET       TON                        of GM-CSF
     Center Inc.                                             Protein plus
     (1124248752)                                            Ipilimumab in
                                                             Patients with
                                                             Advanced
                                                             Melanoma (ECOG
                                                             1608)
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Dynamic
     Cancer Center   HOLCOMBE                                Allocation
     (1053755272)    BLVD                                    Modular
                                                             Sequential
                                                             Trial of
                                                             Approved And
                                                             Promising
                                                             Therapies in
                                                             Men with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (1033650353)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Univ Of         ONE          COLUMBI  MO         65212  Epidemiology of
     Missouri        HOSPITAL     A                          Diabetes
     Health Care     DRIVE                                   Interventions
     (1033499256)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    Yale-New Haven  20 YORK      NEW      CT         06504  Epidemiology of
     Hospital        STREET       HAVEN                      Diabetes
     (1003142225)                                            Interventions
                                                             and
                                                             Complications
    ------------------------------------------------------------------------
    UH Cleveland    11100        CLEVELA  OH         44106  Epidemiology of
     Medical         EUCLID       ND                         Diabetes
     Center          AVENUE                                  Interventions
     (1013954395)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    University Of   22 SOUTH     BATLIMO  MD         21201  Epidemiology of
     Maryland Med    GREENE       RE                         Diabetes
     Sys             STREET                                  Interventions
     (1023304888)                                            and
                                                             Complications
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (1033650353)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Phase II Study
     General         STREET                                  of Clofarabine
     Hospital                                                in Patients
     (1114196961)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    Childrens       4650 SUNSET  LOS      CA         90027  Phase II Study
     Hospital Los    BOULEVARD    ANGELE                     of Clofarabine
     Angeles                      S                          in Patients
     (1003102781)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Dynamic
     Cancer Center   HOLCOMBE                                Allocation
     (1053755272)    BLVD                                    Modular
                                                             Sequential
                                                             Trial of
                                                             Approved and
                                                             Promising
                                                             Therapies in
                                                             Men with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (1033650353)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  A Dynamic
     Cancer Center   HOLCOMBE                                Allocation
     (1053755272)    BLVD                                    Modular
                                                             Sequential
                                                             Trial of
                                                             Approved and
                                                             Promising
                                                             Therapies in
                                                             Men with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Texas           6621 FANNIN  HOUSTON  TX         77030  Phase II Study
     Childrens                                               of Clofarabine
     Hospital                                                in Patients
     (1013283159)                                            with Recurrent
                                                             or Refractory
                                                             Langerhans Cell
                                                             Histiocytosis
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (1033650353)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  IST-1L-
     Cancer Center   HOLCOMBE                                Smoldering
     (1053755272)    BLVD                                    myeloma-PT-IV
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  SAR650984--Anti-
     Cancer Center   HOLCOMBE                                CD38 naked mAb--
     (1053755272)    BLVD                                    isatuximab
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  IST-1L-
     Cancer Center   HOLCOMBE                                Smoldering
     (1053755272)    BLVD                                    myeloma-PT-IV
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  IST-1L-
     Cancer Center   HOLCOMBE                                Smoldering
     (1053755272)    BLVD                                    myeloma-PT-IV
    ------------------------------------------------------------------------
    Rochester       1425         ROCHEST  NY         14617  A Study
     General         PORTLAND     ER                         Evaluating
     Hospital        AVENUE                                  Acute Otitis
     (1023105376)                                            Media and
                                                             Nasopharyngeal
                                                             Colonization
                                                             Caused by
                                                             Streptococcus
                                                             pneumoniae in
                                                             Healthy
                                                             Children
    ------------------------------------------------------------------------
    KFH-Hawaii      3288         HONOLUL  HI         96819  Efficacy of
     (1306928254)    MOANALUA     U                          Flublok study
                     ROAD
    ------------------------------------------------------------------------
    KFH-Hawaii      3288         HONOLUL  HI         96819  Vaccine
     (1306928254)    MOANALUA     U                          effectiveness
                     ROAD                                    of Flublok 18-
                                                             64
    ------------------------------------------------------------------------
    University of   855 WEST     CHARLOT  VA         22908  IRB-HSR#14386
     Virginia        MAIN         TESVIL
     Medical Cente   STREET       L
     (.)
    ------------------------------------------------------------------------
    Tufts Medical   800          BOSTON   MA         02111  The Prevalence,
     Center          WASHINGTON                              Morphology,
     (1114162013)    ST                                      Clinical Course
                                                             and Management
                                                             of Patients
                                                             with Anderson-
                                                             Fabry Disease
                                                             Identified
                                                             Among a Large
                                                             Adult
                                                             Population
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Characterization
     General         STREET                                  and analysis of
     Hospital                                                pathophysiology
     (1114196961)                                            of the
                                                             gastrointestina
                                                             l complications
                                                             of Fabry
                                                             disease.
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  Biomarkers of
     Clinic          AVENUE       ND                         Disease
     Hospital                                                Heterogeneity
     (1013392125)                                            in Multiple
                                                             Sclerosis:
                                                             Phase II
    ------------------------------------------------------------------------
    UCI Medical     101 THE      SOUTH    CA         92868  Investigating
     Center (.)      CITY DRIVE   ORANGE                     Pompe
                                                             Prevalence in
                                                             NEuromuscular
                                                             Medicine
                                                             Academic
                                                             Practices
                                                             (IPANEMA Study)
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    Cleveland       9500 EUCLID  CLEVELA  OH         44195  A Randomized,
     Clinic          AVENUE       ND                         Controlled,
     Hospital                                                open-labeled
     (1013392125)                                            Clinical Trial
                                                             of
                                                             Thymoglobulin?
                                                             Induction and
                                                             Extended Delay
                                                             of Calcineurin
                                                             Inhibitor
                                                             Therapy for
                                                             Renal Failure
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  A Phase I/II
     And Clinics     JACKSON      D                          Trial of
     (1033650353)    PARK ROAD                               Concurrent
                                                             Chemohormonal
                                                             Therapy Using
                                                             Enzalutamide
                                                             (MDV-3100) and
                                                             Cabazitaxel in
                                                             Patients with
                                                             Metastatic
                                                             Castration-
                                                             Resistant
                                                             Prostate Cancer
    ------------------------------------------------------------------------
    Mount Sinai     1ST AVENUE@   NEW     NY         10003  Gaucher
     Beth Israel     16TH         YORK                       Generation--Cog
     (1003052200)    STREET                                  nition, Motor
                                                             Control,
                                                             Imaging and
                                                             Pathologic
                                                             Biomarkers in
                                                             GBA1 Mutation
                                                             Carriers
    ------------------------------------------------------------------------
    Mount Sinai     1ST AVENUE@  NEW      NY         10003  Gaucher
     Beth Israel     16TH         YORK                       Generation--Cog
     (1003052200)    STREET                                  nition, Motor
                                                             Control,
                                                             Imaging and
                                                             Pathologic
                                                             Biomarkers in
                                                             GBA1 Mutation
                                                             Carriers
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Newborn
     University      CLIFTON                                 Screening XLSD
     Hospital (.)    ROAD                                    Pilot Study
    ------------------------------------------------------------------------
    University of   619 SOUTH    BIRMING  AL         35233  Comparative
     Alabama         19TH         HAM                        Proteomics and
     Hospital (.)    STREET                                  Lipidomics of
                                                             Exosomes
                                                             Isolated from
                                                             Serum and Urine
                                                             in Fabry
                                                             Disease
    ------------------------------------------------------------------------
    UT MD Anderson  1515         HOUSTON  TX         77030  Interest of CT
     Cancer Center   HOLCOMBE                                Morphological
     (1053755272)    BLVD                                    Evaluation in
                                                             Patients with
                                                             Metastatic
                                                             Colorectal
                                                             Cancer Treated
                                                             with ZIV-
                                                             Aflibercept
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  New England
     Womens          STREET                                  Multiple
     Hospital                                                Sclerosis
     (1013935550)                                            Pregnancy
                                                             Registry (PREG-
                                                             MS)
    ------------------------------------------------------------------------
    Brigham and     75 FRANCIS   BOSTON   MA         02115  New England
     Womens          STREET                                  Multiple
     Hospital                                                Sclerosis
     (1013935550)                                            Pregnancy
                                                             Registry (PREG-
                                                             MS)
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  New England
     Womens          STREET                                  Multiple
     Hospital                                                Sclerosis
     (1013935550)                                            Pregnancy
                                                             Registry (PREG-
                                                             MS)
    ------------------------------------------------------------------------
    Univ Of Mi      2301         ANN      MI         48105  Regulatory B
     Hospitals &     COMMONWEAL   ARBOR                      Lymphocytes as
     Hlth Ctrs       TH BLVD                                 Central
     (1043488760)                                            Mediators of
                                                             the Therapeutic
                                                             Effects of
                                                             Teriflunomide
                                                             in MS
    ------------------------------------------------------------------------
    Univ Of Mi      2301         ANN      MI         48105  Regulatory B
     Hospitals &     COMMONWEAL   ARBOR                      Lymphocytes as
     Hlth Ctrs       TH BLVD                                 Central
     (1043488760)                                            Mediators of
                                                             the Therapeutic
                                                             Effects of
                                                             Teriflunomide
                                                             in MS
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  Bright tongue
     and Clinics     JACKSON      D                          sign in Pompe
     (1033650353)    PARK ROAD                               disease:
                                                             sensitivity and
                                                             specificity
    ------------------------------------------------------------------------
    OHSU Hospital   3181 SAM     PORTLAN  OR         97239  Bright tongue
     And Clinics     JACKSON      D                          sign in Pompe
     (1033650353)    PARK ROAD                               disease:
                                                             sensitivity and
                                                             specificity
    ------------------------------------------------------------------------
    Brigham And     75 FRANCIS   BOSTON   MA         02115  miRNA profiling
     Womens          STREET                                  in
     Hospital                                                Teriflunomide
     (1013935550)                                            (Aubagio)
                                                             treated
                                                             patients
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Enzyme
     General         STREET                                  Replacement
     Hospital                                                Therapy and
     (1114196961)                                            Podocyte
                                                             Function
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  KINDRED--Kidney
     General         STREET                                  Information
     Hospital                                                Network for
     (1114196961)                                            Disease
                                                             Research and
                                                             Education
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  ThinkGenetic
     University      CLIFTON                                 LSD: A project
     Hospital (.)    ROAD                                    to identify
                                                             educational
                                                             gaps in the
                                                             informational
                                                             needs of
                                                             individuals
                                                             with Pompe,
                                                             Fabry, Gaucher,
                                                             Mucopolysacchar
                                                             ide Diseases
    ------------------------------------------------------------------------
    Cedars-Sinai    8700         LOS      CA         90048  A Pilot
     Medical         BEVERLY      ANGELE                     Randomized
     Center (.)      BLVD.        S                          Study to Assess
                                                             the Effect and
                                                             Safety Profile
                                                             of
                                                             Thymoglobulin?
                                                             in Primary
                                                             Cardiac
                                                             Transplant
                                                             Recipients: A
                                                             12-month,
                                                             single center
                                                             study
    ------------------------------------------------------------------------
    Massachusetts   FRUIT        BOSTON   MA         02114  Characterization
     General         STREET                                  and analysis of
     Hospital                                                pathophysiology
     (1114196961)                                            of the
                                                             gastrointestina
                                                             l complications
                                                             of Fabry
                                                             disease.
    ------------------------------------------------------------------------
    University Of   619 SOUTH    BIRMING  AL         35233  Teriflunomide as
     Alabama         19TH         HAM                        a disease
     Hospital (.)    STREET                                  modifying anti-
                                                             inflammatory
                                                             therapy for a
                                                             severe animal
                                                             model of
                                                             chronic
                                                             inflammatory
                                                             demyelinating
                                                             polyneuropathy
    ------------------------------------------------------------------------
    USC Norris      1441         LOS      CA         90033  Assessing the
     Cancer          EASTLAKE     ANGELE                     induction of
     Hospital        AVE          S                          long-term
     (1104096577)                                            immune
                                                             regulation
                                                             following
                                                             treatment with
                                                             Lemtrada?
                                                             (Alemtuzumab).
    ------------------------------------------------------------------------
    USC Norris      1441         LOS      CA         90033  Assessing the
     Cancer          EASTLAKE     ANGELE                     induction of
     Hospital        AVE          S                          long-term
     (1104096577)                                            immune
                                                             regulation
                                                             following
                                                             treatment with
                                                             Lemtrada?
                                                             (Alemtuzumab).
    ------------------------------------------------------------------------
    Emory           1364         ATLANTA  GA         30302  Functional
     University      CLIFTON                                 Resolution of
     Hospital (.)    ROAD                                    Multi-loci
                                                             Pathogenic
                                                             Variants and
                                                             VUSs in Pompe
                                                             Disease
    ------------------------------------------------------------------------

    Prepared Statement of Giovanni Caforio, M.D., Chairman of the Board and
             Chief Executive Officer, Bristol-Myers Squibb Company
        Chairman Grassley, Ranking Member Wyden, and members of the
    committee, thank you for the opportunity to be here today on behalf of
    the 24,000 employees at Bristol-Myers Squibb, who are working every day
    to improve the lives of patients with serious diseases. I look forward
    to working together to align incentives to ensure all Americans have
    access to the medicines they need.

        I am a physician who joined the biopharmaceutical industry 30 years
    ago because of the impact companies like Bristol-Myers Squibb--and the
    others represented here today--have on patients with serious diseases.
    We should all be proud that American companies lead our industry.

        Bristol-Myers Squibb researchers have contributed to the
    development of medicines that have reduced mortality from
    cardiovascular disease, helped transform HIV/AIDS into a chronic
    disease, and are now making significant progress in the treatment of
    cancer.

        Just 10 years ago, the idea of harnessing the immune system to
    treat cancer was viewed with great skepticism. But Bristol-Myers Squibb
    researchers saw the promise of the approach and ignited an era of
    scientific innovation that has changed survival expectations in
    multiple tumor types.

        Prior to the availability of Immuno-Oncology treatments, only 25
    percent of patients diagnosed with metastatic melanoma survived 1 year.
    Today, thanks to Immuno-Oncology therapies, this has increased to 74
    percent.

        The potential of this approach has also been seen in lung cancer,
    kidney cancer, and many other difficult-to-treat tumors. Patients with
    these diseases now have a chance for quality, long-term survival.

        But not all patients respond to current immunotherapies, so we must
    do more. We recently opened a new discovery facility dedicated to
    investigating Immuno-
    Oncology resistance, and we continuously seek external innovation to
    augment our pipeline across multiple therapeutic areas. In this
    context, we recently announced our plan to acquire Celgene, a natural
    next step for our company. Our goal is to bring together the drive and
    dedication of two science-driven organizations to do even more for
    patients.

        As a physician, I recognize that medicines are only helpful if
    patients and health-care systems can afford them. We share the
    committee's concern with escalating health-care costs and believe that
    our responsibility to patients extends to ensuring they can access and
    afford our medicines.

        The average net pricing across our U.S. portfolio of medicines
    increased by 5 percent or less per year during the last 5 years. In
    2018, it did not increase and we anticipate the same in 2019.

        Despite this fact, we recognize that patients' out-of-pocket costs
    continue to increase. We believe it is possible to work together to
    realign incentives to ensure patients can afford medicines without
    stifling scientific innovation.

        So what are the solutions?

              We are supportive of the proposed rule aimed at reforming
            the rebate system with a focus on what is best for patients.

              We need to ensure more generics are available whenever
            permissible under our system, and applaud Congress and the
            administration's success with speeding the approval of
            generics.

              We support value-based purchasing arrangements that tie
            payments to value. These models can reduce costs, improve
            access and adherence, and contribute to better outcomes. We
            applaud efforts by Health and Human Services and the Committee
            to remove regulatory barriers and facilitate greater use of
            these arrangements.

        We do not believe the U.S. should adopt policies that stifle
    innovation in other countries, which could reduce a patient's access to
    new medicines. Outside of the U.S., reimbursement of new medicines can
    often take more than two years. Our Opdivo and Yervoy regimen was first
    approved in September 2015 to treat metastatic melanoma in the U.S.
    Today, six of the 16 countries included in the International Price
    Index proposal do not provide access to this combination, which is now
    considered the standard of care for this cancer.

        This exemplifies why Bristol-Myers Squibb does not support HHS's
    proposed International Price Index Model for Medicare Part B drugs.

        I would like to leave you with a few thoughts.

        We are witnessing a historic era in biomedical innovation. But we
    must ensure patients have affordable access to these innovations.

        We recognize the need for change, and we are committed to working
    with Congress to ensure every patient can benefit from today's medical
    innovations.

        American research-based companies are leading the next wave of
    biomedical innovation to help patients whose diseases cannot be
    adequately treated with today's medicines. We should work to ensure
    policies that support and reward these investments.

        On behalf of my colleagues at Bristol-Myers Squibb, and the
    patients we serve, my sincere thanks for your time and attention today.
    I look forward to working together to implement real change that
    broadens access to innovative medicines for patients.

                                     ______

          Questions Submitted for the Record to Giovanni Caforio, M.D.
                   Questions Submitted by Hon. Chuck Grassley
        Question. At the hearing, you testified that Bristol-Myers Squibb
    does not withhold samples from generic manufacturers in order to block
    generic versions of your drug from entering the market. You also
    expressed your support for the ``Creating and Restoring Equal Access to
    Equivalent Samples Act,'' also known as the CREATES Act.

        As you know, the FDA has a list on its website which identifies
    reference listed drug (RLD) access inquiries where brand manufacturers
    may have prevented generic companies from obtaining samples of products
    necessary to support FDA approval. Celgene is on this FDA list.
    According to your testimony, Bristol-Myers Squibb is in the process of
    acquiring Celgene.

        Are you aware that Celgene is on the FDA list and that Celgene had
    multiple access inquiries?

        Answer. Yes.

        Question. Will you ensure that Bristol-Myers Squibb/Celgene will
    not block access to samples once the Celgene acquisition is final?

        Answer. As Dr. Caforio testified at the hearing, BMS does not
    withhold samples from generic manufacturers in order to block generic
    versions of the drug from entering the market. BMS believes it is
    important to ensure generics are made available whenever that is
    permissible under our system, and supports the administration's focus
    on increasing the approval of generics. As part of that system, it is
    important that generic companies perform the needed testing to ensure
    product quality and patient safety. BMS cannot comment on Celgene's
    practices in this area, but once the transaction closes, BMS's
    practices with regard to generic samples will govern the combined
    portfolio.

        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant. If the HHS proposed rule is finalized, can you assure the
    committee that your company will offer up-front discounts? If not, why?

        Answer. BMS supports the HHS proposed rule to eliminate safe harbor
    protection for back-end rebates under Medicare Part D and the rule's
    objective to ensure that patients benefit from price reductions that
    BMS provides on its drugs. As the proposed rule notes, there is
    uncertainty as to the strategic behavior changes that will occur if the
    rule is enacted, and therefore uncertainty as to precise mechanisms
    that will be available to meet the objectives of the rule. However,
    there is some risk that manufacturers would have to defend themselves
    against antitrust litigation if they were to offer up-front discounts
    instead of rebates if the proposed rule were finalized. In particular,
    there may be risk of claims being crafted under the Robinson-Patman
    Act, 15 U.S.C. Sec. 13. Any such claims would have to meet significant
    substantive requirements and be subject to important statutory
    defenses. Nonetheless, even if meritless, Robinson-Patman claims can be
    expensive and time consuming for manufacturers to defend against.

        In light of the potential for antitrust litigation, BMS recommends
    that the committee consider how best to address this risk as it
    considers the HHS proposal. Congress, could, for example, enact
    legislation that immunizes from liability under the Robinson-Patman Act
    drug manufacturers who offer up-front discounting under Medicare Part D
    in accordance with the fraud and abuse safe harbor created by the HHS
    rule.

        Question. Please describe how you expect your company to respond to
    the HHS proposed rule to eliminate safe harbor protection for back-end
    rebates in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. BMS supports the HHS proposed rule to eliminate safe harbor
    protection for back-end rebates in Medicare Part D, and we believe it
    would lead to lower out-of-pocket costs. This question rightly supposes
    that the goals of the proposed rule could be achieved through lower
    list prices, negotiated discounts at the point-of-sale, or some
    combination of these two approaches. While it is unclear how Part D
    plans and PBMs will react to the proposed rule, at this time, BMS
    envisions that we would offer point-of-sale discounts to Part D plans
    equivalent on average to the current contracted rebate amount and will
    continue to assess the possibility of lowering list price on a product-
    by-product basis. Our ability to lower list prices, however, is
    constrained by the fact that the HHS proposed rule does not apply to
    the commercial insurance market, where we anticipate back-end rebates
    to continue for the foreseeable future.

        Please also see the answer to the previous question.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. The back-end rebates BMS currently offers pursuant to its
    Medicare Part D agreements are not contingent on the amount of market
    share realized for any of BMS's drugs as a result of Part D plan
    formulary placement or any other performance requirement.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

        Answer. This information is not available publicly and is
    competitively sensitive.

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees? To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. BMS does not hire consultants or lobbyists to promote its
    products at State Medicaid P&T Committees. BMS complies with the
    applicable lobbying laws across all 50 States, Puerto Rico, and the
    District of Columbia. Many States require engagement with its Medicaid
    officials to be reported. We disclose required lobbying activities to
    each State in accordance with the individual State lobbying disclosure
    and ethics laws.

        Question. Please describe how the costs of patient assistance
    programs are accounted for within your company's financial statements.
    Please also describe the types of market information, such as
    prescribing and use patterns that your company collects from different
    types of patient assistance programs and patient hub services.

        Answer. For purposes of responding to this request, BMS interprets
    ``patient assistance programs'' and ``patient hub services'' as BMS
    programs or services supporting education, access and/or treatment
    adherence for eligible patients who are prescribed a BMS medicine.
    Costs associated with these programs are accounted for in our financial
    statements as marketing, selling and administrative expenses or gross-
    to-net sales adjustments, depending on the type of assistance offered.

        Data captured through the administration of patient support
    programs allows our program administrators to validate information
    provided directly from patients and providers in support of the
    specific program(s) for which assistance is being requested. This data
    capture includes, but may not be limited to: (1) information that
    supports determination of patient eligibility; (2) validation of
    licensed provider/prescriber; (3) prescription related information
    necessary to execute patient assistance available through program(s)
    (i.e., dosage and units being prescribed/dispensed); and, (4) insurance
    information.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. For each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. BMS refers the committee to the Corporate Giving page on
    the BMS website (https://www.bms.com/about-us/responsibility/corporate-
    giving.html). This page includes comprehensive information about BMS'
    Corporate Giving policies and practices. It also includes comprehensive
    lists of IME Grants, Charitable Donations and Corporate Giving for
    calendar years 2016, 2017 and 2018. These grants are made for a variety
    of appropriate purposes, not limited to issues related to drugs within
    the BMS product line.

        BMS supports the BMS Patient Assistance Foundation (BMSPAF), a non-
    profit organization that helps patients in the United States who need
    temporary help obtaining various BMS medications. In 2018, BMS donated
    over $1 billion worth of BMS medicines to the BMSPAF, and the BMSPAF
    provided free medicine to more than 75,000 patients.

        BMS also supports the Bristol-Myers Squibb Foundation, a non-profit
    organization that promotes health equity and seeks to improve the
    health outcomes of populations disproportionately affected by serious
    diseases by strengthening health-care worker capacity, integrating
    medical care and community based support services, and mobilizing
    communities to fight against disease. BMS views the activities of the
    BMS Foundation as outside the scope of this question.

        Question. Pay for delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the ``Preserve Access to
    Affordable Generics and Biosimilars Act,'' which would help put an end
    to these deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Answer. BMS agrees that patent settlement agreements that have
    substantial payments going from innovators to generics, and are solely
    intended to delay competition, are anticompetitive.

        Question. Has your company ever entered into these kinds of
    settlements with a generic company?

        Answer. BMS has not entered into patent settlements that have
    substantial payments going from innovator to generics and are solely
    intended to delay competition.

        Question. Do you support the pay for delay bill?

        Answer. In general, the ability to settle patent litigation, like
    any litigation, reflects a balancing of considerations by the involved
    parties and often leads to earlier generic entry than patent
    expiration. The current system provides the government with the ability
    to monitor and review these settlements, and has worked well.

        With regard to S. 64, BMS supports the goals of the legislation but
    has objections to the legislation as currently drafted. For example,
    the legislation should be revised: (1) only to apply prospectively and
    not retroactively to agreements already entered into; (2) eliminate the
    presumption that all settlements are presumptively anticompetitive; (3)
    eliminate restrictions on the arguments companies would be permitted to
    advance to defend agreements; and (4) include ``exclusions'' for
    certain types of agreements, such as those containing exclusive
    licenses, to name a few. BMS would be happy to follow up and provide
    further details to the committee.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Answer. BMS does not have any Medicare Part D or any other payer
    contracts with bundling of rebates.

        Question. Does your company view these practices as anticompetitive
    or harmful to patients' access to quality, lower cost medicine?

        Answer. BMS believes that clinical treatment decisions should be
    made by physicians in consultation with patients. As noted, BMS does
    not have bundled payer agreements and without insight to the specific
    terms of other manufacturers' bundling agreements, it is difficult to
    assess the impact on patient access and healthcare costs. BMS does not
    support agreements that create barriers to patients' access to quality,
    lower cost medicines.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. BMS believes that requiring PBMs and payers to pass
    manufacturer rebates on to patients has the potential to lower patient
    out-of-pocket costs, and therefore benefit consumers. However, it is
    unclear how payers will adjust their benefit plan designs in response
    to this change and whether it would completely solve the issue of
    rebate ``traps'' and ``walls.'' It is possible, for example, that in
    response to such changes, PBM and payer business models might evolve,
    and thus we recommend implementing safeguards to protect consumers'
    access to medicines.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        Answer. BMS does not consider these costs in setting list price.

        Question. When setting the list price of a drug, does your company
    consider the risk of liability or litigation? If so, how specifically
    do those factors affect the list price of a drug? Please provide at
    least one specific example, if applicable, from your current product
    portfolio.

        Answer. BMS does not consider the risk of liability or litigation
    in setting list price.

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see Value Based Arrangements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        Answer. Manufacturers and payers have been participating in Value
    Based Agreements (VBAs) with increasing frequency. These agreements can
    potentially reduce overall health-care costs by reducing costs for
    medicines, and importantly, improving outcomes for patients and
    reducing overall health-care costs. Although there are many types of
    VBAs, and the goals and impact of these arrangements differ by specific
    medicines and therapeutic areas, we believe that as the sophistication
    of these payer and manufacturer arrangements increase, and the capture,
    integrity and timeliness of health-care data improves, these agreements
    will evolve to the ``sweet spot'' between controlling costs and
    encouraging the innovation of new medicines.

        Question. How can VBAs help lower what patients pay out-of-pocket?

        Answer. VBAs may lower patient out-of-pocket costs where, as a
    result of the VBA, the drug is placed on a preferred or lower formulary
    tier. In addition, as explained above, VBAs can potentially reduce
    overall healthcare costs, including patient out-of-pocket costs, by
    improving outcomes for patients through the reduction or elimination of
    the need for additional medicines and/or healthcare services.

        Question. Can Congress do more to allow for and encourage the use
    of VBAs?

        Answer. Yes. Congress can do more to allow for and encourage the
    use of VBAs. For example, Congress could adopt an exception to the
    Anti-Kickback Statute and enact measures to avoid unintended
    consequences under Medicaid price reporting.

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad. Pharmacy benefit managers
    and plans have argued that rebates are used to lower premiums across
    the board and that it is the best way to seek a price concession on
    otherwise expensive drugs. Your industry argues that these payers are
    insisting on higher rebates that can only be achieved by raising list
    prices. But patients often lose under this system, with out of pocket
    costs being tied to list price. Insulin patients appear to be routinely
    impacted by this perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        Answer. BMS supports the HHS proposed rule to eliminate safe harbor
    protection for back-end rebates in Medicare Part D, and we believe it
    would lead to lower out-of-pocket costs. The goals of the proposed rule
    could be achieved through lower list prices, negotiated discounts at
    the point-of-sale, or some combination of these two approaches. While
    it is unclear how Part D plans and PBMs will react to the proposed
    rule, at this time, BMS envisions that we would offer point-of-sale
    discounts to Part D plans equivalent on average to the contracted
    rebate amount and will continue to assess the possibility of lowering
    list prices on a product-by-product basis. BMS would likely follow a
    similar approach if back-end rebates were eliminated from the
    commercial insurance market.

        Question. What assurance can you provide that you would in fact
    lower your prices?

        Answer. Please see answer to previous question.

        Question. What actions should be taken to ensure that patients are
    actually seeing the benefits of lower out of pocket costs?

        Answer. In order to ensure that patients receive the full benefits
    of manufacturer discounts, we support the proposed rule's requirement
    that manufacturer discounts be passed on to patients at the point-of-
    sale. In addition, we recommend implementing safeguards to protect
    consumers' access to medicines, to prevent increases in patients' out-
    of-pocket costs, and to ensure that patients' costs at the point-of-
    sale fully reflect manufacturer discounts.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        Answer. The price increases for BMS Part B drugs have been largely
    in line with Medical CPI. We cannot comment on the Part B price
    increase practices of other manufacturers.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices.

        With the increased scrutiny of the industry and of the drug supply
    chain as a whole in the United States, have any of your companies re-
    evaluated your business strategy in foreign countries?

        Answer. Please see answer below.

        Question. If not, then why?

        Answer. Please see answer below.

        Question. If a proposal, like IPI, were implemented, would it force
    your companies to potentially ``walk away from the negotiating table
    when other countries demand low prices subsidized by America's
    seniors,'' as HHS Senior Advisor for Drug Pricing Reform John O'Brien
    has said?

        Answer. Please see answer below.

        Question. What are some of your ideas on how we can ensure
    Americans aren't shouldering the full cost of pharmaceuticals?

        Answer. BMS reviews its business strategies within and outside of
    the U.S. on a regular basis. BMS believes that all patients deserve
    access to life changing medicines. Because of these ethical
    considerations, BMS would not walk away from discussions about access
    to our medicines in foreign countries. We believe that the most likely
    outcome of IPI is further delays in access to life extending and
    innovative medicines within the referenced countries, resulting in, for
    example, lower cancer survival rates.

        The IPI proposal imposes price controls in the U.S. based on the
    policies of foreign countries with socialized health-care systems that
    often deny their citizens access to innovative medicines. Patients in
    many of the countries included in the reference basket wait
    significantly longer for new, life extending and innovative medicines
    to reach them. Outside of the U.S., reimbursement of new medicines can
    often take more than 2 years. In Greece, for example, only 8 percent of
    new cancer therapies are available, and on average it requires 32
    months for these products to be available to patients. In comparison,
    in the U.S., 96 percent of new cancer drugs are available within 3
    months of market approval. Eventually, the industry often accepts
    foreign prices which do not recognize the value and cost-effectiveness
    of our medicines because patients can wait no longer.

        BMS is committed to working with Congress and the administration to
    advance better, more effective ways to lower drug prices for patients.
    As an alternative to the IPI model, finalizing the proposed rebate rule
    would lower seniors' out-of-pocket costs at the pharmacy counter.
    Regulatory reforms at the FDA are leading to more medicine approvals
    and greater competition in the market. Value-based arrangements (VBAs)
    and indication-based pricing (IBP) can reduce the payer risk of
    exposure to failed outcomes, more closely associate drug costs and
    value, and make prescription medicines more affordable for patients.
                  foreign countries' pricing and reimbursement
        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year.

        ``When foreign governments extort unreasonably low prices from U.S.
    drug makers, Americans have to pay more to subsidize the enormous cost
    of research and development. . . . It's unfair and it's ridiculous, and
    it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing medical advances?

        Answer. Please see answer below.

        Question. How do foreign countries' pricing and reimbursement
    systems affect our prescription drug costs?

        Answer. Please see answer below.

        Question. Are foreign governments taking note of the concerns being
    raised by the Trump administration, and have they responded in any way?

        Answer. Please see answer below.

        Question. Has there been any noticeable change in any of our trade
    agreements since these concerns have been raised by the Trump
    administration?

        Answer. Drug pricing in markets outside of the U.S. must take into
    account significant differences in economic status, cultural beliefs
    and values, as well as differences in the local processes for setting
    prices, which vary significantly from market-to-market. Countries vary
    significantly in their per capita gross domestic product (GDP), their
    willingness to invest in, and provide rapid access to, health-care
    innovation, their focus on a single best average treatment for a
    population versus focusing on patient heterogeneity and preserving
    consumer choice and provider autonomy, and their tolerance and
    acceptability for optimal patient care.

        The countries selected for international comparison through the IPI
    model are not economically comparable with the U.S. Many of the
    countries in the IPI model, most notably Greece, the Czech Republic,
    and Italy, do not have comparable economies as measured in per capita
    gross domestic product (GDP). The significant difference in drug costs
    between the U.S. and other countries referred to by CMS in the IPI
    proposal is also seen with the comparative cost of physician services,
    hospital care, diagnostics, and medical devices. For example, according
    to a recent report by the OECD, hospital services in the U.S. cost 150
    percent more than in Japan, France, Germany, Finland and Spain; 170
    percent higher than in UK, Greece, and Italy.

        Through the USMCA and other trade actions, the Trump administration
    has taken steps to crack down on foreign violations of U.S.
    intellectual property rights. There remain, however, several practices
    that undermine U.S. intellectual property and violate existing trade
    deals. We need to continue to negotiate better trade deals with better
    enforcement that protect American medical innovations.
                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various States
    have been exploring whether to exclude certain drugs from its Medicaid
    program. For example, the State of Massachusetts' recently asked CMS
    for permission to create a closed formulary where the State Medicaid
    program would pick at least one drug per therapeutic class. CMS denied
    their waiver request citing violation of Federal law, but this proposal
    does bring up important questions on how to contain drug prices in
    State Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to State Medicaid programs,
    do you think it lower drugs costs while ensuring access to patients?

        Answer. It is unlikely that applying Part D principles to Medicaid
    would lower drug costs. Medicaid is already a lower-cost channel and
    patients have little to no copay obligations.
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        Answer. For BMS, Medicaid ``best price'' is not a consideration in
    determining initial product pricing.

        Question. What, if any, changes would you suggest we make to the
    program?

        Answer. As clarification, prices offered to Medicare Part D plans
    are excluded from Medicaid ``best price,'' and therefore, manufacturers
    can offer deeper discounts to Part D without impacting Medicaid best
    price.

        More generally, BMS recommends the creation of an exemption from
    best price and AMP for select value based purchasing arrangements and
    greater clarity on best price and AMP reporting on issues related to
    such arrangements.
                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        Answer. The goal and design of outcome-based contracts will vary
    depending on the specific drug and the therapeutic area/disease State
    which is being evaluated. In general, outcome-based contracts are
    designed to demonstrate the efficacy, safety, clinical superiority,
    cost savings and/or improvement in overall patient health outcomes. To
    the extent that outcomes-based contracts demonstrate improvement in
    clinical outcomes and/or reduction in overall health-care costs and
    facilitate access to appropriate medicines, patients will benefit from
    improved outcomes and reduced out-of-pocket costs, and Federal health-
    care programs will benefit from lower overall health-care costs.

        Question. How will they lower overall health-care costs for our
    Federal programs?

        Answer. Please see answer to previous question.

        Question. What have the preliminary results looked like so far?

        Answer. Eliquis has demonstrated a better safety profile than
    alternate therapies (less bleeding events) as proven through outcomes-
    based contracts using real world data. Oncology patients have higher
    rates of diagnostic testing done to monitor disease progression (as
    recommended by guidelines), through our testing based value-based
    contract.
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point-of-sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        Answer. To the extent that discounts provided by manufacturers to
    PBMs and payers are passed through to the patients at the point-of-
    sale, transactions within the drug supply chain will be more
    transparent.

        Question. If so, would this transparency bring down drug costs--
    overall and for specialty drugs?

        Answer. In terms of bringing down drug costs, the result of passing
    discounts through to patients at the point-of-sale will likely vary
    depending on the individual drug. We anticipate that patients who are
    prescribed high-cost, highly discounted drugs, primarily specialty
    drugs, and are subject to high co-insurance costs, will experience the
    greatest reduction in drug costs.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the Pharmacy Benefit Manager. But there's
    another side of the equation that I'd like to ask about.

        How do wholesalers negotiate pricing with manufacturers?

        Answer. Wholesalers and manufacturers negotiate distribution
    service agreements that include terms and fees. The fees are typically
    a percentage of list price.

        Question. What impact does this have on drug costs?

        Answer. It is BMS's understanding that the fees negotiated by
    wholesalers and manufacturers do not have a material impact on drug
    costs.

        Question. What incentives or disincentives do they have to contain
    price increases?

        Answer. This question is best answered by wholesalers.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price.

        Like many Oregonians, I am skeptical drug manufacturers would
    voluntarily lower their prices. Therefore, would you support
    legislation that would (1) make similar changes the administration has
    put forward related to Part D and Medicaid managed care, (2) change the
    rebate system in a similar way to the proposal for the commercial
    market, and (3) require drug makers to lower the list price of their
    drugs equal to the amount of rebates provided today?

        Answer. BMS supports the extension of rebate reforms to the
    commercial market. However, given the significant market change in the
    proposed Part D safe harbor change, we urge the committee to pursue an
    implementation timeline that will allow manufacturers, PBMs, plans,
    retail pharmacies, wholesalers, and other impacted parties to address
    the many operational challenges for the industry. We anticipate that
    the implementation of the safe harbor change in Part D will provide
    important learnings, but in order to extend these changes to the
    commercial market, industry will need additional lead time to do so.

        Given the many payers and channels in the health-care market, an
    individual drug has multiple net price points. Moreover, the goals of
    the proposed rebate rule can be achieved not only through lower list
    prices, but also through negotiated discounts at the point-of-sale, or
    through some combination of the two approaches. We believe the goals of
    the proposed rule can be best achieved by giving manufacturers the full
    range of options in their negotiations with plans and PBMs.
    Consequently, BMS would not support legislation that required drug
    makers to lower the list price of their drugs equal to the amount of
    rebates provided today.

        There may be instances where a reduction in product list price is
    warranted, but with or without a list price change, in order for
    patients to benefit fully from the changes, regulations would need to
    ensure that manufacturer discounts are passed through to patients at
    the point-of-sale and that patient out-of-pocket costs are based on
    product net price.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        Answer. Please see answer below.

        Question. For each drug listed in response to question 1, please
    also provide a list of which quarters and years each drug hit the cap.

                                     Answer
    ------------------------------------------------------------------------
               Product                              Quarter
    ------------------------------------------------------------------------
    BARACLUDE TAB 0.5MG            Q3 2014, Q4 2014, Q1 2015, Q2 2015, Q3
                                    2015, Q4 2015
    ------------------------------------------------------------------------
    BARACLUDE TAB 1MG              Q3 2014, Q4 2014, Q1 2015, Q2 2015, Q3
                                    2015, Q4 2015
    ------------------------------------------------------------------------
    COUMADIN TAB 4MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 4MG (1BTLX1000)   Q3 2014, Q4 2014, Q1 2015, Q2 2015
     US
    ------------------------------------------------------------------------
    COUMADIN TAB 1MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 2MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 5MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 7.5MG             Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 10MG              Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 2.5MG             Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 3MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 6MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1
                                    2016, Q2 2016, Q3 2016, Q4 2016, Q1
                                    2017, Q2 2017, Q3 2017, Q4 2017, Q1
                                    2018, Q2 2018, Q3 2018, Q4 2018
    ------------------------------------------------------------------------
    COUMADIN TAB 6MG US            Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015
    ------------------------------------------------------------------------
    AVAPRO TAB 75MG                Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015
    ------------------------------------------------------------------------
    AVAPRO TAB 150MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1 2016
    ------------------------------------------------------------------------
    AVAPRO TAB 300MG               Q1 2014, Q2 2014, Q3 2014, Q4 2014, Q1
                                    2015, Q2 2015, Q3 2015, Q4 2015, Q1 2016
    ------------------------------------------------------------------------
    AVALIDE TAB 150/12.5MG         Q1 2014, Q2 2014, Q3 2014, Q4 2014
    ------------------------------------------------------------------------
    AVALIDE TAB 300/12.5MG         Q1 2014, Q2 2014
    ------------------------------------------------------------------------

                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. For example, an analysis by the U.S.
    Department of Health and Human Services Office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.
    Accordingly, please describe the following:

        Your company's current compliance plan and procedures used to
    ensure compliance with the requirements of the Medicaid Drug Rebate
    Program including internal audits or other checks you use to identify
    compliance vulnerabilities.

        Answer. The Company routinely assigns new employees working in the
    government pricing area formal training on U.S. government pricing and
    contracting. This training includes an overview of the Medicaid Program
    obligations and requirements. BMS also maintains policy and procedural
    documents which govern compliance relative to the Medicaid Drug Rebate
    Program. In addition, BMS periodically holds informal training sessions
    as part of departmental and other internal meetings, where compliance
    training is provided on topics relevant to the Medicaid Drug Rebate
    Program. BMS has also identified key controls related to the Medicaid
    Drug Rebate Program which are independently tested as part of the
    Company's Sarbanes-Oxley controls. As part of these controls, all
    Medicaid pricing submissions are reviewed and approved by the
    appropriate Company management. In addition, BMS Global Internal Audit
    and Assurance periodically conducts internal audits of the Company's
    operations, which include activities that support the Medicaid Drug
    Rebate Program.

        Question. Any past or ongoing issues of non-compliance.

        Answer. There are no ongoing issues of non-compliance with the
    Medicaid Drug Rebate Program, nor were there any within the past 5
    years. (BMS interprets the question as asking for a reasonable period
    in the past, and has selected 5 years).

        Question. Any corrective actions taken to address identified
    problems or issues of non-compliance with the MDRP and how such steps
    were communicated to the Centers for Medicare and Medicaid Services.

        Answer. There are no ongoing issues of non-compliance with the
    Medicaid Drug Rebate Program, nor were there any within the past 5
    years. (BMS interprets the question as asking for a reasonable period
    in the past, and has selected 5 years).

        Question. Any steps taken to improve compliance and ensure that all
    Medicaid drug rebates owed to the Federal Government and the States are
    paid in full.

        Answer. In addition to the compliance and audit activities already
    outlined, the BMS Government Pricing team conducts regular cross-
    functional information sharing meetings in order to facilitate
    communication within the organization, to gather all relevant pricing
    and contracting information, and to provide education that is focused
    on ensuring compliance with our Medicaid reporting obligations. The
    Government Pricing team also conducts quarterly Medicaid Best Price
    review meetings with key members of the pricing and contracting
    organization and requires that leaders of key functions within the
    pricing and contracting organization sign-off on quarterly Medicaid
    Best Price information prior to the Company's final. Additionally, the
    Company has made significant investments in the systems which are used
    to support the calculation and payment of Medicaid rebates to help
    ensure greater compliance, standardization and automation of our
    processes. BMS also maintains a Compliance and Ethics hotline and
    encourages all employees to raise potential compliance concerns so that
    they can be investigated and addressed.

        More specifically with regard to the payment of Medicaid drug
    rebates, based on the current portfolio of active drugs, all BMS drugs
    are classified as Innovator Single Source or Innovator Multiple Source
    drugs which are subject to the higher basic rebate calculation. When
    BMS launches a new drug that is subject to Medicaid reporting, the drug
    classification is reviewed as part of the Medicaid submission approval
    process.

        To the extent that BMS has questions on MDRP compliance or on
    interpretative approaches to MDRP price reporting, we communicate with
    the Centers for Medicare and Medicaid Services.
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus, or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus or other compensation was tied.

        Answer. No, Dr. Caforio's salary and bonus are not tied to sales or
    revenue targets for a single product. Dr. Caforio's compensation is
    tied in part to the revenue of the Company as a whole. Please see
    answer below.

        Question. Is your salary, bonus, or other compensation tied to
    either revenue or net income of the company as a whole? Has it ever
    been? If yes, please explain what assumptions about price increases are
    used when the compensation committee sets revenue or net income goals.
    Does the compensation committee provide any guidance to executives in
    regards to the amount of revenue that the company will generate from
    price increases versus volume growth?

        Answer. Dr. Caforio's compensation is tied in part to the revenue
    of the Company as a whole. The revenue metric is based on the overall
    Company target for the applicable performance period (annual for annual
    bonus and longer-term, 3 years for Performance Share Units), which
    typically includes assumptions concerning both price changes and volume
    growth. Over the last few years, BMS' revenue growth has been primarily
    attributable to increased volume arising from increased demand for our
    products rather than price increases.

        Dr. Caforio's compensation is reviewed and recommended by the
    Compensation and Management Development Committee, which is a committee
    consisting of only independent directors, and approved by at least
    three-fourths of the independent directors of our Board of Directors.
    The Compensation Management and Development committee annually
    completes a thoughtful and rigorous evaluation of the Company's
    executive compensation program to ensure that the program is aligned
    with our mission and delivers shareholder value, while not encouraging
    excessive or inappropriate risk-taking by our executives. When
    determining metrics and setting incentive plan targets each year and
    for 3 year performance period, the committee is aware of the risks
    associated with drug pricing, among other risks, and ensures our plans
    do not incentivize risky behavior in order to meet targets and goals.
                                   net prices
        Question. In your testimony you stated, ``for this reason, the
    average net pricing across our U.S. portfolio of medicines increased by
    5 percent of the last year-over-year for the last 5 years. Importantly,
    it did not increase at all in 2018 and we expect that it will not
    increase in 2019.'' Please describe how the company's year-over-year
    aggregate net price is calculated. Please also specifically address the
    following questions.

        Answer. Dr. Caforio testified that BMS's average net pricing across
    the company's U.S. portfolio increased by 5 percent or less year-over-
    year for the last 5 years. Please see the answer below for a
    description of how year-over-year net price is calculated.

        Question. How many products are included in the calculation of the
    average net price change? What was the median net price change?

        Answer. Approximately 20 products are included in the calculation
    of the average net price change. The median net price change over the
    last 5 years is 3.4% based on the following net price change per year:

         2018           2017           2016           2015          2014

    (0.3%)         1.6%           5.2%           3.4%           4.0%

        Question. Is net price weighted? If so, how? For example, in
    determining the aggregate net price does the company assign different
    weights to different products based on volume or other factors? Are
    ``on patent'' and ``off patent'' drugs weighted identically? Are other
    statistical weights used or are all products treated equally?

        Answer. Net price is weighted according to the product's sales
    relative to total BMS sales. Year-over-year change in Net Price =
    Change in List Price + Change in effective discount rate across all
    channels. Patent and off-patent drugs are treated equally in the
    calculation.

        Question. Does the figure that you provided during your testimony
    account for U.S. prices, international prices, or both? Generally
    speaking, when your company reports net price changes, does it
    differentiate between U.S. and international prices?

        Answer. The figure included in Dr. Caforio's testimony accounted
    for U.S. prices. Yes, BMS discloses by region (i.e., U.S., Europe, Rest
    of World) in our quarterly 10Q and Annual 10K filings. However, the
    only net price changes specifically outlined (i.e., in percentage
    terms) is for the U.S.

        Question. Please list the five drugs your company sold in the U.S.
    that had the greatest year-over-year net price increase in 2018, noting
    the increase for each drug by dollar figure and percentage. Please list
    the five drugs your company sold in the U.S. that had the lowest year-
    over-year net price increase (and/or the greatest decrease) in 2018,
    noting the increase (or decrease) for each drug by dollar figure and
    percentage.

        Answer. This question calls for information that BMS does not
    disclose publicly and considers to be competitively sensitive.

        Question. For 2018, what was the average net price change in the
    U.S. market for (1) drugs with no competition, (2) drugs with only
    branded competition, and (3) drugs with generic competition?

        Answer. This questions calls for information that BMS does not
    disclose publicly and considers to be competitively sensitive.

        Question. You stated that average net price increased 5 percent in
    2017, but did not increase in 2018, and that you do not expect it to
    increase in 2019. What factors contributed to the change from 2017 to
    2018? What would the net price increase have been if your company
    excluded the impact of drugs like Reyataz and Sustiva, which lost
    exclusivity in the United States at the end of 2017, and Daklinza,
    which the company reported losing revenue on?

        Answer. Dr. Caforio testified that BMS's average net pricing across
    the Company's U.S. portfolio increased by 5 percent or less year-over-
    year for the last 5 years. Average U.S. net price remained unchanged
    from 2017 to 2018 (i.e., 0 percent net price increase from 2017 to
    2018), because discounts across all channels increased at a rate higher
    than list price increased. If drugs which lost exclusivity, like
    Reyataz, Sustiva and Daklinza, were excluded, the net price change
    would still be 0 percent.

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. When new products enter the market, do drug companies set
    high initial rebates and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. BMS does not. We cannot comment on the pricing practices of
    other manufacturers.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. If CMS were to finalize the rebate rule, the impact on list
    prices of future products would likely differ by product depending on
    such factors as the clinical profile of the product, competition,
    market dynamics, and the channel into which the product is primarily
    sold. As noted above, the goals of the proposed rule could be achieved
    through lower list prices, negotiated discounts at the point-of-sale,
    or some combination of these two approaches.

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D?

        Answer. BMS believes that market-based reforms are the best way to
    lower costs and maintain the appropriate incentives for innovation. BMS
    supports policies that enable payers to negotiate innovative and
    flexible ways to pay for medicines, including value-based purchasing
    arrangements. Additionally, we need to ensure generics are available
    whenever permissible under our system. BMS notes also that even
    manufacturers pay coverage gap discounts for all Part D drugs
    regardless of whether a payer rebate is provided for that drug.

        Question. In the health insurance plans that you offer your
    employees, do you ask your insurers to pass through the full
    manufacturer rebates to the beneficiaries?

        Answer. Based on the contract negotiated with the PBM with which
    BMS has contracted, BMS has elected to reinvest the rebates we would
    otherwise have received from the PBM to reduce the per claim cost for
    brand drugs across the entire population of members we cover. BMS
    provides health care coverage to approximately 10,000 active employees,
    4,000 retirees and 18,000 spouses and other dependents.

        Under this reinvested model, those rebate dollars are applied to
    reduce the negotiated rate our enrollees pay for brand drugs. This
    means that the PBM charges the plan a lower negotiated rate for all
    branded drugs (not just those associated with specific rebates),
    benefiting a broader portion of our covered population. Since our
    health plan benefit design uses a coinsurance for member cost sharing,
    this lower negotiated drug cost enabled by the application of the
    rebate value, reduces the coinsurance amount our members pay for their
    medications at the pharmacy counter.

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand. What are your recommendations for
    increasing transparency in how your companies set the list prices for
    drugs, and for improving transparency in the supply chain for
    prescription drugs? Would you support Federal standards for
    transparency in setting the list prices for drugs?

        Answer. BMS intends to provide added transparency around the list
    prices for its medicines. We are creating pricing pages for all of our
    advertised medicine websites to include list price and additional
    information on out-of-pocket costs and support programs. Any DTC TV ads
    will direct patients to the site through a web link. Our plan is to
    have this information available by April 15, 2019. We solicited
    feedback from the patient community to ensure the resources we provide
    about pricing are meaningful to patients. The research suggests
    patients may misinterpret list price information in a television
    advertisement without additional context.

        BMS is complying with the recently enacted California drug price
    transparency legislation and would like to work with the committee on
    similar legislation at the Federal level, or legislation similar to the
    SPIKE Act (S. 474), both of which are intended to require manufacturers
    to disclose price increases above a certain threshold.

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently. How many of your drugs are included in
    value-based contracts and how many patients are benefiting from them?
    How do these value-based contracts work to lower drug prices for both
    patients and taxpayers?

        Answer. Currently, BMS has value-based contracts for two products.
    Approximately 39 million patients are eligible for potential coverage
    under those contracts.

        The goal and design of outcome-based contracts will vary depending
    on the specific drug and the therapeutic area/disease state which is
    being evaluated. In general, outcome-based contracts are designed to
    demonstrate the efficacy, safety, clinical superiority, cost savings
    and/or improvement in overall patient health outcomes. To the extent
    that outcomes-based contracts demonstrate improvement in clinical
    outcomes and/or reduction in overall health-care costs, patients will
    benefit from improved outcomes and reduced costs, and the Federal
    programs will benefit from lower overall health-care costs.

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    Federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack. Are any of your
    companies providing medical necessity paperwork to doctors in order to
    get your drugs covered by Medicare?

        Answer. BMS offers patient support programs that help eligible
    patients who are prescribed our medicines obtain access to those
    medicines. This includes assisting patients in navigating the insurance
    approval process. Consistent with longstanding OIG guidance and common
    industry practices, BMS does provide the template forms required by
    insurers for use in making coverage determinations, but BMS does not
    provide medical necessity content. That content must be independently
    provided by the prescribing health-care provider.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers. What is delaying the
    uptake of biosimilar drugs in the United States? What policies do you
    recommend to increase the development of biosimilar drugs?

        Answer. BMS does not have a biosimilar or a branded product with
    biosimilar competition, and consequently, is not in a position to offer
    first-hand insight.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach.

        Researchers say that this type of imagery, combined with viewing
    hours of drug commercials each month, leads consumers to underestimate
    the risks associated with medications. For the past decade, studies
    have shown that aggressive direct-to-consumer advertising is associated
    with rising drug prices and an increase in inappropriate drug
    prescriptions.

        Question. Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. BMS engages in DTC TV advertising selectively and only when
    we think it will help educate patients. Our DTC TV advertising is
    submitted to the FDA for advisory comments prior to being broadcast in
    accordance with FDA guidance. BMS believes that our DTC advertising
    clearly and appropriately communicates the benefits and risks of our
    medicines.

        BMS believes responsible DTC communications play a critical role in
    educating patients and families about treatment options and encourages
    them to have an informed discussion with their physician about the best
    treatment for their needs. BMS would be open to considering any
    additional policy proposals that further facilitate the achievement of
    this goal.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organization for Economic Cooperation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price.

        One of the most well-known examples is Mylan's increase of the
    price of EpiPen from less than $100 in 2007 to more than $600 in 2016.
    Another example, is the ever-increasing price of insulin. Sanofi
    increased the price of a vial of Lantus from $88.20 in 2007 to $307.20
    in 2017. And those are just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. Although list prices for a drug without new formulations or
    added benefits may not decrease over time, in our experience, net
    prices generally decrease over time and/or volume decreases
    significantly as generics enter the market.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market.

        These ``pay-for-delay'' patent settlements benefit both brand-name
    pharmaceutical companies by helping them avoid costly patent litigation
    and general manufacturers by rewarding them a hefty sum to delay
    entering the market with a cheaper drug alternative. However, these
    deals do not benefit consumers. According to an FTC study, these
    anticompetitive deals cost consumers and taxpayers $3.5 billion in
    higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Answer. No.

        Question. Why would a pharmaceutical company enter into a pay-for
    delay agreement?

        Answer. As stated above, BMS does not enter into any pay-for-delay
    settlements. We cannot comment on the actions and motivations of other
    manufacturers.

        Question. Do you think these agreements stifle competition and
    prevent generic alternatives to your branded medications?

        Answer. BMS agrees that patent settlement agreements that have
    substantial payments going from innovators to generics, and are solely
    intended to delay competition, are anticompetitive. In contrast,
    agreements that do not contain such substantial payments and properly
    balance litigation considerations often lead to earlier generic entry
    than patent expiration.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) Office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections.

        The rule is predicted to increase net drug costs in its early
    years. The CMS actuaries estimate it would cost $196 billion over 10
    years. Despite this high price tag, the beneficiary benefits are
    limited. The proposed rule notes that under the CMS Actuary's analysis,
    the majority of beneficiaries would see an increase in their total out-
    of-pocket payments and premium costs; reductions in total cost sharing
    will exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. BMS supports HHS's proposed rule because BMS believes it
    will lower patient costs at the point-of-sale and ensure patients
    realize the benefit of manufacturer discounts. We do not anticipate
    that manufacturer average net prices will increase as a result of this
    rule.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spent nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9 percent of all medical marketing, in 1997 to $9.6
    billion, or 32 percent of total spending, in 2016.

        Can you please provide what your ratio of spending on sales and
    marketing to research and development is today?

        Answer. BMS does not disclose sales and marketing investments
    separately. In 2018, BMS marketing, selling and administrative expenses
    were $4.6 billion, which is inclusive of sales and marketing, and R&D
    expenses were $6.3 billion. That ratio is approximately 7 to 10.
                                 price-gouging
        Question. Sanofi, as I understand it, has made a pledge to the
    public to limit its price increases to the national health expenditures
    growth projection.

        Would your company commit to a cap on annual price increases as
    part of your PhRMA membership criteria?

        Answer. It is BMS's understanding that a cap on annual price
    increases as part of PhRMA membership would raise significant antitrust
    concerns.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. BMS does not believe that government policies should govern
    launch pricing of new drugs. Payers, providers, patients, and the
    marketplace should freely assess the value of new innovative therapies
    relative to their improvement in outcomes and impact to total cost of
    care. At BMS, we believe the prices of our medicines reflect the value
    they bring to patients, healthcare providers, payers, and society as a
    whole.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates do
    not rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. Yes, BMS agrees that manufacturer's net prices should be
    transparent to and passed through to beneficiaries. BMS also believes
    that this transparency should be required for all entities in the
    health-care market.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        Answer. Yes.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, how do you utilize the
    rebates your PBM negotiates to lower health care costs or drug costs
    for your employee plans and what does your company do with that
    savings? Specifically, do the savings go toward lowing premiums?

        Answer. BMS uses a PBM for our self-funded Pharmacy Benefit
    Program, which is part of our overall healthcare plan. The PBM offers
    the option of direct point-of-sale rebates, however, based on the
    contract negotiated with the PBM, BMS has elected to reinvest the
    rebates we would otherwise have received from the PBM to reduce the per
    claim cost for brand drugs. Under this reinvested model those rebate
    dollars are applied to reduce the negotiated rate our enrollees pay for
    branded drugs. This means that the PBM charges the plan a lower
    negotiated rate for all branded drugs (not just those associated with
    specific rebates). Since our health plan benefit design uses a
    coinsurance for beneficiary cost sharing, this lower negotiated drug
    cost enabled by the application of the rebate value, reduces the
    coinsurance amount our members pay for their medications at the
    pharmacy counter. Under this model, a greater number of participants
    benefit from the value of the rebates.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, does your PBM offer
    point-of-sale rebates to your employees?

        Answer. Please see answer to previous question.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. BMS supports the HHS proposed rule to eliminate safe harbor
    protection for back-end rebates in Medicare Part D, and we believe it
    would lead to lower out-of-pocket costs. The goals of the proposed rule
    could be achieved through lower list prices, negotiated discounts at
    the point-of-sale, or some combination of these two approaches. While
    it is unclear how Part D plans and PBMs will react to the proposed
    rule, at this time, BMS envisions that we would offer point-of-sale
    discounts to Part D plans equivalent to the contracted rebate amount
    and will continue to assess the possibility of lowering list price on a
    product-by-product basis. Our ability to lower list prices, however, is
    constrained by the fact that the HHS proposed rule does not apply to
    the commercial insurance market, where we anticipate back-end rebates
    to continue for the foreseeable future.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)? How many of your company's products are
    based, at least in part, on NIH research, and how many are the result
    of research funded solely by your company?

        Answer. Government institutions such as NIH and NCI do critically
    important basic research. However, the most significant investment
    behind any molecule is the clinical development program, which is
    usually when a pharmaceutical company comes into the development
    process. On average it takes 10 to 15 years and about $2.5 B to bring a
    medicine to patients, depending on the asset, therapeutic area, number
    of indications, and other factors. This is highly dependent on the
    stage of the molecule/asset when it comes to BMS. There is also
    considerable risk of failure given the complexity of clinical
    development. Only about 12 percent of drugs that make it to Phase 1
    clinical trials result in an approved product.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer. BMS does not publicly disclose specific advertising and
    marketing expenditures. The figures below are for marketing, sales and
    administrative expenses, which includes advertising and marketing
    expenditures.

            2018 spend:
            Marketing, selling, and administrative expenses: $4.6 billion
            Research and development expenses: $6.3 billion

            2017 spend:
            Marketing, selling, and administrative expenses: $4.8 billion
            Research and development expenses: $6.5 billion

            2016 spend:
            Marketing, selling, and administrative expenses: $5.0 billion
            Research and development expenses: $5.0 billion

            2015 spend:
            Marketing, selling, and administrative expenses: $4.8 billion
            Research and development expenses: $5.9 billion

            2014 spend:
            Marketing, selling, and administrative expenses: $4.8 billion
            Research and development expenses: $4.5 billion

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. While it is unclear how health plans and PBMs would react
    if the HHS proposed rule's policy were extended to the private market,
    at this time, BMS envisions that we generally would offer point-of-sale
    discounts to health plans equivalent on average to the contracted
    rebate amount and would continue to assess the possibility of lowering
    list price on a product-by-product basis. In the absence of list price
    reductions, the policy requirement that manufacturer discounts be
    passed on at the point-of-sale would accomplish the goal of reducing
    patient out-of-pocket costs.

        Question. How will this proposal affect how your company sets the
    list prices for new drug products?

        If the proposal is finalized and not extended to the private
    market, will your company make any list price reductions? If so, how
    large would the reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. While it is unclear how health plans and PBMs would react
    if the HHS proposed rule were finalized and not extended to the private
    market, at this time, BMS envisions that we would offer point-of-sale
    discounts to Part D plans equivalent on average to the contracted
    rebate amount and would continue to assess the possibility of lowering
    list price on a product-by-product basis. In the absence of a list
    price reduction, the proposed rule's requirement that manufacturer
    discounts be passed through to patients at the point-of-sale would
    accomplish the goal of reducing patient out-of-pocket costs.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\1\
    ---------------------------------------------------------------------------
        \1\ MACPAC, ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wp-content/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        This requirement created an unintended loophole. Rather than use
    the price of the authorized generic, drug companies can sell its
    authorized generic to a corporate subsidiary at an artificially lower
    price, and use that lower price to bring down the AMP, which in turn
    ---------------------------------------------------------------------------
    lowers the rebate obligation.

        Does your company engage in this practice? Has your company ever
    engaged in this practice in the past?

        Answer. No. BMS does not have any authorized generics with its own
    corporate subsidiary.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. Dr. Caforio, your company has entered a merger agreement
    to acquire Celgene, which makes the cancer drug Remlivid. The price of
    Remlivid was hiked nearly 20 percent in 2017, 5 percent last year, and
    another 3.5 percent just last month.\2\ Remlivid was also high on a
    list of brands whose manufacturers have refused to provide generic
    companies with the samples they need to submit an FDA application.
    Celgene refused 13 such inquiries, despite FDA's assurance that they
    were safe to share.\3\, \4\ Today Remlivid stands as a
    $70,000 sole source drug with no competition.\5\ You mention increasing
    access to generics as a priority in your testimony. In a case were
    Remlivid falls under your purview, what specific actions will you take
    to promote generic competition of that drug?
    ---------------------------------------------------------------------------
        \2\ https://www.reuters.com/article/us-celgene-results/celgene-
    profit-tops-expectations-will-limit-
    future-price-hikes-idUSKBN1KG1IC.
        \3\ https://www.fda.gov/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandApp
    roved/ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm
    ?utm_campaign=FDA%20publishes%20list%20of%20inquiries%20from%20generic%2
    0drug%20
    applicants%20about%20RLD%20access&utm_medium=email&utm_source=Eloqua.
        \4\ https://www.npr.org/sections/health-shots/2018/05/17/571986468/
    how-a-drugmaker-gamed-the-system-to-keep-generic-competition-away.
        \5\ https://twitter.com/megtirrell/status/1016769284025016320.

        Answer. BMS believes it is important to ensure generics are made
    available whenever that is permissible under our system, and supports
    the administration's focus on increasing the approval of generics. As
    part of that system, it is important that generic companies perform the
    ---------------------------------------------------------------------------
    needed testing to ensure product quality and patient safety.

        Until the transaction closes, BMS and Celgene will continue to
    operate as separate companies. BMS thus does not know and cannot
    comment on Celgene's practices as they relate to generic manufacturers.
    Once the transaction closes, BMS' practices with regard to generic
    manufacturers, including the provision of samples, will govern the
    combined portfolio.

        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? For those drugs is
    your list price equal to your net price?

        Answer. Although the level of rebates varies by product and
    channel, BMS pays rebates for all products in our portfolio.

        Question. Do you invest more in R&D than you generate in US sales
    revenue? Please include specific figures.

        Answer. BMS invested $6.3 billion in R&D in 2018, which includes
    the discovery and development of new medicines.

        U.S. sales for 2018 were $12.5 billion.

        Question. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. BMS does not publicly disclose specific marketing and
    administration expenditures. The figures below are for marketing, sales
    and administrative expenses, which includes marketing and
    administration expenditures.

            2018 spend:
            Marketing, selling, and administrative expenses: $4.6 billion
            Research and development expenses: $6.3 billion

            2017 spend:
            Marketing, selling, and administrative expenses: $4.8 billion
            Research and development expenses: $6.5 billion

            2016 spend:
            Marketing, selling, and administrative expenses: $5.0 billion
            Research and development expenses: $5.0 billion

            2015 spend:
            Marketing, selling, and administrative expenses: $4.8 billion
            Research and development expenses: $5.9 billion

            2014 spend:
            Marketing, selling, and administrative expenses: $4.8 billion
            Research and development expenses: $4.5 billion

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. BMS does not publicly disclose the functions included in
    sales nor specific marketing and sales expenditures. Please see the
    answer to the prior question for R&D and marketing, selling and
    administrative expenses.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. BMS believes responsible DTC communications plays a
    critical role in educating patients and families about treatment
    options, and encourages them to have an informed discussion with their
    physician about the best treatment for their needs. As a company, BMS
    engages in DTC TV advertising selectively and only when we think it
    will help educate patients. Currently BMS is engaging in DTC TV
    advertising for one product (Eliquis).

                                     ______

            Prepared Statement of Kenneth C. Frazier, Chairman and
                Chief Executive Officer, Merck and Company, Inc.
        Mr. Chairman, Senator Wyden, and members of the committee, thank
    you for the opportunity to appear today. Merck's mission is to save and
    improve lives around the world by bringing forward breakthrough
    medicines and vaccines, and ensuring they are available and affordable
    to patients who need them.

        Merck is a science-based company that exists to help solve the
    world's most vexing medical challenges. We have a long history of doing
    this, from the development of most of the common childhood vaccines, to
    bringing the first protease inhibitor to patients, turning AIDS from a
    death sentence to a chronic disease, to developing the first statin,
    which led to significant reductions in the negative health effects of
    high cholesterol. This legacy of invention continues today.

        Research is at the core of who we are and what we do. Last year,
    Merck invested nearly $10 billion in research and development toward
    our mission of preventing, treating, and curing disease, and since 2010
    we've invested nearly $70 billion in these efforts. Our more than
    12,000 researchers are focused on cancer, infectious diseases, and
    Alzheimer's, as well as other major health challenges that affect large
    numbers of people around the world. For our breakthrough immuno-
    oncology drug Keytruda alone we have over 900 clinical trials under
    way.

        In pursuit of these efforts, we are also investing significantly in
    infrastructure here in the United States. We have invested more than $5
    billion in the last five years, and we plan to invest $9 billion more
    over the next few years to increase manufacturing capacity and open two
    new discovery research centers.

        Our mission is to go where the science leads us, which means we
    don't allocate resources only to addressing diseases in wealthy
    countries; we focus our efforts on conditions that significantly impact
    people living all over the world.

        For instance, we are proud to have deployed 70,000 doses of our
    experimental Ebola vaccine in the Democratic Republic of the Congo,
    working in partnership with the Centers for Disease Control and
    Prevention, the Biomedical Advanced Research and Development Authority,
    and the Department of Health and Human Services. For efforts such as
    this there is no commercial opportunity, but we pursue them because
    these are the challenges that Merck was created to tackle.

        At the end of the day we do all of this to serve patients. We
    understand that patients are having a harder and harder time affording
    their health care, including their prescription medicines. As a result
    of robust negotiation and competition in the marketplace, medicine
    costs are growing at the slowest rate in years, but the system is still
    not working for patients who are too often being asked to pay more out-
    of-pocket due to the complex system of pricing, distribution, and
    insurance. I am here today to suggest a few ways that we can address
    this problem together.

        First, we want to be clear that our industry has a duty to be
    responsible in our pricing practices and contribute to solutions that
    address the affordability problems facing patients. We have all heard
    the egregious examples of irresponsible behavior. At Merck, we have a
    history of responsible pricing. To help increase transparency about our
    pricing practices, we publicly disclose information about our prices in
    the U.S. and the rebates and discounts we provide to payers--including
    insurers, pharmacy benefit managers, and the government. Last year, we
    pledged that we will not increase our average net prices for our
    portfolio by more than the rate of inflation annually.

        From 2010 to 2017, Merck's average net price increase across our
    portfolio each year has been in the low to mid-single digits. In fact,
    our average net price declined in 2017 by almost 2 percent. In 2017,
    the average discount for our medicines and vaccines was more than 45
    percent lower than the list price. Despite these very large discounts,
    patients do not see a commensurate benefit. In fact, patient out-of-
    pocket costs continue to rise, and patients are being asked to shoulder
    more of their drug costs than other health-care services.

        Second, we must ensure that patients get the benefit of the large
    rebates and discounts that manufacturers are paying to PBMs and
    insurance companies.

        The incentives in the current system are badly misaligned. As a
    result, the current system of drug competition that depends on rebating
    is not working for patients. The growing gap between our list prices
    and our net prices that results from rebating has created incentives
    for supply chain entities to favor products with higher list prices.
    For instance, in 2016, we introduced our hepatitis C therapy, Zepatier,
    at a list price that was 42 percent below the price of the therapy that
    was the standard of care. However, due to the misaligned incentives in
    the supply chain that create a preference for higher priced products,
    we had difficulty gaining access for patients in certain market
    segments.

        This kind of misalignment can have a significant negative impact on
    patients because their cost-sharing is often based on the list price of
    a drug, even when insurance companies and PBMs are paying a fraction of
    that price. Our current system that incentivizes high list prices and
    large rebates as a mechanism to keep insurance premiums low means that
    sick patients are essentially subsidizing healthy patients. In this
    way, our insurance system is broken. We urge you to support action to
    make sure that all patients benefit from the discounts we make
    available.

        Third, we can significantly reduce spending on pharmaceuticals,
    especially for patients, by ensuring that we have a viable market for
    biosimilars in the United States. We believe, like with traditional
    small molecule medicines, generic competition after a reasonable period
    of exclusivity will create headroom for patients to afford the newest,
    most innovative medicines. Research shows that generics and biosimilars
    are expected to drive savings of $105 billion through 2022 in the
    U.S.\1\
    ---------------------------------------------------------------------------
        \1\ IQVIA Institute for Human Data Science. ``Medicine use and
    spending in the U.S.: A review of 2017 and outlook to 2022.'' https://
    www.iqvia.com/institute/reports/medicine-use-and-spending-in-the-us-
    review-of-2017-outlook-to-2022. Published April 19, 2018. Accessed
    April 2018.

        However, we share the concerns expressed by FDA Commissioner
    Gottlieb regarding the challenges biosimilars have experienced in
    penetrating the market. Merck introduced a biosimilar to the market 18
    months ago at a 35 percent discount to the originator product, yet we
    have captured only a tiny fraction of the market. In general,
    biosimilars competition thus far has resulted in moderation of prices,
    but actual utilization of the biosimilars remains modest at best. We
    fear that an environment where market entry of biosimilars brings value
    to the market, but little or none of that value accrues to the
    ---------------------------------------------------------------------------
    biosimilar, will not be sustainable.

        Therefore, we urge Congress to pursue policies to encourage and
    support biosimilar uptake and utilization in order to realize these
    potential savings for the system and patients. These could include
    reduced cost sharing in Medicare Part B.

        Fourth, we believe that prices can more align with a drug's value
    when manufacturers and payers are able to negotiate innovative
    contracts that base payment on a drug's benefits. Manufacturers should
    be rewarded based on the value that our therapies deliver. When we
    developed our breakthrough immuno-oncology treatment Keytruda, we
    incorporated a biomarker where clinically appropriate so that we could
    identify those patients most likely to benefit, but this is not always
    the case. We did this because we believe in giving the right medicine
    to the right patient at the right time. This is important both for
    therapeutic and economic reasons. If patients regularly take our
    medicines as they are prescribed, we are prepared to stand behind their
    effectiveness.

        Moving to a system where we are reimbursed for the value our
    medicines provide would be revolutionary. Yet there remain major
    regulatory and operational obstacles to value-based payment and
    contracting in the commercial and public markets, which we urge
    Congress to address.

        Fifth, we support efforts to encourage generic competition. A
    version of Chairman Grassley's CREATES Act could make some needed
    reforms to encourage generic competition, and there are likely other
    policies we should consider as well to ensure there is no inappropriate
    gaming of the system.

        We also support the idea of eliminating the use of drug company
    coupons in cases where a brand name drug now has generic competition.
    This slows the use of generics and violates the spirit of the Hatch-
    Waxman drug price competition law.

        Finally, we would also like to work with the committee to find ways
    to end the price gouging pursued by those who jack up the prices of
    off-patent drugs that have no competition. These high prices hurt
    patients and do not create incentives for the kind of cutting edge
    research we pursue.

        These six changes could bring real relief to patients while
    preserving the incentives that allow us to invest billions in
    developing new medicines. These are exciting times, when decades of
    investment in scientific research are yielding life-changing
    discoveries. But it is the investment of today that fuels the
    innovations of tomorrow, and if we damage the ecosystem that drives
    those investments, we'll never know what we could have achieved for the
    patients we are all here to serve.

        The single most important contribution that we make at Merck--to
    economies, to health care, and to individual patients and their
    families--is to continue making the necessary costly and long-term
    investments in R&D and persuading thousands of brilliant researchers to
    sit at a lab bench and try to create something transformative--despite
    the overwhelming odds that their efforts will not succeed, since 9 out
    of 10 compounds that even start clinical trials will fail.

    The solutions to health-care spending and out-of-pocket costs for
    patients must be achieved in a way that provides the balance necessary
    for innovation to occur. The innovation ecosystem includes academia,
    small biotechnology companies, large pharmaceutical companies,
    government, and patients and providers. It is incumbent on all of us to
    solve the affordability challenges of today's patients without
    compromising our ability to invent for tomorrow's patients.

        I'd like to end on a personal note. My mother died when I was a
    child and my siblings and I were raised by my dad who worked as a
    janitor in North Philadelphia. He was a giant in my life and it was
    devastating when Alzheimer's took him away from me and my family.

        Last year, after spending many years and over a billion dollars,
    Merck had to end development of a promising new Alzheimer's therapy
    because it simply didn't work. Yet we continue on, seeking better
    approaches. And I truly believe Merck or one of the other companies at
    this table can and will find a medicine that will ensure that no one
    will have to experience the pain of seeing a loved one taken from them
    in this way.

        But, our success depends on having a U.S. market that is free,
    competitive, and predictable. The changes I've discussed today have the
    potential to vastly improve that market and help patients survive and
    thrive without financial hardship. I am here to pledge our cooperation
    with you for creating such changes.

        Thank you.

                                     ______

            Questions Submitted for the Record to Kenneth C. Frazier
                   Questions Submitted by Hon. Chuck Grassley
        Question. At the hearing, you testified that Merck does not
    withhold samples from generic manufacturers in order to block generic
    versions of your drug from entering the market. You also expressed your
    support for the ``Creating and Restoring Equal Access to Equivalent
    Samples Act,'' also known as the CREATES Act.

        However, the FDA has a list on its website which identifies
    reference listed drug (RLD) access inquiries where brand manufacturers
    may have prevented generic companies from obtaining samples of products
    necessary to support FDA approval. Cubist Pharmaceuticals is on this
    FDA list. According to news reports, Merck bought this company in 2014.
    If this is accurate, this would appear to contradict your testimony at
    the hearing that Merck has not withheld samples of their products to
    delay generic competition.

        Could you please explain in detail the discrepancy between your
    testimony and the FDA list?

        Has Merck ever blocked access to samples?

        Answer. Merck does not block generic companies from accessing
    samples. Your inquiry references FDA's website for reference listed
    drugs, or RLDs, which lists inquiries the agency has received from
    potential generic companies for samples of RLDs. Importantly, FDA's
    website also provides the following statement in describing the various
    inquiries related to the RLDs listed: ``We note that FDA has not
    independently investigated or confirmed the access limitations
    described in the inquiries received.''

        As FDA's website details, ENTEREG (alvimopan) has a restricted
    distribution requirement mandated by its FDA-approved Risk Evaluation
    and Mitigation Strategy (REMS). ENTEREG is the only Merck product
    subject to an FDA-approved REMS. Under this program, ENTEREG is
    available only to hospitals that perform surgeries that include a bowel
    resection and dispensed by pharmacies that are enrolled in the E.A.S.E.
    ENTEREG REMS Program. This program is designed to ensure that ENTEREG
    is used in accordance with the FDA-approved label.

        Merck acquired ENTEREG from Cubist Pharmaceuticals in 2015. Since
    acquiring ENTEREG, whenever Merck has received a request from a
    generics company to supply ENTEREG, we have directed them to the draft
    FDA Guidance which outlines how the generics company can obtain a
    letter from FDA stating that their study protocols contain the
    appropriate safety protections for products subject to this type of
    REMS. If provided with a copy of such a letter from FDA, Merck is happy
    to work with generics companies on supply arrangements. To date, we
    have not received any such letters. FDA's website also details that the
    agency has not issued any Safety Determination Letters for samples of
    ENTEREG.

        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant. If the HHS proposed rule is finalized, can you assure the
    committee that your company will offer up-front discounts? If not, why?

        Answer. Merck is aware that some in the industry have asked whether
    the antitrust laws as interpreted in the In re Brand Name Prescription
    Drugs Antitrust Litigation would limit the ability of manufacturers to
    offer point-of-sale discounts (as opposed to rebates). But, the U.S.
    antitrust laws, including the Robinson-Patman Act, apply to price
    discrimination in any context (including rebates), and nothing about In
    re Brand Name Prescription Drugs Antitrust Litigation changes this
    fact. As a result, Merck commits that, if the OIG's Proposed Rule is
    finalized, we will modify our contracts to comply with the new safe
    harbors and will provide discounts in a manner consistent with the new
    regulations.

        Question. Please describe how you expect your company to respond to
    the HHS proposed rule to eliminate safe harbor protection for back-end
    rebates in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. We expect that the robust negotiations that occur today
    will continue in the highly competitive Part D market, and we expect to
    realize the same level of net price that we do today. In fact, we
    expect that there could be additional pricing pressure under the new
    system, which could lead to lower net prices.

        Over time, we expect that our list prices will go down if the
    misaligned incentives across the system are addressed. We are currently
    working with other stakeholders in the system to solve the operational
    challenges that will enable these changes.

        But, it is also important to note that if the rule is implemented,
    Medicare beneficiaries' out-of-pocket costs will be reduced,
    independent of any lowering of list prices, since their cost-sharing
    will be based on the net price. Nonetheless, we believe the rebate rule
    will align incentives in a way that will restrain list prices.

        If this rule is implemented as written, it would only apply to our
    contracts with PBMs and health plans for Medicare Part D and Managed
    Medicaid. If PBMs and health plans maintain the rebate model in the
    commercial market, we would still have commercial contracts based on
    rebates, which would be subject to the existing constraints to lowering
    list price. We also would still need a mechanism to revalue drug in the
    distribution channel in a financially viable manner.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. Our contracts typically provide rebates to Part D plans in
    exchange for a specified formulary status. We are aware of only one
    current agreement that makes a Part D rebate contingent on reaching a
    certain market share.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

        Answer. The table below provides a proxy for volume by reporting
    percentages based on gross sales from 2018, given that there is no
    standard unit of volume measure that can be applied across our diverse
    product line (e.g., tablet products, injectable products, vaccines).

    ------------------------------------------------------------------------
                            Segment                            Gross/Volume
    ------------------------------------------------------------------------
    CML+Specialty Pharm                                                  28%
    ------------------------------------------------------------------------
    Hospital / GPO / 340B                                                23%
    ------------------------------------------------------------------------
    Medicare Part D                                                      19%
    ------------------------------------------------------------------------
    Medicare Part B                                                      12%
    ------------------------------------------------------------------------
    Medicaid                                                             12%
    ------------------------------------------------------------------------
    Federal                                                               6%
    ------------------------------------------------------------------------

            Notes: CML refers to private commercial payers; Medicare Part B
            also encompasses Part B products sold through Medicare
            Advantage Plans; Medicaid includes fee for service and managed
            Medicaid; Federal includes the VA, DoD, Coast Guard, Public
            Health Service and other similar purchasers.

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees?

        Answer. No. While Merck does contract with lobbyists who may
    interact with individuals associated with State Medicaid programs, they
    do not promote products at State Pharmacy and Therapeutics Committees.

        Question. To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. Merck requires employees to adhere to State ethics law
    requirements for disclosing advocacy activity. Additionally, employees
    who attend Medicaid program meetings must comply with State public
    meeting law requirements pertaining to their attendance and
    participation.

        Question. Please describe how the costs of patient assistance
    programs are accounted for within your company's financial statements.
    Please also describe the types of market information, such as
    prescribing and use patterns, that your company collects from different
    types of patient assistance programs and patient hub services.

        Answer. For purposes of this question, we are interpreting
    ``patient assistance programs'' to include the Merck Patient Assistance
    Program (Merck PAP), which provides free product to qualifying
    patients, Merck donations to independent patient assistance
    foundations, and Merck's patient coupon programs which help eligible
    privately insured patients afford their prescribed medications. Merck
    also makes available patient hub support programs to assist patients
    with accessing their prescribed medications.

        With respect to the company's financial statements, for Merck PAP
    and Merck's donations to independent patient assistance foundations,
    the costs are recorded to the ``Selling, general and administrative''
    category on our Consolidated Statement of Income. The co-pay assistance
    made available to patients through Merck's coupon programs is treated
    as a reduction to Merck's gross sales for the applicable products and
    is included in the ``Sales'' line of our Consolidated Statement of
    Income. The expenses associated with administering Merck's coupon
    programs are recorded in the ``Selling, general and administrative''
    category on our Consolidated Statement of Income. Similarly, the
    expenses associated with administering Merck's patient hub support
    programs are recorded in the ``Selling, general and administrative''
    category of our Consolidated Statement of Income.

        Merck receives different types of market information in connection
    with the different programs identified above. For market information
    associated with the Merck PAP, the Merck PAP reviews data, such as
    patient insurance status and household income, to determine an
    individual's eligibility for PAP program enrollment. Merck PAP also
    tracks the number of prescriptions associated with the PAP for
    budgeting and planning purposes, but Merck PAP does not collect
    information associated with the courses of therapy for individual
    patients. With respect to Merck's donations to independent patient
    assistance foundations Merck does not receive any market information.
    Merck receives only a final report that confirms donations were
    received and spent in their totality for their intended purpose.

        With respect to Merck's patient coupon programs, Merck may receive
    certain market information to assist it with evaluating whether its
    coupons programs are functioning consistent with their intended purpose
    and whether the vendor is meeting its contractual obligations. The
    information also may be used to assist Merck with budgeting and
    planning. For example, Merck may receive information about: the product
    filled; the product dispensing date and site; the prescriber; the
    number of patients enrolled in the coupon program; the number of
    coupons redeemed; the patient out-of-pocket costs associated with the
    use of a Merck coupon; and the benefit amount Merck pays on behalf of
    privately-insured patients using a coupon.

        With respect to Merck's patient hub support programs, Merck may
    receive certain market information to assist it with evaluating whether
    its hub support programs are functioning consistent with their intended
    purpose and whether the vendor is meeting its contractual obligations.
    The information also may be used to assist Merck with budgeting and
    planning. For example, Merck may receive aggregate information about:
    call type, frequency, and vendor response times; the number of patients
    enrolled in the program; patient enrollment demographic and diagnosis
    information; patient benefit investigations; insurance coverage
    information for the applicable product; and pharmacy product
    fulfillment information.

        Merck's third-party contractors may receive additional, patient-
    specific information that is not shared directly with Merck.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax-exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. For each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. The information concerning our Philanthropic grants and
    charitable contributions, including contributions made through the
    Office of Corporate Responsibility, our company's Foundation, U.S.
    Global Human Health, and the MSD for Mothers Program can be found here:
    https://www.msdresponsibility.com/ethics-transparency/transparency-
    disclosures/. Please note the website does not include grants or
    contributions from Merck's Research Laboratories or Merck's
    Manufacturing Division.

        In addition, the information concerning our grants of more than
    $500 provided by the company's Global Human Health division to U.S.
    organizations in support of independent, accredited educational
    programs for health-care professionals, as well as grants to patient
    organizations and other medical education or scientific societies and
    organizations in the United States, Europe, the Middle East, Africa and
    Canada can also be found at the website referenced above.

        Question. Pay for delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the Preserve Access to Affordable
    Generics and Biosimilars Act, which would help put an end to these
    deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Answer. Patent settlement agreements challenged by the FTC as anti-
    competitive, in which brands pay generic companies to stay out of the
    market when it would otherwise be lawful for them to enter the market,
    could delay patient access to lower cost alternatives. In contrast,
    patent settlement agreements in which the brand, while not conceding
    the invalidity or non-infringement of the patents, but in the face of
    the uncertainties and costs associated with protracted litigation,
    settles cases in a manner that allows a generic to enter the market
    prior to expiry of the brand's patents could actually accelerate
    patient access to lower cost alternatives. Still, brands do not enter
    into such agreements lightly because they believe in the rights of
    patent holders to vigorously enforce their intellectual property rights
    in court. At the end of the day, these settlements do not delay entry
    or cause the loss of any lawful competition because entry prior to the
    expiry of these patents would be unlawful infringement unless and until
    the generic manufacturers prevailed in court.

        Question. Has your company ever entered into these kinds of
    settlements with a generic company?

        Answer. Merck has not entered into patent settlement agreements
    with generic companies to delay their entry past when it would
    otherwise be lawful for them to enter the market. Merck has been party
    to a number of patent settlement agreements that provide for generic
    market entry prior to patent expiry, including some that have provided
    some level of exclusivity for a limited time. These agreements allowed
    generic products to enter the market earlier than would have otherwise
    been the case. The FTC has not challenged as anti-competitive any of
    these types of agreements involving Merck.

        Question. Do you support the pay for delay bill?

        Answer. Merck does not support S. 64 in its present form. Merck
    believes that the development of the law through the judicial process
    is the most effective way to address the balance between antitrust law
    and patent law raised by settlement agreements. S. 64 upsets the
    careful balance embodied in a rule-of-reason analysis by creating a
    presumption that ``anything of value'' or an ``exclusive license'' are
    anticompetitive, thus denying an antitrust defendant the ability to
    present and rely on countervailing evidence of pro-competitive effects,
    such as the impact on competition by the entry of the generic product
    before the expiration of the patent or statutory exclusivity term. As
    noted by the Supreme Court in FTC v. Actavis:

            Given these factors, it would be incongruous to determine
            antitrust legality by measuring the settlement's
            anticompetitive effects solely against patent law policy,
            rather than by measuring them against procompetitive antitrust
            policies as well.\1\
    ---------------------------------------------------------------------------
        \1\ FTC v. Actavis, 570 U.S. 136, 148 (2013).

        S. 64 also seeks to insulate the FTC's fact finding from judicial
    review. Finally, the retroactive application of the provisions of the
    bill to June 2013 is unworkable. While there had been a split between
    the Circuit Courts over the proper analysis of reverse payment
    settlements, the Supreme Court's opinion in Actavis in 2013 settled
    that split by holding that patent settlements including those with
    reverse payments were subject to a rule-of-reason analysis. That
    decision did not provide hard and fast rules for the balance between
    antitrust and patent principles. To impose a process that alters that
    balance, and to do so retroactively, is imprudent and unfair.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Answer. Merck understands this question to refer to certain
    concerns about contracting practices applied to contracts between
    manufacturers and PBMs or health plans. Merck offers rebates to payers
    on bundles of products within certain product families (e.g., JANUVIA
    and JANUMET, ASMANEX TWISTHALER and ASMANEX HFA). These bundled
    discounts benefit patients by ensuring that multiple therapies are
    maintained on a PBM or health plan formulary, thus ensuring wider
    patient access to our medicines at lower costs to the payer. Merck also
    offers discounts with respect to multiple bundled products outside of
    the PBM and health plan contracts, such as in the vaccine and hospital
    markets.

        Question. Does your company view these practices as anticompetitive
    or harmful to patients' access to quality, lower cost medicine?

        Answer. No. Merck believes the rebates it offers to payers on
    pharmaceutical products are procompetitive. Merck does not believe that
    its rebating practices are harmful to patients.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. Merck is very supportive of current efforts to change the
    system. We believe these efforts will remove misaligned incentives
    within the system, drive more transparency in the system and, most
    importantly, benefit patients by lowering out-of-pocket costs. It is
    difficult to predict whether these changes will solve all of the issues
    seen today, but Merck is committed to working toward additional
    solutions if issues remain after these changes are implemented.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        When setting the list price of a drug, does your company consider
    the risk of liability or litigation? If so, how specifically do those
    factors affect the list price of a drug? Please provide at least one
    specific example, if applicable, from your current product portfolio.

        Answer. In setting the list price for a drug, we do not
    specifically consider the regulatory costs or compliance or the risk of
    liability or litigation.

        Merck approaches pricing from the perspective of value. This
    approach looks at the value that a medicine provides through multiple
    lenses with the goal of reflecting its benefit to patients and to
    society, while at the same time paying an appropriate return on
    invested capital to our investors, to ensure that we are able to
    sustain R&D. While each individual situation varies based on factual
    circumstances and market dynamics, generally, we consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see value-based arrangements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        How can VBAs help lower what patients pay out-of-pocket?

        Can Congress do more to allow for and encourage the use of VBAs?

        Answer. For more than 10 years, Merck has worked with payers and
    health-care providers to advance alternative pricing and contracting
    arrangements, and Merck has publicly shared information about value-
    based agreements (VBAs) it entered into with the payers Aetna and
    Cigna. We are continuously reviewing ways in which the company may
    enter into VBAs for our products, which we define as a contractual
    framework aimed at achieving a mutually agreed upon value objective
    that that drives greater value from health care spending. Merck is
    interested, where business and customer objectives align, to implement
    VBAs across the health care market, including Medicare Part D, Managed
    Medicaid, and Fee-For-Service Medicaid.

        By aligning payments for medicines more directly with their value
    in improving meaningful health outcomes and/or reducing the need for
    other health-care services (such as hospitalizations), VBAs make
    pharmaceutical manufacturers accountable for the results their products
    achieve in a concrete way and can help improve patients' health and
    maximize the benefits of health-care spending. A recent Avalere survey
    of payers found that 44 percent of payers engaged in outcomes-based
    contracts experienced improvements in patient outcomes.\2\
    ---------------------------------------------------------------------------
        \2\ Avalere Health. ``Outcomes-Based Contracts: Payer
    Perspectives.'' Avalere Policy 360. July 19, 2018.

        VBAs also can increase patient access to new therapies which could
    ultimately improve patient outcomes. A payer that might otherwise
    decline to cover a new medicine (or that would only cover the medicine
    with significant utilization management restrictions or high cost
    sharing) due to uncertainties about the expected percentage of its
    patient population who would benefit might increase access to the
    medicine if the manufacturer shared the risks of the medicine's
    performance. These agreements may make medicines more accessible to
    patients who will benefit from them and increase competition in
    relevant therapeutic classes.\3\ Researchers have found that value-
    based arrangements can improve patient access to medicines.\4\
    ---------------------------------------------------------------------------
        \3\ Staley, L. ``A Drug's Worth: Why Federal Law Makes It Hard to
    Pay for Pharmaceutical Performance.'' Boston University Law Review.
    2018;98(1):303-334. (``Tying reimbursement to health outcomes presents
    new opportunities for competition with rival manufacturers. . . . [A]
    manufacturer that can demonstrate sustained health benefits in post-
    market studies may distinguish itself from competitors.'').
        \4\ See, for example, description of Entresto and Repatha contracts
    in: Seely, E., and Kesselheim, A. ``Outcomes-Based Pharmaceutical
    Contracts: An Answer to High U.S. Drug Spending?'' Commonwealth Fund.
    Issue Brief. September 2017.

        While Merck has had some experience with VBAs, these efforts have
    not been as robust as they could be due to the challenges involved in
    developing and implementing them. In addition to infrastructure and
    data limitations, challenges include regulatory limitations such as
    government pricing frameworks (e.g., Medicaid Best Price (BP) rules,
    ---------------------------------------------------------------------------
    Medicare's Average Sales Price (ASP)) and Federal fraud and abuse laws.

        Accordingly, we support opportunities that would enable greater
    experimentation in the design, structure, and implementation of VBAs.
    Further innovation in this space is needed to support overall sponsor
    and plan learning, and to determine the range of potential benefits to
    diverse health systems and beneficiaries. To fully achieve these goals,
    however, the impacts of the current regulatory framework, including
    government pricing requirements, the Federal Anti-Kickback Statute
    (AKS), and overall environmental barriers, must be analyzed and
    addressed as appropriate. Policy solutions such as the Patient
    Affordability Value and Efficiency Act (PAVE), introduced by Senators
    Warner and Cassidy, could provide necessary regulatory flexibility for
    properly structured VBAs.

                                     ______

                  Questions Submitted by Hon. Michael B. Enzi
        Question. More than 10 years ago, I worked on a bipartisan basis
    with my good friends Ted Kennedy and Orrin Hatch to develop a
    biosimilars approval pathway. One of the difficult things was
    accounting for the differences between biosimilars and generics. I have
    said before that if a drug was a three-bedroom, two-bath home, a
    biologic would be a skyscraper. The size and complexity of the items
    are just that different. I understand that it is much harder to build a
    skyscraper without blueprints than a house. Even though the science has
    come a long way since then, there aren't as many biosimilars on the
    market as we might have hoped. Do you think the incentives in the law
    appropriately account for the differences between biosimilars and
    generics?

        Answer. In general, biosimilars competition thus far has resulted
    in moderation of prices, but actual utilization of the biosimilars
    remains modest at best. We fear that an environment where market entry
    of biosimilars brings value to the market, but little or none of that
    value accrues to the biosimilar patient or the health-care system, will
    not be sustainable.

        Merck remains an advocate for rigorous biosimilarity standards
    globally, and we believe that all biosimilar product applicants should
    be required to demonstrate equivalence (i.e., biosimilarity) in safety
    (including immunogenicity) and efficacy, and no differences in purity
    and potency profiles between the originator reference product and the
    biosimilar candidate. We believe the FDA has instituted such a standard
    with its Totality of the Evidence approach, ``including structural and
    functional characterization, nonclinical evaluation, human PK and PD
    data, clinical immunogenicity data, and comparative clinical study(ies)
    data.'' \5\
    ---------------------------------------------------------------------------
        \5\ U.S. Food and Drug Administration. ``Scientific Considerations
    in Demonstrating Biosimilarity to a Reference Product Guidance for
    Industry.'' (Apr. 2015), https://www.fda.gov/downloads/drugs/guidances/
    ucm291128.pdf.

        We are urging Congress to pursue policies to encourage and support
    biosimilar uptake and utilization in order to realize these potential
    savings for the system and patients. These policies could include
    ---------------------------------------------------------------------------
    reduced cost sharing in Medicare Part B.

        Question. I know there are proposals to essentially pay more for
    biosimilars to make them more attractive, but that is not exactly what
    we were intending when we wrote the law. Can you talk about adverse
    incentives in the market and any barriers to market penetration that we
    might address to help improve patient access to these lower cost
    products?

        Answer. Merck introduced a biosimilar to the market 18 months ago
    at a 35-
    percent discount to the originator product, yet we have captured only a
    tiny fraction of the market. Uptake of the product was limited, we
    believe due to physician confusion regarding interchangeability and
    extrapolation, and a lack of physician, patient, and payer incentives.
    While we believe that the prescribing physician must always have the
    authority to designate exactly which biological product is dispensed to
    the patient, we believe there are market barriers that hamper
    appropriate adoption of biosimilars. Merck encountered the following
    market barriers that hampered uptake of RENFLEXIS:

              We have observed cases where Medicare Advantage plans seem
            to be imposing utilization management controls that require
            providers to first use the reference biologic before providing
            coverage for the biosimilar. This is a significant disincentive
            to biosimilar uptake in that setting, and we believe is
            contrary to policy objectives to promote the uptake of
            biosimilars.

              Some providers may be hesitant to adopt biosimilar products
            due to overall confusion and the current lack of standardized
            definitions of biosimilarity (including the concepts of
            extrapolation and interchangeability). Currently, we lack
            standardized definitions of interchangeability as it relates to
            clinical significance, and concerns about the clinical
            appropriateness of switching stable patients to a biosimilar
            product have been contentious issues for some prescribers.
            Further, prescribers may be comfortable with a single switch
            (i.e., moving a stable patient from a reference product
            treatment protocol to a biosimilar), but may have concerns
            about switching a patient multiple times, absent the
            interchangeability designation. We believe that regulatory
            clarification of these terms and concepts could help mitigate
            concerns for providers and support biosimilar product adoption.

        We suggest the following policy changes to help encourage and
    support prescriber biosimilar utilization:

              Consider options to reduce or eliminate patient cost sharing
            in Medicare Part B for biosimilars. While some Part B
            beneficiaries are already able to reduce their 20 percent cost
            sharing via supplemental coverage, we believe eliminating cost
            sharing will encourage many physicians to use biosimilars for
            their patients. A similar approach in Part D and in Medicaid
            for small-molecule generics has driven generic utilization up
            to 90 percent.\6\
    ---------------------------------------------------------------------------
        \6\ Department of Health and Human Services. Office of Inspector
    General. ``Generic Drug Utilization in the Medicare Part D Program.''
    (Nov. 2007), https://oig.hhs.gov/oei/reports/oei-05-07-00130.pdf.

              Create pathways for MA and Part D plans to receive bonus
            payments and/or enhanced star ratings for achieving metrics
            related to access to biosimilars. This will incentivize plans
            to implement policies that drive additional utilization of
    ---------------------------------------------------------------------------
            biosimilars.

              Consider alternative reimbursement methodologies that adjust
            the current Part B reimbursement formula. The current structure
            in Part B to reimburse at ASP + 6 percent of the reference
            product's ASP ensures there is no reimbursement downside to
            physicians for using biosimilars. But so far, the evidence does
            not suggest the current reimbursement rate sufficiently
            incentivizes providers to use biosimilar products. Congress
            should consider alternatives to further incentivize physician
            adoption of biosimilars.

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad.

        Pharmacy benefit managers and plans have argued that rebates are
    used to lower premiums across the board and that it is the best way to
    seek a price concession on otherwise expensive drugs.

        Your industry argues that these payers are insisting on higher
    rebates that can only be achieved by raising list prices.

        But patients often lose under this system, with out of pocket costs
    being tied to list price. Insulin patients appear to be routinely
    impacted by this perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        What assurance can you provide that you would in fact lower your
    prices?

        What actions should be taken to ensure that patients are actually
    seeing the benefits of lower out of pocket costs?

        Answer. As we stated when we reduced the list price of several of
    our products in July 2018, we will continue to look for opportunities
    to reduce our list prices. We think the proposed rule will help create
    those opportunities, but it can't happen overnight. We are currently
    working with other stakeholders in the system to solve the operational
    challenges that will enable these changes.

        It is important to note that if the proposed rule is implemented,
    Medicare beneficiaries' out-of-pocket costs will be reduced,
    independent of any lowering of list prices, since their cost-sharing
    will be based on the net price. Further actions to ensure patients
    actually see the benefit of lower out of pocket costs might include
    prohibitions on changes in benefit design by payers/PBMs that could
    allow payers/PBMs to defeat the intent of delivering savings to
    patients.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        Answer. While the misaligned incentives of Part D are partly
    responsible for PBMs favoring high list prices, that is not the sole
    dynamic associated with price increases. There may be unique reasons
    for price increases on specific products given their individual
    circumstances, including competitive dynamics and the costs of clinical
    research and manufacturing improvements. In addition, while PBMs
    generally do not manage Part B benefits, this does not mean that
    discounts are not provided or applied on these products. Providers and
    commercial health plans do receive discounts, the average of which is
    passed along to patients through ASP-based reimbursement.

        The 20-percent coinsurance paid by a patient is based on the ASP,
    which reflects the average discounts received by providers and payers.
                         biosimilar competition/insulin
        Question. Biosimilars have been much anticipated as a solution to
    the drug pricing crisis. In particular, the FDA is moving to make
    insulin a biologic that would be subject to biosimilar competition in
    the future.

        But we are hearing from all of you that the biosimilar market
    doesn't work and the benefit of these cheaper but equally effective
    alternatives are really not available to U.S. patients.

        Can a biosimilar version of insulin be part of the solution for
    diabetes patients?

        If so, what changes need to be made to the system so that patients
    and the taxpayer can realize the benefit of biosimilars? (Merck gave up
    on pursuing a biosimilar to Sanofi's Lantus \7\)
    ---------------------------------------------------------------------------
        \7\ Arlene Weintraub. ``Merck Ditches Biosimilar Lantus, But Will
    That Ease the Path for Mylan's Rival Insulin Product?'' FiercePharma.
    (Oct. 12, 2018), https://www.fiercepharma.com/pharma/merck-ditches-
    biosimilar-lantus-but-will-ease-path-for-mylan-s-rival-insulin-product.

        Answer. We believe there is potential for significant savings to
    national health-care systems if high quality biosimilars--including
    insulins--can be brought to the market and compete with those biologics
    ---------------------------------------------------------------------------
    that have exhausted their intellectual property protections.

        Biosimilar products are still the subject of a great deal of
    confusion, particularly among providers, regarding the scientific,
    regulatory, and clinical basis for extrapolation and interchangeability
    decisions made by the FDA. Merck has urged the FDA to expand its work
    in educating providers and other stakeholders on these topics.

        Beyond that, we believe Congress should consider policy changes to
    help encourage and support prescriber biosimilar utilization. In our
    Blueprint comments to HHS we recommended incentives targeting patients,
    health plans, and providers that we believe can move the needle in
    stimulating uptake. One idea is for Congress to consider options to
    reduce or eliminate patient cost sharing in Medicare Part B for
    biosimilars.

        As to the Lantus biosimilar, after a comprehensive assessment of
    the current and future market environment for insulin glargine,
    including biosimilars, which included an assessment of anticipated
    pricing and cost of production, we made the business decision to
    terminate our agreement on the commercialization of the Lusduna pen and
    vial. There is already one other biosimilar glargine on the market and
    others on the way. So, we concluded this space was, or soon will be,
    adequately covered. This will allow us to allocate resources to other
    products in development.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices.

        With the increased scrutiny of the industry and of the drug supply
    chain as a whole in the United States, have any of your companies re-
    evaluated your business strategy in foreign countries?

        If not, then why?

        If a proposal, like IPI, were implemented, would it force your
    companies to potentially ``walk away from the negotiating table when
    other countries demand low prices subsidized by America's seniors,'' as
    HHS Senior Advisor for Drug Pricing Reform John O'Brien has said?

        What are some of your ideas on how we can ensure Americans aren't
    shouldering the full cost of pharmaceuticals?

        Answer. Merck continually reevaluates its business strategies in
    all markets, seeking in particular to make its vaccines and medicines
    accessible to patients while realizing their full value in foreign
    markets with regulatory schemes that do not recognize the full value of
    these products and artificially reduce prices. Nevertheless, in most
    markets there are very limited options for adjusting prices to
    recognize the full value of our medicines and vaccines. One-sided and
    onerous pricing and reimbursement schemes most often leave little room
    for negotiation.

        With regard to ``walking away from the negotiating table,'' Merck
    always reserves that option. However, we recognize the serious and
    negative implications on patient health and access, the company's
    ultimate mission, and other possible repercussions that would result
    from denying patient access to our medicines. Moreover, foreign
    governments can resort to compulsory licensing, essentially seizing
    patent rights, where a company refuses to market a product, which also
    makes it difficult to withdraw from a foreign market.

        Regarding ideas to ensure Americans aren't shouldering the full
    cost of pharmaceuticals, we believe appropriate U.S. trade strategies
    are a promising avenue to dealing with unreasonable foreign government
    action. Positive actions in the U.S. can also reduce prices in the
    U.S., including removing misaligned incentives that cause PBMs to favor
    more expensive products and lead to higher out-of-pocket costs for U.S.
    patients, like the administration's proposal regarding the rebate safe
    harbor. One potential proposal would be to create a special USTR
    negotiator specifically for drug pricing issues.
                  foreign countries' pricing and reimbursement
        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year.

        ``When foreign governments extort unreasonably low prices from U.S.
    drug makers, Americans have to pay more to subsidize the enormous cost
    of research and development. . . . It's unfair and it's ridiculous, and
    it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing medical advances?

        How do foreign countries' pricing and reimbursement systems affect
    our prescription drug costs?

        Are foreign governments taking note of the concerns being raised by
    the Trump administration and have they responded in any way?

        Has there been any noticeable change in any of our trade agreements
    since these concerns have been raised by the Trump administration?

        Answer. We agree that foreign countries' pricing and reimbursement
    systems result in their not paying enough to support the
    biopharmaceutical innovation from which they benefit. This causes the
    U.S. to shoulder more than its fair share of financing medical
    advances. These pricing and reimbursement systems do not necessarily,
    however, affect prescription drug costs in the U.S. in any direct or
    algorithmic fashion. Rather, Merck approaches pricing from the
    perspective of value. This approach looks at the value that a medicine
    provides through multiple lenses with the goal of reflecting its
    benefit to patients and to society, while at the same time paying an
    appropriate return on invested capital to our investors, to ensure that
    we are able to sustain R&D. While each individual situation varies
    based on factual circumstances and market dynamics, generally, we
    consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

        Prices in other countries often reflect different value systems and
    criteria. It is important to note that all components of the health
    care system, including hospital services, physician services, physician
    salaries, and medical devices are considerably less expensive in
    foreign countries than in the U.S. That said, we agree that foreign
    countries' pricing and reimbursement systems result in their not
    sufficiently supporting biopharmaceutical innovation. While foreign
    governments are generally aware of concerns raised by the Trump
    administration, we are not aware of any substantive response.

        There has been some change in trade agreements, but more work needs
    to be done. U.S. free trade agreements address discriminatory
    approaches to pricing and reimbursement and ensure fair treatment for
    innovative medicines through commitments established by trade partners.
    Free trade agreements can help advance innovation, versus approaches
    proposed by the administration such as the International Pricing Index
    that have the potential to stifle investment in R&D by driving down
    prices across markets.

        Here are three examples:

              A 2004 U.S. Department of Commerce study examining OECD
            countries found that foreign price controls restrict the
            ability to innovate in our sector and identified trade
            agreements as a key lever. We strongly encourage the Trump
            administration to update this report to reflect the impact of
            continued price controls in OECD countries.

              The pharmaceutical pricing and reimbursement provisions in
            the U.S.-
            Mexico-Canada Agreement commit governments to provide
            transparency and due process protections in national
            pharmaceutical reimbursement processes and decisions. This is a
            step in the right direction, but more is needed to ensure that
            many countries, such as Canada, appropriately recognize the
            value of innovative medicines.

              The Trump administration has worked to ensure adherence to
            commitments in pricing and reimbursement in the Korea-U.S. Free
            Trade Agreement, and direct advocacy by the U.S. has also made
            an impact in Japan to mitigate some approaches.

        There is clearly more work to be done in these areas, and trade
    tools such as a new U.S.-Japan Free Trade Agreement, are critical.
                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various States
    have been exploring whether to exclude certain drugs from its Medicaid
    program. For example, the State of Massachusetts' recently asked CMS
    for permission to create a closed formulary where the State Medicaid
    program would pick at least one drug per therapeutic class. CMS denied
    their waiver request citing violation of Federal law, but this proposal
    does bring up important questions on how to contain drug prices in
    State Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to State Medicaid programs,
    do you think it lower drugs costs while ensuring access to patients?

        Answer. There are important differences in the population covered
    under Medicaid and the coverage options available that need to be
    considered. Medicaid beneficiaries remain some of the sickest and most
    complex populations of patients, with sometimes inconsistent
    relationships with health-care providers and other complicating factors
    that make accessing medical care already difficult. Many Medicaid
    patients have complex diseases for which there are not always
    therapeutically equivalent drugs available, so access to the specific
    drug providers prescribe is crucial.

        Part D is a highly competitive, successful program that has come in
    at nearly half the cost that was originally projected. It also has
    extremely high rates of beneficiary satisfaction--generally around 90
    percent. While Part D offers multiple plan options and levels of
    benefits such that patients can shop for plans that cover their
    medicines at varying levels of cost-sharing, patients in Medicaid do
    not have access to alternative coverage options. So, if a medicine they
    need is not available, they do not have the ability to switch plans or
    otherwise obtain access to the medicine.

        As a result, the use of restrictive formularies is likely to result
    in adverse effects on beneficiary outcomes and increased costs when
    applied in Medicaid. While the patient protections that exist in Part D
    may provide beneficiaries with an option to appeal formulary decisions,
    it would be complicated to navigate for Medicaid patients and their
    providers, who may have limited resources to take on the additional
    responsibility and may take time that patients with complex conditions
    may not have.

        Medicaid is already receiving the best price based on the statutory
    rebate and States have flexibility to exert utilization management
    controls to negotiate supplemental rebates. Given this, we believe that
    applying the principles of Medicare Part D in Medicaid is not likely to
    result in lower drug costs without significantly impacting access.
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        What, if any, changes would you suggest we make to the program?

        Answer. We can speak only to Merck's practices, and Merck does not
    consider the Medicaid Best Price requirement when setting initial
    prices. Merck approaches pricing from the perspective of value. This
    approach looks at the value that a medicine provides through multiple
    lenses with the goal of reflecting its benefit to patients and to
    society, while at the same time paying an appropriate return on
    invested capital to our investors, to ensure that we are able to
    sustain R&D. While each individual situation varies based on factual
    circumstances and market dynamics, generally, we consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically-important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

        We recognize the value that the Medicaid program provides for
    patients who need it, and we do not believe the ``best price''
    requirement encourages manufacturers to increase initial prices.

        Merck believes that the exclusion of value-based arrangements
    (VBAs) from the calculations of Best Price, Average Manufacturer Price,
    and Average Sales Price would facilitate VBA implementation, which
    would further align prices with the value that pharmaceutical products
    bring to the market.
                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        How will they lower overall health-care costs for our Federal
    programs?

        What have the preliminary results looked like so far?

        Answer. For more than 10 years, Merck has worked with payers and
    health-care providers to advance alternative pricing and contracting
    arrangements and Merck has publicly shared information about value-
    based agreements (VBAs) it entered into with the payers Aetna and
    Cigna. We are continuously reviewing ways in which the company may
    enter into VBAs for our products, which we define as a contractual
    framework aimed at achieving a mutually agreed upon value objective
    that that drives greater value from health-care spending. Merck is
    interested, where business and customer objectives align, to implement
    VBAs across the health-care market, including Medicare Part D, Managed
    Medicaid, and Fee-For-Service Medicaid.

        By aligning payments for medicines more directly with their value
    in improving meaningful health outcomes and/or reducing the need for
    other health-care services (such as hospitalizations), VBAs make
    pharmaceutical manufacturers accountable for the results their products
    achieve in a concrete way and can help improve patients' health and
    maximize the benefits of health-care spending. A recent Avalere survey
    of payers found that 44 percent of payers engaged in outcomes-based
    contracts experienced improvements in patient outcomes.\8\
    ---------------------------------------------------------------------------
        \8\ Avalere Health. ``Outcomes-Based Contracts: Payer
    Perspectives.'' Avalere Policy 360. July 19, 2018.

        VBAs also can increase patient access to new therapies which could
    ultimately improve patient outcomes. A payer that might otherwise
    decline to cover a new medicine (or that would only cover the medicine
    with significant utilization management restrictions or high cost
    sharing) due to uncertainties about the expected percentage of its
    patient population who would benefit might increase access to the
    medicine if the manufacturer shared the risks of the medicine's
    performance. These agreements may make medicines more accessible to
    patients who will benefit from them and increase competition in
    relevant therapeutic classes.\9\ Researchers have found that value-
    based arrangements can improve patient access to medicines.\10\
    ---------------------------------------------------------------------------
        \9\ Staley, L. ``A Drug's Worth: Why Federal Law Makes it Hard to
    Pay for Pharmaceutical Performance.'' Boston University Law Review.
    2018;98(1):303-334. (``Tying reimbursement to health outcomes presents
    new opportunities for competition with rival manufacturers. . . . [A]
    manufacturer that can demonstrate sustained health benefits in post-
    market studies may distinguish itself from competitors.'').
        \10\ See, for example, description of Entresto and Repatha
    contracts in: Seely, E., and Kesselheim, A. ``Outcomes-Based
    Pharmaceutical Contracts: An Answer to High U.S. Drug Spending?''
    Commonwealth Fund. Issue Brief. September 2017.

        While Merck has had some experience with VBAs, these efforts have
    not been as robust as they could be due to the challenges involved in
    developing and implementing them. In addition to infrastructure and
    data limitations, challenges include regulatory limitations such as
    government pricing frameworks (e.g., Medicaid Best Price (BP) rules,
    ---------------------------------------------------------------------------
    Medicare's Average Sales Price (ASP)) and Federal fraud and abuse laws.

        Accordingly, we support opportunities that would enable greater
    experimentation in the design, structure, and implementation of VBAs.
    Further innovation in this space is needed to support overall sponsor
    and plan learning, and to determine the range of potential benefits to
    diverse health systems and beneficiaries. To fully achieve these goals,
    however, the impacts of the current regulatory framework, including
    government pricing requirements, the Federal Anti-Kickback Statute
    (AKS), and overall environmental barriers, must be analyzed and
    addressed as appropriate. Policy solutions such as the Patient
    Affordability Value and Efficiency Act (PAVE), introduced by Senators
    Warner and Cassidy, could provide necessary regulatory flexibility for
    properly structured VBAs.
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point-of-sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        If so, would this transparency bring down drug costs--overall and
    for specialty drugs?

        Answer. We believe we must change the system to ensure that
    patients receive the benefit of the significant rebates and discounts
    that manufacturers like Merck pay to PBMs and plans. The proposed rule
    is a positive step in that direction. Based on our initial assessment
    of the proposal, we believe that it will remove misaligned incentives
    within the system, drive more transparency in the system, and most
    importantly, lower beneficiaries' out-of-pocket costs.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the Pharmacy Benefit Manager. But there's
    another side of the equation that I'd like to ask about.

        How do wholesalers negotiate pricing with manufacturers?

        What impact does this have on drug costs?

        What incentives or disincentives do they have to contain price
    increases?

        Answer. There are many entities supporting the distribution and
    dispensing of pharmaceutical products. Wholesalers purchase
    pharmaceutical products directly from manufacturers and subsequently
    sell those products to sites of care for dispensing. Downstream
    customers of the wholesalers include retail and specialty pharmacies,
    hospitals, clinics, and others. Those entities that purchase from the
    wholesalers ultimately dispense or administer the drug to patients.

        Many manufacturers typically offer a ``prompt pay'' discount to
    wholesalers in exchange for timely payment of invoices (2 percent for
    payment within 30 or 35 days is fairly standard in the industry).

        Manufacturers also contract with wholesalers for services that
    support the appropriate storage and distribution of product to
    appropriate customers within the supply chain. These ``Distribution
    Service Agreements'' provide wholesalers with an opportunity to earn
    fees based on performance against pre-defined metrics that are part of
    a set of standard services. These services include managing inventory
    levels, achieving defined service levels, consolidating receipt of
    inventory to a central location, and administering contract pricing and
    chargebacks. Although these distribution service fees manufacturers pay
    to wholesalers are commonly administered as a percent of the list
    price, they are negotiated at arm's length and are based on fair market
    value for the services rendered.

        The terms of wholesaler agreements with their downstream customers
    vary; however, in general, the prices they offer to their customers are
    set relative to a product's list prices. In general, fees paid to
    wholesalers by manufacturers are modest and wholesaler economics
    (including both buy and sell side) are not likely to influence the
    setting of a product's list price.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price.

        Like many Oregonians, I am skeptical drug manufacturers would
    voluntarily lower their prices. Therefore, would you support
    legislation that would (1) make similar changes the administration has
    put forward related to Part D and Medicaid managed care, (2) change the
    rebate system in a similar way to the proposal for the commercial
    market, and (3) require drug makers to lower the list price of their
    drugs equal to the amount of rebates provided today?

        Answer. We believe we must change the system to ensure that
    patients receive the benefit of the significant rebates and discounts
    that manufacturers like Merck pay to PBMs and plans. The proposed rule
    is a positive step in that direction. Based on our initial assessment
    of the proposed rule, we believe that it will remove misaligned
    incentives within the system, drive more transparency in the system,
    and most importantly, lower beneficiaries' out-of-pocket costs. Merck
    supports the earliest possible implementation of the proposed rule that
    can be achieved without creating disruption for the beneficiaries who
    rely on Medicare for their drug coverage. We are committed to working
    with the PBMs and health plans and other intermediaries to make this
    happen.

        We do not support legislation to require manufacturers to lower
    their list price equal to the amount of rebates today. First, different
    purchasers receive different levels of discounts, based on
    individualized negotiations and the formulary positioning of Merck's
    products. So, there is not a uniform ``rebate amount'' that could
    reduce the list price. Moreover, we expect that the robust negotiations
    that occur today will continue in the highly competitive Part D market,
    and we expect to realize the same level of net price that we do today.
    In fact, we expect that there could be additional pricing pressure
    under the new system, which could lead to lower net prices.

        Over time, we expect that our list prices will go down if the
    misaligned incentives across the system are addressed. We are currently
    working with other stakeholders in the system to solve the operational
    challenges that will enable these changes.

        But, it is also important to note that if the rule is implemented,
    Medicare beneficiaries' out-of-pocket costs will be reduced,
    independent of any lowering of list prices, since their cost-sharing
    will be based on the net price. Nonetheless, we believe the rebate rule
    will align incentives in a way that will restrain list prices.

        As we stated when we reduced the list price of several of our
    products in July 2018, we have continued to look for opportunities to
    reduce our list prices. We think the proposed rule would help create
    those opportunities, but it can't happen overnight. All the players in
    the ecosystem will need to adjust to the new model. We are actively
    working to support the move to a contracting model in Part D that would
    change the incentives to support lower list prices.

        Lowering list prices is not an easy thing to do in our health-care
    system:

              One of the key challenges to lowering list prices is the
            contractual arrangements that companies have with PBMs and
            health plans, which are intended to ensure access to our
            products. These contracts are often multi-year and are most
            often written to provide a discount off of the list price,
            which is paid as a rebate later.

              To reduce the list price without significant financial
            consequences, all of these contracts would need to be modified
            to maintain the same net price. Unless the entire system
            changes, one manufacturer runs the risk of being disadvantaged
            and losing formulary status or being required to pay the same
            percentage discount on a lower list, which could be
            unsustainable.

              In addition, drugs flow through a complex supply chain, from
            the manufacturer, to the wholesaler, to a pharmacy or hospital
            who dispenses the drug to patients. For any product but even
            more so for a high volume primary care product that is flowing
            through to all pharmacies and hospitals, there is not a
            mechanism in place to readjust the value of the inventory being
            held by all those parties.

        If the proposed rule is implemented as written, it would only apply
    to our contracts with PBMs and health plans for Medicare Part D and
    Managed Medicaid. If PBMs and health plans maintain the rebate model in
    the commercial market, we would still have commercial contracts based
    on rebates, which would be subject to the existing constraints to
    lowering list price. We also would still need a mechanism to revalue
    drug in the distribution channel in a financially viable manner.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        For each drug listed in response to question 1, please also provide
    a list of which quarters and years each drug hit the cap.

        Answer. Merck conforms to all statutory, regulatory, and sub-
    regulatory guidance regarding its participation in the Medicaid Drug
    Rebate Program, including the payment of Medicaid rebates. The
    information requested by this question, however, is confidential,
    proprietary, and commercially and competitively sensitive. Merck would
    be happy to explore other means to share this information with the
    committee in a confidential fashion.
                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. For example, an analysis by the U.S.
    Department of Health and Human Services Office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.
    Accordingly, please describe the following:

        Your company's current compliance plan and procedures used to
    ensure compliance with the requirements of the Medicaid Drug Rebate
    Program including internal audits or other checks you use to identify
    compliance vulnerabilities.

        Answer. Merck's government price reporting team--in consultation
    with in-house attorneys, outside counsel, and third-party vendors as
    appropriate--maintains comprehensive and detailed government price
    reporting policies, procedures, and reasonable assumptions for
    compliance with all price reporting programs, including the Medicaid
    Drug Rebate Program (MDRP). Merck's policies are evaluated and updated,
    as needed, on an annual basis by the government price report team, in-
    house attorneys, and outside counsel to ensure that they are consistent
    with current regulations and applicable guidance from the Centers for
    Medicare and Medicaid Services (CMS). Additionally, Merck's reasonable
    assumptions are evaluated and updated, as needed, on a monthly basis
    for Average Manufacturer Price and on a quarterly basis for Best Price
    by the government price reporting team, in-house attorneys, and outside
    counsel. Merck has a long history of transparency and communication
    with CMS regarding its MDRP compliance and reasonable assumptions, and
    company compliance personnel regularly oversee Merck's price reporting
    operations. Merck evaluates any new guidance issued by CMS to ensure
    that its price reporting calculations and processes are in compliance
    with the law.

        Question. Any past or ongoing issues of non-compliance.

        Answer. Merck maintains comprehensive and detailed reasonable
    assumptions for its MDRP participation. In situations in which Merck is
    uncertain about a calculation approach that is not clearly addressed in
    CMS rules or guidance, the company documents its approach in
    assumptions and/or discloses its intended approach to CMS.
    Additionally, given the complexity of the calculations, Merck may
    identify calculation mistakes or other issues that require correction.
    This may happen, for example, to the extent that Merck believes that
    any new CMS rules or guidance call into question a reasonable
    assumption that the company has previously maintained. In such cases,
    if Merck has any concern about its program compliance, it promptly
    communicates with CMS to seek the agency's guidance and potentially
    restate its prior MDRP reports.

        Question. Any corrective actions taken to address identified
    problems or issues of non-compliance with the MDRP and how such steps
    were communicated to the Centers for Medicare and Medicaid Services.

        Answer. As noted above, to the extent that Merck believes that any
    of its existing calculation or compliance processes for MDRP
    participation are not in keeping with current CMS rules or guidance,
    the Company would promptly engage with the agency to identify any
    necessary remedial steps and the appropriate way forward, including
    filing pricing restatements.

        Question. Any steps taken to improve compliance and ensure that all
    Medicaid drug rebates owed to the Federal Government and the States are
    paid in full.

        Answer. As noted above, Merck takes its government price reporting
    obligations very seriously, and the Company maintains robust, ongoing
    legal and compliance oversight of its price reporting team and its
    operations. As discussed above, we routinely review our policies,
    procedures, and reasonable assumptions to ensure compliance with
    current law. Merck also has an annual training requirement for
    government price reporting compliance. If Merck were to identify any
    potential noncompliance issue associated with the underpayment of
    rebates to the State Medicaid Programs, Merck immediately would
    identify this issue to CMS and would work with the agency to ensure the
    implementation of any appropriate remedy (including restating pricing
    metrics and reconciling rebate amounts with the States).
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus, or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus, or other compensation was tied.

        Answer. My salary, bonus, or other compensation is not tied to
    sales or revenue targets of a single product that Merck sells. In 2011,
    a very small percentage of my annual bonus was tied to the net sales of
    3 new products (DULERA, SIMPONI, and VICTRELIS).

        Question. Is your salary, bonus, or other compensation tied to
    either revenue or net income of the company as a whole? Has it ever
    been? If yes, please explain what assumptions about price increases are
    used when the compensation committee sets revenue or net income goals.
    Does the compensation committee provide any guidance to executives in
    regards to the amount of revenue that the company will generate from
    price increases versus volume growth?

        Answer. Yes, a portion of my annual bonus is tied to revenue and
    pretax income (i.e., a variation of net income) of the company as a
    whole, with each contributing 40 percent (for a total of 80 percent) to
    the aggregate incentive target, and research and development
    productivity constituting the other 20 percent of the target. The final
    bonus that I receive is then calculated based on the company's actual
    performance for those three metrics.

        The Compensation and Benefits Committee of the Board sets annual
    targets for revenue and pretax income based upon the company's annual
    plan, as approved by the full Board of Directors.

        The company's annual plan includes U.S. pricing assumptions
    informed by several variables, including volume, price, and discount
    rates, which for 2019 are fully consistent with our July 19, 2018
    commitment to not increase net price across our product portfolio in
    the U.S. by more than inflation annually.

        Neither the board of directors as a whole, nor the Compensation and
    Benefits Committee specifically, provides guidance to executives with
    regard to the amount of revenue that the company will generate from
    price increases versus volume growth.
                                   net prices
        Question. In your testimony, you stated, ``last year we pledged
    that we will not increase our average net prices for our portfolio by
    more than the rate of inflation annually,'' and that ``From 2010 to
    2017, Merck's average net price increase across our portfolio each year
    has been in the low to mid-single digits. In fact, our average net
    price declined in 2017 by almost 2 percent. In 2017, the average
    discount for our medicines and vaccines was more than 45 percent lower
    than the list price.'' Please describe how the company's year-over-year
    aggregate net price is calculated. Please also specifically address the
    following questions:

        Answer. Net Price Change represents the year-over-year change in
    average net price, which is Wholesale Acquisition Cost (WAC) less
    rebates, discounts, and returns. The annual percent change versus prior
    year was calculated at a product level and weighted across the
    company's U.S. Product Portfolio. U.S. Product Portfolio includes human
    health pharmaceutical and vaccine products marketed by the company,
    excluding partnered products. The product sales utilized in the
    analysis represent 97 percent of the total U.S. Product Portfolio in
    2010, increasing each year to approach 99.8 percent of coverage in
    2017.

        Question. How many products are included in the calculation of the
    average net price change? What was the median net price change?

        Answer. In 2017, 78 products were included. The median net price
    change was 0 percent.

        Question. Is net price weighted? If so, how? For example, in
    determining the aggregate net price does the company assign different
    weights to different products based on volume or other factors? Are
    ``on patent'' and ``off patent'' drugs weighted identically? Are other
    statistical weights used or are all products treated equally?

        Answer. The Net Price Change percent for each product is weighted
    by its Net Sales relative to the Total Net Sales of the Product
    Portfolio for the current year. On and off patent drugs are calculated
    in the same fashion, and no other ``statistical weighting'' is applied.

        Question. Does the figure that you provided during your testimony
    account for U.S. prices, international prices, or both? Generally
    speaking, when your company reports net price changes, does it
    differentiate between U.S. and international prices?

        Answer. Only U.S. prices are used in the report.

        Question. Please list the five drugs your company sold in the U.S.
    that had the greatest year-over-year net price increase in 2018, noting
    the increase for each drug by dollar figure and percentage. Please list
    the five drugs your company sold in the U.S. that had the lowest year-
    over-year net price increase (and/or the greatest decrease) in 2018,
    noting the increase (or decrease) for each drug by dollar figure and
    percentage.

        Answer. The product-specific information requested is competitively
    sensitive and Merck therefore cannot produce it in a public setting in
    which it could be accessed by competitors. However, Merck does report
    similar information in an aggregated format in its annual price
    transparency report, which we proactively make available on our
    corporate responsibility website:

        https://s3.amazonaws.com/msd18-assets/wp-content/uploads/2019/02/
    281553
    45/2018-US-PRICING-TRANSPARENCY-REPORT_02.2019.pdf

        The report sets forth the average annual list price changes across
    the Merck portfolio as well as other price related information
    concerning Merck medicines and vaccines. The report shows that in 2018
    the average annual list price across the Merck portfolio increased by
    5.5 percent--the lowest increase since 2010--as compared with a 6.6
    percent increase in 2017. In 2018, the Company's gross U.S. sales were
    reduced by 44.3% as a result of rebates, discounts and returns. The
    below chart reflects additional information about the price changes for
    Merck products.

                                  U.S. Product Portfolio Percent Change vs. Prior Year
    ----------------------------------------------------------------------------------------------------------------
                                                       2010   2011   2012   2013   2014   2015   2016   2017    2018
    ----------------------------------------------------------------------------------------------------------------
    List Price Change (WAC)                             7.4    9.5    9.2    9.6   10.5    9.8    9.6     6.6    5.5
    ----------------------------------------------------------------------------------------------------------------
    Net Price                                           3.4    5.1    6.2    5.5    3.7    5.5    5.5   (1.9)   2.99
    ----------------------------------------------------------------------------------------------------------------
                                                 U.S. Product Portfolio
    ----------------------------------------------------------------------------------------------------------------
    Average Discount (%)                               27.3   28.9   29.9   32.1   37.0   38.2   40.9    45.1   44.3
    ----------------------------------------------------------------------------------------------------------------

        Question. For 2018, what was the average net price change in the
    U.S. market for (1) drugs with no competition, (2) drugs with only
    branded competition, and (3) drugs with generic competition?

        Answer. The product-specific information requested is competitively
    sensitive and Merck therefore cannot produce it in a public setting in
    which it could be accessed by competitors. However, Merck does report
    similar information in an aggregated format in its annual price
    transparency report, which we proactively make available on our
    corporate responsibility website:

        https://s3.amazonaws.com/msd18-assets/wp-content/uploads/2019/02/
    281553
    45/2018-US-PRICING-TRANSPARENCY-REPORT_02.2019.pdf

        The report sets forth the average annual list price changes across
    the Merck portfolio as well as other price related information
    concerning Merck medicines and vaccines. The report shows that in 2018
    the average annual list price across the Merck portfolio increased by
    5.5 percent--the lowest increase since 2010--as compared with a 6.6-
    percent increase in 2017. In 2018, the company's gross U.S. sales were
    reduced by 44.3% as a result of rebates, discounts and returns. The
    below chart reflects additional information about the price changes for
    Merck products.

                                  U.S. Product Portfolio Percent Change vs. Prior Year
    ----------------------------------------------------------------------------------------------------------------
                                                       2010   2011   2012   2013   2014   2015   2016   2017    2018
    ----------------------------------------------------------------------------------------------------------------
    List Price Change (WAC)                             7.4    9.5    9.2    9.6   10.5    9.8    9.6     6.6    5.5
    ----------------------------------------------------------------------------------------------------------------
    Net Price                                           3.4    5.1    6.2    5.5    3.7    5.5    5.5   (1.9)   2.99
    ----------------------------------------------------------------------------------------------------------------
                                                 U.S. Product Portfolio
    ----------------------------------------------------------------------------------------------------------------
    Average Discount (%)                               27.3   28.9   29.9   32.1   37.0   38.2   40.9    45.1   44.3
    ----------------------------------------------------------------------------------------------------------------

        Question. In Merck's most recent pricing transparency report, the
    company notes that the ``the average annual net price across our
    portfolio declined by 1.9 percent, reflecting specific in-year
    dynamics, including the impact of loss of patent protection for three
    major medicines.'' Please identify these medicines, and the net price
    change for each of them on a dollar and percentage basis for 2017. What
    was Merck's average net price increase/decrease in 2017 for drugs
    excluding these three medications?

        Answer. This information is confidential, proprietary, and
    commercially sensitive. Merck's average net price increase/decrease in
    2017 excluding the three drugs referred to is -0.6 percent.

        Question. In Merck's pricing transparency report, the company
    states that its net price is ``represents the year-over-year change in
    average net price, which is WAC less rebates, discounts and returns,''
    while its average discount is ``weighted . . . [and] calculated by
    dividing annual rebates, discounts and returns by annual gross sales.''
    Please clarify whether the company's average net price is weighted for
    purposes of complying with its publically stated pledge.

        Answer. Yes, the average net price is weighted.

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. When new products enter the market, do drug companies set
    high initial rebates and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. Merck approaches pricing from the perspective of value.
    This approach looks at the value that a medicine provides through
    multiple lenses with the goal of reflecting its benefit to patients and
    to society, while at the same time paying an appropriate return on
    invested capital to our investors, to ensure that we are able to
    sustain R&D. While each individual situation varies based on factual
    circumstances and market dynamics, generally, we consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

        When the company launched ZEPATIER into the Hepatitis C market,
    Merck chose a low list price strategy, while competitors had a higher
    price with significant rebates. Unfortunately, we were unable to gain
    reasonable formulary status or resulting sales in certain market
    segments with this strategy. Positive actions in the U.S., such as the
    administration's proposal regarding the rebate safe harbor could
    provide incentives for lower initial list prices in the future.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. Over time, we expect that list prices will go down if you
    remove the misaligned incentives in the system. It is also important to
    note that if the rule is implemented, Medicare beneficiaries' out-of-
    pocket costs will be reduced--independent of any lowering of list
    prices--since their cost-sharing will be based on the net price. But we
    believe the rebate rule will align incentives in a way that will
    restrain list prices.

        If this rule is implemented as written, it would only apply to our
    contracts with PBMs and health plans for Medicare Part D and Managed
    Medicaid. If PBMs and health plans maintain the rebate model in the
    commercial market, we would still have commercial contracts based on
    rebates, which would be subject to the existing constraints to lowering
    list price. We also would still need a mechanism to revalue drug in the
    distribution channel in a financially viable manner.

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D?

        Answer. Assuming the 40 percent reference is correct, we believe
    that the administration's rebate safe harbor proposal will lead to
    lower prices even for products which currently may offer no or minimal
    rebates in Medicare Part D. We believe the increasing transparency of
    prices will spur heightened competition even in classes and for
    products where rebating has been limited in the current system.
    Similarly, the fact that price concessions will be made directly
    available to patients will also create a price-reducing dynamic since
    price concessions will make products more affordable to patients,
    resulting potentially in greater adherence and appropriate use of
    prescribed medicines, clearly benefiting patients and encouraging
    manufacturers to offer price concessions. Additionally, assuming policy
    changes are made to further incentivize value-based contracts, we
    believe that value-based contracts can also help to restrain initial
    list prices by tying those prices to the value that the products bring
    to patients and the health-care system.

        Question. In the health insurance plans that you offer your
    employees, do you ask your insurers to pass through the full
    manufacturer rebates to the beneficiaries?

        Answer. Merck offers a generous health-care benefit for our 24,000
    U.S. employees. There is no deductible for medications covered under
    our pharmacy benefit, and employees never have to pay more than $50 for
    a retail prescription for a covered medication, and in most cases pay
    less. We contract with a PBM for management of the prescription drug
    benefits for our employees, and the benefit does not offer point-of-
    sale rebates to our employees. Merck uses savings generated by rebates
    to lower overall costs for employees while ensuring low out-of-pocket
    costs.

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand. What are your recommendations for
    increasing transparency in how your companies set the list prices for
    drugs, and for improving transparency in the supply chain for
    prescription drugs? Would you support Federal standards for
    transparency in setting the list prices for drugs?

        Answer. We are open and transparent about the factors we consider
    in setting prices. Merck approaches pricing from the perspective of
    value. This approach looks at the value that a medicine provides
    through multiple lenses with the goal of reflecting its benefit to
    patients and to society, while at the same time paying an appropriate
    return on invested capital to our investors, to ensure that we are able
    to sustain R&D. While each individual situation varies based on factual
    circumstances and market dynamics, generally, we consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently. How many of your drugs are included in
    value-based contracts and how many patients are benefiting from them?
    How do these value-based contracts work to lower drug prices for both
    patients and taxpayers?

        Answer. Merck has been party to value-based discounting
    arrangements for four of its products. It is difficult to assess
    exactly how many patients have benefitted from them, however, since
    that information is not in Merck's possession under the arrangements.

        Merck agrees that value-based discounting strategies can benefit
    patients and the Federal health care programs by ensuring that payment
    aligns with the value or outcomes that a manufacturer's products bring
    to the system. If, for example, a value-based agreement demonstrates
    that a manufacturer's product helps patients to achieve meaningful
    clinical outcomes (or even to avoid more serious illness complications
    or comorbidities), the product would have demonstrated a savings to
    patients and taxpayers (for example, by avoiding hospitalization or
    further treatment for a particular condition). There are, however,
    significant impediments under current law regarding adopting this type
    of contract--including under the Anti-Kickback Statute and manufacturer
    government price reporting obligations--and Merck supports legislative
    or regulatory reforms to increase the proliferation of value- or
    outcomes-based discounting.

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    Federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack. Are any of your
    companies providing medical necessity paperwork to doctors in order to
    get your drugs covered by Medicare?

        Answer. In the United States, Merck provides limited reimbursement
    support for patients in connection with the purchase of certain of
    Merck's products following a physician's prescribing decision (in
    accordance with Department of Health and Human Services Office of
    Inspector General guidance). In certain cases, this support includes
    identifying--for patients and physicians--the appropriate forms and
    insurance processes attendant to securing insurance coverage for our
    products. But it is Merck's policy never to interfere with the
    physician-patient relationship or the decision about whether to seek
    insurance coverage.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers. What is delaying the
    uptake of biosimilar drugs in the United States? What policies do you
    recommend to increase the development of biosimilar drugs?

        Answer. Merck agrees that we can significantly reduce spending on
    pharmaceuticals, especially for patients, by ensuring that we have a
    viable market for biosimilars in the United States. We believe, like
    with traditional small molecule medicines, generic competition after a
    reasonable period of exclusivity will create headroom for patients to
    afford the newest, most innovative medicines. In addition to the RAND
    data that you referenced, other research shows that generics and
    biosimilars are expected to drive savings of $105 billion through 2022
    in the U.S.\11\
    ---------------------------------------------------------------------------
        \11\ IQVIA. ``Medicine Use and Spending in the U.S.: A Review of
    2017 and Outlook to 2022.'' (Apr. 19, 2018), https://www.iqvia.com/
    institute/reports/medicine-use-and-spending-in-the-us-review-of-2017-
    outlook-to-2022.

        We suggest the following policy changes to help encourage and
    ---------------------------------------------------------------------------
    support prescriber biosimilar utilization:

              Consider options to reduce or eliminate patient cost sharing
            in Medicare Part B for biosimilars. While some Part B
            beneficiaries are already able to reduce their 20 percent cost
            sharing via supplemental coverage, we believe eliminating cost
            sharing will encourage many physicians to use biosimilars for
            their patients. A similar approach in Part D and in Medicaid
            for small-molecule generics has driven generic utilization up
            to 90 percent.\12\
    ---------------------------------------------------------------------------
        \12\ Department of Health and Human Services. Office of Inspector
    General. ``Generic Drug Utilization in the Medicare Part D Program.''
    (Nov. 2007), https://oig.hhs.gov/oei/reports/oei-05-07-00130.pdf.

              Create pathways for MA and Part D plans to receive bonus
            payments and/or enhanced star ratings for achieving metrics
            related to access to biosimilars. This will incentivize plans
            to implement policies that drive additional utilization of
    ---------------------------------------------------------------------------
            biosimilars.

              Consider alternative reimbursement methodologies that adjust
            the current Part B reimbursement formula. The current structure
            in Part B to reimburse at ASP + 6 percent of the reference
            product ASP ensures there is no reimbursement downside to
            physicians for using biosimilars. But so far, the evidence does
            not suggest the current reimbursement rate sufficiently
            incentivizes providers to use biosimilar products. The
            administration should consider alternatives to further
            incentivize physician adoption of biosimilars.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach.

        Researchers say that this type of imagery, combined with viewing
    hours of drug commercials each month, leads consumers to underestimate
    the risks associated with medications. For the past decade, studies
    have shown that aggressive direct-to-consumer advertising is associated
    with rising drug prices and an increase in inappropriate drug
    prescriptions.

        Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. Merck believes that direct-to-consumer (DTC) advertising
    can be an important and helpful way to inform patients about diseases
    that may be relevant to them and therapeutic options they may want to
    discuss with their physician. Data demonstrate that DTC can have a
    positive impact on patient health in terms of diagnosis, treatment, and
    adherence to prescribed therapies. We recognize that DTC is one channel
    amongst many to help educate patients. Print materials, telephone,
    websites, and other channels are also used to provide more in-depth
    information to patients. The ultimate decision to prescribe a product
    for any specific patient remains with the physician following
    discussion with their patient.

        Merck adheres to FDA regulations and guidelines governing DTC
    promotion and has a long-standing policy to voluntarily submit new DTC
    broadcast advertising campaigns to FDA for pre-review. Merck also
    follows the PhRMA Guiding Principles for DTC Advertisements About
    Prescription Medicines. We are currently considering what additional
    information we can make available to consumers to ensure that they can
    make informed health care decisions.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organization for Economic Cooperation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price.

        One of the most well-known examples is Mylan's increase of the
    price of EpiPen from less than $100 in 2007 to more than $600 in 2016.
    Another example is the ever-increasing price of insulin. Sanofi
    increased the price of a vial of Lantus from $88.20 in 2007 to $307.20
    in 2017. And those are just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. List prices do not generally decline largely owing to many
    of the misaligned incentives that the administration's rebate safe
    harbor proposal is designed to address. Specifically, rebate contracts
    for commercial and Medicare Part D payers/PBMs are designed as set
    percentages from the list price. Lowering list prices while maintaining
    these same percentage discounts/rebates usually precludes the
    commercial viability of reducing list prices.

        We do in fact see price decreases for products that have been on
    the market for years--extremely large ones. They occur at the time of
    patent expiry, and often reduce prices by over 90 percent. This is
    unlike any other part of the health care system we are aware of, where
    prices drop massively after a specified period. If these massive one-
    time price reductions occurred more gradually, it would be far more
    obvious that prices were decreasing. Even putting this aside, net
    prices on many products drop dramatically over time as competition from
    new products increases. For instance, the average net price of our
    anti-diabetes medicine Januvia is less today than it was when it was
    launched in 2007.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market.

        These ``pay-for-delay'' patent settlements benefit both brand-name
    pharmaceutical companies by helping them avoid costly patent litigation
    and general manufacturers by rewarding them a hefty sum to delay
    entering the market with a cheaper drug alternative. However, these
    deals do not benefit consumers. According to an FTC study, these
    anticompetitive deals cost consumers and taxpayers $3.5 billion in
    higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Answer. Merck has not entered into patent settlement agreements
    with generic companies to delay their entry past when it would
    otherwise be lawful for them to enter the market. Merck has been party
    to a number of patent settlement agreements that provide for generic
    market entry prior to patent expiry, including some that have provided
    some level of exclusivity for a limited time. These agreements allowed
    generic products to enter the market earlier than would have otherwise
    been the case. The FTC has not challenged as anti-competitive any of
    these types of agreements involving Merck.

        Question. Why would a pharmaceutical company enter into a pay-for-
    delay agreement?

        Answer. Parties enter into settlements of patent litigation for all
    the same reasons parties settle other civil litigation. These include
    allocation of risk in the dispute, avoidance of litigation costs, or
    beneficial access to technology from cross-licensing of the litigant's
    patents. Merck would be speculating as to why litigants would enter
    into settlements with large unjustified reverse payments.

        Question. Do you think these agreements stifle competition and
    prevent generic alternatives to your branded medications?

        Answer. Merck believes that the patent settlements it has made did
    not stifle competition nor unlawfully prevent generic alternatives to
    our patented medications.

        Patent settlement agreements in which a brand settles cases in a
    manner that allows a generic to enter the market prior to expiry of the
    brand's patents could actually accelerate patient access to lower cost
    alternatives. These settlements do not delay entry or cause the loss of
    any lawful competition because entry prior to the expiry of these
    patents would be unlawful infringement unless and until the generic
    manufacturers prevailed in court.

        Merck works within the statutory framework set by Hatch-Waxman and
    BPCIA to protect its intellectual property. We believe that patent
    holders have a valid right to enforce legitimate patents and that the
    courts are an appropriate venue to resolve such disputes.

        Our patents are a direct result of the investment we have made in
    R&D. When others seek to commercialize our innovations, Merck has
    engaged in litigation to enforce our patents.

        Merck is a strong supporter of bringing more generics to the
    market. It is important to remember that generics all started as a
    branded medication. A period of patent protection is provided for all
    new medicines as an incentive to research-based biopharmaceutical
    companies for the costly and risky research that is undertaken to
    develop them. Following the loss of patent protection, the medicines
    become low-cost generics that are available for many years, often
    decades into the future.

        Merck is proud that more than 40 million Americans annually benefit
    from our science in the form of generic medicines. Several of our
    discoveries--including cholesterol-lowering, heart disease,
    osteoporosis, and asthma treatments--are now widely available to a
    patient as generics, including some for about $20 per year, bringing
    billions of dollars in savings to consumers and the health care system.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) Office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections.

        The rule is predicted to increase net drug costs in its early
    years. The CMS actuaries estimate it would cost $196 billion over 10
    years. Despite this high price tag, the beneficiary benefits are
    limited. The proposed rule notes that under the CMS Actuary's analysis,
    the majority of beneficiaries would see an increase in their total out-
    of-pocket payments and premium costs; reductions in total cost sharing
    will exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. Over time, we expect that list prices will go down if the
    misaligned incentives across the system are addressed. It is also
    important to note that if the rule is implemented, Medicare
    beneficiaries' out-of-pocket costs will be reduced, independent of any
    lowering of list prices, since their cost-sharing will be based on the
    net price. Nonetheless, we believe the rebate rule will align
    incentives in a way that will restrain list prices.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spent nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9% of all medical marketing, in 1997 to $9.6
    billion, or 32% of total spending, in 2016.

        Can you please provide what your ratio of spending on sales and
    marketing to research and development is today?

        Answer. In 2018, Merck incurred $9.8 billion in research and
    development costs globally, the vast majority of which was conducted in
    the U.S. Since 2010, Merck has invested nearly $70 billion in R&D to
    create new medicines and vaccines that address the greatest health
    challenges of our time--including antimicrobial resistance, Ebola, HIV,
    and cancer--to save and improve lives around the world. In 2018, Merck
    spent about $2.3 billion in the U.S. market on direct marketing and
    selling expenses. This number includes all sales and marketing
    expenses, including creative development of resources and headcount
    related to all marketing and sales activity in the U.S. market.
                                 price-gouging
        Question. Sanofi, as I understand it, has made a pledge to the
    public to limit its price increases to the national health expenditures
    growth projection.

        Would your company commit to a cap on annual price increases as
    part of your PhRMA membership criteria?

        Answer. In July 2018, Merck pledged to not increase the average net
    price across our portfolio by more than inflation annually.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. Merck approaches pricing from the perspective of value.
    This approach looks at the value that a medicine provides through
    multiple lenses with the goal of reflecting its benefit to patients and
    to society, while at the same time paying an appropriate return on
    invested capital to our investors, to ensure that we are able to
    sustain R&D. While each individual situation varies based on factual
    circumstances and market dynamics, generally, we consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

        We believe the proper objective should be that launch prices
    appropriately reflect the true value of the medicine and are not
    distorted by any misaligned incentives in Medicare Part D or any other
    sector. We believe the administration's proposed rebate safe harbor,
    and similar changes in commercial plans, would address the misaligned
    incentives in the marketplace that favor high list prices and high
    rebates in competitive markets. In addition, addressing the misaligned
    incentives for the 340B program would allow for more flexibility in
    list prices.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates do
    not rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. Yes. We believe there should be greater transparency of the
    financial arrangements between manufacturers and PBMs. In particular,
    we believe we must change the system to ensure that patients receive
    the benefit of the significant rebates and discounts that manufacturers
    like Merck pay to PBMs and plans. The administration's proposed rule is
    a positive step in that direction.

        Based on our initial assessment of the proposed rule, we believe
    that it will remove misaligned incentives within the system, drive more
    transparency in the system, and most importantly, lower beneficiaries'
    out-of-pocket costs.

        Question. Senator Thune asked if this administration rule would
    lead you to lowering list prices. Both of you answered that you would
    be likely to lower your prices. However, if this rule were finalized
    tomorrow as proposed, would any of your companies be required to lower
    the list price of any of your drugs?

        Answer. Under the proposed rule, there is no requirement to lower
    list prices. However, over time, we expect that our list prices will go
    down if the misaligned incentives across the system are addressed. It
    is also important to note that if the rule is implemented, Medicare
    beneficiaries' out-of-pocket costs will be reduced, independent of any
    lowering of list prices, since their cost-sharing will be based on the
    net price. Nonetheless, we believe the rebate rule will align
    incentives in a way that will restrain list prices.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health-care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        For those of you who do use a PBM to help manage the prescription
    drug benefit for your employees, how do you utilize the rebates your
    PBM negotiates to lower health care costs or drug costs for your
    employee plans and what does your company do with that savings?
    Specifically, do the savings go toward lowing premiums?

        For those of you who do use a PBM to help manage the prescription
    drug benefit for your employees, does your PBM offer point-of-sale
    rebates to your employees?

        Answer. Merck offers a generous health care benefit for our 24,000
    U.S. employees. There is no deductible for medications covered under
    our pharmacy benefit, and employees never have to pay more than $50 for
    a retail prescription for a covered medication, and in most cases pay
    less. We contract with a PBM for management of the prescription drug
    benefits for our employees, and the benefit does not offer point-of-
    sale rebates to our employees. Merck uses savings generated by the PBM
    on rebates to lower overall costs for employees while ensuring low out-
    of-pocket costs.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. Over time, we expect that our list prices will go down if
    the misaligned incentives across the system are addressed. Nonetheless,
    we believe the rebate rule will align incentives in a way that will
    restrain list prices.

        As we stated when we reduced the list price of several of our
    products in July 2018, we have continued to look for opportunities to
    reduce our list prices. We think the proposed rule would help create
    those opportunities, but it can't happen overnight. All of the players
    in the ecosystem will need to adjust to the new model.

        If the proposed rule is implemented as written, it would only apply
    to our contracts with PBMs and health plans for Medicare Part D and
    Managed Medicaid. If PBMs and health plans maintain the rebate model in
    the commercial market, we would still have commercial contracts based
    on rebates, which would be subject to the existing constraints to
    lowering list price. We also would still need a mechanism to revalue
    drug in the distribution channel in a financially viable manner.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)? How many of your company's products are
    based, at least in part, on NIH research, and how many are the result
    of research funded solely by your company?

        Answer. The U.S. leads the world in biomedical research thanks to a
    robust biomedical ecosystem comprised of important and unique
    contributions from the National Institutes of Health (NIH), academic
    institutions, and the biopharmaceutical industry. Historically, the
    NIH's focus has been on basic biomedical science and research
    concerning public health (including in the recent budget funding for
    drug and alcohol abuse prevention, reducing health-care disparities,
    and other important causes). Through this basic research, NIH seeks to
    understand the fundamental biological processes and leverage that
    understanding to determine which processes are involved in the
    development and progression of disease. There is significant basic
    research that in some respects contributes to all new medicines. Most
    of this is considered ``pre-competitive'' since the individual
    contributions are in themselves too small or too broad to lead directly
    to a new therapy, which takes considerable work to invent and develop.

        Merck also conducts basic research. However, where we use
    intellectual property that others have created, we are diligent in
    recognizing and agreeing on terms to use that property (including
    financial compensation), which may include with agencies of the U.S.
    government such as NIH. After this stage of basic research, our
    company's further role is to then engage in the most risky and costly
    part of discovery--to invent something that's never existed in the
    history of the world that will alter the targets that come from basic
    research and unlock treatments and cures for disease. This invention is
    then followed by extensive clinical trial programs to demonstrate
    safety and effectiveness.

        On occasion, we will rely on work by government agencies that is
    more advanced; however, we take the same approach of respecting
    intellectual property rights and agreeing on terms of use of that
    property. For example, Merck, along with Instituto Butantan, has
    licensed certain rights from National Institute of Allergy and
    Infectious Diseases (NIAID), part of NIH, for the development of live
    attenuated tetravalent vaccines (LATV).

        All parts of the ecosystem are needed to continue to lead in
    biomedical research: the portion of NIH's entire $33 billion budget
    that it devoted to biomedical research in 2017 as well as the $70
    billion the biopharmaceutical industry spent in 2017--$10 billion of
    which was spent by Merck--to invent and bring to market new treatments
    and cures.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer. In 2018, Merck incurred $9.8 billion in research and
    development costs globally, the vast majority of which was conducted in
    the U.S. Since 2010, Merck has invested nearly $70 billion in R&D to
    create new medicines and vaccines that address the greatest health
    challenges of our time--including antimicrobial resistance, Ebola, HIV,
    and cancer--to save and improve lives around the world. In 2018, Merck
    spent about $2.3 billion in the U.S. on direct marketing and selling
    expenses. This number includes all sales and marketing expenses,
    including creative development of resources and headcount related to
    all marketing and sales activity in the U.S. market.

        For the remaining years, we spent the following:

              In 2017, Merck invested $10.3 billion in R&D and $2.5
            billion in U.S. marketing and selling expenses.

              In 2016, Merck invested $10.3 billion in R&D and $2.5
            billion on U.S. marketing and selling expenses.

              In 2015, Merck invested $6.8 billion in R&D and $2.4 billion
            on U.S. marketing and selling expenses.

              In 2014, Merck invested $7.3 billion in R&D and $2 billion
            on U.S. marketing and selling expenses.

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. It is hard to predict an exact amount of list price
    reduction if the rule were implemented as described. However, we
    believe that removing the misaligned incentives from the system should
    result in downward pressure on list prices. It is also important to
    understand that different purchasers receive different levels of
    discounts, based on the access provided for patients. So, there is not
    a uniform ``rebate amount'' that could reduce the list price. Moreover,
    we expect that the robust negotiations that occur today will continue
    in the highly competitive Part D market, and we expect to realize the
    same level of net price that we do today. In fact, we expect that there
    could be additional pricing pressure under the new system, which could
    lead to lower net prices.

        Question. How will this proposal affect how your company sets the
    list prices for new drug products?

        Answer. Merck approaches pricing from the perspective of value.
    This approach looks at the value that a medicine provides through
    multiple lenses with the goal of reflecting its benefit to patients and
    to society, while at the same time paying an appropriate return on
    invested capital to our investors, to ensure that we are able to
    sustain R&D. While each individual situation varies based on factual
    circumstances and market dynamics, generally, we consider:

              Value provided to patients--to what extent does a new
            medicine or vaccine establish a new standard of care that has
            the potential to significantly extend and improve patient
            lives?

              Value provided to health-care systems--to what extent does a
            new medicine or vaccine reduce the costs associated with
            hospitalization and other costly complications of disease if
            not appropriately (or optimally) treated?

              Unmet need--does a new medicine or vaccine address a
            critically unmet medical need, where few or no treatments
            exist?

              Access--what is the ability of various customers around the
            world--including national, regional or local institutional
            payers, physicians, employers and patients--to pay for our
            products?

              R&D sustainability--given the long-term risk and cost of
            capital, can we appropriately compensate our investors to
            ensure continued investment in the kind of risky and capital-
            intensive research and development that will bring forward
            medically important breakthroughs?

              Competition--what are the costs of other treatments
            currently on the market relative to the value provided by
            Merck's products?

        We do not expect this approach to change based on the Trump
    administration's proposed rule.

        Question. If the proposal is finalized and not extended to the
    private market, will your company make any list price reductions? If
    so, how large would the reductions be relative to the size of the
    rebates your company is currently providing?

        Answer. We expect that the robust negotiations that occur today
    will continue in the highly competitive Part D and commercial markets,
    and we expect to realize the same level of net price that we do today.
    In fact, we expect that there could be additional pricing pressure
    under the new system, which could lead to lower net prices, but
    predicting the size of any such reductions is difficult.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\13\
    ---------------------------------------------------------------------------
        \13\ MACPAC. ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wp-content/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        This requirement created an unintended loophole. Rather than use
    the price of the authorized generic, drug companies can sell its
    authorized generic to a corporate subsidiary at an artificially lower
    price and use that lower price to bring down the AMP, which in turn
    ---------------------------------------------------------------------------
    lowers the rebate obligation.

        Does your company engage in this practice? Has your company ever
    engaged in this practice in the past?

        Answer. No. Merck does not engage in the practice of selling
    authorized products to a subsidiary and then blending the pricing data
    for the products. Merck does engage with third parties who act as our
    authorized generic partners. Merck has disclosed the methodology used
    to account for these transactions in AMP to CMS.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? For those drugs is
    your list price equal to your net price?

        Answer. Since Merck's entire product portfolio is covered within at
    least one government program that requires a mandated rebate or
    discount (such as Medicaid, 340B, Federal Supply Schedule), there are
    no Merck products that are not rebated or discounted. Merck also offers
    voluntary rebates or discounts on many of its products. We would expect
    similar rebates and discounts to be paid for our drugs in the pipeline,
    barring fundamental changes in the marketplace.

        Question. Do you invest more in R&D than you generate in US sales
    revenue? Please include specific figures.

        Answer. In 2018, Merck incurred $9.8 billion on research and
    development costs globally, the vast majority of which was conducted in
    the U.S. Since 2010, Merck has invested nearly $70 billion in R&D to
    create new medicines and vaccines that address the greatest health
    challenges of our time--including antimicrobial resistance, Ebola, HIV,
    and cancer--to save and improve lives around the world. In 2018, Merck
    had $18.2 billion in U.S. sales revenue.

        Question. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. In 2018, Merck incurred $9.8 billion in research and
    development costs globally, the vast majority of which was conducted in
    the U.S. Since 2010, Merck has invested nearly $70 billion in R&D to
    create new medicines and vaccines that address the greatest health
    challenges of our time--including antimicrobial resistance, Ebola, HIV,
    and cancer--to save and improve lives around the world. In 2018, Merck
    spent about $10.1 billion on marketing, selling, and administration
    globally ($2.6 billion of which is directly attributed to the U.S.
    market). This number includes all sales and marketing expenses,
    including creative development of resources and headcount related to
    all marketing and sales activity, as well as administrative expenses
    associated with business support functions, including information
    technology, human resources, facilities, finance, legal, and others.

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. In 2018, Merck incurred $9.8 billion on research and
    development costs globally, the vast majority of which was conducted in
    the U.S. Since 2010, Merck has invested nearly $70 billion in R&D to
    create new medicines and vaccines that address the greatest health
    challenges of our time--including antimicrobial resistance, Ebola, HIV,
    and cancer--to save and improve lives around the world. In 2018, Merck
    spent about $6.9 billion on direct marketing and selling expenses
    globally ($2.3 billion of which is directly attributable to the U.S.
    market). This number includes all sales and marketing expenses,
    including creative development of resources and headcount related to
    all marketing and sales activity in the U.S. market.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. Merck believes that direct-to-consumer (DTC) advertising
    can be an important and helpful way to inform patients about diseases
    that may be relevant to them and therapeutic options they may want to
    discuss with their physician. Data demonstrate that DTC can have a
    positive impact on patient health in terms of diagnosis, treatment, and
    adherence to prescribed therapies. We recognize that DTC is one channel
    amongst many to help educate patients. Print materials, telephone,
    websites, and other channels are also used to provide more in-depth
    information to patients. The ultimate decision to prescribe a product
    for any specific patient remains with the physician following
    discussion with their patient.

        Merck adheres to FDA regulations and guidelines governing DTC
    promotion and has a long-standing policy to voluntarily submit new DTC
    broadcast advertising campaigns to FDA for pre-review. Merck also
    follows the PhRMA Guiding Principles for DTC Advertisements About
    Prescription Medicines. We are currently considering what additional
    information we can make available to consumers to ensure that they can
    make informed health care decisions.

                                     ______

                  Prepared Statement of Richard A. Gonzalez,
               Chairman and Chief Executive Officer, AbbVie Inc.
        I am Richard Gonzalez, and I am the chairman and chief executive
    officer of AbbVie, a company dedicated to developing new innovative
    medicines for some of healthcare's most challenging diseases, such as
    cancer, Alzheimer's, viral infections, and auto-immune diseases. Since
    our inception in 2013, AbbVie has invested approximately $50 billion in
    pursuit of that goal. However, because we are tackling medicine's most
    challenging problems, solutions do not come easily or without
    significant risk. Where we have succeeded, we have been able to provide
    cures for fatal diseases like hepatitis C and significantly alter the
    disease progression for certain cancers, lessening the burden of
    illness on patients and the health-care system. This is what the 30,000
    employees of AbbVie are dedicated to doing.

        We agree that access to lifesaving medicines is a critical issue
    and we look forward to sharing our perspectives with you. There is no
    one solution to this complex issue, but AbbVie is open to working with
    the committee on how we can commit our resources to better partner in
    your efforts to address pharmaceutical pricing and access. AbbVie and
    the rest of our industry must play a role in solving these issues and
    be prepared to work together with the insurance industry, the
    administration and you to find a better path forward for American
    patients.

        My remarks today will focus on one aspect of this inquiry--the
    Medicare Part D benefit design, which even after pharmaceutical list
    prices are lowered, still contributes to making innovative therapies
    cost-prohibitive for Medicare patients. In general, the Medicare Part D
    program has worked well. Its market-based structure and utilization of
    formularies encourages competitive price discounts that have yielded
    significant savings to the government since the Part D benefit was
    established in 2006. However, despite these cost savings, Part D
    patients' out-of-pocket costs have significantly increased. Some would
    blame that solely on high drug prices, and we agree that price should
    certainly be part of the discussion. But it's also important to
    acknowledge that science has enabled us to advance the standard of care
    far beyond what was possible when the Part D benefit was designed.

        Many of today's specialty medicines offer major advances in
    treating or curing serious chronic or life-threatening conditions and
    save significant amounts of money for the health-care system by
    decreasing overall health-care costs, yet these therapies are also
    costly. Due to the structure of the Part D benefit design, patients are
    charged out-of-pocket costs on a medicine's list price which does not
    reflect the
    market-based rebates that Medicare receives. We are encouraged by the
    proposed rule that would reflect manufacturer discounts in patients'
    Part D out-of-pocket payments. This is an important step in the right
    direction, but we believe more must still be done to help Part D
    patients.

        Let me give you a recent real-world example that demonstrates the
    challenge with the current Part D benefit design and why the focus
    solely on list prices does not fully address the access challenges. An
    uncured hepatitis C infection leads to downstream medical costs for
    surgery, chemotherapy, and radiation for patients who progress to
    needing a liver transplant or having liver cancer. Today we can cure
    hepatitis C with drugs. This cure is highly cost-effective for the
    overall health-care system.

        In 2017, AbbVie launched Mavyret, a highly effective cure for HCV.
    At the time, the list prices for the competitive alternatives were as
    high as $94,500 for their most commonly prescribed treatment duration.
    We launched Mavyret at a list price that is 72 percent lower. But even
    though we cut the list price of an HCV cure for most patients by 72
    percent, Medicare Part D patients' out-of-pocket obligations are still
    too high for many patients to access this medicine.

        We believe it is important that discussions about access and
    affordability include a focus on how to alleviate Medicare Part D out-
    of-pocket burdens above and beyond just lowering list prices. We are
    prepared to step up and discuss how companies like ours can shoulder
    more of the burden of a patient's out-of-pocket expenses, as we do in
    other areas covered by commercial insurance. Additionally, we believe
    the discussion should also include the possibility of Medicare Part D
    beneficiaries being able to purchase insurance (as they do in other
    parts of the Medicare program) to cover more of their out-of-pocket
    expenses.

        We believe AbbVie, the rest of the pharmaceutical industry and
    insurance providers should come together with the administration and
    you to work toward solutions that make life-changing medicines more
    affordable to Part D beneficiaries. I can assure you AbbVie is
    committed to doing its part, and we look forward to working with you.

                                     ______

         Questions Submitted for the Record to Richard A. Gonzalez \1\
    ---------------------------------------------------------------------------
        \1\ Please note that these responses were prepared by and are from
    AbbVie Inc.
    ---------------------------------------------------------------------------
                   Questions Submitted by Hon. Chuck Grassley
        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant. If the HHS proposed rule is finalized, can you assure the
    Committee that your company will offer up-front discounts? If not, why?

        Please describe how you expect your company to respond to the HHS
    proposed rule to eliminate safe harbor protection for back-end rebates
    in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health-care system or pharmaceutical companies, it is premature to
    comment on these items until the administration's rule is finalized,
    implementation timelines are solidified, and there are specific details
    regarding how a new system without rebates will be structured and
    function.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. AbbVie does not have market-share based arrangements.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

        Answer. In 2018, on a U.S. dollars basis approximately 68 percent
    of AbbVie's U.S. net sales were to commercial payers and approximately
    32 percent were to government payers. AbbVie does not maintain this
    information on a volume basis across all products. For Humira, AbbVie's
    top product for sales, on a volume basis in the U.S. approximately 68
    percent of Humira sales were to commercial payers and approximately 32
    percent were to government payers. But on a U.S. dollars basis,
    approximately 83 percent of Humira sales were to commercial payers and
    only approximately 17 percent were to government payers.

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees? To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. AbbVie does not hire consultants or lobbyists to promote
    products at State Medicaid Pharmacy and Therapeutics Committees. We
    adhere to individual State's laws and regulations with respect to
    advocacy disclosures.

        Question. Please describe how the costs of patient assistance
    programs are accounted for within your company's financial statements.
    Please also describe the types of market information, such as
    prescribing and use patterns, that your company collects from different
    types of patient assistance programs and patient hub services.

        Answer. The AbbVie Patient Assistance Program, which provides free
    drug to eligible individuals, falls under the administration portion of
    SG&A. AbbVie's commercial co-pay assistance costs are deducted from
    gross sales.

        The information that AbbVie collects through its patient support
    services varies by products but may include demographic information,
    diagnosis codes and prescription information, insurance information,
    and claim information. AbbVie collects a more limited set of this data
    through its Patient Assistance Program in order to assess patients for
    eligibility and distribute medication to patients.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. for each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. Attached as Exhibit 1 to this response is a list of all
    contributions AbbVie has made in the following categories from January
    1, 2014 through December 31, 2018: (1) charitable donations to non-
    profit organizations; (2) donations for patient education and disease
    state diagnosis, treatment, and awareness; (3) educational grants; (4)
    fellowships and scholarships; and (5) sponsorships of non-profit
    organizations' events.

        The AbbVie Foundation is a separate non-profit entity that makes
    charitable donations and grants. Attached as Exhibit 2 is a list of all
    charitable donations and grants made by The AbbVie Foundation from
    January 1, 2014 through December 31, 2018.

        Question. Pay-for-delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the ``Preserve Access to
    Affordable Generics and Biosimilars Act,'' which would help put an end
    to these deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Has your company ever entered into these kinds of settlements with
    a generic company?

        Answer. ``Pay-for-delay'' is not a self-defining phrase. With
    respect to the term ``pay,'' patent litigation settlements, like all
    litigation settlements, involve compromise in which both sides believe
    they are getting value from the resolution. There is no definition
    explaining the circumstances under which that value would implicate the
    term ``pay'' in ``pay-for-delay'' for purposes of these questions. And
    with respect to ``delay'' virtually all patent settlements provide for
    the generic competitor to enter the market before the expiration of the
    patent at issue. So if the alternative resolution of a patent lawsuit
    would be the innovator company continuing to enforce its patent until
    expiration, then such a settlement, no matter what value is exchanged,
    would actually accelerate competition, not delay it.

        Question. Do you support the pay-for-delay bill?

        Answer. AbbVie supports the goals of the Preserve Access to
    Affordable Generics and Biosimilars Act and would likely support the
    bill upon clarification that enforcement only applies to agreements
    after the date of enactment.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower-cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Does your company view these practices as anticompetitive or
    harmful to patients' access to quality, lower cost medicine?

        Answer. Rebates are a form of price competition that results from
    the aggressive negotiations that occur between health plans (and their
    representative PBMs) and pharmaceutical companies to provide patients
    with access to medicines and treatments that can best help patients
    manage their medical conditions.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health care system or pharmaceutical companies, it is premature to
    comment on these items until the administration's rule is finalized,
    implementation timelines are solidified, and there are specific details
    regarding how a new system without rebates will be structured and
    function.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        Answer. AbbVie does not consider regulatory costs or compliance
    when considering the list price of a medicine.

        Question. When setting the list price of a drug, does your company
    consider the risk of liability or litigation? If so, how specifically
    do those factors affect the list price of a drug? Please provide at
    least one specific example, if applicable, from your current product
    portfolio.

        Answer. AbbVie does not consider the risk of liability or
    litigation when considering the list price of a medicine.

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see value-based arrangements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        How can VBAs help lower what patients pay out-of-pocket?

        Can Congress do more to allow for and encourage the use of VBAs?

        Answer. Value-based arrangements can be an effective and market-
    based solution to managing overall health-care costs when driven by
    patient outcomes. Studies have found that 38 percent of payers with
    outcomes-based contracts experience improved patient outcomes and 33
    percent experience plan health-care cost savings. Additionally, plans
    with outcomes-based contracts have been found to have a 28 percent
    lower patient co-payment. All of these factors work towards moving
    payment for prescription medicines away from volume-based approaches to
    value-based models in a manner that appropriately balances patient
    access with the appropriate use of medications to lower overall health-
    care costs.

        At AbbVie, we believe all our products provide value to patients
    and the larger health-care system and are interested in the
    possibilities that could arise through value-based contracting. To
    further foster value-based arrangements, we support the reforms
    included in the Patient Affordability, Value and Efficiency (PAVE) Act,
    introduced by Senators Cassidy (R-LA) and Warner (D-VA).

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad.

        Pharmacy benefit managers and plans have argued that rebates are
    used to lower premiums across the board and that it is the best way to
    seek a price concession on otherwise expensive drugs.

        Your industry argues that these payers are insisting on higher
    rebates that can only be achieved by raising list prices.

        But patients often lose under this system, with out of pocket costs
    being tied to list price. Insulin patients appear to be routinely
    impacted by this perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        What assurance can you provide that you would in fact lower your
    prices?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health care system or pharmaceutical companies, it is premature to
    comment on these items until the administration's rule is finalized,
    implementation timelines are solidified, and there are specific details
    regarding how a new system without rebates will be structured and
    function.

        Question. What actions should be taken to ensure that patients are
    actually seeing the benefits of lower out-of-pocket costs?

        Answer. Providing discounts to the patient at the point of sale is
    an effective way of ensuring that patients can see lower out-of-pocket
    costs. However, this is just the start. AbbVie believes that more must
    be done.

        The Medicare Part D benefit design contributes to making innovative
    therapies cost-prohibitive for Medicare patients because patients are
    charged out-of-pocket costs based on a medicine's list price, which
    does not reflect the rebates that Medicare receives.

        AbbVie believes it is important to alleviate the burdens that
    patients face due to Medicare Part D out-of-pocket costs. AbbVie
    supports solutions like a patient out-of-pocket cap in Part D and
    smoothing patient out-of-pocket payments over a full year, so patients
    have some predictability with respect to their out-of-pocket costs.

        In addition, AbbVie is prepared to step up and discuss how
    companies like ours can shoulder more of the burden of a patient's out-
    of-pocket expenses.

        As policymakers consider the impact of addressing out-of-pocket
    costs in Medicare Part D, questions may arise around whether it will
    lead to unnecessary utilization and wasteful spending. for specialty
    medicines, increased utilization should not be misunderstood as
    unnecessary or wasteful. Part D plans have tools, like step therapy
    requirements for patients to first try lower cost alternatives before a
    specialty medicine would be covered and prior authorization
    requirements before a specialty medicine would be covered, to manage
    the utilization of the majority of higher cost specialty medicines.
    These tools ensure patients try a less costly medication first and have
    met the clinical criteria for taking the specialty drug prescribed and
    serve the function that an out-of-pocket cost obligation on patients
    might serve to prevent unnecessary use.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        Answer. Manufacturers do offer rebates on Part B products in the
    commercial market. Those rebates are included in the calculation of the
    Part B Average Sales Price (ASP) and are therefore reflected in the
    price Medicare pays for Part B drugs. AbbVie does, however, recognize
    that increased competition in Part B could lead to additional savings
    and welcomes the opportunity to engage in policy discussions that seek
    to increase competition in Part B.

                                     ______

                   Question Submitted by Hon. Michael B. Enzi
        Question. The Food and Drug Administration's drug review process is
    known to many as the ``gold standard'' for evaluating medical products.
    I've long thought that it is critical that we maintain public
    confidence in their ability to ensure that drugs are safe and
    effective. There is a perception among some, however, that biosimilars
    might not be as safe as their reference products. That perception can
    undermine patient and provider confidence. Do you believe that when FDA
    approves a biosimilar, providers can be confident that it is safe and
    effective?

        Answer. Consistent with the US regulatory scheme for biosimilars,
    we recognize that FDA-approved biosimilars are highly similar to the
    reference product with no clinically meaningful differences.

        Unlike small molecule generics, however, biosimilars do not contain
    the identical active ingredient as their reference products and
    biosimilars are not substitutable at the pharmacy for the reference
    drug absent an FDA designation of interchangeability. As FDA has
    acknowledged, multiple exposures to slightly different biologics can
    prime the immune system to recognize subtle differences in structural
    features between products, triggering or increasing the overall immune
    response. Consequently, a finding of interchangeability must be
    supported by additional data demonstrating that the biosimilar is
    ``expected to produce the same clinical result in any given patient,''
    and that there is no risk to patients associated with alternating or
    switching between the biosimilar and the reference product. There is no
    requirement that two biosimilars found to be interchangeable with a
    single reference product must show that it is safe and effective to
    switch between the two interchangeable biosimilars, even though in
    practice this is likely to happen in the marketplace if biosimilars are
    treated like generic drugs. Different biosimilar products each found
    interchangeable with a single reference product will have subtle
    structural differences from each other. Indeed, there may be more
    structural differences--or different types of structural differences--
    between the two biosimilar products than between either biosimilar and
    the reference product. As such, without clinical data assessing the
    effects of switching between two biosimilars of the same reference,
    there is no evidence to scientifically justify interchangeability or
    automatic substitution between them. AbbVie has raised this concern
    with FDA at a 2018 Part 15 Hearing held by the agency on the subject of
    biosimilarity and interchangeability.

        These fundamental distinctions between small molecule and biologic
    medicine regulation should not change the perception that FDA-approved
    biosimilars are safe and effective, but they are central to any
    understanding of the biologics market and the appropriate use of these
    complex products.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices.

        With the increased scrutiny of the industry and of the drug supply
    chain as a whole in the United States, have any of your companies re-
    evaluated your business strategy in foreign countries?

        If not, then why?

        If a proposal, like IPI, were implemented, would it force your
    companies to potentially ``walk away from the negotiating table when
    other countries demand low prices subsidized by America's seniors,'' as
    HHS Senior Advisor for Drug Pricing Reform John O'Brien has said?

        Answer. The focus on U.S. versus ex-U.S. prices for pharmaceuticals
    creates an erroneous impression that medicines are the major driver of
    U.S. health care cost growth--ignoring that medicines account for a
    small share of overall health spending. Many countries impose price
    controls and restrict access to medicines in order to contain costs.
    That is not the system we have here in the United States; nor should it
    be. The U.S. fosters innovation and leads the world in drug discovery
    and development with PhRMA members conducting nearly 80 percent of
    their R&D in the United States. Importing or referencing price controls
    used in other countries in the U.S. would challenge the innovation
    model in a country the size of the U.S.

        The U.S. relies on its competitive marketplace to manage costs,
    while encouraging the development of new therapies. Because of the
    ecosystem that exists in the U.S., patients enjoy access to innovative
    medicines far earlier than patients in countries with centralized price
    controls. Furthermore, most crosscountry comparisons focus solely on
    the list prices of medicines and exclude from calculations the steep
    discounts that are required in U.S. public programs such as Medicaid
    and the rebates negotiated by insurers and pharmacy benefit managers in
    Medicare Part D and the commercial market. In addition, these
    comparisons often only include the list prices of brand-name medicines
    even when lower-cost generic versions are available and widely used.

        Instead of referencing price, AbbVie recommends policymakers focus
    on reforms that address foreign freeloading in new trade agreements or
    increasing enforcement of current agreements. We support enhancements
    to trade agreements to balance share of investment costs. The United
    States-Mexico-Canada Agreement (USMCA), while not yet implemented,
    contains improvements in intellectual property protections as well as
    provisions requiring transparency in pricing and reimbursement
    mechanisms. These elements are critical to ensuring trading partners
    like Mexico and Canada appropriately value innovation, allowing
    innovative biopharmaceutical companies to continue bringing new
    medicines to the market.

        Question. What are some of your ideas on how we can ensure
    Americans aren't shouldering the full cost of pharmaceuticals?

        Answer. Providing discounts to the patient at the point of sale is
    an effective way of ensuring that patients can see lower out-of-pocket
    costs. However, this is just the start. AbbVie believes that more must
    be done.

        The Medicare Part D benefit design contributes to making innovative
    therapies cost-prohibitive for Medicare patients because patients are
    charged out-of-pocket costs based on a medicine's list price, which
    does not reflect the rebates that Medicare receives.

        AbbVie believes it is important to alleviate the burdens that
    patients face due to Medicare Part D out-of-pocket costs. AbbVie
    supports solutions like a patient out-of-pocket cap in Part D and
    smoothing patient out-of-pocket payments over a full year, so patients
    have some predictability with respect to their out-of-pocket costs.

        In addition, AbbVie is prepared to step up and discuss how
    companies like ours can shoulder more of the burden of a patient's out-
    of-pocket expenses.

        As policymakers consider the impact of addressing out-of-pocket
    costs in Medicare Part D, questions may arise around whether it will
    lead to unnecessary utilization and wasteful spending. for specialty
    medicines, increased utilization should not be misunderstood as
    unnecessary or wasteful. Part D plans have tools, like step therapy
    requirements for patients to first try lower cost alternatives before a
    specialty medicine would be covered and prior authorization
    requirements before a specialty medicine would be covered, to manage
    the utilization of the majority of higher cost specialty medicines.
    These tools ensure patients try a less costly medication first and have
    met the clinical criteria for taking the specialty drug prescribed and
    serve the function that an out-of-pocket cost obligation on patients
    might serve to prevent unnecessary use.

                  foreign countries' pricing and reimbursement
        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year.

        ``When foreign governments extort unreasonably low prices from U.S.
    drug makers, Americans have to pay more to subsidize the enormous cost
    of research and development. . . . It's unfair and it's ridiculous, and
    it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing medical advances?

        How do foreign countries' pricing and reimbursement systems affect
    our prescription drug costs?

        Are foreign governments taking note of the concerns being raised by
    the Trump administration and have they responded in any way?

        Has there been any noticeable change in any of our trade agreements
    since these concerns have been raised by the Trump Administration?

        Answer. The focus on U.S. versus ex-U.S. prices for pharmaceuticals
    creates an erroneous impression that medicines are the major driver of
    U.S. health-care cost growth--ignoring that medicines account for a
    small share of overall health spending. Many countries impose price
    controls and restrict access to medicines in order to contain costs.
    That is not the system we have here in the United States; nor should it
    be. The U.S. fosters innovation and leads the world in drug discovery
    and development with PhRMA members conducting nearly 80% of their R&D
    in the United States. Importing or referencing price controls used in
    other countries in the U.S. would challenge the innovation model in a
    country the size of the U.S.

        The U.S. relies on its competitive marketplace to manage costs,
    while encouraging the development of new therapies. Because of the
    ecosystem that exists in the U.S., patients enjoy access to innovative
    medicines far earlier than patients in countries with centralized price
    controls. Furthermore, most crosscountry comparisons focus solely on
    the list prices of medicines and exclude from calculations the steep
    discounts that are required in U.S. public programs such as Medicaid
    and the rebates negotiated by insurers and pharmacy benefit managers in
    Medicare Part D and the commercial market. In addition, these
    comparisons often only include the list prices of brand-name medicines
    even when lower-cost generic versions are available and widely used.

        Instead of referencing price, AbbVie recommends policymakers focus
    on reforms that address foreign freeloading in new trade agreements or
    increasing enforcement of current agreements. We support enhancements
    to trade agreements to balance share of investment costs. The United
    States-Mexico-Canada Agreement (USMCA), while not yet implemented,
    contains improvements in intellectual property protections as well as
    provisions requiring transparency in pricing and reimbursement
    mechanisms. These elements are critical to ensuring trading partners
    like Mexico and Canada appropriately value innovation, allowing
    innovative biopharmaceutical companies to continue bringing new
    medicines to the market.
                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various states
    have been exploring whether to exclude certain drugs from its Medicaid
    program. for example, the state of Massachusetts' recently asked CMS
    for permission to create a closed formulary where the state Medicaid
    program would pick at least one drug per therapeutic class. CMS denied
    their waiver request citing violation of federal law, but this proposal
    does bring up important questions on how to contain drug prices in
    state Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to state Medicaid programs,
    do you think it lower drugs costs while ensuring access to patients?

        Answer. Medicaid patients currently have broad access to medicines
    with nominal co-pay amounts in exchange for steep mandatory rebates
    provided by manufacturers. While the question does not specify what
    ``principles of the Medicare Part D program'' or ``necessary patient
    protections'' are proposed to be applied to State Medicaid programs,
    depending on the specific details that might be proposed, exclusionary
    formularies could upset this broad patient access in Medicaid without
    achieving corresponding savings over the already-existing steep
    mandatory rebates.
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        What, if any, changes would you suggest we make to the program?

        Answer. AbbVie has not found that best price requirements have
    created incentives in the system to increase initial prices.

                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        How will they lower overall health-care costs for our Federal
    programs?

        What have the preliminary results looked like so far?

        Answer. Value-based arrangements can be an effective and market-
    based solution to managing overall health-care costs when driven by
    patient outcomes. Studies have found that 38 percent of payers with
    outcomes-based contracts experience improved patient outcomes and 33
    percent experience plan health-care cost savings. Additionally, plans
    with outcomes-based contracts have been found to have a 28 percent
    lower patient co-payment. All of these factors work towards moving
    payment for prescription medicines away from volume-based approaches to
    value-based models in a manner that appropriately balances patient
    access with the appropriate use of medications to lower overall health-
    care costs.

        At AbbVie, we believe all our products provide value to patients
    and the larger health care system and are interested in the
    possibilities that could arise through value-based contracting. To
    further foster value-based arrangements, we support the reforms
    included in the Patient Affordability, Value and Efficiency (PAVE) Act,
    introduced by Senators Cassidy (R-LA) and Warner (D-VA).
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump Administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point-of-sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        If so, would this transparency bring down drug costs--overall and
    for specialty drugs?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health care system or pharmaceutical companies, it is premature to
    comment on these items until the Administration's rule is finalized,
    implementation timelines are solidified and there are specific details
    regarding how a new system without rebates will be structured and
    function.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the Pharmacy Benefit Manager. But there's
    another side of the equation that I'd like to ask about.

        How do wholesalers negotiate pricing with manufacturers?

        What impact does this have on drug costs?

        What incentives or disincentives do they have to contain price
    increases?

        Answer. Wholesalers provide efficiencies in the distribution of
    products for manufacturers, pharmacies and providers. They track supply
    needs and maintain inventory levels consistent with patient need. They
    also provide manufacturers with data and information related to both
    historical purchasing patterns and projected future need, allowing
    manufacturers to more accurately predict future supply needed in the
    market to determine production needs. Wholesalers are also a ``one-stop
    shop'' for sourcing medications and in some cases provide payer
    contracting efficiencies through their Pharmacy Services Administrative
    Organizations. This allows pharmacies to gain access to payer networks
    efficiently, without negotiating with individual payers.

        Manufacturers pay bona fide fees to wholesalers cover the costs of
    the services described above.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the Administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price.

        Like many Oregonians, I am skeptical drug manufacturers would
    voluntarily lower their prices. Therefore, would you support
    legislation that would (1) make similar changes the administration has
    put forward related to Part D and Medicaid managed care, (2) change the
    rebate system in a similar way to the proposal for the commercial
    market, and (3) require drug makers to lower the list price of their
    drugs equal to the amount of rebates provided today?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health-care system or pharmaceutical companies, it is premature to
    comment on these items until the administration's rule is finalized,
    implementation timelines are solidified, and there are specific details
    regarding how a new system without rebates will be structured and
    function.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        For each drug listed in response to question 1, please also provide
    a list of which quarters and years each drug hit the cap.

        Answer.

    ------------------------------------------------------------------------
           PRODUCT NAME               NDC 11          QTR/YEAR of AMP CAPs
    ------------------------------------------------------------------------
    Androgel 1%, 2.5 G Unit        00051-8425-30   Q1 2015
     Dose, 30'S
    ------------------------------------------------------------------------
    Androgel 1%, 5.0 G Unit        00051-8450-30   Q1 2015
     Dose, 30'S
    ------------------------------------------------------------------------
    Androgel 1.62% 2.5Gm Unit      00051-8462-30   Q2 2017, Q1 2018-Q3 2018
     Dose
    ------------------------------------------------------------------------
    Androgel 1.62% 1.25Gm Unit     00051-8462-31   Q2 2017, Q1 2018-Q3 2018
     Dose
    ------------------------------------------------------------------------
    Androgel 1.62% Pump            00051-8462-33   Q2 2017, Q1 2018-Q3 2018
    ------------------------------------------------------------------------
    Biaxin, Filmtab Tablets,       00074-2586-60   Q3 2016-Q4 2016
     500 Mg, 60'S
    ------------------------------------------------------------------------
    Biaxin XL, Filmtab Tab,        00074-3165-11   Q1 2014-Q4 2015
     500 Mg, 1010'S
    ------------------------------------------------------------------------
    Biaxin XL 500Mg(114)          00074-3165-14   Q1 2014-Q4 2015
    ------------------------------------------------------------------------
    Biaxin XL, Filmtab Tabs,       00074-3165-41   Q1 2014-Q4 2015
     500Mg, 414'S
    ------------------------------------------------------------------------
    Biaxin XL, Filmtab             00074-3165-60   Q1 2014-Q4 2015
     Tablets, 500 Mg, 60'S
    ------------------------------------------------------------------------
    Biaxin OS, 250Mg/5Ml,          00074-3188-13   Q2 2014-Q3 2014, Q1 2016-
     100ML                                          Q2 2018
    ------------------------------------------------------------------------
    Biaxin OS 250Mg/5Ml, 50ML      00074-3188-50   Q2 2014-Q3 2014, Q1 2016-
                                                    Q2 2018
    ------------------------------------------------------------------------
    Biaxin Filmtab Tablets,        00074-3368-60   Q1 2014, Q3 2014, Q1 2015-
     250 Mg, 60'S                                   Q3 2015
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 120     00074-3045-30   Q1 2014-Q3 2014
     Mg, 30'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 120     00074-3045-90   Q1 2014-Q3 2014
     Mg, 90'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 180     00074-3061-30   Q1 2014
     Mg, 30'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 180     00074-3061-90   Q1 2014
     Mg, 90'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 240     00074-3062-30   Q1 2014
     Mg, 30'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 240     00074-3062-90   Q1 2014
     Mg, 90'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 300     00074-3063-30   Q1 2014
     Mg, 30'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 300     00074-3063-90   Q1 2014
     Mg, 90'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 360     00074-3064-30   Q1 2014-Q2 2014
     Mg, 30'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 360     00074-3064-90   Q1 2014-Q2 2014
     Mg, 90'S
    ------------------------------------------------------------------------
    Cardizem LA , Tablets, 420     00074-3069-30   Q1 2014
     Mg, 30'S
    ------------------------------------------------------------------------
    Cardizem LA, Tablets, 420      00074-3069-90   Q1 2014
     Mg, 90'S
    ------------------------------------------------------------------------
    Depacon 500Mg (100Mg/1ML)      00074-1564-10   Q1 2016, Q4 2016-Q4 2017
     105ML SDV
    ------------------------------------------------------------------------
    Depakene 250Mg 100Cap          00074-5681-13   Q1 2014, Q3 2014-Q4 2018
    ------------------------------------------------------------------------
    Depakene OS 250Mg/5ML,         00074-5682-16   Q3 2014-Q4 2018
     16Oz
    ------------------------------------------------------------------------
    Depakote ER 250Mg 1010Tab     00074-3826-11   Q1 2015, Q4 2018
    ------------------------------------------------------------------------
    Depakote ER 250Mg 100Tab       00074-3826-13   Q1 2015, Q4 2018
    ------------------------------------------------------------------------
    Depakote, Sprinkle             00074-6114-11   Q1 2015-Q4 2018
     Capsule, 125 Mg, 10-10
    ------------------------------------------------------------------------
    Depakote Sprinkle Capsule,     00074-6114-13   Q1 2015-Q4 2018
     125Mg, 100
    ------------------------------------------------------------------------
    Depakote 125Mg 100Tab          00074-6212-13   Q1 2014, Q3 2014-Q4 2018
    ------------------------------------------------------------------------
    Depakote 250Mg 100Tab          00074-6214-13   Q1 2014, Q3 2014-Q4 2018
    ------------------------------------------------------------------------
    Depakote 250Mg 500Tab          00074-6214-53   Q1 2014, Q3 2014-Q4 2018
    ------------------------------------------------------------------------
    Depakote 500Mg 100Tab          00074-6215-13   Q1 2014, Q3 2014-Q4 2018
    ------------------------------------------------------------------------
    Depakote 500Mg 500Tab          00074-6215-53   Q1 2014, Q3 2014-Q4 2018
    ------------------------------------------------------------------------
    Depakote ER 500Mg 10X10Tab     00074-7126-11   Q4 2014-Q1 2015, Q1 2017-
                                                    Q3 2017, Q4 2018
    ------------------------------------------------------------------------
    Depakote ER 500Mg 100Tab       00074-7126-13   Q4 2014-Q1 2015, Q1 2017-
                                                    Q3 2017, Q4 2018
    ------------------------------------------------------------------------
    Depakote ER 500Mg 500Tab       00074-7126-53   Q4 2014-Q1 2015, Q1 2017-
                                                    Q3 2017, Q4 2018
    ------------------------------------------------------------------------
    Humira 40Mg/0.8ML (2           00074-3799-02   Q2 2016-Q4 2018
     Syringes)
    ------------------------------------------------------------------------
    Humira Ped Crohns Starter      00074-3799-03   Q2 2016-Q4 2018
     Pack, 40Mg
    ------------------------------------------------------------------------
    Humira Ped Crohns Starter      00074-3799-06   Q2 2016-Q4 2018
     Pack, 40Mg
    ------------------------------------------------------------------------
    Humira 40Mg/0.8 ML (2          00074-4339-02   Q2 2016-Q4 2018
     Pens)
    ------------------------------------------------------------------------
    Humira, Crohn's, 40Mg/0.8      00074-4339-06   Q2 2016-Q4 2018
     ML (6 Pens)
    ------------------------------------------------------------------------
    Humira, Psoriasis, 40Mg/       00074-4339-07   Q2 2016-Q4 2018
     0.8ML (4 Pens)
    ------------------------------------------------------------------------
    Humira, Single Dose            00074-6347-02   Q2 2016-Q4 2018
     Syringe, 10 Mg/0.2ML
    ------------------------------------------------------------------------
    Humira 20Mg/0.4ML (2           00074-9374-02   Q2 2016-Q4 2018
     Syringes)
    ------------------------------------------------------------------------
    K-Tab, Filmtabs, 8Meq,         00074-3058-41   Q3 2018
     600Mg, 100Ct
    ------------------------------------------------------------------------
    K-Tab, Filmtabs, 8Meq,         00074-3058-46   Q3 2018
     600Mg, 1000Ct
    ------------------------------------------------------------------------
    Marinol 2.5 Mg Capsules,       00051-0021-21   Q2 2016
     60'S
    ------------------------------------------------------------------------
    Marinol 5 Mg Capsules,         00051-0022-21   Q3 2018
     60'S
    ------------------------------------------------------------------------
    Marinol 10 Mg Capsules,        00051-0023-21   Q2 2014, Q3 2017
     60'S
    ------------------------------------------------------------------------
    Mavik, Tablets, 1 Mg,          00074-2278-13   Q4 2014, Q2 2015
     100'S
    ------------------------------------------------------------------------
    Niaspan, Tablets, 500 Mg,      00074-3074-90   Q1 2014, Q2 2015, Q1 2016-
     90'S                                           Q3 2016, Q1 2017-Q4 2018
    ------------------------------------------------------------------------
    Niaspan, Tablets, 750 Mg,      00074-3079-90   Q1 2014, Q4 2014, Q2 2015-
     90'S                                           Q2 2016, Q4 2016-Q4 2018
    ------------------------------------------------------------------------
    Niaspan, Tablets, 1000 Mg,     00074-3080-90   Q1 2014, Q1 2015-Q2 2015,
     90'S                                           Q1 2016-Q3 2016, Q1 2017-
                                                    Q4 2018
    ------------------------------------------------------------------------
    Niaspan, Tablets, 500Mg,       00074-3265-90   Q4 2017-Q4 2018
     90'S
    ------------------------------------------------------------------------
    Niaspan, Tablets, 750Mg        00074-3274-90   Q1 2018-Q4 2018
     90'S
    ------------------------------------------------------------------------
    Niaspan, Tablets, 1000Mg       00074-3275-90   Q4 2017-Q4 2018
     90'S
    ------------------------------------------------------------------------
    Prometrium 100 Mg              00032-1708-01   Q2 2016-Q4 2018
     Capsules, 100'S
    ------------------------------------------------------------------------
    Prometrium 200 Mg              00032-1711-01   Q2 2016-Q4 2018
     Capsules, 100'S
    ------------------------------------------------------------------------
    Simcor 500Mg/20Mg, 90Tab       00074-3312-90   Q3 2014
    ------------------------------------------------------------------------
    Simcor 1000Mg/20Mg, 90Tab      00074-3455-90   Q1 2014, Q3 2014
    ------------------------------------------------------------------------
    Tarka ER 2Mg/180Mg, 100Tab     00074-3287-13   Q2 2015-Q4 2015, Q2 2016-
                                                    Q4 2016, Q2 2017-Q4
                                                    2017, Q2 2018-Q4 2018
    ------------------------------------------------------------------------
    Tarka 1Mg/240Mg, 100Tab        00074-3288-13   Q2 2015-Q4 2015, Q2 2016-
                                                    Q4 2018
    ------------------------------------------------------------------------
    Tarka ER 2Mg/240Mg, 100Tab     00074-3289-13   Q1 2014, Q2 2015-Q4 2015,
                                                    Q2 2016-Q4 2016, Q2 2017-
                                                    Q4 2017, Q2 2018-Q4 2018
    ------------------------------------------------------------------------
    Tarka ER 4Mg/240Mg, 100Tab     00074-3290-13   Q1 2014, Q1 2015-Q3 2015,
                                                    Q1 2016-Q2 2016, Q4 2016-
                                                    Q2 2017, Q4 2017-Q3 2018
    ------------------------------------------------------------------------
    Tricor, Tablets, 145Mg,        00074-3189-90   Q3 2018
     90Ct Btl
    ------------------------------------------------------------------------
    Tricor, Tablets, 48 Mg,        00074-6122-90   Q4 2014-Q1 2015
     90'S
    ------------------------------------------------------------------------
    Tricor, Tablets, 145 Mg,       00074-6123-90   Q3 2018
     90'S
    ------------------------------------------------------------------------
    Trilipix, Delayed Release      00074-3161-90   Q2 2017-Q4 2017, Q2 2018-
     Cap, 45Mg 90Ct                                 Q4 2018
    ------------------------------------------------------------------------
    Trilipix, Delayed Release      00074-9189-90   Q3 2018-Q4 2018
     Cap, 135Mg 90'S
    ------------------------------------------------------------------------
    Trilipix, Delayed Release      00074-9642-90   Q3 2014-Q4 2014, Q2 2015-
     Cap, 45Mg 90'S                                 Q3 2015, Q1 2016, Q3
                                                    2016-Q4 2016, Q2 2017-Q4
                                                    2017, Q2 2018-Q4 2018
    ------------------------------------------------------------------------
    Zemplar, Capsules, 2 Mcg,      00074-4314-30   Q3 2014-Q1 2015, Q3 2015-
     30'S                                           Q4 2015, Q2 2016-Q4
                                                    2016, Q2 2017, Q4 2017-
                                                    Q4 2018
    ------------------------------------------------------------------------
    Zemplar, Capsules, 4 Mcg,      00074-4315-30   Q2 2014-Q4 2015
     30'S
    ------------------------------------------------------------------------
    Zemplar, Capsules, 1 Mcg,      00074-4317-30   Q4 2014, Q2 2015, Q4
     30'S                                           2015, Q2 2016, Q1 2018-
                                                    Q4 2018
    ------------------------------------------------------------------------

                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. for example, an analysis by the U.S.
    Department of Health and Human Services office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.
    Accordingly, please describe the following:

        Your company's current compliance plan and procedures used to
    ensure compliance with the requirements of the Medicaid Drug Rebate
    Program including internal audits or other checks you use to identify
    compliance vulnerabilities.

        Answer. AbbVie has established and maintains a comprehensive
    compliance plan and procedures to ensure MDRP compliance, the core
    components of which include policies and procedures relating to MDRP
    issues, routine internal and external monitoring and auditing, and a
    dedicated governance team to monitor and address any potential MDRP
    issues.

        Question. Any past or ongoing issues of non-compliance.

        Answer. We are not aware of past or ongoing issues of non-
    compliance with MDRP legal requirements.

        Question. Any corrective actions taken to address identified
    problems or issues of noncompliance with the MDRP and how such steps
    were communicated to the Centers for Medicare and Medicaid Services.

        Answer. We are not aware of past or ongoing issues of non-
    compliance with MDRP legal requirements.

        Question. Any steps taken to improve compliance and ensure that all
    Medicaid drug rebates owed to the Federal Government and the States are
    paid in full.

        Answer. AbbVie conducts periodic reviews of its compliance plan and
    updates its policies, procedures, and monitoring plans as needed to
    ensure the company's continued implementation of MDRP legal
    requirements.
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus, or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus or other compensation was tied.

        Is your salary, bonus, or other compensation tied to either revenue
    or net income of the company as a whole? Has it ever been? If yes,
    please explain what assumptions about price increases are used when the
    compensation committee sets revenue or net income goals. Does the
    compensation committee provide any guidance to executives in regards to
    the amount of revenue that the company will generate from price
    increases versus volume growth?

        Answer. To determine Mr. Gonzalez's 2018 annual incentive
    compensation (sometimes referred to as a bonus), net revenues, income
    before taxes, and Humira sales were three of several quantitative
    financial metrics that were considered in addition to qualitative
    factors. At most, a single quantitative financial metric had the
    potential to impact up to 3 percent of Mr. Gonzalez's total
    compensation, subject to additional qualitative and relative analyses.
    No other compensation element, beyond the annual incentive
    compensation, includes Humira sales, revenue, or net income as a
    performance metric. While some specific details have differed somewhat,
    the foregoing has generally been true in prior years as well.

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. When new products enter the market, do drug companies set
    high initial rebates and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. Over the last 2 years, AbbVie has brought Mavyret and
    Orilissa to patients. Mavyret is for the treatment of adults with
    chronic hepatitis C virus (HCV) infection across all major genotypes,
    and Orilissa is the first and only oral gonadotropin-releasing hormone
    antagonist specifically developed for women with moderate to severe
    endometriosis pain. Mavyret was introduced with a list price below
    competitive alternatives and Orilissa was introduced at a list price
    below the current standard of care.

        Rebates are a form of price competition that results from the
    aggressive negotiations that occur between health plans (and their
    representative PBMs) and pharmaceutical companies to provide patients
    with access to medicines and treatments that can best help patients
    manage their medical conditions. Plans/PBMs create formularies to list
    brand and generic medicines.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health care system or pharmaceutical companies, it is premature to
    comment on these items until the Administration's rule is finalized,
    implementation timelines are solidified and there are specific details
    regarding how a new system without rebates will be structured and
    function.

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D?

        Answer. A majority of the discussion about the cost of prescription
    drugs has been focused on list prices. We agree that price should be
    part of the discussion, however we also know that solutions targeting
    list price alone are not enough. Our experience in launching a low list
    price HCV medicine made it clear to AbbVie and patients that list price
    reductions will not always address patient affordability and access.

        Providing discounts to the patient at the point of sale is an
    effective way of ensuring that patients can see lower out-of-pocket
    costs. However, this is just the start. AbbVie believes that more must
    be done.

        The Medicare Part D benefit design contributes to making innovative
    therapies cost-prohibitive for Medicare patients because patients are
    charged out-of-pocket costs based on a medicine's list price, which
    does not reflect the rebates that Medicare receives.

        AbbVie believes it is important to alleviate the burdens that
    patients face due to Medicare Part D out-of-pocket costs. AbbVie
    supports solutions like a patient out-of-pocket cap in Part D and
    smoothing patient out-of-pocket payments over a full year, so patients
    have some predictability with respect to their out-of-pocket costs.

        In addition, AbbVie is prepared to step up and discuss how
    companies like ours can shoulder more of the burden of a patient's out-
    of-pocket expenses.

        As policymakers consider the impact of addressing out-of-pocket
    costs in Medicare Part D, questions may arise around whether it will
    lead to unnecessary utilization and wasteful spending. for specialty
    medicines, increased utilization should not be misunderstood as
    unnecessary or wasteful. Part D plans have tools, like step therapy
    requirements for patients to first try lower cost alternatives before a
    specialty medicine would be covered and prior authorization
    requirements before a specialty medicine would be covered, to manage
    the utilization of the majority of higher cost specialty medicines.
    These tools ensure patients try a less costly medication first and have
    met the clinical criteria for taking the specialty drug prescribed and
    serve the function that an out-of-pocket cost obligation on patients
    might serve to prevent unnecessary use.

        Question. In the health insurance plans that you offer your
    employees, do you ask your insurers to pass through the full
    manufacturer rebates to the beneficiaries?

        Answer. AbbVie's benefit plans are structured to ensure employees
    share in the cost of their prescription drugs but are also able to
    access and afford their medicines, with the goal of maximizing
    prescription drug adherence.

        Currently our maximum co-pays and out-of-pocket maximums ensure
    patient access and allow us to utilize rebates to reduce premiums. Our
    benefit includes a deductible and 25-percent co-pay for prescription
    medicines that is capped at $125 for a 30-day supply. For mail order or
    specialty pharmacy, there is a 20-percent co-pay that is capped at $250
    for a 90-day supply. Additionally, our benefit plans include an annual
    out-of-pocket maximum. Our prescription drug adherence levels are high
    year over year across many disease states.

        To increase transparency, members receive a receipt at retail or
    via mail/specialty pharmacies that reflects their share of the
    discounted price of the drug.

        AbbVie has considered the impact of passing through rebates to
    employees and have found a minimal impact on employee out-of-pocket
    expenses for all medicines, including specialty. We have found that it
    would only reduce employee spending if the rebate reduced the co-
    payment obligation below $125 for drugs filled at retail or $250 for
    mail order or specialty drugs.

        Employees who would benefit the most in this scenario would be
    those in high deductible health plans before they meet their
    deductible, however it could slow the time in which they would reach
    their deductible.

        While we have found that providing rebates at point of sale is most
    beneficial to enrollees whose benefit design does not include a maximum
    co-pay and therefore may not be beneficial to AbbVie employees, we are
    continuing to assess the impact in a manner that ensures we can
    maintain the current employee costsharing levels in our benefit design
    that drive adherence.

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand. What are your recommendations for
    increasing transparency in how your companies set the list prices for
    drugs, and for improving transparency in the supply chain for
    prescription drugs? Would you support federal standards for
    transparency in setting the list prices for drugs?

        Answer. AbbVie supports transparency that is accurate, timely,
    comprehensive and meaningful to patients as they make better-informed
    decisions about their health care. This includes broad transparency
    across the entire health-care system and consistent requirements,
    including for all entities in the drug supply chain, rather than a
    narrow focus on one individual sector. It is also important that any
    new transparency requirements are prospective and balanced with
    appropriate protections for confidential, proprietary information so as
    not to undermine competition in the marketplace. As Congress considers
    approaches to address transparency at the Federal level, AbbVie
    welcomes further discussion on this important topic.

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently. How many of your drugs are included in
    valuebased contracts and how many patients are benefiting from them?
    How do these valuebased contracts work to lower drug prices for both
    patients and taxpayers?

        Answer. Value-based arrangements can be an effective and market-
    based solution to managing overall health-care costs when driven by
    patient outcomes. Studies have found that 38 percent of payers with
    outcomes-based contracts experience improved patient outcomes and 33
    percent experience plan health-care cost savings. Additionally, plans
    with outcomes-based contracts have been found to have a 28 percent
    lower patient co-payment. All of these factors work towards moving
    payment for prescription medicines away from volume-based approaches to
    value-based models in a manner that appropriately balances patient
    access with the appropriate use of medications to lower overall health-
    care costs.

        At AbbVie, we believe all our products provide value to patients
    and the larger health care system and are interested in the
    possibilities that could arise through value-based contracting. To
    further foster value-based arrangements, we support the reforms
    included in the Patient Affordability, Value and Efficiency (PAVE) Act,
    introduced by Senators Cassidy (R-LA) and Warner (D-VA).

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack. Are any of your
    companies providing medical necessity paperwork to doctors in order to
    get your drugs covered by Medicare?

        Answer. Unlike the scenarios raised in this question, AbbVie does
    not have a practice of completing medical necessity sections on any
    reimbursement forms, purporting to make medical necessity
    determinations that should be made by physicians, or submitting medical
    necessity forms to payors on behalf of patients or physicians.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers. What is delaying the
    uptake of biosimilar drugs in the United States? What policies do you
    recommend to increase the development of biosimilar drugs?

        Answer. AbbVie believes that FDA's current, patient-centered and
    science-based approach to the development of standards governing the
    approval of biosimilars--including interchangeable biosimilars--helps
    to build a sustainable biosimilar market as patients and health care
    providers become more exposed to, and comfortable with, these products.
    The agency's approach best ensures the approval of quality, safe, and
    effective biosimilar products--products that will instill confidence
    among patients and prescribers. A robust and competitive biologic
    marketplace cannot survive without this stakeholder confidence and
    support.

        Any policies regarding the biologics market must take into
    consideration the fundamental differences between small molecule
    generics and biosimilars. Consequently, competition between biosimilars
    and their reference products will necessarily more closely resemble
    brand-to-brand competition. A key principle for encouraging appropriate
    market competition for biological products, then, is ensuring a level
    playing field for all biologic products. Artificially favoring either
    biosimilars or innovator biologics in coverage or reimbursement creates
    market inefficiencies by reducing incentives to compete on price.
    Moreover, policies designed to artificially drive usage of either the
    biosimilar or the reference biologic risk confusing stakeholders
    regarding the clear regulatory distinctions between biosimilars and
    small-molecule generics. Robust competition should therefore be driven
    by an increasing number of innovator and biosimilar products competing
    to treat disease at the lowest possible cost.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach.

        Researchers say that this type of imagery, combined with viewing
    hours of drug commercials each month, leads consumers to underestimate
    the risks associated with medications. for the past decade, studies
    have shown that aggressive direct-toconsumer advertising is associated
    with rising drug prices and an increase in inappropriate drug
    prescriptions.

        Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. We believe it is unlikely that DTC advertising would lead
    to an ``increase in inappropriate prescriptions'' for AbbVie's largely
    specialty-product portfolio. Both commercial insurance and Part D plans
    have tools, like step therapy requirements for patients to first try
    lower cost alternatives before a specialty medicine would be covered
    and prior authorization requirements before a specialty medicine would
    be covered to manage the utilization of the majority of higher cost
    specialty medicines. These tools ensure patients try a less costly
    medication first and have met the clinical criteria for taking the
    specialty drug prescribed.

        Further, we believe that consumers understand the benefits and
    risks described in AbbVie's advertisements. AbbVie goes beyond the FDA
    regulations to ensure its advertising it accurate, truthful, not
    misleading, and reflects an appropriate balance between the risks and
    benefits of the drugs. This includes complying with PhRMA's voluntary
    principles on direct to consumer advertising.\2\ Some of the key
    principles addressing the issues of educating patients in a clear
    manner include:
    ---------------------------------------------------------------------------
        \2\ See http://phrmadocs.phrma.org/files/dmfile/PhRMA--Guiding--
    Principles_2018.pdf.

              Companies that choose to feature actors in the roles of
            health-care professionals in a DTC television or print
            advertisement that identifies a particular product should
            acknowledge in the advertisement that actors are being used.
            Likewise, if actual health-care professionals appear in such
            advertisements, the advertisement should include an
            acknowledgment if the health-care professional is compensated
    ---------------------------------------------------------------------------
            for the appearance.

              DTC television advertising that identifies a product by name
            should clearly state the health conditions for which the
            medicine is approved and the major risks associated with the
            medicine being advertised.

              DTC television and print advertising should be designed to
            achieve a balanced presentation of both the benefits and the
            risks associated with the advertised prescription medicine.
            Specifically, risks and safety information, including the
            substance of relevant boxed warnings, should be presented with
            reasonably comparable prominence to the benefit information, in
            a clear, conspicuous and neutral manner, and without
            distraction from the content. In addition, DTC television
            advertisements should support responsible patient education by
            directing patients to health care professionals as well as to
            print advertisements and/or websites where additional benefit
            and risk information is available.

              All DTC advertising should respect the seriousness of the
            health conditions and the medicine being advertised.

        AbbVie believes these are important principles that all
    pharmaceutical advertisements should follow. Our approach of listening
    to, and learning from, consumers, caregivers, physicians and other
    health-care professionals continues to confirm our belief that
    accurate, balanced and timely information about our prescription
    medicines and the conditions they treat is an essential component of
    our commitment to putting patient health first.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organization for Economic Cooperation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price.

        One of the most well known examples is Mylan's increase of the
    price of EpiPen from less than $100 in 2007 to more than $600 in 2016.
    Another example, is the everincreasing price of insulin. Sanofi
    increased the price of a vial of Lantus from $88.20 in 2007 to $307.20
    in 2017. And those are just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. Price often does decrease for drugs that have been on the
    market for years. The U.S. has a robust and well-functioning system
    with fast entry of generic medicines following the expiration of patent
    and market exclusivities for brand medications. When generics medicines
    enter the market price reductions can be dramatic. In fact, GAO has
    found that prices are typically reduced by 20 percent for each new
    generic entrant to the market. From 2005 to 2013 prices of medicines
    commonly used to prevent cardiovascular disease dropped 92 percent. The
    daily cost of the top 10 therapeutic classes of medicines most commonly
    used by Medicare Part D enrollees dropped from $1.50 to $0.77 from 2006
    to 2013.

        In addition to dramatic decreases in price, generic uptake is swift
    in the U.S. When a generic version of a medicine becomes available for
    the first time, it captures an average of three-quarters of the market
    within 3 months. Some generics captures as much as 90 percent in that
    same time period. Utilization is also the highest in the U.S. when
    compared to uptake in other markets, such as the UK, France, Japan,
    Germany, and Australia. According to the 2018 Medicare Trustees Report,
    the generic utilization rate for Part D beneficiaries has steadily
    increased each year, from 75 percent in 2010 to 88 percent in 2017.

        Competition is also robust among branded products. From 2005 to
    2011, the time only one medicine was available in its class declined
    from a median of 10 years in the 1970s to close to 2 years from 2005-
    2011. Half of second medicines were approved within 2.3 years and one
    quarter were approved within just 4 months. These competitive forces
    lead to manufacturers offering discounts. An analysis by IQVIA found
    that net prices for brands continued to increase more slowly than
    invoice prices from 2013 to 2016, with average price increases for
    brands at 9.2 percent (down from 12 percent in 2015) and net price
    growth increases at 3.5 percent. For the same year, the analysis found
    that rebates, discounts, and other price concessions offset price
    growth for brand medicines by 62 percent.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market.

        These ``pay-for-delay'' patent settlements benefit both brand-name
    pharmaceutical companies by helping them avoid costly patent litigation
    and general manufacturers by rewarding them a hefty sum to delay
    entering the market with a cheaper drug alternative. However, these
    deals do not benefit consumers. According to an FTC study, these
    anticompetitive deals cost consumers and taxpayers $3.5 billion in
    higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Why would a pharmaceutical company enter into a pay-for delay
    agreement?

        Do you think these agreements stifle competition and prevent
    generic alternatives to your branded medications?

        Answer. ``Pay-for-delay'' is not a self-defining phrase. With
    respect to the term ``pay,'' patent litigation settlements, like all
    litigation settlements, involve compromise in which both sides believe
    they are getting value from the resolution. There is no definition
    explaining the circumstances under which that value would implicate the
    term ``pay'' in ``pay-fordelay'' for purposes of these questions. And
    with respect to ``delay'' virtually all patent settlements provide for
    the generic competitor to enter the market before the expiration of the
    patent at issue. So if the alternative resolution of a patent lawsuit
    would be the innovator company continuing to enforce its patent until
    expiration, then such a settlement, no matter what value is exchanged,
    would actually accelerate competition, not delay it.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections.

        The rule is predicted to increase net drug costs in its early
    years. The CMS actuaries estimate it would cost $196 billion over 10
    years. Despite this high price tag, the beneficiary benefits are
    limited. The proposed rule notes that under the CMS Actuary's analysis,
    the majority of beneficiaries would see an increase in their total out-
    of-pocket payments and premium costs; reductions in total cost sharing
    will exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclude[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health care system or pharmaceutical companies, it is premature to
    comment on these items until the Administration's rule is finalized,
    implementation timelines are solidified and there are specific details
    regarding how a new system without rebates will be structured and
    function.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spent nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9 percent of all medical marketing, in 1997 to $9.6
    billion, or 32 percent of total spending, in 2016.

        Can each of you please provide what your ratio of spending on sales
    and marketing to research and development is today?

        Answer. AbbVie spends more on research and development than on
    global sales, marketing, and promotion costs. The global sales,
    marketing, and promotion spend in 2018 across all AbbVie products was
    $4.24 billion. This is less than the $5.26 billion AbbVie spent on
    research and development in 2018. And AbbVie's research and development
    spend does not include acquired inprocess research and development
    ($424 million in 2018) or money invested externally for technology,
    pharmaceutical compounds, or acquisitions. for example, AbbVie acquired
    Pharmacyclics for $20.8 billion in 2015 and Stemcentrx for $6.4 billion
    in 2016. The acquisition of both companies enhanced AbbVie's pipeline,
    research and development, and clinical programs.

                                 price-gouging
        Answer. Sanofi, as I understand it, has made a pledge to the public
    to limit its price increases to the national health expenditures growth
    projection.

        Would your company commit to a cap on annual price increases as
    part of your PhRMA membership criteria?

        Answer. With respect to the question's proposed collective
    agreement by PhRMA members to cap annual price increases, we note that
    in 1993, PhRMA (then known as PMA, the Pharmaceutical Manufacturers
    Association) sought review of such a proposal from the Antitrust
    Division of the Department of Justice. The Department of Justice opined
    that the proposed agreement for PhRMA members to collectively agree to
    limit their price increases would be per se unlawful under federal
    antitrust laws, even though the proposal was made ``in response to
    concerns about controlling health care costs.'' (Oct. 1, 1993 letter
    from Anne K. Bingaman, Assistant U.S. Attorney General, available at
    https://www.justice.gov/atr/response-pharmaceutical-manufacturers-
    associationsrequest-business-review-letter (``The PMA proposal is an
    arrangement among competitors that limits individual pricing decisions
    on its face. . . . An agreement among independent competitors that
    interferes with free and open price competition by restraining
    individual pricing decisions is a per se violation of the Sherman
    Act.'').) The Department of Justice said it ``intend[ed] to bring suit
    to challenge the program if PMA and its members go forward with its
    proposal.'' AbbVie could not support a proposal that the Department of
    Justice is on record as saying is unlawful and against which it would
    file suit to block.

        As for individual action, the same Department of Justice opinion
    discussed above noted that, while collective agreements among
    competitors raised antitrust violations, an individual company's
    decision to limit its own price increases would not be problematic.
    AbbVie in January 2017 became one of the first pharmaceutical companies
    to commit to limiting increases of its list prices. AbbVie committed to
    not more than one, single-digit price increase annually. AbbVie has
    abided by that commitment.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. A majority of the discussion about the cost of prescription
    drugs has been focused on list prices. We agree that price should be
    part of the discussion, however we also know that solutions targeting
    list price alone are not enough. Our experience in launching a low list
    price HCV medicine made it clear to AbbVie and patients that list price
    reductions will not always address patient affordability and access.

        Providing discounts to the patient at the point of sale is an
    effective way of ensuring that patients can see lower out-of-pocket
    costs. However, this is just the start. AbbVie believes that more must
    be done.

        The Medicare Part D benefit design contributes to making innovative
    therapies cost-prohibitive for Medicare patients because patients are
    charged out-of-pocket costs based on a medicine's list price, which
    does not reflect the rebates that Medicare receives.

        AbbVie believes it is important to alleviate the burdens that
    patients face due to Medicare Part D out-of-pocket costs. AbbVie
    supports solutions like a patient outof-pocket cap in Part D and
    smoothing patient out-of-pocket payments over a full year, so patients
    have some predictability with respect to their out-of-pocket costs.

        In addition, AbbVie is prepared to step up and discuss how
    companies like ours can shoulder more of the burden of a patient's out-
    of-pocket expenses.

        As policymakers consider the impact of addressing out-of-pocket
    costs in Medicare Part D, questions may arise around whether it will
    lead to unnecessary utilization and wasteful spending. for specialty
    medicines, increased utilization should not be misunderstood as
    unnecessary or wasteful. Part D plans have tools, like step therapy
    requirements for patients to first try lower cost alternatives before a
    specialty medicine would be covered and prior authorization
    requirements before a specialty medicine would be covered, to manage
    the utilization of the majority of higher cost specialty medicines.
    These tools ensure patients try a less costly medication first and have
    met the clinical criteria for taking the specialty drug prescribed and
    serve the function that an out-of-pocket cost obligation on patients
    might serve to prevent unnecessary use.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates
    rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. AbbVie supports price transparency across all stakeholders
    that is accurate, timely, comprehensive, and meaningful to patients as
    they make better-
    informed decisions about their health care. This includes broad
    transparency across the entire health-care system and consistent
    requirements, including for all entities in the drug supply chain,
    rather than a narrow focus on one individual sector. It is also
    important that any new transparency requirements are prospective and
    balanced with appropriate protections for confidential, proprietary
    information so as not to undermine competition in the marketplace.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health-care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        For those of you who do use a PBM to help manage the prescription
    drug benefit for your employees, how do you utilize the rebates your
    PBM negotiates to lower health-care costs or drug costs for your
    employee plans and what does your company do with that savings?
    Specifically, do the savings go toward lowing premiums?

        For those of you who do use a PBM to help manage the prescription
    drug benefit for your employees, does your PBM offer point-of-sale
    rebates to your employees?

        Answer. AbbVie does use a PBM to manage pharmacy benefits for its
    employees in the U.S. AbbVie's benefit plans are structured to ensure
    employees share in the cost of their prescription drugs but are also
    able to access and afford their medicines, with the goal of maximizing
    prescription drug adherence.

        Currently our maximum co-pays and out-of-pocket maximums ensure
    patient access and allows us to utilize rebates to reduce premiums. Our
    benefit includes a deductible and 25-percent co-pay for prescription
    medicines that is capped per prescription at $125 for a 30-day supply.
    For mail order or specialty pharmacy, there is a 20-percent co-pay that
    is capped per prescription at $250 for a 90-day supply. Additionally,
    our benefit plans include an annual out-of-pocket maximum. Our
    prescription drug adherence levels are high year over year across many
    disease states.

        To increase transparency, members receive a receipt at retail or
    via mail/specialty pharmacies that reflects their share of the
    discounted price of the drug.

        AbbVie has considered the impact of passing through rebates to
    employees and have found a minimal impact on employee out-of-pocket
    expenses for all medicines, including specialty. We have found that it
    would only reduce employee spending if the rebate reduced the co-
    payment obligation below $125 for drugs filled at retail or $250 for
    mail order or specialty drugs.

        Employees who would benefit the most in this scenario would be
    those in high deductible health plans before they meet their
    deductible, however it could slow the time in which they would reach
    their deductible.

        While we have found that providing rebates at point of sale is most
    beneficial to enrollees whose benefit design does not include a maximum
    co-pay and therefore may not be beneficial to AbbVie employees, we are
    continuing to assess the impact in a manner that ensures we can
    maintain the current employee cost-sharing levels in our benefit design
    that drive adherence.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. A majority of the discussion about the cost of prescription
    drugs has been focused on list prices. We agree that price should be
    part of the discussion, however we also know that solutions targeting
    list price alone are not enough. Our experience in launching a low list
    price HCV medicine made it clear to AbbVie and patients that list price
    reductions will not always address patient affordability and access.

        Providing discounts to the patient at the point of sale is an
    effective way of ensuring that patients can see lower out-of-pocket
    costs. However, this is just the start. AbbVie believes that more must
    be done.

        The Medicare Part D benefit design contributes to making innovative
    therapies cost-prohibitive for Medicare patients because patients are
    charged out-of-pocket costs based on a medicine's list price, which
    does not reflect the rebates that Medicare receives.

        AbbVie believes it is important to alleviate the burdens that
    patients face due to Medicare Part D out-of-pocket costs. AbbVie
    supports solutions like a patient out-of-pocket cap in Part D and
    smoothing patient out-of-pocket payments over a full year, so patients
    have some predictability with respect to their out-of-pocket costs.

        In addition, AbbVie is prepared to step up and discuss how
    companies like ours can shoulder more of the burden of a patient's out-
    of-pocket expenses.

        As policymakers consider the impact of addressing out-of-pocket
    costs in Medicare Part D, questions may arise around whether it will
    lead to unnecessary utilization and wasteful spending. for specialty
    medicines, increased utilization should not be misunderstood as
    unnecessary or wasteful. Part D plans have tools, like step therapy
    requirements for patients to first try lower cost alternatives before a
    specialty medicine would be covered and prior authorization
    requirements before a specialty medicine would be covered, to manage
    the utilization of the majority of higher cost specialty medicines.
    These tools ensure patients try a less costly medication first and have
    met the clinical criteria for taking the specialty drug prescribed and
    serve the function that an out-of-pocket cost obligation on patients
    might serve to prevent unnecessary use.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)? How many of your company's products are
    based, at least in part, on NIH research, and how many are the result
    of research funded solely by your company?

        Answer. The NIH performs important basic research that helps
    scientific understanding. However, AbbVie spends its own money to do
    the vast majority of its drug development and clinical trial work,
    relying on the more than 8,000 people in research and development to
    understand complex diseases and advance medicine. for the eleven AbbVie
    drugs sold in the United States that have been approved since 2000, and
    the two AbbVie drugs currently under review by the FDA, only two
    received funding from the NIH for drug discovery. One of those drugs,
    Orilissa, was developed by Neurocrine. Neurocrine received NIH funding
    for drug development prior to AbbVie's collaboration with Neurocrine.

        For the second, Kaletra, AbbVie's predecessor Abbott Laboratories
    received an NIH discovery grant as part of an effort by the NIH to
    encourage collaborative research among pharmaceutical manufacturers and
    university research centers on protease inhibitors and to explore their
    potential to treat HIV, a then uncontrollable and fatal disease. This
    grant contributed to the development of one of the two active
    ingredients in the drug. This grant, however, represented less than 1
    percent of the total funding for Kaletra, with more than 99 percent of
    the funding coming from Abbott.

        In addition, for AbbVie's two oncology drugs--Venclexta and
    Imbruvica--AbbVie has worked cooperatively with the National Cancer
    Institute to conduct certain clinical trials. To date, these
    cooperative trials have not resulted in any FDA approved indications
    for these drugs.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer. In each of the last four years, AbbVie has spent more on
    research and development than it has on sales and marketing.

    ----------------------------------------------------------------------------------------------------------------
                              2014               2015               2016               2017               2018
    ----------------------------------------------------------------------------------------------------------------
    AbbVie Research      $3.297 billion     $4.285 billion     $4.385 billion     $5.007 billion     $5.259 billion
     and PDevelopment
    ----------------------------------------------------------------------------------------------------------------
    Asset Impairments  .................  .................  .................  .................    $5.070 billion
    ----------------------------------------------------------------------------------------------------------------
    Reported Research    $3.297 billion     $4.285 billion     $4.385 billion     $5.007 billion    $10.329 billion
     and Development
    ----------------------------------------------------------------------------------------------------------------
    Acquired in-           $352 million       $150 million       $200 million       $327 million       $424 million
     process
     Presearch and
     development
    ----------------------------------------------------------------------------------------------------------------
    Global Sales and     $3.652 billion     $3.800 billion     $3.674 billion     $3.830 billion    $4.239 billion
     PMarketing
    ----------------------------------------------------------------------------------------------------------------
    * Sales and marketing includes the cost of AbbVie personnel in the sales and marketing field, related overhead,
      the cost to develop marketing and advertising materials, and the cost of placing advertisements.

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        How will this proposal affect how your company sets the list prices
    for new drug products?

        If the proposal is finalized and not extended to the private
    market, will your company make any list price reductions? If so, how
    large would the reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. There has been significant discussion over the past several
    months about proposals to eliminate rebates from Medicare Part D,
    Medicaid, and the commercial market culminating in the administration's
    publication of a proposed rule to ``expressly exclud[e] from safe
    harbor protection under the Anti-Kickback Statute (AKS) rebates on
    prescription drugs paid by manufacturers to pharmacy benefit managers
    (PBMs), Part D plans, and Medicaid managed care organizations. The
    proposal would create a new safe harbor protecting discounts offered to
    patients at the pharmacy counter. Finally, the proposal would create
    new safe harbor protection for fixed fee services arrangements between
    manufacturers and PBMs.''

        AbbVie is encouraged by the goals of the proposed rule to ensure
    manufacturer discounts are reflected in and reduce patient cost sharing
    under Part D. While we believe the rule is an important step in the
    right direction, we also believe more should be done to help reduce the
    out-of-pocket cost burden on Medicare Part D patients.

        As for what the elimination of rebates might mean to the overall
    health care system or pharmaceutical companies, it is premature to
    comment on these items until the administration's rule is finalized,
    implementation timelines are solidified, and there are specific details
    regarding how a new system without rebates will be structured and
    function.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\3\
    ---------------------------------------------------------------------------
        \3\ MACPAC. ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wpcontent/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        This requirement created an unintended loophole. Rather than use
    the price of the authorized generic, drug companies can sell its
    authorized generic to a corporate subsidiary at an artificially lower
    price, and use that lower price to bring down the AMP, which in turn
    ---------------------------------------------------------------------------
    lowers the rebate obligation.

        Does your company engage in this practice? Has your company ever
    engaged in this practice in the past?

        Answer. AbbVie does not engage in this practice and has not engaged
    in this practice in the past. AbbVie only distributes, and has only
    distributed, authorized generic versions of certain of its branded
    products through authorized generic distribution and/or supply
    agreements with third-parties that are wholly unrelated to AbbVie,
    meaning a third-party entity that is not an affiliate or subsidiary of
    AbbVie or otherwise owned by, controlled by, or under common control
    with, in whole or in part, AbbVie. Those agreements are negotiated by
    AbbVie and the third-party at arms-length and in good faith.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? for those drugs is
    your list price equal to your net price?

        Answer. All of AbbVie's on-market medicines have some rebating/
    discounting in one or multiple channels and we anticipate all of our
    pipeline medicines will be similar.

        Question. Do you invest more in R&D than you generate in US sales
    revenue? Please include specific figures.

        Answer. AbbVie spent $5.26 billion in research and development in
    2018. AbbVie's research and development spend does not include acquired
    in-process research and development ($424 million in 2018) or money
    invested externally for technology, pharmaceutical compounds or
    acquisitions. For example, AbbVie acquired Pharmacyclics for $20.8
    billion in 2015 and Stemcentrx for $6.4 billion in 2016. In 2018, the
    net revenues for products AbbVie sells in the United States was $21.52
    billion. This includes revenues that are split with Janssen for
    Imbruvica. While AbbVie's U.S net revenues are higher than its research
    and development expense, AbbVie's global net income since it became an
    independent company in 2013 is less than the over $50 billion it has
    invested in that same time period to bring drugs to market.

        Question. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. AbbVie spends more on research and development than on
    global sales, marketing, and promotion costs. The global sales,
    marketing, and promotion spend in 2018 across all AbbVie products was
    $4.24 billion. This is less than the $5.26 billion AbbVie spent on
    research and development in 2018. And AbbVie's research and development
    spend does not include acquired inprocess research and development
    ($424 million in 2018) or money invested externally for technology,
    pharmaceutical compounds or acquisitions. for example, AbbVie acquired
    Pharmacyclics for $20.8 billion in 2015 and Stemcentrx for $6.4 billion
    in 2016. However, adding the $3.16 billion spent in administration,
    which includes overhead costs such as corporate human resources,
    corporate finance, corporate ethics and compliance, corporate legal,
    and corporate information technology, as well as other expenses such as
    charitable donations, AbbVie spent a total of $7.4 billion in selling,
    marketing, promotion, and administrative expenses (SG&A).

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. AbbVie spends more on research and development than on
    global sales, marketing, and promotion costs. The global sales,
    marketing, and promotion spend in 2018 across all AbbVie products was
    $4.24 billion. This is less than the $5.26 billion AbbVie spent on
    research and development in 2018. And AbbVie's research and development
    spend does not include acquired in-process research and development
    ($424 million in 2018) or money invested externally for technology,
    pharmaceutical compounds or acquisitions. for example, AbbVie acquired
    Pharmacyclics for $20.8 billion in 2015 and Stemcentrx for $6.4 billion
    in 2016.

        Sales and marketing includes the cost of AbbVie personnel in the
    sales and marketing field, related overhead, the cost to develop
    marketing and advertising materials, and the cost of placing
    advertisements.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. Our goal in advertising is to provide those living with the
    conditions that our drugs treat with the best information possible so
    they can have an informed discussion with their health-care provider.
    For many patients DTC ads are an important source of information about
    new medicines, and advertising also plays an important role in raising
    awareness of diseases, removing stigma from certain conditions, and
    encouraging discussions with their health-care providers.

                                     ______

                                   Exhibit 1

                          Grants Donations Report--2014
        (Parentheses represent refunds of previously disclosed payments)
                             Updated as of 3/31/2018
    ------------------------------------------------------------------------
             Recipient             Payment Amount            Purpose
    ------------------------------------------------------------------------
    100 Black Men of Atlanta,          $20,000.00   Corporate Sponsorship
     Inc.
    A and R Educational Group,          $5,500.00   Corporate Sponsorship
     LLC
    A Runners Love                      $5,000.00   Corporate Sponsorship
    Academia Medica Del                 $(240.57)   Educational Grants
    Academia Medica Del                 $(309.06)   Educational Grants
    Academia Medica Del                $20,000.00   Educational Grants
    Academia Medica Del                $15,000.00   Educational Grants
    Academia Medica Del                 $8,800.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                 $8,900.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $20,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del               $(1,539.53)   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $15,000.00   Educational Grants
    Academia Medica Del                $15,000.00   Educational Grants
    Academia Medica Del                $15,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                 $4,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $15,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $10,000.00   Educational Grants
    Academia Medica Del                $20,000.00   Educational Grants
    Academia Medica Del                $15,000.00   Educational Grants
    Academia Medica Del                 $5,000.00   Educational Grants
    Academy of Managed Care            $50,000.00   Corporate Sponsorship
     Pharmacy
    Advances in Cosmetic and           $50,000.00   Corporate Sponsorship
     Medical Dermatology, Inc.
    Advances in Cosmetic and           $50,000.00   Corporate Sponsorship
     Medical Dermatology, Inc.
    Advances in Cosmetic and          $100,000.00   Corporate Sponsorship
     Medical Dermatology, Inc.
    Advances in Targeted              $150,000.00   Corporate Sponsorship
     Therapies
    Advocate Health and                 $2,500.00   Educational Grants
     Hospitals Corporation
    AIDS Drug Assistance                $2,500.00   Corporate Sponsorship
     Programs Advocacy
     Association
    AIDS Drug Assistance               $10,000.00   Educational Grants
     Programs Advocacy
     Association
    AIDS Drug Assistance                $5,000.00   Corporate Sponsorship
     Programs Advocacy
     Association
    AIDS Foundation of Chicago        $125,000.00   Charitable Donations
    AIDS Foundation of Chicago          $7,500.00   Charitable Donations
    AIDS Project Los Angeles            $5,000.00   Educational Grants
    Alaska Kidney Patients              $1,500.00   Patient Support
     Association
    Albert Einstein College of         $20,000.00   Educational Grants
     Medicine of Yeshiva
     University
    Albert Einstein College of          $5,000.00   Educational Grants
     Medicine of Yeshiva
     University
    Albert Einstein College of         $10,000.00   Educational Grants
     Medicine, Division of
     Dermatology Attending
     Association
    Albert Einstein Healthcare          $2,500.00   Educational Grants
     Network
    Albert Einstein Healthcare          $6,500.00   Corporate Sponsorship
     Network
    Alchemy Communications             $50,000.00   Corporate Sponsorship
     Group, LLC
    Alliance Foundation for            $75,000.00   Educational Grants
     Continuing Education in
     the Health Professions
    Alzheimer's Association            $50,000.00   Corporate Sponsorship
    American Academy of               $(8,842.31)   Educational Grants
     Continuing Medical
     Education, Inc.
    American Academy of                $25,000.00   Educational Grants
     Continuing Medical
     Education, Inc.
    American Academy of                $75,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $50,000.00   Educational Grants
     Dermatology
    American Academy of               $100,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $35,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $10,000.00   Charitable Donations
     Neurology Foundation
    American Academy of                $45,000.00   Educational Grants
     Physician Assistants
    American Academy of                $10,000.00   Educational Grants
     Physician Assistants
    American Academy of Urology         $3,000.00   Educational Grants
     Institute--AANI
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $20,000.00   Charitable Donations
     Laboratory Animal Science
     Foundation
    American Association for          $500,000.00   Charitable Donations
     the Study of Liver
     Diseases
    American Association for            $7,000.00   Corporate Sponsorship
     the Study of Liver
     Diseases
    American Association for          $500,000.00   Charitable Donations
     the Study of Liver
     Diseases
    American Association for          $137,500.00   Corporate Sponsorship
     the Study of Liver
     Diseases
    American Association of            $25,000.00   Educational Grants
     Clinical Endocrinologists
    American Association of            $25,000.00   Educational Grants
     Clinical Endocrinologists
    American Association of            $50,000.00   Educational Grants
     Kidney Patients
    American Association of            $10,000.00   Patient Support
     Kidney Patients
    American Association of            $25,000.00   Corporate Sponsorship
     Pharmaceutical Scientists
    American Brain Tumor               $10,000.00   Corporate Sponsorship
     Association
    American Chemical Society           $1,000.00   Educational Grants
    American College of                 $7,500.00   Educational Grants
     Clinical Pharmacology
    American College of               $321,900.00   Corporate Sponsorship
     Endocrinology
    American College of               $100,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $20,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $85,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $25,000.00   Charitable Donations
     Laboratory Animal Medicine
    American College of                $55,000.00   Corporate Sponsorship
     Physicians Foundation
    American College of                $55,000.00   Corporate Sponsorship
     Physicians Foundation
    American College of                $55,000.00   Corporate Sponsorship
     Physicians Foundation
    American College of               $100,000.00   Corporate Sponsorship
     Rheumatology
    American College of               $200,000.00   Fellowships and
     Rheumatology                                    Scholarships
    American College of                $75,000.00   Educational Grants
     Rheumatology
    American College of                $50,000.00   Educational Grants
     Rheumatology
    American College of                $25,000.00   Educational Grants
     Rheumatology
    American College of                $25,000.00   Educational Grants
     Rheumatology
    American College of               $100,000.00   Corporate Sponsorship
     Rheumatology
    American College of             $2,000,000.00   Corporate Sponsorship
     Rheumatology Research and
     Education Foundation
    American College of                 $5,000.00   Corporate Sponsorship
     Veterinary Pathologists
    American                          $303,800.00   Educational Grants
     Gastroenterological
     Association Institute
    American                            $7,000.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American                          $225,000.00   Educational Grants
     Gastroenterological
     Association Institute
    American                          $100,000.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American Health Resources           $2,000.00   Educational Grants
    American Kidney Fund                $5,000.00   Corporate Sponsorship
    American Liver Foundation          $10,000.00   Charitable Donations
    American Liver Foundation          $10,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Corporate Sponsorship
    American Liver Foundation          $10,000.00   Corporate Sponsorship
    American Liver Foundation           $6,000.00   Corporate Sponsorship
    American Liver Foundation           $2,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Charitable Donations
    American Liver Foundation          $10,000.00   Corporate Sponsorship
    American Liver Foundation           $2,500.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Corporate Sponsorship
    American Liver Foundation         $127,000.00   Corporate Sponsorship
    American Liver Foundation         $106,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Educational Grants
    American Liver Foundation           $2,500.00   Corporate Sponsorship
    American Medical Group              $6,000.00   Corporate Sponsorship
     Association
    American Medical Group              $6,000.00   Corporate Sponsorship
     Association
    American Medical Group              $5,050.00   Corporate Sponsorship
     Association
    American Medical Group              $5,050.00   Corporate Sponsorship
     Association
    American Medical Group              $5,050.00   Corporate Sponsorship
     Association
    American Medical Group              $5,050.00   Corporate Sponsorship
     Association
    American Medical Group              $5,050.00   Corporate Sponsorship
     Association
    American Nephrology Nurses          $2,500.00   Fellowships and
     Association                                     Scholarships
    American Neurological              $25,000.00   Educational Grants
     Association
    American Pancreatic                $15,000.00   Charitable Donations
     Association
    American Pancreatic                $75,000.00   Educational Grants
     Association
    American Pancreatic                $35,000.00   Corporate Sponsorship
     Association
    American Parkinson Disease          $2,000.00   Educational Grants
     Association, Inc., Georgia
     Chapter
    American Physiological              $2,000.00   Educational Grants
     Society
    American Skin Association          $15,000.00   Corporate Sponsorship
    American Society for                $7,000.00   Corporate Sponsorship
     Gastrointestinal Endoscopy
    American Society for Mens          $27,000.00   Corporate Sponsorship
     Health, The
    American Society for Mens          $50,000.00   Corporate Sponsorship
     Health, The
    American Society for Mens          $60,000.00   Corporate Sponsorship
     Health, The
    American Society for               $23,500.00   Corporate Sponsorship
     Microbiology
    American Society for               $23,500.00   Corporate Sponsorship
     Microbiology
    American Society of                 $5,000.00   Corporate Sponsorship
     Andrology
    American Society of                $25,000.00   Educational Grants
     Clinical Oncology
    American Society of                 $4,500.00   Corporate Sponsorship
     Clinical Rheumatologists
    American Society of                $15,000.00   Educational Grants
     Hematology
    American Society of                $75,000.00   Corporate Sponsorship
     Hematology
    American Society of                $30,000.00   Educational Grants
     Nephrology
    American Statistical                $4,225.00   Corporate Sponsorship
     Association
    American Thyroid                   $25,000.00   Educational Grants
     Association, Inc.
    American Uroligical                $12,300.00   Corporate Sponsorship
     Association, Northeastern
     Section
    American Urological                $20,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $70,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $75,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $50,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $30,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $25,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $25,000.00   Educational Grants
     Association Education and
     Research, Inc.
    American Urological                $70,000.00   Corporate Sponsorship
     Association Foundation
    American Urological                 $6,000.00   Corporate Sponsorship ,
     Association Inc. Southeast
     Section
    American Urological                 $6,000.00   Corporate Sponsorship
     Association, Inc. North
     Central Section
    American Urological                $10,000.00   Corporate Sponsorship
     Association, Inc. Western
     Section
    American Urological                $10,000.00   Educational Grants
     Association, Mid-Atlantic
     Section, Education Fund,
     Inc.
    American Urological                $10,000.00   Educational Grants
     Association, New England
    American Urological                 $1,000.00   Corporate Sponsorship
     Association, New York
     Section
    American Urological                 $6,000.00   Corporate Sponsorship
     Association, South Central
     Section
    Americas Committee for             $10,000.00   Corporate Sponsorship
     Treatment And Research In
     Multiple Sclerosis
    Anesthesia Patient Safety          $25,000.00   Charitable Donations
     Foundation
    Angel Wings Foundation                $750.00   Corporate Sponsorship
    Ann & Robert H. Lurie              $10,000.00   Corporate Sponsorship
     Children's Hospital of
     Chicago
    Annenberg Center for Health        $50,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health       $125,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $35,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $65,000.00   Educational Grants
     Sciences at Eisenhower
    Arthritis Foundation               $20,000.00   Corporate Sponsorship
    Arthritis Foundation                $8,000.00   Corporate Sponsorship
    Arthritis Foundation               $28,500.00   Corporate Sponsorship
    Arthritis Foundation               $25,000.00   Corporate Sponsorship
    Arthritis Foundation                $5,000.00   Charitable Donations
    Arthritis Foundation                $5,000.00   Patient Support
    Arthritis Foundation                $5,000.00   Charitable Donations
    Arthritis Foundation                $5,000.00   Corporate Sponsorship
     Central, Pennsylvania
     Chapter
    Arthritis Foundation New           $10,000.00   Corporate Sponsorship
     England
    Arthritis Foundation,             $225,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,             $250,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,             $175,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,              $65,000.00   Patient Support
     Alabama Chapter
    Arthritis Foundation,              $17,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,               $2,500.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,             $259,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,             $175,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,              $35,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation,             $250,000.00   Corporate Sponsorship
     Alabama Chapter
    Arthritis Foundation, Great         $3,000.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $2,500.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $2,500.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great        $35,500.00   Corporate Sponsorship
     Lakes Region
    Arthritis Foundation, Great        $20,000.00   Charitable Donations
     Lakes Region
    Arthritis Foundation, Great         $5,000.00   Charitable Donations
     Lakes Region
    Arthritis Foundation, Great        $12,500.00   Charitable Donations
     Lakes Region
    Arthritis Foundation, Great         $3,000.00   Charitable Donations
     Lakes Region
    Arthritis Foundation, Great         $2,250.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $2,250.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $3,000.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $2,250.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $2,250.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great         $1,000.00   Patient Support
     Lakes Region
    Arthritis Foundation, Great        $35,000.00   Corporate Sponsorship
     West Region
    Arthritis Foundation, Great        $28,000.00   Corporate Sponsorship
     West Region
    Arthritis Foundation, Great        $10,000.00   Charitable Donations
     West Region
    Arthritis Foundation,              $21,000.00   Corporate Sponsorship
     Massachusetts Chapter
    Arthritis Foundation,               $1,853.94   Patient Support
     Massachusetts Chapter
    Arthritis Foundation,               $3,000.00   Corporate Sponsorship
     Massachusetts Chapter
    Arthritis Foundation,               $3,000.00   Corporate Sponsorship
     Massachusetts Chapter
    Arthritis Foundation, Mid          $15,000.00   Corporate Sponsorship
     Atlantic Region
    Arthritis Foundation, Mid           $1,500.00   Educational Grants
     Atlantic Region
    Arthritis Foundation, Mid           $1,000.00   Patient Support
     Atlantic Region
    Arthritis Foundation, South        $14,000.00   Corporate Sponsorship
     Texas Chapter
    Arthritis Foundation, South         $2,500.00   Charitable Donations
     Texas Chapter
    Arthritis Foundation,              $65,000.00   Corporate Sponsorship
     Southern California
     Chapter
    Arthritis Foundation,               $2,500.00   Charitable Donations
     Southern California
     Chapter
    Arthritis Foundation,               $2,500.00   Charitable Donations
     Southern California
     Chapter
    Arthritis Foundation,               $5,000.00   Corporate Sponsorship
     Southern California
     Chapter
    Arthritis Foundation,               $7,000.00   Corporate Sponsorship
     Wisconsin Chapter
    Arthritis Patient Services         $10,000.00   Educational Grants
    Arthritis Patient Services         $25,000.00   Educational Grants
    ASCO Cancer Foundation             $50,000.00   Charitable Donations
    ASCO Cancer Foundation             $40,000.00   Fellowships and
                                                     Scholarships
    ASCO Cancer Foundation             $28,000.00   Educational Grants
    Asociacion de Reumatologos         $15,000.00   Corporate Sponsorship
     de Puerto Rico
    Asociacion Nacional de              $4,000.00   Corporate Sponsorship
     Tecnicos de Farmacia, Inc.
    Asociacion Puertorriquena           $1,200.00   Corporate Sponsorship
     de Ayuda al Paciente de
     Psoriasis
    Association of Dermatology          $7,500.00   Corporate Sponsorship
     Administrators And
     Managers
    Association of Nurses in           $15,000.00   Educational Grants
     AIDS Care, Chicago Chapter
    Association of Physicians           $2,500.00   Corporate Sponsorship
     of Pakistani-Descent of
     North America
    Balm In Gilead Inc.                $75,000.00   Corporate Sponsorship
    Baylor College of Medicine          $5,000.00   Educational Grants
    Baylor University Medical          $67,716.00   Educational Grants
     Center
    Baylor University Medical          $29,340.00   Educational Grants
     Center
    Beth Israel Deaconess              $50,000.00   Fellowships and
     Department of Medicine                          Scholarships
     Foundation
    Beth Israel Deaconess             $(1,948.24)   Educational Grants
     Medical Center
    Beth Israel Deaconess              $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    Billings Clinic                     $5,000.00   Corporate Sponsorship
    Bioconnections, LLC                $15,000.00   Corporate Sponsorship
    Biophysical Society                 $2,500.00   Educational Grants
    Blank Children's Hospital           $2,500.00   Corporate Sponsorship
    Board of Regents of the             $5,000.00   Educational Grants
     University of Wisconsin
     System
    Board of Trustees of the            $1,500.00   Educational Grants
     University of Illinois
    Board of Trustees of The           $40,000.00   Fellowships and
     University of Illinois,                         Scholarships
     The
    Board of Trustees of The           $30,000.00   Fellowships and
     University of Illinois,                         Scholarships
     The
    Boomer Esiason Foundation           $1,200.00   Corporate Sponsorship
    Boomer Esiason Foundation         $100,000.00   Educational Grants
    Boomer Esiason Foundation          $75,000.00   Charitable Donations
    Boomer Esiason Foundation         $400,000.00   Corporate Sponsorship
    Boomer Esiason Foundation          $25,000.00   Corporate Sponsorship
    Boomer Esiason Foundation         $400,000.00   Corporate Sponsorship
    Boston Society, Inc.                $4,000.00   Corporate Sponsorship
    Boston Society, Inc.                $4,000.00   Corporate Sponsorship
    Boston University School of       $124,943.00   Educational Grants
     Medicine
    Brigham and Women's              $(50,000.00)   Fellowships and
     Hospital, Inc.                                  Scholarships
    Brigham and Women's                $50,000.00   Fellowships and
     Hospital, Inc.                                  Scholarships
    California Rheumatology            $30,000.00   Corporate Sponsorship
     Alliance
    California Separation              $60,000.00   Corporate Sponsorship
     Science Society
    California Society of               $3,000.00   Corporate Sponsorship
     Health System Pharmacists
    California Society of               $5,000.00   Corporate Sponsorship
     Health System Pharmacists
    California Society of               $3,000.00   Corporate Sponsorship
     Health System Pharmacists
    Campaign for Public Health         $10,000.00   Charitable Donations
     Foundation
    Cancer and Leukemia Group B        $20,000.00   Educational Grants
     Foundation
    Cancer Molecular                    $5,000.00   Educational Grants
     Therapeutics
    Case Western Reserve               $25,000.00   Educational Grants
     University
    Cedars-Sinai Medical Center        $40,000.00   Educational Grants
    Cedars-Sinai Medical Center        $10,000.00   Educational Grants
    Cedars-Sinai Medical Center        $40,000.00   Fellowships and
                                                     Scholarships
    Central Florida Pharmacy           $25,000.00   Educational Grants
     Council, Inc.
    Central Ohio Parkinson             $20,000.00   Educational Grants
     Society DBA National
     Parkinson Foundation
     Central and Southeast Ohio
    Chelsea Hutchinson                  $2,500.00   Corporate Sponsorship
     Foundation The
    Children and Arthritis,             $5,000.00   Charitable Donations
     Inc.
    Children's Digestive Health        $40,000.00   Fellowships and
     and Nutrition Foundation                        Scholarships
    Children's Digestive Health        $25,000.00   Educational Grants
     and Nutrition Foundation
    Children's Digestive Health        $40,000.00   Fellowships and
     and Nutrition Foundation                        Scholarships
    Children's Digestive Health        $10,000.00   Corporate Sponsorship
     and Nutrition Foundation
    Children's Hospital Medical        $20,000.00   Corporate Sponsorship
     Center
    Children's Hospital Medical        $40,000.00   Fellowships and
     Center                                          Scholarships
    Children's Hospital Medical        $20,000.00   Corporate Sponsorship
     Center
    Children's Oncology                 $5,500.00   Corporate Sponsorship
     Services Inc.
    Chimp Haven                        $50,000.00   Charitable Donations
    Chris Dudley Foundation             $5,000.00   Corporate Sponsorship
    Chronic Liver Disease             $211,000.00   Educational Grants
     Foundation
    Chronic Liver Disease             $211,670.00   Educational Grants
     Foundation
    Chronic Liver Disease           $1,300,000.00   Educational Grants
     Foundation
    Chronic Liver Disease               $7,500.00   Corporate Sponsorship
     Foundation
    Cleveland Clinic                  $(1,340.00)   Educational Grants
    Cleveland Clinic                   $10,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                   $25,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                   $75,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                    $4,500.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                  $(2,033.31)   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                   $75,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                   $15,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                  $385,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                  $132,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                   $15,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                  $(2,638.82)   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                   $75,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation,
     The
    Cleveland Clinic Foundation        $50,000.00   Fellowships and
                                                     Scholarships
    Cleveland Clinic Foundation        $50,000.00   Fellowships and
                                                     Scholarships
    Clinical Care Options, LLC         $75,000.00   Educational Grants
    Clinical Care Options, LLC        $150,000.00   Educational Grants
    Clinical Care Options, LLC         $50,000.00   Educational Grants
    Clinical Care Options, LLC         $25,000.00   Educational Grants
    Clinical Care Options, LLC        $100,000.00   Educational Grants
    Clinical Care Options, LLC        $209,000.00   Educational Grants
    CME Incite, LLC                 $(175,000.00)   Educational Grants
    Coalition for Prevention of         $5,000.00   Corporate Sponsorship
     Colorectal Cancer in
     Puerto Rico
    Coalition on Positive             $125,000.00   Patient Support
     Health Empowerment
    Colegio Medicos-Cirujanos          $20,000.00   Educational Grants
     P.R
    Com & Co Sarl                       $3,550.00   Corporate Sponsorship
    Community Health                   $10,000.00   Corporate Sponsorship
    Community Initiatives              $10,000.00   Corporate Sponsorship
    Community Liver Alliance            $3,000.00   Corporate Sponsorship
    Community Liver Alliance            $1,000.00   Corporate Sponsorship
    Community Liver Alliance            $5,000.00   Corporate Sponsorship
    Community Liver Alliance          $150,000.00   Educational Grants
    Complete Conference                $50,000.00   Educational Grants
     Management
    Complete Conference                $75,000.00   Educational Grants
     Management
    Complete Conference              $(75,000.00)   Educational Grants
     Management
    Complete Conference              $(75,000.00)   Educational Grants
     Management
    Consortium of Multiple             $25,000.00   Educational Grants
     Sclerosis Centers
    Continuing Educational              $(703.13)   Educational Grants
     Alliance, LLC
    Continuing Educational            $362,500.00   Educational Grants
     Alliance, LLC
    Continuing Educational              $(210.66)   Educational Grants
     Alliance, LLC
    Continuing Educational              $(258.18)   Educational Grants
     Alliance, LLC
    Continuing Educational            $(1,696.48)   Educational Grants
     Alliance, LLC
    Continuing Medical                 $85,000.00   Educational Grants
     Education Outfitters, LLC
    Continuous Renal                   $10,000.00   Educational Grants
     Replacement Therapies,
     Inc. (CRRT)
    Cornell University, Weill           $5,000.00   Educational Grants
     Medical College
    Cornerstone Health, Inc.          $(3,664.00)   Educational Grants
    Cornerstone Health, Inc.          $200,000.00   Educational Grants
    Cornerstone Health, Inc.          $175,000.00   Educational Grants
    Cornerstone Health, Inc.           $40,000.00   Educational Grants
    Cornerstone Health, Inc.          $100,000.00    Educational Grants
    Creighton University                $2,220.00   Charitable Donations
    Crohn's and Colitis                 $2,500.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                $22,500.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis               $350,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis               $100,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                $20,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                 $9,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                 $6,000.00   Patient Support
     Foundation of America
    Crohn's and Colitis                $80,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                 $9,000.00   Patient Support
     Foundation of America
    Crohn's and Colitis                 $6,200.00   Patient Support
     Foundation of America
    Crohn's and Colitis                 $4,000.00   Patient Support
     Foundation of America
    Crohn's and Colitis               $(3,095.00)   Educational Grants
     Foundation of America
    Crohn's and Colitis                $65,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                 $3,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                $10,000.00   Patient Support
     Foundation of America
    Crohn's and Colitis                 $1,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                $25,000.00   Charitable Donations
     Foundation of America
    Crohn's and Colitis                 $2,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis               $100,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                 $8,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                 $2,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                 $5,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                 $2,500.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                 $3,500.00   Patient Support
     Foundation of America
    Crohn's and Colitis               $100,000.00   Fellowships and
     Foundation of America                           Scholarships
    Crohn's and Colitis                 $3,000.00   Patient Support
     Foundation of America
    Crohn's and Colitis                 $5,000.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                 $1,500.00   Corporate Sponsorship
     Foundation of America
    Crohn's and Colitis                $10,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                $65,000.00   Educational Grants
     Foundation of America
    Crohn's and Colitis                $25,000.00   Charitable Donations
     Foundation of America
    Crohn's and Colitis               $100,000.00   Educational Grants
     Foundation of America
    Curatio CME Institute           $(100,000.00)   Educational Grants
    Cystic Fibrosis--Reaching          $25,000.00   Charitable Donations
     Out Foundation
    Cystic Fibrosis Foundation--        $5,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $3,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--      $100,000.00   Charitable Donations
     Albany
    Cystic Fibrosis Foundation--        $2,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $5,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--       $10,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $4,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--       $10,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $2,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $3,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $2,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $2,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $2,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--       $25,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--        $1,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Foundation--       $15,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Research,             $500.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research,          $10,000.00   Educational Grants
     Inc.
    Cystic Fibrosis Research,           $9,000.00   Patient Support
     Inc.
    Cystic Fibrosis Research,           $5,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research,           $5,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research,          $15,000.00   Charitable Donations
     Inc.
    Cystic Fibrosis Research,          $10,000.00   Corporate Sponsorship
     Inc.
    Dade County Medical                $10,000.00   Educational Grants
     Association
    Dallas fort Worth Business          $5,000.00   Corporate Sponsorship
     Group on Health
    Davis Phinney Foundation           $30,000.00   Educational Grants
    Davis Phinney Foundation           $75,000.00   Educational Grants
    Davis Phinney Foundation           $15,000.00   Educational Grants
    Davis Phinney Foundation           $30,000.00   Educational Grants
    Decatur General Hospital            $2,500.00   Corporate Sponsorship
     Foundation
    Dermatology Education              $15,000.00   Corporate Sponsorship
     Foundation
    Dermatology Foundation             $50,000.00   Corporate Sponsorship
    Diversity And Leadership            $5,000.00   Corporate Sponsorship
     Inc.
    Duke University                     $6,550.00   Educational Grants
    Duke University                   $250,000.00   Educational Grants
    Duke University                   $150,000.00   Educational Grants
    Duke University                    $50,000.00   Fellowships and
                                                     Scholarships
    Duke University                   $(3,061.96)   Educational Grants
    Educational Review Systems         $10,000.00   Educational Grants
    Elizabeth Glaser Pediatric         $10,000.00   Charitable Donations
     AIDS Foundation
    Elsevier, Inc.                     $70,000.00   Educational Grants
    Employers Health Colition           $4,000.00   Corporate Sponsorship
     Inc.
    Endocrine Education, Inc           $25,000.00   Educational Grants
    Endocrine Nurses Society            $4,000.00   Corporate Sponsorship
    Endocrine Society, The             $25,000.00   Educational Grants
    Endocrine Society, The            $150,000.00   Educational Grants
    Endometriosis Association          $10,000.00   Charitable Donations
    Engineering Conferences             $1,000.00   Educational Grants
     International
    Enzyme Mechanisms                   $1,500.00   Educational Grants
     Conference
    Epilepsy Foundation                $80,000.00   Charitable Donations
    ERA-Eurocongress, Ltd.             $25,000.00   Corporate Sponsorship
    ERA-Eurocongress, Ltd.             $15,000.00   Corporate Sponsorship
    Escuela De Medicina De             $10,000.00   Educational Grants
     Ponce
    Escuela De Medicina De             $10,000.00   Educational Grants
     Ponce
    European Society for              $250,000.00   Corporate Sponsorship
     Dermatological Research
    European Society for               $10,000.00   Corporate Sponsorship
     Medical Oncology
    Excel Continuing Education          $8,225.00   Educational Grants
    Excellence in Rheumatology        $100,000.00   Corporate Sponsorship
     Education, LLC
    Facing Our Risk of Cancer          $25,000.00   Charitable Donations
     Empowerement
    Facing Our Risk of Cancer           $5,000.00   Corporate Sponsorship
     Empowerement (FORCE)
    Federation of American              $1,500.00   Educational Grants
     Societies for Experimental
     Biology
    Federation of American              $1,500.00   Educational Grants
     Societies for Experimental
     Biology
    Federation of American              $5,000.00   Corporate Sponsorship
     Societies for Experimental
     Biology
    Federation of Clinical             $20,000.00   Educational Grants
     Immunology Societies
    Federation of Clinical             $15,000.00   Educational Grants
     Immunology Societies
    Federation of Clinical             $20,000.00   Educational Grants
     Immunology Societies
    Florida Academy of                  $8,300.00   Educational Grants
     Physician Assistants
    Florida Health Care                 $1,500.00   Corporate Sponsorship
     Coalition
    Foundation for Anesthesia          $20,000.00   Fellowships and
     Education and Research                          Scholarships
    Foundation for Biomedical         $120,000.00   Charitable Donations
     Research
    Foundation for Indiana              $2,220.00   Charitable Donations
     University of Pennsylvania
    Foundation for Indiana              $2,220.00   Charitable Donations
     University of Pennsylvania
    Foundation for Men's               $50,000.00   Corporate Sponsorship
     Health, Inc
    Foundation for the National       $400,000.00   Corporate Sponsorship
     Institutes of Health
    Friends of Prentice                $10,000.00   Corporate Sponsorship
    Friends of the St. Louis           $50,000.00   Corporate Sponsorship
     University Liver Center
    Fundacion Puertorriquena De         $7,500.00   Educational Grants
     Pacientes Con
     Endometriosis
    Gastrointestinal Health           $150,000.00   Educational Grants
     Foundation, Inc.
    Gastrointestinal Health            $50,000.00   Educational Grants
     Foundation, Inc.
    Gastrointestinal Health            $75,000.00   Corporate Sponsorship
     Foundation, Inc.
    Gastro-Intestinal Research         $15,000.00   Charitable Donations
     Foundation
    Gastro-Intestinal Research          $1,000.00   Corporate Sponsorship
     Foundation
    Gastro-Intestinal Research          $6,600.00   Corporate Sponsorship
     Foundation
    Gastro-Intestinal Research          $1,500.00   Corporate Sponsorship
     Foundation
    Gateway for Cancer Research         $6,000.00   Charitable Donations
    Gay City Health Project            $10,000.00   Charitable Donations
    Georgia ObGyn Society               $2,500.00   Corporate Sponsorship
    Georgia Prostate Cancer             $4,000.00   Patient Support
     Coalition, The
    Georgia Society of                  $3,000.00   Corporate Sponsorship
     Dermatology and
     Dermatologic Surgery
    Gilda's Club Chicago               $10,000.00   Charitable Donations
    Gilda's Club New York City         $50,000.00   Charitable Donations
    Globalization of                   $10,000.00   Corporate Sponsorship
     Pharmaceutics Education
     Network
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Grupo de Apoyo de Ninos y           $3,000.00   Corporate Sponsorship
     Adolescentes con
     Reumatologia
    Gynecologic Oncology Group,        $25,000.00   Educational Grants
     The
    $7                                 $23,000.00   Educational Grants
    Haymarket Center-Health             $5,000.00   Educational Grants
     Education
    Haymarket Medical Education       $243,190.00   Educational Grants
    Health Sciences Foundation          $2,500.00   Educational Grants
     dba South East AHEC
    Healthcare Businesswomen's          $5,000.00   Corporate Sponsorship
     Association, Inc.
    Healthcare Financial               $50,000.00   Corporate Sponsorship
     Management Association
    Hep C Connection                   $50,000.00   Educational Grants
    Hep C Connection                   $40,000.00   Patient Support
    Hep C Connection                    $5,000.00   Corporate Sponsorship
    Hepatitis C Association            $45,000.00   Educational Grants
    Hepatitis C Mentor and             $10,000.00   Patient Support
     Support Group, The
    Hepatitis Education Project       $100,000.00   Charitable Donations
    HIV Treaters Medical               $10,000.00   Educational Grants
     Association of Puerto Rico
    Hope Foundation, The               $10,000.00   Educational Grants
    Housing Works, Inc.                $10,000.00   Charitable Donations
    Howard Brown Health Center         $25,000.00   Corporate Sponsorship
    Howard Center Inc.                 $10,000.00   Charitable Donations
    Howard University Hospital         $10,000.00   Educational Grants
    Hubbard Street Dance               $10,000.00   Educational Grants
     Chicago
    Human Growth Foundation             $2,000.00   Corporate Sponsorship
    IDSA Education and Research        $10,000.00   Fellowships and
     Foundation                                      Scholarships
    Imedex, LLC                        $20,000.00   Educational Grants
    Imedex, LLC                        $75,000.00   Educational Grants
    Imedex, LLC                        $15,000.00   Educational Grants
    Imedex, LLC                        $25,000.00   Educational Grants
    Imedex, LLC                        $60,000.00   Educational Grants
    Impact Education, LLC             $125,000.00   Educational Grants
    Indiana Chamber of Commerce         $2,500.00   Corporate Sponsorship
    Indiana Chamber of Commerce         $1,500.00   Corporate Sponsorship
    Indiana University                  $2,500.00   Fellowships and
                                                     Scholarships
    Induniv Research                    $2,000.00   Corporate Sponsorship
    Infectious Diseases Society        $35,000.00   Educational Grants
     of America
    Inflammatory Bowel Disease        $300,000.00   Educational Grants
     Support Foundation
    Inflammatory Bowel Disease         $50,000.00   Educational Grants
     Support Foundation
    Inflammatory Bowel Disease        $200,000.00   Educational Grants
     Support Foundation
    Inflammatory Bowel Disease        $200,000.00   Educational Grants
     Support Foundation
    Innovation Development            $250,000.00   Corporate Sponsorship
     Institute, Inc.
    Institute for Medical and          $10,000.00   Educational Grants
     Nursing Education, Inc.
    Integrated Benefits                $35,000.00   Corporate Sponsorship
     Institute, Inc.
    Integrated Medical                 $50,000.00   Charitable Donations
     Foundation
    Integrated Medical                  $5,000.00   Corporate Sponsorship
     Foundation
    Integrated Medical                 $35,000.00   Charitable Donations
     Foundation
    Interfaith House                    $2,000.00   Charitable Donations
    Intermountain Dermatology          $20,000.00   Educational Grants
     Society
    International AIDS Society--      $100,000.00   Educational Grants
     USA
    International AIDS Society--      $100,000.00   Educational Grants
     USA
    International AIDS Society--       $75,000.00   Educational Grants
     USA
    International Alliance for          $3,000.00   Educational Grants
     Biologicals
    International Association          $10,000.00   Educational Grants
     of Physicians in AIDS Care
    International Association          $25,000.00   Educational Grants
     of Physicians in AIDS Care
    International Chemical              $2,000.00   Educational Grants
     Biology Society
    International Pelvic Pain           $7,500.00   Educational Grants
     Society
    International Psoriasis           $100,000.00   Corporate Sponsorship
     Council, The
    International Psoriasis            $50,000.00   Corporate Sponsorship
     Council, The
    International Society for           $5,000.00   Educational Grants
     Antiviral Research
    International Society for          $10,000.00   Corporate Sponsorship
     Medical Publication
     Professionals
    International Society for           $3,000.00   Educational Grants
     the Study of Xenobiotics
    International Society of           $50,000.00   Charitable Donations
     Nephrology
    International Society of           $40,000.00   Charitable Donations
     Nephrology
    International Society of          $175,000.00   Corporate Sponsorship
     Nephrology
    Jefferson Medical College           $3,000.00   Corporate Sponsorship
     at Thomas Jefferson
     University
    Jefferson Medical College          $30,000.00   Educational Grants
     at Thomas Jefferson
     University
    Jefferson Medical College           $5,000.00   Educational Grants
     at Thomas Jefferson
     University
    John Hopkins University           $(1,706.15)   Educational Grants
     School of Medicine
    Johns Hopkins University          $225,000.00   Educational Grants
     School of Medicine
    Johns Hopkins University           $25,000.00   Educational Grants
     School of Medicine
    Johns Hopkins University         $(60,000.00)   Educational Grants
     School of Medicine
    Johns Hopkins University           $30,000.00   Educational Grants
     School of Medicine
    Johns Hopkins University           $50,000.00   Fellowships and
     School of Medicine                              Scholarships
    Johns Hopkins University           $95,000.00   Educational Grants
     School of Medicine
    Johns Hopkins University            $5,000.00   Educational Grants
     School of Medicine
    Joint Township District             $4,064.00   Patient Support
     Memorial Hospital
    Joint Township District           $(1,508.00)   Patient Support
     Memorial Hospital
    JWC Covenant, Inc.                 $35,000.00   Educational Grants
    Kansas University                  $25,000.00   Educational Grants
     Neurological Foundation
    Kansas University                  $35,000.00   Educational Grants
     Neurological Foundation
    Kelsey Research Foundation         $40,000.00   Fellowships and
                                                     Scholarships
    Kenes International Ltd.           $35,000.00   Corporate Sponsorship
    Kidney Disease Improving           $40,128.00   Corporate Sponsorship
     Global Outcomes
    KnowledgePoint360 Group,           $94,785.30   Corporate Sponsorship
     LLC
    Laboratorio Clinico Toledo          $2,460.00   Patient Support
    Laboratorio Clinico Toledo            $795.00   Patient Support
    Laboratorio Clinico Toledo            $345.00   Patient Support
    Laboratorio Clinico Toledo          $2,760.00   Patient Support
    Laboratorio Clinico Toledo          $2,145.00   Patient Support
    Laboratorio Clinico Toledo            $615.00   Patient Support
    Laboratorio Clinico Toledo          $2,160.00   Patient Support
    Laboratorio Clinico Toledo          $2,115.00   Patient Support
    Laboratorio Clinico Toledo          $1,380.00   Patient Support
    Laboratorio Clinico Toledo          $4,260.00   Patient Support
    Laboratorio Clinico Toledo          $2,070.00   Patient Support
    Laboratorio Clinico Toledo          $1,650.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,395.00   Patient Support
    Laboratorio Clinico Toledo          $1,380.00   Patient Support
    Laboratorio Clinico Toledo          $1,290.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $996.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo            $804.00   Patient Support
    Laboratorio Clinico Toledo          $4,455.00   Patient Support
    Laboratorio Clinico Toledo            $945.00   Patient Support
    Laboratorio Clinico Toledo            $690.00   Patient Support
    Laboratorio Clinico Toledo          $1,530.00   Patient Support
    Laboratorio Clinico Toledo          $1,335.00   Patient Support
    Laboratorio Clinico Toledo          $1,065.00   Patient Support
    Laboratorio Clinico Toledo            $975.00   Patient Support
    Laboratorio Clinico Toledo          $2,250.00   Patient Support
    Laboratorio Clinico Toledo          $2,250.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo            $720.00   Patient Support
    Laboratorio Clinico Toledo            $510.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,365.00   Patient Support
    Laboratorio Clinico Toledo          $1,185.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo          $1,110.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo            $855.00   Patient Support
    Laboratorio Clinico Toledo            $765.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo          $1,230.00   Patient Support
    Laboratorio Clinico Toledo          $1,185.00   Patient Support
    Laboratorio Clinico Toledo          $1,110.00   Patient Support
    Laboratorio Clinico Toledo            $960.00   Patient Support
    Laboratorio Clinico Toledo            $300.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,230.00   Patient Support
    Laboratorio Clinico Toledo            $720.00   Patient Support
    Laboratorio Clinico Toledo            $570.00   Patient Support
    Laboratorio Clinico Toledo          $1,035.00   Patient Support
    Laboratorio Clinico Toledo            $990.00   Patient Support
    Laboratorio Clinico Toledo            $810.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo            $255.00   Patient Support
    Laboratorio Clinico Toledo          $1,470.00   Patient Support
    Laboratorio Clinico Toledo          $1,275.00   Patient Support
    Laboratorio Clinico Toledo          $1,230.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo            $585.00   Patient Support
    Laboratorio Clinico Toledo          $1,890.00   Patient Support
    Laboratorio Clinico Toledo          $1,380.00   Patient Support
    Laboratorio Clinico Toledo          $1,185.00   Patient Support
    Laboratorio Clinico Toledo            $975.00   Patient Support
    Laboratorio Clinico Toledo          $2,190.00   Patient Support
    Lake County Haven                   $5,000.00   Corporate Sponsorship
    Large Urology Group                 66,400.00   Corporate Sponsorship
     Practice Association
    Latinos Salud, Inc.                 $7,500.00   Charitable Donations
    Legacy Counseling Center            $7,500.00   Charitable Donations
    Leukemia and Lymphoma               $2,500.00   Educational Grants
     Society, The
    Leukemia Research                   $2,500.00   Charitable Donations
     Foundation
    Life Sciences Foundation           $30,000.00   Charitable Donations
    Life Sciences Foundation           $30,000.00   Charitable Donations
    Life Sciences Foundation           $30,000.00   Charitable Donations
    Linking Leaders, LLC               $20,000.00   Corporate Sponsorship
    Liver Institute and                $50,000.00   Educational Grants
     Foundation for Education
     and Research
    Living Beyond Breast Cancer        $10,000.00   Corporate Sponsorship
    Living Beyond Breast Cancer         $5,000.00   Corporate Sponsorship
    Living Beyond Breast Cancer         $5,000.00   Corporate Sponsorship
    Loma Linda University               $1,200.00   Fellowships and
     School of Medicine                              Scholarships
    Malecare                           $12,000.00   Patient Support
    Marsha Rivkin Center for            $2,500.00   Educational Grants
     Ovarian Cancer Research
    Massachusetts General              $25,000.00   Fellowships and
     Hospital                                        Scholarships
    Massachusetts Institute of          $2,220.00   Charitable Donations
     Technology
    Massachusetts Institute of          $2,220.00   Charitable Donations
     Technology
    Massachusetts Institute of          $5,000.00   Educational Grants
     Technology
    Massachusetts Prostate              $5,000.00   Educational Grants
     Cancer Coalition, Inc.
    May We Help                         $3,000.00   Corporate Sponsorship
    May We Help                         $2,500.00   Corporate Sponsorship
    May We Help                         $2,500.00   Corporate Sponsorship
    Mayo Clinic                        $10,000.00   Educational Grants
    Medical College of                 $10,000.00   Educational Grants
     Wisconsin
    Medical College of                 $15,000.00   Educational Grants
     Wisconsin
    Medical Learning Institute         $90,000.00   Educational Grants
    Medical Learning Institute       $(90,000.00)   Educational Grants
    Medical Learning Institute         $75,000.00   Educational Grants
    Medicinal and Bioorganic            $5,000.00   Educational Grants
     Chemistry Foundation, The
    Medscape, LLC                     $250,000.00   Educational Grants
    Medscape, LLC                     $250,000.00   Educational Grants
    Medscape, LLC                     $100,000.00   Educational Grants
    Medscape, LLC                      $75,000.00   Educational Grants
    Medscape, LLC                     $740,500.00   Educational Grants
    Medscape, LLC                     $471,000.00   Educational Grants
    Medscape, LLC                      $37,000.00   Educational Grants
    Medscape, LLC                     $155,000.00   Educational Grants
    Medscape, LLC                     $150,000.00   Educational Grants
    Memorial Hermann Foundation        $40,000.00   Fellowships and
                                                     Scholarships
    Memphis Business Group on           $4,820.00   Corporate Sponsorship
     Health
    Mercer County Joint                 $2,646.00   Patient Support
     Township Community
     Hospital dba Mercer Health
    Methodist Hospital, The            $25,000.00   Corporate Sponsorship
    Michael J. Fox Foundation          $32,000.00   Educational Grants
    Michael J. Fox Foundation          $25,000.00   Corporate Sponsorship
    Michael J. Fox Foundation          $25,000.00   Corporate Sponsorship
    Michigan Council of Nurse           $1,200.00   Educational Grants
     Practitioners
    Michigan Institute of               $5,000.00   Corporate Sponsorship
     Urology
    Mid Atlantic Business Group         $3,000.00   Corporate Sponsorship
     Health
    Mid-America Coalition on            $1,000.00   Corporate Sponsorship
     Health Care
    Miles for Cystic Fibrosis           $5,000.00   Corporate Sponsorship
    Mississippi Kidney                  $2,000.00   Educational Grants
     Foundation
    Missouri Hepatitis C               $20,000.00   Charitable Donations
     Alliance
    Missouri Hepatitis C               $10,000.00   Patient Support
     Alliance
    Montana Association of              $2,000.00   Corporate Sponsorship
     Health Care Purchaser
    Mount Sinai School of              $40,000.00   Fellowships and
     Medicine                                        Scholarships
    Mount Sinai School of             $240,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $10,000.00   Charitable Donations
     Medicine
    Mount Sinai School of              $20,000.00   Educational Grants
     Medicine
    Mount Sinai School of               $8,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $10,000.00   Educational Grants
     Medicine
    Movement Disorder Society,         $12,000.00   Educational Grants
     The
    Movement Disorder Society,        $234,000.00   Corporate Sponsorship
     The
    National Academy of                $40,000.00   Educational Grants
     Sciences
    National Academy of                $10,000.00   Charitable Donations
     Sciences
    National Academy of                $85,000.00   Corporate Sponsorship
     Sciences
    National AIDS Treatment           $300,000.00   Charitable Donations
     Advocacy Project
    National Alliance of State        $100,000.00   Charitable Donations
     and Territorial AIDS
     Directors
    National Association for          $100,000.00   Educational Grants
     Continuing Education
    National Association of            $11,500.00   Corporate Sponsorship
     Chain Drug Stores, Inc.
    National Association of            $25,000.00   Educational Grants
     Managed Care Physicians
    National Association of            $35,000.00   Educational Grants
     Managed Care Physicians
    National Association of            $10,000.00   Charitable Donations
     School Nurses, Inc.
    National Commission on              $5,000.00   Educational Grants
     Correctional Health Care
    National Committee for             $10,000.00   Corporate Sponsorship
     Quality Assurance
    National Committee for            $150,000.00   Educational Grants
     Quality Assurance
    National Committee for             $10,000.00   Corporate Sponsorship
     Quality Assurance
    National Committee for            $125,000.00   Corporate Sponsorship
     Quality Assurance
    National Comprehensive             $10,000.00   Educational Grants
     Cancer Network
    National Comprehensive            $(1,492.41)   Educational Grants
     Cancer Network
    National Comprehensive             $10,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $25,000.00   Charitable Donations
     Cancer Network
    National Comprehensive             $10,000.00   Corporate Sponsorship
     Cancer Network
    National Foundation for the       $500,000.00   Corporate Sponsorship
     Centers for Disease
     Control and Prevention
    National Foundation for the        $37,500.00   Corporate Sponsorship
     Centers for Disease
     Control and Prevention
    National Hispanic Council          $10,000.00   Charitable Donations
     on Aging
    National Jewish Health            $151,840.00   Educational Grants
    National Jewish Health             $75,000.00   Educational Grants
    National Kidney Foundation            $500.00   Corporate Sponsorship
     of Louisiana, Inc.
    National Kidney Foundation          $3,000.00   Patient Support
     of Northeast New York
    National Kidney Foundation,         $5,000.00   Corporate Sponsorship
     Inc.
    National Kidney Foundation,        $20,000.00   Educational Grants
     Inc.
    National Kidney Foundation,       $333,333.33   Corporate Sponsorship
     Inc.
    National Medical                    $5,000.00   Corporate Sponsorship
     Association
    National Multiple Sclerosis        $10,000.00   Corporate Sponsorship
     Society
    National Pancreas                   $6,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                 $200,000.00   Educational Grants
     Foundation
    National Pancreas                  $50,000.00   Charitable Donations
     Foundation
    National Pancreas                  $65,000.00   Educational Grants
     Foundation
    National Parkinson                 $25,000.00   Corporate Sponsorship
     Foundation, Inc.
    National Parkinson                 $40,000.00   Educational Grants
     Foundation, Inc.
    National Parkinson                 $25,000.00   Educational Grants
     Foundation, Inc.
    National Psoriasis                $125,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                 $20,000.00   Educational Grants
     Foundation
    National Psoriasis                $500,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                 $20,000.00   Educational Grants
     Foundation
    National Psoriasis                  $2,500.00   Corporate Sponsorship
     Foundation
    National Psoriasis                 $50,000.00   Patient Support
     Foundation
    National Psoriasis                 $15,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                  $1,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                $125,000.00   Corporate Sponsorship
     Foundation
    National Society for               $50,000.00   Corporate Sponsorship
     Cutaneous Medicine
    National Society for              $100,000.00   Corporate Sponsorship
     Cutaneous Medicine
    National Society for              $100,000.00   Corporate Sponsorship
     Cutaneous Medicine
    NephCure Foundation                 $5,000.00   Patient Support
    Neuro Community Foundation          $2,000.00   Educational Grants
    New England Baptist                 $5,000.00   Corporate Sponsorship
     Hospital
    New Jersey Association for          $2,000.00   Educational Grants
     Biomedical Research
    New York Academy of                 $2,000.00   Educational Grants
     Sciences
    New York Academy of                 $5,000.00   Educational Grants
     Sciences
    New York Academy of                 $2,500.00   Educational Grants
     Sciences
    New York Medical College,           $2,000.00   Educational Grants
     office of Continuing
     Medical Education
    New York State Rheumatology        $17,500.00   Corporate Sponsorship
     Society
    New York University School          $5,000.00   Educational Grants
     of Medicine
    New York University School         $40,000.00   Fellowships and
     of Medicine                                     Scholarships
    New York University School          $5,000.00   Educational Grants
     of Medicine
    New York University School          $5,800.00   Educational Grants
     of Medicine
    New York University School         $55,000.00   Educational Grants
     of Medicine
    New York University School         $15,000.00   Educational Grants
     of Medicine
    New York University School          $5,000.00   Educational Grants
     of Medicine
    Nicole Jarvis MD Parkinsons           $500.00   Corporate Sponsorship
     Research Foundation
    NL Communications, Inc.            $35,000.00   Educational Grants
    NL Communications, Inc.            $25,000.00   Educational Grants
    NL Communications, Inc.            $50,000.00   Educational Grants
    No AIDS Task force                  $2,000.00   Educational Grants
    North American Center for         $252,250.00   Educational Grants
     Continuing Medical
     Education
    North American Center for          $45,000.00   Educational Grants
     Continuing Medical
     Education
    North American Center for         $124,975.00   Educational Grants
     Continuing Medical
     Education
    North American Center for         $318,000.00   Educational Grants
     Continuing Medical
     Education
    North American Center for          $95,000.00   Educational Grants
     Continuing Medical
     Education
    North American Center for         $475,000.00   Educational Grants
     Continuing Medical
     Education
    North American Center for         $200,000.00   Educational Grants
     Continuing Medical
     Education
    North American Center for         $250,000.00   Educational Grants
     Continuing Medical
     Education
    North American Center for          $99,500.00   Educational Grants
     Continuing Medical
     Education
    North American Center for         $225,000.00   Educational Grants
     Continuing Medical
     Education
    North American Society for         $20,000.00   Educational Grants
     Pediatric
     Gastroenterology,
     Hepatology, and Nutrition
    North Carolina Rheumatology        $20,000.00   Corporate Sponsorship
     Association
    North Dakota Academy of             $1,500.00   Educational Grants
     Physician Assistants
    Northeast Business Group on         $8,000.00   Corporate Sponsorship
     Health
    Northwest Arthritis and           $150,000.00   Educational Grants
     Osteoporosis Institute
    Northwest Kidney Centers            $2,500.00   Corporate Sponsorship
    Northwest Kidney Centers            $2,500.00   Corporate Sponsorship
    Northwest Urological                $5,000.00   Corporate Sponsorship
     Society
    Northwestern Lake forest              $984.00   Charitable Donations
     Hospital
    Northwestern University             $2,220.00   Charitable Donations
    Northwestern University             $2,220.00   Charitable Donations
    Northwestern University            $40,000.00   Fellowships and
                                                     Scholarships
    Northwestern University             $5,000.00   Educational Grants
    Northwestern University            $40,000.00   Fellowships and
                                                     Scholarships
    Northwestern University            $50,000.00   Fellowships and
                                                     Scholarships
    Northwestern University             $5,000.00   Educational Grants
    Northwestern University             $7,500.00   Educational Grants
    Ohio Association of                $10,000.00   Corporate Sponsorship
     Rheumatology
    Ohio Gastroenterology               $5,000.00   Corporate Sponsorship
     Society
    Oregon Health & Science               $800.00   Educational Grants
     University
    Osteoarthritis Research            $10,000.00   Educational Grants
     Society International
    Pacific Dermatologic               $10,000.00   Corporate Sponsorship
     Association
    PACK Health, LLC                  $135,875.00   Educational Grants
    Pancreas Club, The                 $10,000.00   Educational Grants
    Pancreatic Cancer Action            $2,500.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $2,500.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action          $147,600.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Pancreatic Cancer Action            $5,000.00   Corporate Sponsorship
     Network, Inc.
    Parkinson Association of            $7,500.00   Educational Grants
     the Rockies
    Parkinson Foundation of the         $5,000.00   Educational Grants
     National Capital Area
    Parkinson Research                 $10,000.00   Educational Grants
     Foundation
    Parkinson Research                  $5,000.00   Educational Grants
     Foundation
    Parkinson Research                  $5,000.00   Educational Grants
     Foundation
    Parkinson Study Group               $8,000.00   Educational Grants
    Parkinson Support Group of          $2,000.00   Educational Grants
     Upstate NY dba NPF Greater
     Rochester
    Parkinson's Action Network         $35,000.00   Corporate Sponsorship
     Foundation
    Parkinson's Action Network         $15,000.00   Corporate Sponsorship
     Foundation
    Parkinson's Action Network         $25,000.00   Corporate Sponsorship
     Foundation
    Parkinson's Disease                $20,000.00   Educational Grants
     Foundation
    Parkinson's Disease                $50,000.00   Educational Grants
     Foundation
    Parkinsons Resources of             $5,000.00   Educational Grants
     Oregon
    Parkinsons Resources of             $5,000.00   Educational Grants
     Oregon
    Parkinson's Unity Walk            $150,000.00   Corporate Sponsorship
    Parkinsons Voice Project            $1,000.00   Corporate Sponsorship
    Partners HealthCare System         $40,000.00   Educational Grants
    Partnership for a Drug Free       $100,000.00   Charitable Donations
     America
    Patient Empowerment Network        $20,000.00   Educational Grants
    Patient Empowerment Network        $15,000.00   Educational Grants
    Pediatric IBD Foundation           $15,000.00   Corporate Sponsorship
    Peer Health Communications,        $50,000.00   Educational Grants
     LLC
    Pennsylvania Prostate               $5,000.00   Educational Grants
     Cancer Coalition
    Pennsylvania Society of            $11,400.00   Corporate Sponsorship
     Gastroenterology
    Pennsylvania State                 $75,000.00   Educational Grants
     University
    Pennsylvania State                $456,750.00   Educational Grants
     University
    Pennsylvania State                  $5,000.00   Educational Grants
     University
    Pharmaceutical Care                $50,000.00   Corporate Sponsorship
     Management Association
    Pharmaceutical Care                $75,000.00   Corporate Sponsorship
     Management Association
    Pharmaceutical Research and       $200,000.00   Charitable Donations
     Manufacturers of America
     Foundation
    Pharmacy Quality Alliance          $15,000.00   Educational Grants
    Pharmacy Quality Alliance          $12,500.00   Educational Grants
    Pharmacy Times office of           $90,000.00   Educational Grants
     Continuing Professional
     Education
    Pharmacy Times office of           $25,000.00   Educational Grants
     Continuing Professional
     Education
    Physicians Education               $45,000.00   Educational Grants
     Resource
    Pittsburgh Magazine                 $3,500.00   Corporate Sponsorship
    Postgraduate Institute for        $245,035.00   Educational Grants
     Medicine
    Potomac Center for Medical          $(550.00)   Educational Grants
     Education
    President and Fellows of           $25,000.00   Corporate Sponsorship
     Harvard College
    Prevent Cancer Foundation          $10,000.00   Corporate Sponsorship
    Primary Care Network, Inc.        $142,375.00   Educational Grants
    Prime Education, Inc.             $100,110.00   Educational Grants
    Prime Education, Inc.             $148,780.00   Educational Grants
    Prime Education, Inc.             $482,600.00   Educational Grants
    Prime Education, Inc.             $138,850.00   Educational Grants
    Prime Education, Inc.               $(769.00)   Educational Grants
    Prime Education, Inc.             $315,393.00   Educational Grants
    Prime Oncology, Inc.               $10,000.00   Educational Grants
    Prime Oncology, Inc.               $35,000.00   Educational Grants
    Prime Oncology, Inc.               $30,000.00   Educational Grants
    Pri-Med Institute, LLC             $77,500.00   Educational Grants
    Princeton University,              $50,000.00   Fellowships and
     Trustees                                        Scholarships
    Project Inform, Inc.               $75,000.00   Educational Grants
    Project Inform, Inc.               $75,000.00   Charitable Donations
    Projects In Knowledge, Inc.       $125,000.00   Educational Grants
    Projects In Knowledge, Inc.       $150,000.00   Educational Grants
    Prostate Cancer Foundation          $5,000.00   Corporate Sponsorship
     Rodin Group
    Prostate Cancer Research           $25,000.00   Educational Grants
     Institute
    Prostate Cancer Research           $10,000.00   Corporate Sponsorship
     Institute
    Prostate Conditions                 $2,500.00   Corporate Sponsorship
     Education Council
    Prostate Health Education          $15,000.00   Patient Support
     Network
    Prostate Health Education          $15,000.00   Educational Grants
     Network
    Prostate Health                     $5,000.00   Corporate Sponsorship
     International
    Puerto Rico Association of         $10,000.00   Educational Grants
     Gastroenterology
    Puerto Rico Association of         $10,000.00   Educational Grants
     Gastroenterology
    Purdue University                  $83,890.00   Educational Grants
    Purdue University                 $400,000.00   Educational Grants
    Purdue University                 $450,000.00   Educational Grants
    Rector & Visitors of the           $25,000.00   Educational Grants
     University of Virginia
    Regents of the University          $40,000.00   Fellowships and
     of California, The                              Scholarships
    Regents of the University           $5,000.00   Educational Grants
     of California, The
    Regents of the University          $12,000.00   Corporate Sponsorship
     of California, The
    Regents of the University           $5,000.00   Educational Grants
     of California, The
    Regents of the University           $8,000.00   Educational Grants
     of California, The
    Regents of the University          $10,000.00   Educational Grants
     of California, The
    Regents of the University          $10,000.00   Corporate Sponsorship
     of Michigan
    Research America                   $25,000.00   Corporate Sponsorship
    Rheumatology Alliance of           $25,000.00   Corporate Sponsorship
     Louisiana
    Rheumatology Nurses Society        $50,000.00   Educational Grants
    Rheumatology Nurses Society        $74,225.00   Educational Grants
    Rheumatology Nurses Society        $50,000.00   Educational Grants
    Rheumatology Nurses Society         $7,500.00   Corporate Sponsorship
    Richmond University Medical         $1,100.00   Educational Grants
     Center
    Robert Michael Educational         $70,000.00   Educational Grants
     Institute, LLC
    Robert Michael Educational        $150,000.00   Educational Grants
     Institute, LLC
    Rush University Medical            $40,000.00   Educational Grants
     Center
    Rush University Medical             $5,000.00   Patient Support
     Center
    Rush University Medical            $10,000.00   Educational Grants
     Center
    Rutgers, The State                $125,000.00   Educational Grants
     University of New Jersey
    Rutgers, The State                 $60,000.00   Educational Grants
     University of New Jersey
    Rutgers, The State                 $75,000.00   Educational Grants
     University of New Jersey
    Rutgers, The State                 $25,000.00   Educational Grants
     University of New Jersey
    Sacramento Valley Society             $500.00   Corporate Sponsorship
     of Health System
     Pharmacists
    Safety Pharmacology Society         $2,500.00   Educational Grants
    Saint Anthony Hospital              $3,410.00   Patient Support
     Foundation
    Saint Louis University              $5,000.00   Educational Grants
    San Francisco AIDS                 $25,000.00   Corporate Sponsorship
     Foundation
    San Juan Bautista Medical          $40,000.00   Fellowships and
                                                     Scholarships
    Schneps Publications Inc.             $695.00   Corporate Sponsorship
     DBA Queens Courier
    Scripps Health                    $150,000.00   Educational Grants
    Sexual Medicine Society of         $55,000.00   Corporate Sponsorship
     North America, Inc.
    Sexual Medicine Society of        $225,000.00   Corporate Sponsorship
     North America, Inc.
    Shanti Project, Inc.               $20,000.00   Educational Grants
    Skin Disease Education             $30,000.00   Corporate Sponsorship
     Foundation
    Skin Disease Education             $80,000.00   Corporate Sponsorship
     Foundation
    Skin Disease Education             $42,750.00   Corporate Sponsorship
     Foundation
    Skin Disease Education             $46,250.00   Corporate Sponsorship
     Foundation
    Smart Ride, The                    $20,000.00   Corporate Sponsorship
    Smith Wholesale Drug                $9,000.00   Corporate Sponsorship
     Company
    Sociedad Pr Endocrinologia        $(7,500.00)   Educational Grants
     Y Diabetologia
    Sociedad Puertorriquena             $1,000.00   Educational Grants
     Pediatria
    Society for Neuroscience            $2,500.00   Educational Grants
    Society for Neuroscience,           $1,000.00   Educational Grants
     Chicago Chapter
    Society for Surgery of The          $7,000.00   Corporate Sponsorship
     Alimentary Tract
    Society of Dermatology             $20,000.00   Corporate Sponsorship
     Physician Assistants
    Society of Toxicologic             $15,000.00   Corporate Sponsorship
     Pathology
    Society of Toxicology               $5,000.00   Corporate Sponsorship
    South Carolina Alliance of          $5,000.00   Corporate Sponsorship
     Health Plans
    Southern California Society         $5,500.00   Corporate Sponsorship
     of Gastroenterologists
    Southern California Society        $10,000.00   Educational Grants
     of Gastroenterology
    Southern Illinois                   $3,000.00   Fellowships and
     University School of                            Scholarships
     Medicine
    Spondylitis Association of         $40,000.00   Patient Support
     America
    Spondylitis Association of         $19,084.50   Educational Grants
     America
    St. Francis Hospital and           $20,000.00   Educational Grants
     Medical Center
    State of Maryland                 $(1,308.80)   Educational Grants
    State of Maryland                  $45,000.00   Fellowships and
                                                     Scholarships
    State University of Iowa            $1,500.00   Educational Grants
    States United for                   $5,000.00   Charitable Donations
     Biomedical Research
    Super Jake Foundation, The         $25,000.00   Corporate Sponsorship
    Teratology Society                  $1,500.00   Educational Grants
    Test positive Aware Network         $2,500.00   Patient Support
    Test positive Aware Network        $30,000.00   Corporate Sponsorship
    Texas Association of Health         $1,500.00   Corporate Sponsorship
     Plans
    Texas Urological Society            $6,000.00   Corporate Sponsorship
    The Endocrine Society              $25,000.00   Educational Grants
    The Hitchcock Foundation           $25,000.00   Educational Grants
    The Reginald and Dionne             $5,000.00   Patient Support
     Smith Foundation, Inc.
    The Reginald and Dionne             $5,000.00   Patient Support
     Smith Foundation, Inc.
    Tides Center                       $10,000.00   Educational Grants
    Tides Center                       $50,000.00   Educational Grants
    Tides Center                       $50,000.00   Educational Grants
    Trinitas Regional Medical           $1,800.00   Educational Grants
     Center
    Triple Step Toward the Cure         $5,000.00   Corporate Sponsorship
    Trustees of the University         $69,742.00   Educational Grants
     of Pennsylvania
    Trustees of the University         $50,000.00   Educational Grants
     of Pennsylvania
    Tufts Medical Center              $(3,825.00)   Educational Grants
    Tufts Medical Center                $4,000.00   Fellowships and
                                                     Scholarships
    Tufts University                    $8,000.00   Educational Grants
    Twine Clinical Consulting         $158,000.00   Educational Grants
     LLC
    UC Regents Maxillofacial           $20,000.00   Educational Grants
     Prosthetics Clinic
    UC Regents Maxillofacial           $50,000.00   Fellowships and
     Prosthetics Clinic                              Scholarships
    UC Regents Maxillofacial           $50,000.00   Fellowships and
     Prosthetics Clinic                              Scholarships
    UC Regents Maxillofacial            $5,000.00   Educational Grants
     Prosthetics Clinic
    UC Regents Maxillofacial           $20,000.00   Educational Grants
     Prosthetics Clinic
    Ultimate Medical Academy           $90,000.00   Educational Grants
     Med Learning Group, LLC
    Ultimate Medical Academy        $(125,000.00)   Educational Grants
     Med Learning Group, LLC
    United States Adult Cystic          $6,000.00   Educational Grants
     Fibrosis Association, Inc.
    United Way of Central               $5,000.00   Corporate Sponsorship
     Massachusetts
    Universidad De Puerto Rico         $40,000.00   Fellowships and
                                                     Scholarships
    Universidad De Puerto Rico          $6,325.00   Educational Grants
    University Health Services         $25,000.00   Educational Grants
     at Stony Point, Inc.
    University Health Services        $150,111.40   Educational Grants
     at Stony Point, Inc.
    University Hospital of             $10,000.00   Educational Grants
     Brooklyn
    University of Alabama at           $40,000.00   Fellowships and
     Birmingham                                      Scholarships
    University of California            $5,000.00   Educational Grants
    University of California--         $15,000.00   Corporate Sponsorship
     San Francisco
    University of California--         $10,000.00   Educational Grants
     San Francisco
    University of California--         $10,000.00   Educational Grants
     San Francisco
    University of California           $30,000.00   Charitable Donations
     Berkeley
    University of California           $40,000.00   Fellowships and
     Irvine                                          Scholarships
    University of Chicago              $60,000.00   Educational Grants
    University of Chicago              $28,961.64   Fellowships and
                                                     Scholarships
    University of Chicago               $5,000.00   Educational Grants
    University of Chicago             $204,525.00   Educational Grants
    University of Chicago               $5,000.00   Educational Grants
    University of Chicago             $150,000.00   Educational Grants
    University of Chicago              $75,000.00   Educational Grants
    University of Chicago             $100,000.00   Educational Grants
    University of Chicago              $25,000.00   Charitable Donations
     Cancer Research Foundation
    University of Cincinnati          $100,000.00   Corporate Sponsorship
    University of Cincinnati           $75,000.00   Educational Grants
    University of Cincinnati          $100,000.00   Educational Grants
    University of Cincinnati           $75,000.00   Educational Grants
    University of Cincinnati          $100,000.00   Educational Grants
    University of Cincinnati           $50,000.00   Educational Grants
    University of Cincinnati        $2,542,080.00   Educational Grants
    University of Cincinnati           $50,000.00   Corporate Sponsorship
    University of Cincinnati            $8,000.00   Educational Grants
    University of Cincinnati           $10,000.00   Educational Grants
    University of Connecticut          $12,000.00   Fellowships and
                                                     Scholarships
    University of Florida             $142,709.00   Educational Grants
    University of Florida              $65,000.00   Educational Grants
    University of Florida              $50,000.00   Fellowships and
     Foundation                                      Scholarships
    University of Illinois              $2,220.00   Charitable Donations
     Foundation
    University of Illinois              $2,220.00   Charitable Donations
     Foundation
    University of Louisville            $2,220.00   Charitable Donations
     Foundation
    University of Louisville          $150,000.00   Educational Grants
     Research Foundation
    University of Louisville           $35,000.00   Educational Grants
     Research Foundation
    University of Louisville           $25,000.00   Educational Grants
     Research Foundation
    University of Maryland             $10,000.00   Educational Grants
     Baltimore Foundation
    University of Massachusetts        $10,000.00   Charitable Donations
     Medical School
    University of Miami               $112,000.00   Educational Grants
    University of Michigan              $(254.37)   Educational Grants
    University of Minnesota             $2,220.00   Charitable Donations
    University of Minnesota,            $5,000.00   Educational Grants
     Regents
    University of Minnesota,            $(160.43)   Corporate Sponsorship
     Regents
    University of Mississippi          $10,000.00   Charitable Donations
     Foundation
    University of Nebraska              $5,000.00   Educational Grants
     Medical Center
    University of Nebraska              $2,500.00   Educational Grants
     Medical Center
    University of Nebraska             $15,000.00   Educational Grants
     Medical Center
    University of New Mexico          $142,150.00   Educational Grants
     Health Sciences Center,
     Department of Pediatrics
     Neonatology Division
    University of North                $50,000.00   Fellowships and
     Carolina at Chapel Hill                         Scholarships
    University of North                 $5,000.00   Educational Grants
     Carolina at Chapel Hill
    University of Notre Dame            $1,000.00   Educational Grants
    University of Pittsburgh            $1,500.00   Fellowships and
                                                     Scholarships
    University of Pittsburgh           $10,000.00   Educational Grants
    University of Pittsburgh           $20,000.00   Educational Grants
    University of Rochester            $40,000.00   Fellowships and
                                                     Scholarships
    University of Rochester             $4,225.00   Educational Grants
    University of Rochester           $(1,207.00)   Educational Grants
    University of South Florida       $150,000.00   Educational Grants
     Health Professions
     Conferencing Corporation
    University of Southern            $180,000.00   Educational Grants
     California
    University of Southern              $1,500.00   Educational Grants
     California
    University of Southern             $30,000.00   Educational Grants
     California
    University of Texas Health         $25,000.00   Educational Grants
     Science Center at San
     Antonio
    University of Texas Health         $10,000.00   Educational Grants
     Science Center at San
     Antonio
    University of Texas Health         $10,000.00   Educational Grants
     Science Center at San
     Antonio
    University of Texas M.D.           $20,000.00   Educational Grants
     Anderson Cancer Center
    University of Texas M.D.           $10,000.00   Educational Grants
     Anderson Cancer Center
    University of Utah                 $40,000.00   Fellowships and
                                                     Scholarships
    University of Utah                  $2,200.00   Educational Grants
    University of Washington           $50,000.00   Fellowships and
                                                     Scholarships
    University of Washington           $40,000.00   Fellowships and
                                                     Scholarships
    University of Wisconsin             $2,220.00   Charitable Donations
     Medical Foundation
    University of Wisconsin             $2,000.00   Educational Grants
     Systems
    University of Wisconsin             $(500.00)   Corporate Sponsorship
     Systems
    University of Wisconsin-          $(1,857.88)   Educational Grants
     Madison
    University of Wisconsin-            $2,000.00   Educational Grants
     Madison
    Urological Association of           $2,500.00   Educational Grants
     Pennsylvania
    Urology Center of Colorado          $7,500.00   Corporate Sponsorship
     Foundation
    Us Too International               $15,000.00   Educational Grants
    Us Too International                $5,000.00   Educational Grants
    Us Too International               $25,000.00   Corporate Sponsorship
    Us Too International                $5,000.00   Corporate Sponsorship
    Us Too International                $1,000.00   Corporate Sponsorship
    Valley Children's Hospital          $2,500.00   Patient Support
     Foundation
    Venice Family Clinic               $10,000.00   Charitable Donations
    Veritas Institute for            $(50,000.00)   Educational Grants
     Medical Education, Inc.
    Vindico Medical Education         $337,509.00   Educational Grants
    Virginia Commonwealth               $2,100.00   Patient Support
     University, School of
     Medicine
    Wake forest University             $40,000.00   Fellowships and
                                                     Scholarships
    Washington Hospital Center         $10,000.00   Educational Grants
     Corporation
    Washington Rheumatology            $30,000.00   Corporate Sponsorship
     Alliance
    Washington State Urology            $5,000.00   Corporate Sponsorship
     Society
    Washington University in            $2,220.00   Charitable Donations
     St. Louis
    Wayne State University              $2,220.00   Charitable Donations
    We Care in Inflammatory            $50,000.00   Charitable Donations
     Bowel Disease
    West Penn Allegheny Health          $6,000.00   Educational Grants
     System, Inc.
    West Penn Allegheny Health        $(5,905.00)   Fellowships and
     System, Inc.                                    Scholarships
    West Virginia University            $2,220.00   Charitable Donations
    Western States Pharmacy             $7,500.00   Corporate Sponsorship
     Conference for Pharmacy
     Residents Fellowships and
     Preceptors
    Why Me, Inc.                        $2,500.00   Charitable Donations
    WINGS Program Inc.                 $25,000.00   Charitable Donations
    Wisconsin Dairyland Chapter         $2,000.00   Corporate Sponsorship
     of Healthcare Information
     and Management Systems
     Society
    Wisconsin Rheumatology             $10,000.00   Corporate Sponsorship
     Association
    Wishes And Dreams for               $1,000.00   Corporate Sponsorship
     Cystic Fibrosis
    Worcester Regional Research         $2,500.00   Corporate Sponsorship
     Bureau, Inc.
    World Endometriosis                $18,000.00   Corporate Sponsorship
     Research Foundation
    World Endometriosis Society       $150,000.00   Corporate Sponsorship
    World Endometriosis Society       $150,000.00   Corporate Sponsorship
    World Health                       $50,000.00   Educational Grants
     Communications, Ltd.
    World Parkinson Coalition          $15,000.00   Educational Grants
     Inc.
    World Senior Games                  $5,250.00   Corporate Sponsorship
    Yale University School of           $5,000.00   Educational Grants
     Medicine
    Yale University School of        $(10,000.00)   Educational Grants
     Medicine
    Yale University School of          $10,000.00   Educational Grants
     Medicine
    Young Survival Coalition            $5,000.00   Corporate Sponsorship
    Zero, The Project to End            $7,500.00   Corporate Sponsorship
     Prostate Cancer
    Zero, The Project to End          $210,800.00   Corporate Sponsorship
     Prostate Cancer
    Zero, The Project to End           $15,000.00   Corporate Sponsorship
     Prostate Cancer
    Zero, The Project to End            $2,500.00   Corporate Sponsorship
     Prostate Cancer
    ------------------------------------------------------------------------

                          Grants Donations Report--2015
        (Parentheses represent refunds of previously disclosed payments)
                             Updated as of 4/30/2018
    ------------------------------------------------------------------------
             Recipient             Payment Amount           Purpose
    ------------------------------------------------------------------------
    A Runner's Love                     $5,000.00   Corporate Sponsorship
    Academia Medica Del Sur            $12,000.00   Educational Grants
    Academia Medica Del Sur             $8,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur             $9,000.00   Educational Grants
    Academia Medica Del Sur            $12,000.00   Educational Grants
    Academia Medica Del Sur            $14,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur             $5,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur             $5,000.00   Educational Grants
    Academia Medica Del Sur             $7,500.00   Educational Grants
    Academia Medica Del Sur            $12,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur             $7,500.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $12,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur             $9,000.00   Educational Grants
    Academia Medica Del Sur            $10,000.00   Educational Grants
    Academia Medica Del Sur            $15,000.00   Educational Grants
    Academia Puertorriquena De          $8,500.00   Corporate Sponsorship
     Neurologia
    Academy of Managed Care            $25,000.00   Corporate Sponsorship
     Pharmacy
    Academy of Managed Care            $75,000.00   Corporate Sponsorship
     Pharmacy
    Academy of Managed Care            $30,000.00   Corporate Sponsorship
     Pharmacy
    Academy of Managed Care            $25,000.00   Corporate Sponsorship
     Pharmacy
    Academy of Managed Care            $40,000.00   Corporate Sponsorship
     Pharmacy
    Advances in Cosmetic and           $50,000.00   Corporate Sponsorship
     Medical Dermatology Inc.
    Advances in Cosmetic and           $50,000.00   Corporate Sponsorship
     Medical Dermatology Inc.
    Advances in Cosmetic and          $100,000.00   Corporate Sponsorship
     Medical Dermatology Inc.
    Adventist Hlth System--            $15,000.00   Corporate Sponsorship
     Sunbelt Inc.
    Advocate Health & Hospitals         $2,500.00   Educational Grants
     Corporation
    Aids Drug Assistance                $5,000.00   Educational Grants
     Programs Advocacy Asoc
    AIDS Action Committee               $5,000.00   Corporate Sponsorship
    AIDS Foundation of Chicago        $125,000.00   Charitable Donation
    AIDS Foundation of Chicago         $25,000.00   Corporate Sponsorship
    AIDS Foundation of Chicago         $10,000.00   Corporate Sponsorship
    Alabama Dermatology Society        $35,000.00   Corporate Sponsorship
    Albany Medical Center              $10,000.00   Corporate Sponsorship
    Albany Medical Center               $5,000.00   Educational Grants
    Albert Einstein Colg of            $10,000.00   Educational Grants
     Medicine Div of
     Dermatology Attending Asoc
    Albert Einstein Colg of            $85,000.00   Educational Grants
     Medicine of Yeshiva Univ
    Albert Einstein Med Ctr.            $2,500.00   Educational Grants
    Alliance for Clinical              $25,000.00   Educational Grants
     Trials in Oncology
     Foundation
    Alliance for Safe Biologic        $100,000.00   Corporate Sponsorship
     Medicines
    Alliance Foundation for            $50,000.00   Educational Grants
     Continuing Education In
     The Health Professions
    American Academy of                $75,000.00   Educational Grants
     Continuing Medical
     Education
    American Academy of              ($37,982.00)   Educational Grants
     Dermatology
    American Academy of                $75,000.00   Educational Grants
     Dermatology
    American Academy of                $40,000.00   Charitable Donation
     Dermatology
    American Academy of                $35,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $40,000.00   Educational Grants
     Dermatology
    American Academy of                $20,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $10,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $35,000.00   Corporate Sponsorship
     Dermatology
    American Academy of               $200,000.00   Corporate Sponsorship
     Dermatology
    American Academy of Family         $38,000.00   Corporate Sponsorship
     Phys
    American Academy of Family         $38,000.00   Corporate Sponsorship
     Phys
    American Academy of                $38,500.00   Educational Grants
     Neurology Institute
    American Academy of                $10,000.00   Educational Grants
     Neurology Institute
    American Assoc for Lab             $20,000.00   Charitable Donation
     Animal Scnc Foundation
    American Assoc for The             $50,000.00   Charitable Donation
     Study of Liver Diseases
    American Assoc for The            $500,000.00   Charitable Donation
     Study of Liver Diseases
    American Assoc for The            $130,000.00   Corporate Sponsorship
     Study of Liver Diseases
    American Assoc of Phys of          $15,000.00   Corporate Sponsorship
     Indian Origin Arkansas
    American Assoc of Phys of          $10,000.00   Corporate Sponsorship
     Indian Origin Arkansas
    American Assoc of Phys of           $5,000.00   Corporate Sponsorship
     Indian Origin Arkansas
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $35,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for            $5,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for            $5,000.00   Educational Grants
     Laboratory Animal Science
     New England Branch
    American Association of            $18,940.00   Educational Grants
     Clinical Endocrinologists
    American Association of            $20,000.00   Educational Grants
     Clinical Endocrinologists
    American Association of             $7,500.00   Educational Grants
     Clinical Endocrinologists
    American Association of             $5,000.00   Educational Grants
     Clinical Endocrinologists
    American Association of            $50,000.00   Corporate Sponsorship
     Pharmaceutical Scientists
    American Association of             $3,150.00   Charitable Donation
     Pharmaceutical Scientists
    American Autoimmune Related        $46,000.00   Corporate Sponsorship
    American Autoimmune Related        $10,000.00   Corporate Sponsorship
    American Autoimmune Related         $2,500.00   Corporate Sponsorship
    American Autoimmune Related         $5,000.00   Corporate Sponsorship
    American Autoimmune Related        $30,000.00   Corporate Sponsorship
    American Brain Tumor               $10,000.00   Corporate Sponsorship
     Association
    American Cancer Society            $10,000.00   Corporate Sponsorship
    American Cancer Society             $2,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $7,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $5,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $1,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society            $10,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $1,000.00   Corporate Sponsorship
     Cancer Action Network
    American Chem Socty                 $2,500.00   Educational Grants
    American Chem Socty                 $1,000.00   Educational Grants
    American Chem Socty                 $2,500.00   Educational Grants
    American Chem Socty                 $2,500.00   Educational Grants
    American Colg of                  $355,000.00   Corporate Sponsorship
     Endocrinology
    American Colg of Lab Animal        $50,000.00   Charitable Donation
     Medicine
    American Colg of                    $1,000.00   Corporate Sponsorship
     Obstetricians And
     Gynecologists District 1
    American College of                 $1,000.00   Educational Grants
     Clinical Pharmacology
    American College of                $90,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $20,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $25,000.00   Charitable Donation
     Gastroenterology
    American College of               $100,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $45,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $90,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                $20,000.00   Corporate Sponsorship
     Gastroenterology
    American College of                 $3,000.00   Corporate Sponsorship
     Healthcare Executives
     Wisconsin Chapter
    American College of             $2,000,000.00   Corporate Sponsorship
     Rheumatology
    American College of                 $5,000.00   Corporate Sponsorship
     Veterinary Pathologists
    American Drug Utilization          $20,000.00   Corporate Sponsorship
     Review Society Adurs
    American Enterprise                $10,000.00   Corporate Sponsorship
     Institute
    American                          $153,517.00   Educational Grants
     Gastroenterological
     Association Institute
    American                          $427,536.66   Educational Grants
     Gastroenterological
     Association Institute
    American                           $25,000.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American                           $25,000.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American                          $133,200.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American                           $43,000.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American                           $25,000.00   Corporate Sponsorship
     Gastroenterological
     Association Institute
    American Kidney Fund                $5,000.00   Corporate Sponsorship
    American Legion                    $10,000.00   Corporate Sponsorship
    American Legion National           $20,000.00   Corporate Sponsorship
     Headquarters
    American Liver Foundation          $10,000.00   Corporate Sponsorship
    American Liver Foundation           $4,500.00   Corporate Sponsorship
    American Liver Foundation         $400,000.00   Corporate Sponsorship
    American Liver Foundation        ($10,000.00)   Corporate Sponsorship
    American Liver Foundation          $25,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Corporate Sponsorship
    American Liver Foundation          $25,000.00   Corporate Sponsorship
    American Liver Foundation           $5,000.00   Corporate Sponsorship
    American Liver Foundation          $35,000.00   Corporate Sponsorship
    American Medical Group             $24,700.00   Corporate Sponsorship
     Association
    American Neurological              $25,000.00   Educational Grants
     Association
    American Pancreatic                $75,000.00   Educational Grants
     Association, Inc.
    American Pancreatic                $25,000.00   Corporate Sponsorship
     Association, Inc.
    American Pancreatic                $15,000.00   Charitable Donation
     Association, Inc.
    American Parkinson Disease          $5,350.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease          $2,000.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease         $15,000.00   Educational Grants
     Association, Inc.
    American Parkinson Disease          $2,500.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease         $40,000.00   Educational Grants
     Association, Inc.
    American Parkinson Disease          $3,000.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease          $1,000.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease          $5,000.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease          $1,000.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease          $1,000.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association, Inc.
    American Parkinson Disease          $1,000.00   Corporate Sponsorship
     Association, Inc.
    American Peptide Society            $1,000.00   Educational Grants
    American Pharmacists               $10,000.00   Corporate Sponsorship
     Association
    American Society for Mens          $10,000.00   Corporate Sponsorship
     Health
    American Society of                $15,000.00   Corporate Sponsorship
     Andrology
    American Society of                $15,000.00   Educational Grants
     Clinical Oncology
    American Society of                $25,000.00   Educational Grants
     Clinical Oncology
    American Society of                $15,000.00   Educational Grants
     Clinical Oncology
    American Society of                 $9,500.00   Corporate Sponsorship
     Clinical Rheumatologists
    American Society of Health         $23,400.00   Corporate Sponsorship
     System Pharmacists
    American Socty of                  $95,000.00   Corporate Sponsorship
     Hematology
    American Socty of                   $2,550.00   Corporate Sponsorship
     Hematology
    American Socty of                  $25,000.00   Corporate Sponsorship
     Hematology
    American Socty of                  $60,000.00   Corporate Sponsorship
     Hematology
    American Statistical                $2,500.00   Educational Grants
     Association
    American Thyroid                   $45,000.00   Educational Grants
     Association, Inc.
    American Uroligical Asoc           $11,500.00   Corporate Sponsorship
     Northeastern Section
    American Urological Asoc           $10,000.00   Corporate Sponsorship
     Foundation
    American Urological Asoc            $6,000.00   Corporate Sponsorship
     Inc. North Ctrl Section
    American Urological Asoc           $10,000.00   Corporate Sponsorship
     Inc. Western Section
    American Urological Asoc            $1,000.00   Corporate Sponsorship
     New York Section
    American Urological Asoc            $6,000.00   Corporate Sponsorship
     South Ctrl Section
    American Urological               $100,000.00   Corporate Sponsorship
     Association
    American Urological                $25,000.00   Corporate Sponsorship
     Association
    American Urological                $37,500.00   Corporate Sponsorship
     Association
    American Urological                $41,000.00   Corporate Sponsorship
     Association
    American Urological                $75,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $50,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $30,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $25,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                $10,000.00   Educational Grants
     Association Education And
     Research, Inc.
    American Urological                 $8,000.00   Educational Grants
     Association Education And
     Research, Inc.
    Americans for Medical             $110,000.00   Charitable Donation
     Progress Educational Found
    Americares Foundation, Inc.        $10,000.00   Corporate Sponsorship
    Anesthesia Patient Safety          $15,000.00   Charitable Donation
     Foundation
    Annenberg Center for Health        $50,000.00   Educational Grants
     Science
    Annenberg Center for Health       $140,000.00   Educational Grants
     Science
    Annenberg Center for Health        $90,000.00   Educational Grants
     Science
    Annenberg Center for Health       $641,628.00   Educational Grants
     Science
    Annenberg Center for Health        $85,000.00   Educational Grants
     Science
    Annenberg Center for Health        $75,000.00   Educational Grants
     Science
    Annenberg Center for Health       ($5,000.00)   Educational Grants
     Science
    Arizona United Rheum                $5,000.00   Corporate Sponsorship
     Alliance Aura
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.         $50,000.00   Educational Grants
    Arthritis Foundation, Inc.         $30,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.         $10,000.00   Educational Grants
    Arthritis Foundation, Inc.          $2,500.00   Patient Support
    Arthritis Foundation, Inc.         $30,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.         $40,000.00   Patient Support
    Arthritis Foundation, Inc.         $20,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.         $12,500.00   Patient Support
    Arthritis Foundation, Inc.         $25,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.         $25,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $1,500.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $2,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $3,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $1,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $2,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $1,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.          $2,500.00   Patient Support
    Arthritis Foundation, Inc.          $5,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.         $30,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.        $250,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.        $175,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.        $300,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.        $300,000.00   Corporate Sponsorship
    Arthritis Foundation, Inc.        $259,000.00   Corporate Sponsorship
    Arthritis Patient Services         $10,000.00   Educational Grants
    Arthritis Patient Services         $25,000.00   Educational Grants
    Asco Cancer Foundation             $50,000.00   Charitable Donation
    Asco Cancer Foundation             $40,000.00   Fellowships or
                                                     Scholarships
    Asco Cancer Foundation              ($689.37)   Fellowships or
                                                     Scholarships
    Asociacion De Hematologia Y         $5,000.00   Corporate Sponsorship
     Oncologia Medica De Puerto
     Rico
    Asociacion De Reumatologos         $22,500.00   Corporate Sponsorship
     De Puerto Rico
    Asociacion De Salud                 $2,000.00   Corporate Sponsorship
     Primaria De Puerto Rico,
     Inc.
    Asociacion Pr De                   $10,000.00   Corporate Sponsorship
     Gastroenterologia
    Asociacion Pr De                   $40,000.00   Corporate Sponsorship
     Gastroenterologia
    Asociacion Pr De                   $30,000.00   Corporate Sponsorship
     Gastroenterologia
    Asociacion Puertorriquena           $2,500.00   Corporate Sponsorship
     De Ayuda Al Paciente De
     Psiorasis
    Asociacion Puertorriquena          $15,000.00   Corporate Sponsorship
     De Medicina Fisica Y
     Rehabilitacion
    Asociacion Puertorriquena           $6,000.00   Corporate Sponsorship
     De Medicina Fisica Y
     Rehabilitacion
    Aspen Cancer Conference,            $7,500.00   Educational Grants
     Inc.
    Association for Assessment          $5,000.00   Charitable Donation
     And Accreditation of
     Laboratory Animal Care
     International
    Association of Physician           $10,000.00   Corporate Sponsorship
     Assistants In Oncology
     Inc.
    Association of Women in            $30,000.00   Corporate Sponsorship
     Rheumatology
    Association of Women in            $30,000.00   Corporate Sponsorship
     Rheumatology
    At Point of Care, LLC             $150,000.00   Educational Grants
    Autoimmune Advocacy                 $2,500.00   Corporate Sponsorship
     Alliance
    Baehr Challenge Ltd.                $2,500.00   Corporate Sponsorship
    Baehr Challenge Ltd.                $4,000.00   Corporate Sponsorship
    Balm In Gilead Inc.                $75,000.00   Corporate Sponsorship
    Baylor College of Medicine          $5,000.00   Educational Grants
    Baylor College of Medicine          $5,000.00   Corporate Sponsorship
    Baylor Health Care System          $40,000.00   Fellowships or
     Foundation                                      Scholarships
    Baylor Univ Med Ctr.               $40,000.00   Educational Grants
    Beth Israel Deaconess              $35,000.00   Fellowships or
     Medical Center                                  Scholarships
    Beth Israel Deaconess              $40,000.00   Fellowships or
     Medical Center                                  Scholarships
    Beth Israel Deaconess              $25,000.00   Fellowships or
     Medical Center                                  Scholarships
    Beth Israel Deaconess               $8,000.00   Educational Grants
     Medical Center
    Bioconnections LLC                $125,000.00   Corporate Sponsorship
    Board of Trustees of The           $40,000.00   Fellowships or
     University of Illinois                          Scholarships
    Board of Trustees of The            $1,500.00   Educational Grants
     University of Illinois
    Boomer Esiason Foundation          $25,000.00   Corporate Sponsorship
    Boomer Esiason Foundation         $400,000.00   Corporate Sponsorship
    Borland Groover Foundation          $1,000.00   Corporate Sponsorship
    Boston Univ School of              $70,000.00   Educational Grants
     Medicine
    Boston Univ School of             $125,000.00   Educational Grants
     Medicine
    Boston Univ School of               $1,500.00   Educational Grants
     Medicine
    Boston Univ School of               $5,000.00   Corporate Sponsorship
     Medicine
    Boston Univ School of              $10,000.00   Educational Grants
     Medicine
    Boston University Mdcn            ($3,402.40)   Educational Grants
     Psychtry
    Brandeis University                 $1,250.00   Charitable Donation
    Breast Friends                      $1,500.00   Corporate Sponsorship
    Business Hlth Coalition             $3,300.00   Corporate Sponsorship
     Foundation
    Butler University                   $1,250.00   Charitable Donation
    California Association for          $1,500.00   Corporate Sponsorship
     Nurse Practitioners
    California Healthcare               $1,500.00   Corporate Sponsorship
     Institute
    California Life Sciences            $5,000.00   Corporate Sponsorship
     Association
    California Life Sciences            $1,500.00   Corporate Sponsorship
     Association
    California Socty of                $10,000.00   Corporate Sponsorship
     Dermatology & Dermatology
     Surgry
    Cancer Care                         $2,500.00   Educational Grants
    Cancer Care                         $2,500.00   Educational Grants
    Cancer Care                       ($2,500.00)   Educational Grants
    Cancer Care                        $25,000.00   Educational Grants
    Cancer Care                        $25,000.00   Educational Grants
    Cancer Molecular                    $5,000.00   Educational Grants
     Therapeutics Research
     Association
    Capital Meeting Planning            $2,000.00   Educational Grants
     Inc.
    Caribe Gyn, Inc.                    $5,000.00   Corporate Sponsorship
    Casa Lake County                   $10,000.00   Corporate Sponsorship
    Catholic Charities of The           $8,500.00   Corporate Sponsorship
     Archdiocese of Chicago
    Cedars-Sinai Medical Center        $40,000.00   Fellowships or
                                                     Scholarships
    Cedars-Sinai Medical Center       ($4,000.00)   Educational Grants
    Central Florida Pharmacy           $15,000.00   Patient Support
     Council
    Central Savannah River Area         $1,000.00   Corporate Sponsorship
     Csra Parkinson Support
     Group
    Chicago Help Initiative             $7,500.00   Charitable Donation
    Childhood Arthritis And            $35,000.00   Corporate Sponsorship
     Rheumatology Research
     Alliance Carra
    Children And Arthritis,             $4,500.00   Charitable Donation
     Inc.
    Childrens Digestive Hlth           $40,000.00   Fellowships or
     And Nutrition Foundation                        Scholarships
    Childrens Digestive Hlth         ($40,000.00)   Fellowships or
     And Nutrition Foundation                        Scholarships
    Childrens Digestive Hlth           $56,000.00   Educational Grants
     And Nutrition Foundation
    Childrens Digestive Hlth           $10,000.00   Corporate Sponsorship
     And Nutrition Foundation
    Childrens Digestive Hlth            $2,500.00   Corporate Sponsorship
     And Nutrition Foundation
    Chimp Haven, Inc.                  $25,000.00   Charitable Donation
    Chronic Liver Disease           $1,000,000.00   Educational Grants
     Foundation
    Chronic Liver Disease             $364,315.00   Educational Grants
     Foundation
    Chronic Liver Disease           $1,513,875.00   Educational Grants
     Foundation
    Chronic Liver Disease             ($2,700.00)   Educational Grants
     Foundation
    Chronic Liver Disease             ($9,044.17)   Educational Grants
     Foundation
    Chronic Liver Disease             ($9,045.00)   Educational Grants
     Foundation
    Chronic Liver Disease              $27,500.00   Corporate Sponsorship
     Foundation
    Chronic Lymphoytic Leukemia        $25,000.00   Charitable Donation
     Society, Inc.
    Chronic Lymphoytic Leukemia        $25,000.00   Educational Grants
     Society, Inc.
    Chronic Lymphoytic Leukemia        $10,000.00   Patient Support
     Society, Inc.
    Cincinnati Childrens               $40,000.00   Educational Grants
     Hospital
    Cincinnati Childrens               $22,500.00   Corporate Sponsorship
     Hospital Medical Center
     Pulmonary Medicine
    Cleveland Clinic Foundation         $3,000.00   Educational Grants
    Cleveland Clinic Foundation        $50,000.00   Fellowships or
                                                     Scholarships
    Cleveland Clinic Foundation        $40,000.00   Fellowships or
                                                     Scholarships
    Cleveland Clinic Minority           $5,000.00   Educational Grants
     Men's Health Center
    Cleveland Clnc Educational          ($542.72)   Educational Grants
     Foundation The
    Cleveland Clnc Educational         $50,000.00   Educational Grants
     Foundation The
    Cleveland Clnc Educational         $50,000.00   Educational Grants
     Foundation The
    Cleveland Clnc Educational        ($6,109.89)   Educational Grants
     Foundation The
    Cleveland Clnc Educational        ($1,147.40)   Educational Grants
     Foundation The
    Clinical Care Options, LLC         $75,000.00   Educational Grants
    Clinical Care Options, LLC        $100,000.00   Educational Grants
    Clinical Care Options, LLC         $75,000.00   Educational Grants
    Clinical Care Options, LLC        $100,000.00   Educational Grants
    Cll Global Research                $15,000.00   Educational Grants
     Foundation
    Cll Global Research                $25,000.00   Educational Grants
     Foundation
    Coalition for Prevention of         $5,000.00   Corporate Sponsorship
     Colorectal Cancer In
     Puerto Rico
    Coalition for Prevention of         $3,000.00   Corporate Sponsorship
     Colorectal Cancer In
     Puerto Rico
    Colegio De Medicos                 $20,000.00   Educational Grants
     Cirujanos De Puerto Rico
    Columbia Univ Med Ctr               $1,250.00   Charitable Donation
    Community Health                   $10,000.00   Corporate Sponsorship
    Community Health                   $10,000.00   Corporate Sponsorship
    Community Health                   $10,000.00   Corporate Sponsorship
    Community Health And Men's          $5,000.00   Patient Support
     Promotion Summit
    Community Initiatives               $5,000.00   Corporate Sponsorship
    Community Initiatives              $57,000.00   Corporate Sponsorship
    Community Initiatives              $50,000.00   Corporate Sponsorship
    Community Liver Alliance            $5,000.00   Corporate Sponsorship
    Complete Conference Mgmt            ($916.00)   Educational Grants
    Connect1D                           $2,500.00   Corporate Sponsorship
    Connecticut Academy of              $1,700.00   Corporate Sponsorship
     Physician Assistants
    Connecticut Advocates for             $500.00   Corporate Sponsorship
     Parkinsons Inc.
    Connecting To Cure Crohns           $5,000.00   Corporate Sponsorship
     And Colitis
    Consortium of Multiple             $25,000.00   Educational Grants
     Sclerosis Centers
    Continuing Education              $400,000.00   Educational Grants
     Alliance, LLC
    Continuing Education              $350,000.00   Educational Grants
     Alliance, LLC
    Continuing Education              ($1,972.99)   Educational Grants
     Alliance, LLC
    Continuing Education              ($5,392.00)   Educational Grants
     Alliance, LLC
    Continuing Education                ($723.11)   Educational Grants
     Alliance, LLC
    Continuing Education              ($3,353.94)   Educational Grants
     Alliance, LLC
    Continuing Education              $439,195.00   Educational Grants
     Alliance, LLC
    Continuing Education              ($1,553.15)   Educational Grants
     Alliance, LLC
    Continuing Education              ($1,523.00)   Educational Grants
     Alliance, LLC
    Continuing Education                ($567.24)   Educational Grants
     Alliance, LLC
    Cope Coalition On Positive         $20,000.00   Corporate Sponsorship
     Health Empowerment
    Cope Coalition On Positive         $15,000.00   Corporate Sponsorship
     Health Empowerment
    Core Foundation                    $10,000.00   Corporate Sponsorship
    Cornell University Weill            $2,500.00   Educational Grants
     Cornell Medical College
    Cornell University Weill            $2,500.00   Educational Grants
     Cornell Medical College
    Cornerstones Health Inc.           $90,000.00   Educational Grants
    Cornerstones Health Inc.         ($20,375.00)   Educational Grants
    Cornerstones Health Inc.           $75,000.00   Educational Grants
    Crape Myrtle Festival                 $300.00   Corporate Sponsorship
    Creighton University                $7,500.00   Educational Grants
    Crohn's and Colitis               $400,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $22,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $5,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis             $1,200,000.00   Educational Grants
     Foundation of America,
     Inc.
    Crohn's and Colitis               $180,000.00   Educational Grants
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $5,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 ($265.00)   Educational Grants
     Foundation of America,
     Inc.
    Crohn's and Colitis                $50,160.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $3,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $2,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $1,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $25,000.00   Charitable Donation
     Foundation of America,
     Inc.
    Crohn's and Colitis                $25,000.00   Charitable Donation
     Foundation of America,
     Inc.
    Crohn's and Colitis                $90,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $35,000.00   Educational Grants
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $2,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $5,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $1,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $5,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $10,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis               $100,000.00   Fellowships or
     Foundation of America,                          Scholarships
     Inc.
    Crohn's and Colitis                $32,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $10,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $1,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                 $1,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $90,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $10,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis               $400,000.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Crohn's and Colitis                $22,500.00   Corporate Sponsorship
     Foundation of America,
     Inc.
    Culinary Care                       $2,500.00   Corporate Sponsorship
    Curatio Cme Inst                  ($3,261.00)   Educational Grants
    Curatio Cme Inst                    ($180.00)   Educational Grants
    Curatio Cme Inst                 ($50,000.00)   Educational Grants
    Curatio Cme Inst                  ($8,855.73)   Educational Grants
    Cure CF                               $500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation         $10,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $3,750.00   Corporate Sponsorship
    Cystic Fibrosis Foundation        $500,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation        $100,000.00   Charitable Donation
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $7,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation         $10,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation         $50,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $3,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation         $25,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation         $15,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation            $750.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $3,750.00   Corporate Sponsorship
    Cystic Fibrosis Foundation        $750,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation         $16,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Research            $5,000.00   Corporate Sponsorship
     Fund Emily's Entourage
    Cystic Fibrosis Research            $1,250.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research            $3,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research           $15,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorship
     Inc.
    Dallas Fort Worth Business          $5,000.00   Corporate Sponsorship
     Group on Health
    Dava Oncology LP                   $95,000.00   Corporate Sponsorship
    Davis Phinney Foundation           $30,000.00   Educational Grants
    Davis Phinney Foundation           $30,000.00   Educational Grants
    Davis Phinney Foundation           $40,000.00   Patient Support
    Dermatology Education              $30,000.00   Corporate Sponsorship
     Foundation
    Dermatology Foundation             $40,000.00   Fellowships or
                                                     Scholarships
    Dermatology Foundation            $135,000.00   Charitable Donation
    Dermatology Foundation             $50,000.00   Corporate Sponsorship
    Dermatology Nurses                 $15,000.00   Educational Grants
     Association
    Dermatology Nurses                 $23,270.00   Corporate Sponsorship
     Association
    Dermatology Nurses                 $25,850.00   Corporate Sponsorship
     Association
    Desert Aids Project Inc.            $2,000.00   Corporate Sponsorship
    Digestive Disease Week             $55,000.00   Corporate Sponsorship
    Digestive Disease Week              $3,500.00   Corporate Sponsorship
    Digestive Health Foundation        $25,000.00   Corporate Sponsorship
    Duke University                    $40,000.00   Fellowships or
                                                     Scholarships
    Duke University                     ($780.00)   Educational Grants
    Duke University Medical            $10,000.00   Fellowships or
     Center                                          Scholarships
    East Hawaii IPA                     $8,000.00   Corporate Sponsorship
    Efficient Collaborative            $28,100.00   Corporate Sponsorship
     Retail Marketing
    Eicosanoid Research                 $2,000.00   Educational Grants
     Foundation
    El Centro Regional Medical          $5,000.00   Corporate Sponsorship
     Center Foundation
    El Centro Regional Medical          $5,000.00   Corporate Sponsorship
     Center Foundation
    Elsevier Inc.                     $150,000.00   Educational Grants
    Emory University                   $10,000.00   Corporate Sponsorship
    Emory University                    $2,000.00   Corporate Sponsorship
    Emory University                   $10,000.00   Corporate Sponsorship
    Emory University School of         $25,000.00   Educational Grants
     Medicine
    Employers Health Coalition          $4,000.00   Corporate Sponsorship
     Inc.
    Endocrine Society                  $10,000.00   Corporate Sponsorship
    Endocrine Society                  $15,000.00   Educational Grants
    Endometriosis Foundation of         $2,500.00   Corporate Sponsorship
     America
    Epilepsy Foundation                $15,000.00   Charitable Donation
    Erie Family Health Center           $5,000.00   Sponsorship
                                                 Corporate
    Escuela De Medicina De              $8,000.00   Educational Grants
     Ponce
    Escuela De Medicina San            $40,000.00   Fellowships or
     Juan Bautista                                   Scholarships
    Evergreen Foundation of               $750.00   Corporate Sponsorship
     Western New York
    Excellence In Rheumatology        $100,000.00   Corporate Sponsorship
     Education LLC
    Facing Our Risk of Cancer          $15,000.00   Educational Grants
     Empowerement Force
    Federation of American              $5,000.00   Corporate Sponsorship
     Societies for Experimental
     Biology
    Federation of American              $1,500.00   Educational Grants
     Societies for Experimental
     Biology
    Federation of American              $1,500.00   Educational Grants
     Societies for Experimental
     Biology
    Federation of American              $1,500.00   Educational Grants
     Societies for Experimental
     Biology
    Federation of American              $1,500.00   Educational Grants
     Societies for Experimental
     Biology
    Federation of Clinical             $18,000.00   Educational Grants
     Immunology Societies
    Federation of Clinical             $15,000.00   Educational Grants
     Immunology Societies
    Florida Health Care                $10,000.00   Corporate Sponsorship
     Coalition
    Florida Health Care                 $4,500.00   Corporate Sponsorship
     Coalition
    Florida Society of                 $25,000.00   Corporate Sponsorship
     Rheumatology
    Focus Medical                     $150,000.00   Corporate Sponsorship
     Communications LLC
    Food Outreach                      $10,000.00   Corporate Sponsorship
    force--Facing Our Risk of           $5,000.00   Corporate Sponsorship
     Cancer Emp
    Foundation for Anesthesia          $15,000.00   Fellowships or
     Education And Research                          Scholarships
    Foundation for Arthritis            $5,500.00   Corporate Sponsorship
     Treatment
    Foundation for The National        $10,000.00   Corporate Sponsorship
     Institutes of Health
    Foundation for Veterans            $25,000.00   Corporate Sponsorship
     Health Care
    Foundation of Consortium of         $8,000.00   Charitable Donation
     Multiple Sclerosis Centers
     Cmsc
    Foundcare Inc.                      $2,500.00   Corporate Sponsorship
    Foundcare Inc.                      $2,500.00   Corporate Sponsorship
    Friends of Cancer Research         $30,000.00   Corporate Sponsorship
    Friends of Parkinsons               $2,500.00   Corporate Sponsorship
    Friends of Prentice                $25,000.00   Charitable Donation
    Fundacion De Investigacion         $25,000.00   Educational Grants
    Gastro Intestinal Research         $50,000.00   Corporate Sponsorship
     Foundation
    Gastro Intestinal Research         $25,000.00   Corporate Sponsorship
     Foundation
    Gastrointestinal And Liver         $75,000.00   Educational Grants
     Association of The
     Americas Inc.
    Gateway for Cancer Research         $6,000.00   Corporate Sponsorship
    General Hospital                   $10,000.00   Educational Grants
     Corporation
    Georgia Dermatology                 $7,500.00   Corporate Sponsorship
     Physician Assistants
    Georgia Dermatology                $15,000.00   Corporate Sponsorship
     Physician Assistants
    Georgia Health Sciences             $1,500.00   Educational Grants
     Foundation Inc.
    Georgia Prostate Cancer             $5,000.00   Patient Support
     Coalition
    Georgia Society of                  $3,000.00   Corporate Sponsorship
     Dermatology And
     Dermatologic Surgery
    Gilda's Club Chicago               $25,000.00   Corporate Sponsorship
    Global Academy for Medical         $72,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $35,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $18,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $72,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $72,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $45,000.00   Corporate Sponsorship
     Education
    Global Alliance for Patient        $30,000.00   Corporate Sponsorship
     Access
    Global Alliance for Patient        $50,000.00   Corporate Sponsorship
     Access
    Global Alliance for Patient        $50,000.00   Corporate Sponsorship
     Access
    Global Alliance for Patient       $250,000.00   Educational Grants
     Access
    Global Healthy Living              $24,000.00   Corporate Sponsorship
     Foundation
    Global Healthy Living              $25,000.00   Corporate Sponsorship
     Foundation
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,000.00   Educational Grants
    Gospel Heritage Foundation         $10,000.00   Corporate Sponsorship
    Great Lakes Chapter of The          $1,000.00   Corporate Sponsorship
     American Society for
     Pharmacology And
     Experimental Therapeutics
    Group of Research And              $15,000.00   Corporate Sponsorship
     Assessment of Psoriasis
     And Psoriatic Arthritis
    Grupo De Apoyo De Ninos Y           $3,000.00   Corporate Sponsorship
     Adolescentes Con
     Reumatologia
    Gynecologic Oncology Group         $25,000.00   Educational Grants
    Gynecologic Oncology Group         $25,000.00   Educational Grants
    Heals of The South, Inc.--          $5,000.00   Charitable Donation
     Hepatitis Education
     Awareness And Liver
     Support
    Health Action Council Ohio          $3,780.00   Corporate Sponsorship
    Healthcare 21 Business              $5,000.00   Corporate Sponsorship
     Coalition
    Healthcare 21 Business              $5,000.00   Corporate Sponsorship
     Coalition
    Healthcare Financial               $50,000.00   Corporate Sponsorship
     Management Association
     Hfma
    Heather Robidoux                    $7,500.00   Corporate Sponsorship
    Heb Grocery Company LP             $10,000.00   Corporate Sponsorship
    Hep C Connection                   $75,000.00   Patient Support
    Hep C Connection                    $5,000.00   Corporate Sponsorship
    Hepatitis Education Project        $75,000.00   Charitable Donation
    Hepatitis Education Project        $50,000.00   Corporate Sponsorship
    Herbert Kosten Pancreatic           $2,000.00   Corporate Sponsorship
     Cancer Charitable Fund
    Hitchcock Foundation               $25,000.00   Educational Grants
    Hiv Treaters Med Asoc of           $10,000.00   Educational Grants
     Puerto Rico
    HMP Communications LLC             $40,000.00   Corporate Sponsorship
    Honor Health Virginia G               $800.00   Corporate Sponsorship
     Piper Cancer Center
    Hope Foundation The                $20,000.00   Educational Grants
    Houston Area Parkinson              $2,500.00   Corporate Sponsorship
     Society
    Howard Brown Health Center         $20,000.00   Corporate Sponsorship
    Howard Hanna Children's            $10,000.00   Charitable Donation
     Free Care Fund
    Hubbard Street Dance               $10,000.00   Educational Grants
     Chicago
    Hughes Healthcare                 $177,550.00   Educational Grants
     Disparities Group
    Human Growth Foundation             $5,000.00   Corporate Sponsorship
    Human Growth Foundation             $4,000.00   Corporate Sponsorship
    Humboldt--Del Norte County          $4,000.00   Educational Grants
     Med Socty
    Hyacinth Aids Foundation            $5,000.00   Corporate Sponsorship
    Illinois African American          $10,000.00   Corporate Sponsorship
     Coalition
    Illinois African American          $10,000.00   Corporate Sponsorship
     Coalition
    Imedex, LLC                        $40,000.00   Educational Grants
    Imedex, LLC                        $30,000.00   Educational Grants
    Imedex, LLC                        $40,000.00   Educational Grants
    Imedex, LLC                        $15,000.00   Corporate Sponsorship
    Imedex, LLC                        $50,000.00   Educational Grants
    Imedex, LLC                        $75,000.00   Educational Grants
    Indiana University                  $4,100.00   Fellowships or
                                                     Scholarships
    Infant Welfare Society of          $10,000.00   Charitable Donation
     Chicago
    Infectious Diseases Society        $25,000.00   Charitable Donation
     of America
    Infectious Diseases Society        $50,000.00   Educational Grants
     of America
    Integrated Benefits                $25,000.00   Corporate Sponsorship
     Institute Inc.
    Integrated Benefits                $25,000.00   Corporate Sponsorship
     Institute Inc.
    Integrated Medical                 $35,000.00   Charitable Donation
     Foundation
    Integrated Medical                  $2,000.00   Corporate Sponsorship
     Foundation
    Integrated Medical                  $2,000.00   Corporate Sponsorship
     Foundation
    Integrated Medical                  $1,000.00   Corporate Sponsorship
     Foundation
    Interfaith House                    $2,000.00   Charitable Donation
    International Aids Socty--        $200,000.00   Educational Grants
     USA
    International Aids Socty--         $80,000.00   Educational Grants
     USA
    International Aids Socty--         $75,000.00   Educational Grants
     USA
    International Asoc for The          $2,500.00   Corporate Sponsorship
     Study of Lung Cancer IASLC
    International Association          $10,000.00   Educational Grants
     of Providers of Aids Care
    International Association          $10,000.00   Educational Grants
     of Providers of Aids Care
    International Chinese               $3,000.00   Educational Grants
     Statistical Association
    International Dermatology          $70,000.00   Corporate Sponsorship
     Outcome Measures
    International Foot And              $2,000.00   Corporate Sponsorship
     Ankle Foundation
    International League of            $20,000.00   Charitable Donation
     Association for
     Rheumatology
    International Liver                $10,000.00   Educational Grants
     Transplantation Society
    International Liver                $40,000.00   Educational Grants
     Transplantation Society
    International Medical Corps         $5,000.00   Corporate Sponsorship
    International Psoriasis           $100,000.00   Corporate Sponsorship
     Council
    International Psoriasis            $50,000.00   Corporate Sponsorship
     Council
    International Psoriasis            $50,000.00   Corporate Sponsorship
     Council
    International Psoriasis            $50,000.00   Corporate Sponsorship
     Council
    International Society for           $3,000.00   Educational Grants
     The Study of Xenbiotics
    International Society of            $2,000.00   Educational Grants
     Biopharmaceutical
     Statistics
    International Society of            $1,500.00   Educational Grants
     Heterocyclic Chemistry
    Iowa Pharmacy Association           $5,000.00   Corporate Sponsorship
    Johns Hopkins Univ School          $75,000.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School          $25,000.00   Corporate Sponsorship
     of Medicine
    Johns Hopkins Univ School          $40,000.00   Fellowships or
     of Medicine                                     Scholarships
    Johns Hopkins Univ School         ($5,646.02)   Educational Grants
     of Medicine
    Johns Hopkins Univ School          $46,213.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School          $50,000.00   Educational Grants
     of Medicine
    JWC Covenant, Inc.                 $20,000.00   Educational Grants
    JWC Covenant, Inc.                 $25,000.00   Corporate Sponsorship
    JWC Covenant, Inc.                  $2,500.00   Corporate Sponsorship
    Kansas University Endowment           $500.00   Corporate Sponsorship
     Association
    Keck Medical Center of USC         $25,000.00   Educational Grants
    Kelsey Research Foundation         $35,000.00   Fellowships or
                                                     Scholarships
    Ken Zebrowski Memorial Walk         $2,000.00   Corporate Sponsorship
    Kidney Disease Improving          $200,000.00   Corporate Sponsorship
     Global Outcomes
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo          $1,365.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $615.00   Patient Support
    Laboratorio Clinico Toledo            $720.00   Patient Support
    Laboratorio Clinico Toledo          $1,275.00   Patient Support
    Laboratorio Clinico Toledo          $1,365.00   Patient Support
    Laboratorio Clinico Toledo          $1,365.00   Patient Support
    Laboratorio Clinico Toledo          $2,040.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,365.00   Patient Support
    Laboratorio Clinico Toledo            $945.00   Patient Support
    Laboratorio Clinico Toledo          $1,320.00   Patient Support
    Laboratorio Clinico Toledo          $3,600.00   Patient Support
    Laboratorio Clinico Toledo          $1,800.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,245.00   Patient Support
    Laboratorio Clinico Toledo          $4,125.00   Patient Support
    Laboratorio Clinico Toledo          $2,220.00   Patient Support
    Laboratorio Clinico Toledo          $2,160.00   Patient Support
    Laboratorio Clinico Toledo          $1,605.00   Patient Support
    Laboratorio Clinico Toledo          $2,040.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,455.00   Patient Support
    Laboratorio Clinico Toledo          $1,650.00   Patient Support
    Laboratorio Clinico Toledo          $1,365.00   Patient Support
    Laboratorio Clinico Toledo            $360.00   Patient Support
    Laboratorio Clinico Toledo            $876.00   Patient Support
    Laboratorio Clinico Toledo          $1,110.00   Patient Support
    Laboratorio Clinico Toledo          $1,470.00   Patient Support
    Laboratorio Clinico Toledo          $2,715.00   Patient Support
    Laboratorio Clinico Toledo          $1,140.00   Patient Support
    Laboratorio Clinico Toledo          $1,770.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,485.00   Patient Support
    Laboratorio Clinico Toledo          $1,455.00   Patient Support
    Laboratorio Clinico Toledo          $1,335.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,380.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,215.00   Patient Support
    Laboratorio Clinico Toledo            $975.00   Patient Support
    Laboratorio Clinico Toledo            $945.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo          $1,140.00   Patient Support
    Laboratorio Clinico Toledo          $2,730.00   Patient Support
    Laboratorio Clinico Toledo          $1,065.00   Patient Support
    Laboratorio Clinico Toledo            $990.00   Patient Support
    Laboratorio Clinico Toledo          $1,980.00   Patient Support
    Laboratorio Clinico Toledo          $2,610.00   Patient Support
    Laboratorio Clinico Toledo          $1,650.00   Patient Support
    Laboratorio Clinico Toledo          $2,190.00   Patient Support
    Laboratorio Clinico Toledo            $855.00   Patient Support
    Laboratorio Clinico Toledo          $1,785.00   Patient Support
    Laboratorio Clinico Toledo            $276.00   Patient Support
    Laboratorio Clinico Toledo          $1,680.00   Patient Support
    Laboratorio Clinico Toledo            $510.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo          $1,335.00   Patient Support
    Laboratorio Clinico Toledo          $1,650.00   Patient Support
    Laboratorio Clinico Toledo            $630.00   Patient Support
    Laboratorio Clinico Toledo            $990.00   Patient Support
    Laboratorio Clinico Toledo          $1,020.00   Patient Support
    Laboratorio Clinico Toledo          $1,275.00   Patient Support
    Laboratorio Clinico Toledo          $1,395.00   Patient Support
    Laboratorio Clinico Toledo            $315.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,290.00   Patient Support
    Laboratorio Clinico Toledo          $1,275.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $510.00   Patient Support
    Laboratorio Clinico Toledo            $315.00   Patient Support
    Laboratorio Clinico Toledo          $1,035.00   Patient Support
    Laboratorio Clinico Toledo            $240.00   Patient Support
    Laboratorio Clinico Toledo          $1,065.00   Patient Support
    Laboratorio Clinico Toledo            $660.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo            $810.00   Patient Support
    Laboratorio Clinico Toledo          $1,020.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo          $3,000.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $2,400.00   Patient Support
    Laboratorio Clinico Toledo            $465.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,410.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $444.00   Patient Support
    Laboratorio Clinico Toledo            $645.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo          $1,185.00   Patient Support
    Laboratorio Clinico Toledo          $1,320.00   Patient Support
    Laboratorio Clinico Toledo          $2,160.00   Patient Support
    Laboratorio Clinico Toledo          $1,740.00   Patient Support
    Lake County Haven                  $10,000.00   Corporate Sponsorship
    Large Urology Group                $20,000.00   Corporate Sponsorship
     Practice Association
    Large Urology Group                $15,000.00   Corporate Sponsorship
     Practice Association
    Large Urology Group                $66,400.00   Corporate Sponsorship
     Practice Association
    Large Urology Group                $25,000.00   Corporate Sponsorship
     Practice Association
    Leading Edge US LLC               $125,000.00   Educational Grants
    Leukemia and Lymphoma               $5,000.00   Educational Grants
     Society
    Leukemia and Lymphoma               $2,500.00   Educational Grants
     Society
    Leukemia and Lymphoma              $15,000.00   Corporate Sponsorship
     Society
    Leukemia and Lymphoma             $100,000.00   Corporate Sponsorship
     Society
    Leukemia Research                  $10,000.00   Corporate Sponsorship
     Foundation
    Leukemia Research                  $10,000.00   Corporate Sponsorship
     Foundation
    Leukemia Research                  $20,000.00   Corporate Sponsorship
     Foundation
    Leukemia Research                   $5,000.00   Corporate Sponsorship
     Foundation
    Life Sciences Foundation           $30,000.00   Charitable Donation
    Los Angeles Urological              $8,500.00   Corporate Sponsorship
     Society
    Louisiana State Univ Hlth         ($9,779.71)   Fellowships or
     Scnc Ctr                                        Scholarships
    Louisiana State Univ Hlth           $1,200.00   Corporate Sponsorship
     Scnc Foundation
    Lupus Research Inst Inc.           $50,000.00   Corporate Sponsorship
    Magellan Health Services           $35,000.00   Corporate Sponsorship
    Main Line Health, Inc.              $2,500.00   Educational Grants
    Map International                  $25,000.00   Corporate Sponsorship
    Maryland Dermatologic Socty        $75,000.00   Corporate Sponsorship
    Massachusetts Biotechnology         $5,000.00   Corporate Sponsorship
     Council
    Massachusetts Institute of          $1,250.00   Charitable Donation
     Technology
    Massachusetts Institute of          $1,250.00   Charitable Donation
     Technology
    Massachusetts Prostate              $5,000.00   Educational Grants
     Cancer Coalition
    Massachusetts Public Health         $2,500.00   Corporate Sponsorship
     Association
    Massachusetts Public Health         $2,500.00   Corporate Sponsorship
     Association
    Massachusetts Society for           $5,000.00   Educational Grants
     Medical Research
    Max Foundation                     $45,000.00   Corporate Sponsorship
    Medina Community Clinic             $1,000.00   Corporate Sponsorship
    Med-IQ, LLC                       $200,000.00   Educational Grants
    Med-IQ, LLC                       $156,924.00   Educational Grants
    Medscape LLC                      $205,000.00   Educational Grants
    Medscape LLC                        $1,000.00   Educational Grants
    Medscape LLC                      $175,000.00   Educational Grants
    Medscape LLC                      $300,000.00   Educational Grants
    Medscape LLC                      $150,000.00   Educational Grants
    Medscape LLC                      $150,000.00   Educational Grants
    Medscape LLC                       $50,000.00   Educational Grants
    Medscape LLC                      $190,000.00   Educational Grants
    Medscape LLC                      $250,000.00   Educational Grants
    Medscape LLC                       $60,000.00   Educational Grants
    Medscape LLC                       $50,000.00   Educational Grants
    Medscape LLC                        $8,000.00   Educational Grants
    Medscape LLC                      $150,000.00   Educational Grants
    Memorial Hermann Foundation        $35,000.00   Fellowships or
                                                     Scholarships
    Memphis Business Group on           $5,120.00   Corporate Sponsorship
     Health
    Memphis Business Group on           $6,500.00   Corporate Sponsorship
     Health
    Men Educating Men, Inc.            $20,000.00   Patient Support
    Mercer County Joint Twnshp          ($336.00)   Educational Grants
     Commty Hosp Dba Mercer
     Hlth
    Mercer County Joint Twnshp          $3,000.00   Patient Support
     Commty Hosp Dba Mercer
     Hlth
    Methodist Hosp The                 $25,000.00   Corporate Sponsorship
    Mexican American                    $5,000.00   Corporate Sponsorship
     Legislative Leadership
     Foundation
    Michael J Fox Foundation           $69,500.00   Educational Grants
    Michael J Fox Foundation           $25,000.00   Corporate Sponsorship
    Michael J Fox Foundation           $50,000.00   Corporate Sponsorship
    Michael J Fox Foundation            $7,500.00   Corporate Sponsorship
    Michigan Parkinson                  $2,000.00   Corporate Sponsorship
     Foundation
    Michigan Rheumatism Society        $15,000.00   Corporate Sponsorship
    Mid Atlantic Business Group         $7,500.00   Corporate Sponsorship
     Heatlh
    Midwest Business Group on           $1,000.00   Corporate Sponsorship
     Health
    Midwest Pediatric Endocrine         $6,300.00   Corporate Sponsorship
     Society
    Military officers                  $10,000.00   Corporate Sponsorship
     Association of America
     Family Initiative
    Minnesota Urological                $2,500.00   Corporate Sponsorship
     Society
    Mississippi                         $1,000.00   Corporate Sponsorship
     Gastroenterology Society
    Mississippi                         $1,500.00   Corporate Sponsorship
     Gastroenterology Society
    Missouri Hepatitis C               $25,000.00   Educational Grants
     Alliance
    Missouri Hepatitis C               $25,000.00   Educational Grants
     Alliance
    Missouri Hepatitis C               $25,000.00   Charitable Donation
     Alliance
    Montefiore Medical Center          $25,000.00   Educational Grants
    Montefiore Medical Center          $75,000.00   Educational Grants
    Montefiore Medical Center        ($10,457.00)   Educational Grants
    Mount Sinai School of               $8,000.00   Corporate Sponsorship
     Medicine
    Mount Sinai School of             $250,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $15,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $40,000.00   Educational Grants
     Medicine
    Mount Sinai School of               $5,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $20,000.00   Educational Grants
     Medicine
    Mount Sinai School of             $200,000.00   Educational Grants
     Medicine
    Movement Disorder Socty The       $172,000.00   Corporate Sponsorship
    Movement Disorder Socty The       $111,230.00   Educational Grants
    Movement Disorder Socty The       $184,500.00   Corporate Sponsorship
    Multiple Myeloma Research          $10,000.00   Educational Grants
     Foundation
    My Gut Instinct Inc.                $1,500.00   Corporate Sponsorship
    National Academy of                $30,000.00   Corporate Sponsorship
     Dermatology Nurse
     Practitioners
    National Academy of                $30,000.00   Corporate Sponsorship
     Dermatology Nurse
     Practitioners
    National AIDS Treatment           $150,000.00   Patient Support
     Advocacy Project
    National AIDS Treatment           $300,000.00   Charitable Donation
     Advocacy Project
    National Alliance of Mental         $5,000.00   Corporate Sponsorship
     Illness Michigan
    National Alliance of Mental         $2,500.00   Corporate Sponsorship
     Illness Oregon
    National Alliance of Mental         $2,500.00   Corporate Sponsorship
     Illness Washington
    National Alliance of State         $30,000.00   Corporate Sponsorship
     And Territorial Aids
     Directors
    National Alliance of State         $75,000.00   Charitable Donation
     And Territorial Aids
     Directors
    National Animal Interest           $20,000.00   Charitable Donation
     Alliance
    National Association of            $25,000.00   Corporate Sponsorship
     Latino Elected & Appointed
     officials Educational Fund
    National Black Leadership           $6,000.00   Corporate Sponsorship
     Commission on AIDS
    National Black Leadership           $5,000.00   Corporate Sponsorship
     Commission on AIDS
    National Black Leadership          $14,000.00   Corporate Sponsorship
     Commission on AIDS
    National Coalition for             $40,000.00   Corporate Sponsorship
     Cancer
    National Coalition for              $2,500.00   Corporate Sponsorship
     Cancer
    National Comprehensive             $25,000.00   Corporate Sponsorship
     Cancer Network
    National Comprehensive              $7,196.32   Educational Grants
     Cancer Network
    National Comprehensive             $50,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $50,000.00   Educational Grants
     Cancer Network
    National Comprehensive            ($1,824.00)   Educational Grants
     Cancer Network, Inc.
    National Family Caregivers         $30,000.00   Corporate Sponsorship
     Association
    National Foundation for            $25,000.00   Corporate Sponsorship
     Celiac Awareness
    National Hispanic Council          $30,000.00   Corporate Sponsorship
     on Aging
    National Kidney Foundation            $500.00   Corporate Sponsorship
    National Minority Quality          $20,000.00   Corporate Sponsorship
     forum Inc.
    National Minority Quality           $5,000.00   Corporate Sponsorship
     forum Inc
    National Multiple Sclerosis        $10,000.00   Corporate Sponsorship
     Society
    National Multiple Sclerosis        $10,000.00   Corporate Sponsorship
     Society
    National Multiple Sclerosis       $225,000.00   Corporate Sponsorship
     Society
    National Pancreas                   $5,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                  $75,000.00   Charitable Donation
     Foundation
    National Pancreas                  $75,000.00   Educational Grants
     Foundation
    National Pancreas                   $6,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                  $25,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                 $200,000.00   Educational Grants
     Foundation
    National Pancreas                   $2,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $1,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $1,500.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $2,500.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $2,500.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $2,500.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $1,500.00   Corporate Sponsorship
     Foundation
    National Pancreas                   $6,000.00   Corporate Sponsorship
     Foundation
    National Pancreas                     $500.00   Corporate Sponsorship
     Foundation
    National Patient Advocate          $65,000.00   Corporate Sponsorship
     Foundation Inc.
    National Psoriasis                 $30,000.00   Patient Support
     Foundation
    National Psoriasis                 $15,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                 $25,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                 $40,000.00   Educational Grants
     Foundation
    National Psoriasis                 $10,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                $150,000.00   Corporate Sponsorship
     Foundation
    National Psoriasis                 $50,000.00   Corporate Sponsorship
     Foundation
    National Society for               $50,000.00   Corporate Sponsorship
     Cutaneous Medicine
    National Society for              $125,000.00   Corporate Sponsorship
     Cutaneous Medicine
    National Society for              $135,000.00   Corporate Sponsorship
     Cutaneous Medicine
    Nationwide Childrens Hosp           $7,500.00   Corporate Sponsorship
     Foundation
    Natl Commission On                 $20,000.00   Educational Grants
     Correctional Hlth Care
    Natl Committee for Quality         $25,000.00   Corporate Sponsorship
     Assurance
    Natl Comprehensive Cancer          $40,000.00   Charitable Donation
     Ntwrk
    Natl Comprehensive Cancer          $25,000.00   Charitable Donation
     Ntwrk
    Natl Multiple Sclerosis            $15,000.00   Corporate Sponsorship
     Socty Greater Illinois
     Chapter
    Nebraska Gut Club                     $600.00   Corporate Sponsorship
    Neuro Challenge Foundation          $5,000.00   Corporate Sponsorship
     Inc.
    Neuropathy Action                   $2,500.00   Corporate Sponsorship
     Foundation
    New Jersey Association for          $2,500.00   Educational Grants
     Biomedical Research
    New Mexico Parkinsons               $3,000.00   Educational Grants
     Disease Coalition
    New York Academy of                 $2,500.00   Educational Grants
     Sciences
    New York State Rheumatology        $15,000.00   Corporate Sponsorship
     Society
    New York Univ School of            $10,000.00   Educational Grants
     Medicine
    New York Univ School of          ($40,000.01)   Fellowships or
     Medicine                                        Scholarships
    New York Univ School of            $10,000.00   Educational Grants
     Medicine
    Nicole Jarvis Md Parkinsons         $1,000.00   Corporate Sponsorship
     Research Foundation
    Nl Communications Inc.             $20,000.00   Educational Grants
    Nl Communications Inc.             $20,000.00   Educational Grants
    Nl Communications Inc.             $50,000.00   Educational Grants
    Nl Communications Inc.             $15,000.00   Educational Grants
    North American Ctr for            $350,000.00   Educational Grants
     Continuing Med Education
    North American Ctr for             $60,000.00   Educational Grants
     Continuing Med Education
    North American Ctr for            $200,000.00   Educational Grants
     Continuing Med Education
    North American Ctr for            $200,000.00   Educational Grants
     Continuing Med Education
    North American Ctr for            $375,000.00   Educational Grants
     Continuing Med Education
    North American Ctr for             $39,500.00   Educational Grants
     Continuing Med Education
    North American Ctr for             $88,000.00   Educational Grants
     Continuing Med Education
    Northeast Business Group on         $1,000.00   Corporate Sponsorship
     Health
    Northeast Business Group on         $5,000.00   Corporate Sponsorship
     Health
    Northwest Arthritis and           $120,000.00   Educational Grants
     Osteoporosis Institute
    Northwest Arthritis and            $30,000.00   Educational Grants
     Osteoporosis Institute
    Northwest Kidney Centers            $2,500.00   Corporate Sponsorship
    Northwest Kidney Centers            $2,500.00   Corporate Sponsorship
    Northwest Parkinson's               $4,500.00   Educational Grants
     Foundation
    Northwest Parkinson's                 $550.00   Corporate Sponsorship
     Foundation
    Northwestern University            $40,000.00   Fellowships or
                                                     Scholarships
    Northwestern University            $40,000.00   Fellowships or
                                                     Scholarships
    Northwestern University             $3,000.00   Educational Grants
    Norton Healthcare                   $1,200.00   Corporate Sponsorship
     Foundation
    Novation LLC                       $25,000.00   Corporate Sponsorship
    Nyu Langone Medical Center          $3,000.00   Corporate Sponsorship
    Ochsner Clinic Foundation           $2,000.00   Corporate Sponsorship
    Ohio Association of                $10,000.00   Corporate Sponsorship
     Rheumatology
    Ohio Gastroenterology               $5,000.00   Corporate Sponsorship
     Society
    Oklahoma State Urological          $10,000.00   Corporate Sponsorship
     Association
    Oncology Nursing Society            $5,000.00   Educational Grants
    One Health Research                $50,000.00   Charitable Donation
    Oregon Health And Science           $3,000.00   Corporate Sponsorship
     University
    Oregon Health And Science          $12,000.00   Educational Grants
     University
    Oregon Health And Science           $5,000.00   Educational Grants
     University
    Oregon Health And Science           $3,000.00   Corporate Sponsorship
     University
    Oregon State University             $7,500.00   Corporate Sponsorship
     Foundation
    Orthopaedic Research                $5,000.00   Educational Grants
     Society
    Pacific Dermatologic               $10,000.00   Corporate Sponsorship
     Association
    Pacific Dermatologic               $20,000.00   Corporate Sponsorship
     Association
    Pancreas Club The                  $10,000.00   Educational Grants
    Pancreatic Cancer Action            $3,000.00   Corporate Sponsorship
     Network
    Pancreatic Cancer Action            $3,000.00   Corporate Sponsorship
     Network
    Pancreatic Cancer Action          $200,000.00   Corporate Sponsorship
     Network
    Park Nicollet Foundation            $1,000.00   Corporate Sponsorship
    Parkinson Alliance Inc.               $500.00   Corporate Sponsorship
    Parkinson Alliance Inc.             $1,000.00   Corporate Sponsorship
    Parkinson And Movement              $4,000.00   Corporate Sponsorship
     Disorder Alliance
    Parkinson Association of            $2,500.00   Corporate Sponsorship
     Alabama
    Parkinson Association of            $1,000.00   Corporate Sponsorship
     The Carolinas
    Parkinson Association of            $8,000.00   Patient Support
     The Rockies
    Parkinson Council                   $1,000.00   Corporate Sponsorship
    Parkinson Foundation of               $500.00   Corporate Sponsorship
     Oklahoma
    Parkinson Foundation of             $1,500.00   Corporate Sponsorship
     Oklahoma
    Parkinson Foundation of The         $5,000.00   Educational Grants
     National Capital Area
    Parkinson Foundation of The         $2,500.00   Corporate Sponsorship
     National Capital Area
    Parkinson Foundation                $5,000.00   Corporate Sponsorship
     Western Pennsylvania
    Parkinson Institute                $25,000.00   Corporate Sponsorship
    Parkinson Society of                  $250.00   Corporate Sponsorship
     Greenville Area
    Parkinson Support Group of          $2,000.00   Educational Grants
     Upstate NY
    Parkinson Voice Project             $2,500.00   Corporate Sponsorship
    Parkinsons Action Network           $1,000.00   Corporate Sponsorship
     Foundation
    Parkinsons Action Network           $1,000.00   Corporate Sponsorship
     Foundation
    Parkinsons Action Network           $2,500.00   Corporate Sponsorship
     Foundation
    Parkinsons Action Network           $5,000.00   Corporate Sponsorship
     Foundation
    Parkinsons And Movement             $2,000.00   Corporate Sponsorship
     Disorder Foundation
    Parkinson's Disease                $50,000.00   Educational Grants
     Foundation
    Parkinsons Disease Research         $1,000.00   Corporate Sponsorship
     Society
    Parkinson's Resources of            $5,000.00   Patient Support
     Oregon
    Parkinson's Resources of            $2,500.00   Corporate Sponsorship
     Oregon
    Partnership for A Drug-Free        $50,000.00   Charitable Donation
     America
    Patient Access Network          $3,000,000.00   Charitable Donation
     Foundation
    Patient Access Network          $5,000,000.00   Charitable Donation
     Foundation
    Patient Access Network          $5,000,000.00   Charitable Donation
     Foundation
    Patient Access Network            $250,000.00   Charitable Donation
     Foundation
    Patient Access Network            $387,500.00   Charitable Donation
     Foundation
    Patient Access Network            $400,000.00   Charitable Donation
     Foundation
    Patient Access Network            $500,000.00   Charitable Donation
     Foundation
    Patient Empowerment Network         $9,000.00   Educational Grants
    Patient Empowerment Network        $20,000.00   Patient Support
    Patient Empowerment Network        $20,000.00   Educational Grants
    Patient Empowerment Network        $35,000.00   Educational Grants
    Pediatric Endocrinology             $5,000.00   Corporate Sponsorship
     Nursing Society
    Pediatric Ibd Foundation           $15,000.00   Corporate Sponsorship
    Pediatric Specialists of            $2,500.00   Corporate Sponsorship
     Virginia LLC
    Pennsylvania Biotechnology          $3,000.00   Corporate Sponsorship
     Association
    Pennsylvania Prostate               $5,000.00   Patient Support
     Cancer Coalition
    Pennsylvania Society of            $15,000.00   Corporate Sponsorship
     Gastroenterology
    Pennsylvania State Univ           $135,000.00   Educational Grants
    Pennsylvania State Univ            $50,000.00   Educational Grants
    Pennsylvania State Univ           ($3,067.00)   Educational Grants
    Pennsylvania State Univ            $50,000.00   Educational Grants
    Pennsylvania State Univ           ($9,660.00)   Educational Grants
    Pennsylvania State Univ          ($32,062.00)   Educational Grants
    Pennsylvania State Univ            $75,000.00   Educational Grants
    Pennsylvania State Univ            $75,000.00   Educational Grants
    Philadelphia Dermatological        $75,000.00   Corporate Sponsorship
     Society
    Philadelphia Fight                  $5,000.00   Corporate Sponsorship
    Philadelphia Fight                  $2,500.00   Corporate Sponsorship
    Phmcy Quality Alliance             $10,000.00   Educational Grants
    Phrmct Care Mgmt Asoc              $75,000.00   Corporate Sponsorship
    Phrmct Care Mgmt Asoc              $60,000.00   Corporate Sponsorship
    Phrmct Care Mgmt Asoc              $85,000.00   Corporate Sponsorship
    Phrmct Care Mgmt Asoc              $70,000.00   Corporate Sponsorship
    Physicians' Education              $40,000.00   Educational Grants
     Resource, LLC
    Physicians' Education              $85,000.00   Educational Grants
     Resource, LLC
    Pikes Peak Habitat for              $2,500.00   Charitable Donation
     Humanity
    Premier Cares Foundation            $5,000.00   Corporate Sponsorship
    Premier Cares Foundation            $5,000.00   Corporate Sponsorship
    President and Fellows of            $3,000.00   Educational Grants
     Harvard College
    President and Fellows of            $5,000.00   Educational Grants
     Harvard College
    Prevent Cancer Foundation          $25,000.00   Corporate Sponsorship
    Prevent Cancer Foundation          $10,000.00   Corporate Sponsorship
    Prevent Cancer Foundation          $75,000.00   Corporate Sponsorship
    Prime Education, Inc.             $198,011.00   Educational Grants
    Prime Education, Inc.             $400,000.00   Educational Grants
    Project Inform Inc.                $75,000.00   Patient Support
    Project Inform Inc.                $75,000.00   Charitable Donation
    Prostate Cancer Education           $2,500.00   Corporate Sponsorship
     Council
    Prostate Cancer Foundation          $4,000.00   Corporate Sponsorship
     Chicago
    Prostate Cancer Research           $25,000.00   Educational Grants
     Institute
    Prostate Cancer Research           $10,000.00   Corporate Sponsorship
     Institute
    Prostate Health Education          $15,000.00   Educational Grants
     Network, Inc.
    Prostate Health Education          $15,000.00   Educational Grants
     Network, Inc.
    Prostate Health                     $5,000.00   Corporate Sponsorship
     International
    Prostate Health                     $5,000.00   Corporate Sponsorship
     International
    Protein Society                     $1,500.00   Educational Grants
    Puerto Rico Academy of              $5,000.00   Corporate Sponsorship
     Family Physician
    Puerto Rico Community               $5,000.00   Educational Grants
     Network for Clinical
     Research On Aids Inc.
    Puerto Rico                        $20,000.00   Educational Grants
     Gastroenterology
     Association
    Puerto Rico                        $10,000.00   Educational Grants
     Gastroenterology
     Association
    Purdue University                 $125,000.00   Educational Grants
    Purdue University                 $200,000.00   Educational Grants
    Purdue University                 $300,000.00   Educational Grants
    PVI Peerview Institute for        $100,000.00   Educational Grants
     Medical Education
    PVI Peerview Institute for          ($207.00)   Educational Grants
     Medical Education
    Quinsigamond Community                $500.00   Charitable Donation
     College
    Rectors And Visitors of The         $3,000.00   Educational Grants
     University of Virginia
    Regents of The University          $40,000.00   Fellowships or
     of California                                   Scholarships
    Regents of The University          $25,000.00   Educational Grants
     of California
    Regents of The University           $5,000.00   Educational Grants
     of California
    Regents of The University           $3,500.00   Educational Grants
     of California
    Regents of The University           $5,000.00   Educational Grants
     of California
    Regents of The University           $4,000.00   Educational Grants
     of California
    Regents of The University          $10,000.00   Educational Grants
     of California
    Regents of The University           $2,000.00   Educational Grants
     of Michigan
    Regents of The University          $10,000.00   Educational Grants
     of Michigan
    Regents of The University          $10,000.00   Corporate Sponsorship
     of Michigan
    Regents University of              $40,000.00   Fellowships or
     California Los Angeles                          Scholarships
    Regents University of              $10,000.00   Educational Grants
     California Los Angeles
    Regents University of              $40,000.00   Fellowships or
     California Los Angeles                          Scholarships
    Regents University of               $5,000.00   Educational Grants
     California Los Angeles
    Respiratory Health                  $3,500.00   Corporate Sponsorship
     Association of
     Metropolitan Chicago
    Respiratory Health                  $4,050.00   Corporate Sponsorship
     Association of
     Metropolitan Chicago
    Rheumatism Society of The          $15,000.00   Corporate Sponsorship
     District of Columbia
    Rheumatism Society of The           $5,000.00   Corporate Sponsorship
     District of Columbia
    Rheumatology Alliance of           $25,000.00   Corporate Sponsorship
     Louisiana
    Rheumatology Nurses Society        $29,700.00   Corporate Sponsorship
    Rhode Island Pharmacy                 $600.00   Corporate Sponsorship
     Association
    Riverside Medical Clinic            $7,500.00   Patient Support
     Charitable Foundation
    Robert Michael Educational        $236,065.00   Educational Grants
     Institute LLC
    Robert Michael Educational         $90,000.00   Educational Grants
     Institute LLC
    Robert Michael Educational        $275,000.00   Educational Grants
     Institute LLC
    Robert Michael Educational         $90,000.00   Educational Grants
     Institute LLC
    Rock Hlth Inc.                     $15,000.00   Corporate Sponsorship
    Rush University Medical            $15,000.00   Educational Grants
     Center
    Rush University Medical             $5,000.00   Educational Grants
     Center
    Rutgers University                  $1,250.00   Charitable Donation
     Foundation
    Rutgers, The State                 $60,000.00   Educational Grants
     University of New Jersey
    Rutgers, The State                 $25,000.00   Educational Grants
     University of New Jersey
    Rutgers, The State                 $60,000.00   Educational Grants
     University of New Jersey
    Rutgers, The State                 $25,000.00   Educational Grants
     University of New Jersey
    Safety Pharmacology Society         $5,000.00   Educational Grants
    Saint Francis Hospital And         $15,000.00   Educational Grants
     Medical Center
    Saint Louis University             $50,000.00   Corporate Sponsorship
     Hospital
    Scientists Center for               $2,500.00   Educational Grants
     Animal Welfare
    Scott And White Healthcare            $300.00   Corporate Sponsorship
     Foundation
    Scripps Health                     $75,000.00   Educational Grants
    Scripps Research Institute          $2,000.00   Educational Grants
    Scripps Research Institute          $2,000.00   Educational Grants
    Sexual Medicine Society of         $25,000.00   Educational Grants
     North America
    Sexual Medicine Society of        $225,000.00   Corporate Sponsorship
     North America
    Shanti Project Inc.                $20,000.00   Patient Support
    Smart Ride The                     $25,000.00
                                                 Corporate
                                      Sponsorship
    Sociedad Dermatologica De          $20,000.00   Corporate Sponsorship
     Puerto Rico
    Sociedad Dermatologica De          $10,000.00   Corporate Sponsorship
     Puerto Rico
    Sociedad Endocrinologia            $10,000.00   Corporate Sponsorship
     Metabolismo Y Diabetes Del
     Sur
    Sociedad Puertorriquena De         $15,000.00   Corporate Sponsorship
     Endocronologia Y
     Diabetologia
    Sociedad Puertorriquena De         $10,000.00   Corporate Sponsorship
     Endocronologia Y
     Diabetologia
    Sociedad Puertorriquena De          $5,000.00   Corporate Sponsorship
     Pediatria
    Sociedad Puertorriquena De          $5,000.00   Corporate Sponsorship
     Pediatria
    Sociedad Puertorriquena De          $5,000.00   Corporate Sponsorship
     Pediatria
    Society for Investigative          $20,000.00   Educational Grants
     Dermatology
    Society for Leukocyte               $1,500.00   Educational Grants
     Biology
    Society for Mucosal                $16,398.00   Corporate Sponsorship
     Immunology
    Society for Neuroscience          ($2,500.00)   Educational Grants
    Society for Neuroscience            $1,000.00   Educational Grants
    Society for Neuroscience            $2,000.00   Educational Grants
    Society for Translational          $15,000.00   Educational Grants
     Oncology
    Society of Dermatology             $20,000.00   Corporate Sponsorship
     Physician Assistants
    Society of Dermatology             $45,000.00   Corporate Sponsorship
     Physician Assistants
    Society of Dermatology             $30,000.00   Corporate Sponsorship
     Physician Assistants
    Society of Gastroenterology        $25,000.00   Educational Grants
     Nurses & Associates
    Society of Neuro Oncology          $16,000.00   Corporate Sponsorship
    Society of Nuclear Medicine         $4,000.00   Corporate Sponsorship
    Society of Toxicologic             $15,000.00   Corporate Sponsorship
     Pathology
    Socty of Toxicology                 $2,000.00   Fellowships or
                                                     Scholarships
    Somos El Futuro, Inc.               $5,000.00   Corporate Sponsorship
    South Carolina Alliance of          $5,000.00   Corporate Sponsorship
     Health Plans
    Southern Illinois                   ($711.12)   Fellowships or
     University                                      Scholarships
    Spondylitis Association of         $40,000.00   Educational Grants
     America
    Spondylitis Association of         $19,000.00   Educational Grants
     America
    Spondyloarthritis Research         $25,000.00   Corporate Sponsorship
     And Treatment Network
     Spartan
    St. Christophers Foundation         $5,000.00   Corporate Sponsorship
     for Children
    St. Lukes Regional Medical         $10,000.00   Corporate Sponsorship
     Center
    St. Luke's-Roosevelt                $5,000.00   Educational Grants
     Hospital Center
    Take A Breather Foundation         $10,000.00   Corporate Sponsorship
    Tampa Bay Latin American            $3,000.00   Corporate Sponsorship
     Medical Society
    Team Fox North Texas                  $500.00   Corporate Sponsorship
    Tennessee Rheumatology              $7,500.00   Corporate Sponsorship
     Society
    Teratology Society                  $2,000.00   Educational Grants
    Test Positive Awareness            $30,000.00   Corporate Sponsorship
     Network
    Texas Liver Inst The               $30,000.00   Corporate Sponsorship
    Texas Osteopathic Medical           $1,000.00   Corporate Sponsorship
     Association
    Texas Urological Society            $6,000.00   Corporate Sponsorship
    Thomas Jefferson University       $500,000.00   Educational Grants
     Medical College
    Thomas Jefferson University        $10,000.00   Educational Grants
     Medical College
    Thomas Jefferson University         $2,500.00   Corporate Sponsorship
     Medical College
    Torrington Area Parkinsons            $500.00   Corporate Sponsorship
     Support Group
    Trustees of The University         $40,000.00   Educational Grants
     of Pennsylvania
    Twine Clinical Consulting         $411,950.00   Educational Grants
     LLC
    Ultimate Med Academy Med          ($3,550.00)   Educational Grants
     Learning Grp LLC
    United States Adult Cystic          $7,500.00   Educational Grants
     Fibrosis Association
    Univ Hlth Srvc At Stony            $20,000.00   Educational Grants
     Point Inc.
    Univ of Colorado Denver             $2,500.00   Educational Grants
     School of Medicine
    Universidad Central Del            $10,000.00   Educational Grants
     Caribe, Inc.
    University At Buffalo               $1,250.00   Charitable Donation
     Foundation Inc.
    University of Alabama At           $40,000.00   Fellowships or
     Birmingham                                      Scholarships
    University of California--         $10,000.00   Educational Grants
     San Francisco
    University of California           $30,000.00   Educational Grants
     Berkeley
    University of California            $5,000.00   Educational Grants
     Irvine
    University of Chicago            ($75,000.00)   Educational Grants
    University of Chicago              $65,000.00   Educational Grants
    University of Chicago               $5,000.00   Educational Grants
    University of Chicago               $7,000.00   Educational Grants
    University of Chicago             $157,000.00   Educational Grants
    University of Chicago             ($4,249.00)   Educational Grants
    University of Chicago             ($3,746.25)   Educational Grants
    University of Chicago               $1,000.00   Corporate Sponsorship
    University of Chicago             $400,000.00   Educational Grants
    University of Chicago               $1,500.00   Educational Grants
    University of Chicago            ($13,195.00)   Educational Grants
    University of Cincinnati           $60,000.00   Educational Grants
    University of Cincinnati         ($25,000.00)   Educational Grants
    University of Cincinnati         ($50,000.00)   Educational Grants
    University of Cincinnati         ($25,000.00)   Educational Grants
    University of Cincinnati        $2,081,222.00   Educational Grants
    University of Cincinnati            $5,000.00   Educational Grants
    University of Cincinnati            $2,000.00   Educational Grants
    University of Cincinnati           $30,000.00   Educational Grants
    University of Cincinnati            $8,000.00   Educational Grants
    University of Cincinnati           $75,000.00   Educational Grants
    University of Connecticut          $40,000.00   Fellowships or
                                                     Scholarships
    University of Connecticut          $12,000.00   Fellowships or
                                                     Scholarships
    University of Florida             $125,875.00   Educational Grants
    University of Florida             ($5,709.00)   Educational Grants
    University of Florida               $1,500.00   Educational Grants
     Foundation Inc.
    University of Florida              $40,000.00   Fellowships or
     Foundation Inc.                                 Scholarships
    University of Illinois             $12,000.00   Corporate Sponsorship
    University of Illinois             $12,000.00   Corporate Sponsorship
    University of Louisville           $15,000.00   Educational Grants
     Research Foundation, Inc.
    University of Maryland              $5,500.00   Educational Grants
    University of Maryland             $10,000.00   Educational Grants
     Baltimore
    University of Maryland              $1,250.00   Charitable Donation
     Baltimore Foundation
    University of Massachusetts         $2,500.00   Charitable Donation
     Med School
    University of Miami                $25,000.00   Educational Grants
    University of Miami                $10,000.00   Educational Grants
    University of Miami                $50,000.00   Corporate Sponsorship
     Department of Dermatology
    University of Minnesota             $1,250.00   Charitable Donation
    University of Minnesota             $1,250.00   Charitable Donation
    University of Minnesota             $1,250.00   Charitable Donation
    University of Missouri Dept           $500.00   Corporate Sponsorship
     of Neurology
    University of Nebraska Med         $25,000.00   Educational Grants
     Ctr
    University of Nebraska Med         $10,000.00   Educational Grants
     Ctr
    University of Nebraska Med         $50,000.00   Educational Grants
     Ctr
    University of Nebraska Med          $5,000.00   Educational Grants
     Ctr
    University of North                $40,000.00   Fellowships or
     Carolina At Chapel Hill                         Scholarships
    University of North                 $2,500.00   Educational Grants
     Carolina At Chapel Hill
    University of Pittsburgh           $10,000.00   Educational Grants
    University of Pittsburgh           $10,000.00   Educational Grants
    University of Pittsburgh            $2,250.00   Educational Grants
    University of Pittsburgh            $2,000.00   Educational Grants
    University of Pittsburgh           $20,000.00   Educational Grants
    University of Rochester,           $40,000.00   Fellowships or
     Center for Experiential                         Scholarships
     Learning
    University of South Florida        $50,000.00   Educational Grants
     Hlth Professions
     Conferencing Corporation
    University of South Florida        $10,000.00   Corporate Sponsorship
     Hlth Professions
     Conferencing Corporation
    University of South Florida        $10,000.00   Corporate Sponsorship
     Hlth Professions
     Conferencing Corporation
    University of Southern              $1,500.00   Educational Grants
     California
    University of Southern           ($17,026.00)   Educational Grants
     California
    University of Southern            ($2,974.00)   Educational Grants
     California
    University of Southern             $71,800.00   Fellowships or
     California                                      Scholarships
    University of Texas Hlth            $2,500.00   Educational Grants
     Scnc Ctr At San Antonio
    University of Texas Hlth          $135,000.00   Corporate Sponsorship
     Scnc Ctr At San Antonio
    University of Texas Hlth           $50,000.00   Educational Grants
     Scnc Ctr At San Antonio
    University of Texas             ($100,000.00)   Educational Grants
     Southwestern Med Ctr
    University of The                   $1,500.00   Corporate Sponsorship
     Philippines Med Alumni
     Socty In America Nevada
    University of Toledo                $2,000.00   Educational Grants
    University of Utah                 $40,000.00   Fellowships or
                                                     Scholarships
    Urological Association of          $10,000.00   Corporate Sponsorship
     Physician Assistants
    Urological Association of          $25,000.00   Corporate Sponsorship
     Physician Assistants
    Urology Center of Colorado          $7,500.00   Corporate Sponsorship
     Foundation
    US Pain Foundation, Inc.           $25,000.00   Corporate Sponsorship
    US Pain Foundation, Inc.           $30,000.00   Corporate Sponsorship
    US Pain Foundation, Inc.           $80,000.00   Corporate Sponsorship
    Us Too International Inc.           $5,000.00   Corporate Sponsorship
    Us Too International Inc.           $5,000.00   Corporate Sponsorship
    Us Too International Inc.          $25,000.00   Corporate Sponsorship
    USMD Health System                 $10,000.00   Corporate Sponsorship
    Van Andel Research                  $5,000.00   Educational Grants
     Institute
    Vanderbilt University Med          $25,000.00   Fellowships or
     Ctr                                             Scholarships
    Vanderbilt University               $2,500.00   Educational Grants
     Medical Center
    Vindico Medical Education         $146,000.00   Educational Grants
     LLC
    Vindico Medical Education         $500,000.00   Educational Grants
     LLC
    Vindico Medical Education          $35,000.00   Educational Grants
     LLC
    Virginia Commonwealth Univ          $1,250.00   Charitable Donation
     School of Medicine
    Virginia Commonwealth Univ          $1,000.00   Corporate Sponsorship
     School of Medicine
    Wall Las Memorias                  $25,000.00   Corporate Sponsorship
    Washington State Urology            $7,500.00   Corporate Sponsorship
     Society
    Washington University               $5,000.00   Educational Grants
    Washington University             ($1,248.95)   Fellowships or
                                                     Scholarships
    WC Research Inc.                    $8,500.00   Corporate Sponsorship
    Webmd Global LLC                  $430,600.00   Educational Grants
    Webmd Global LLC                $1,165,500.00   Educational Grants
    Well Project Inc.                  $20,000.00   Charitable Donation
    Western States Phmcy               $10,000.00   Corporate Sponsorship
     Conference for Phmcy
     Residents Fellowships &
     Preceptors
    Wheaton Franciscan                    $500.00   Corporate Sponsorship
     Healthcare Foundation
    Wisconsin Academy of Phys           $4,000.00   Corporate Sponsorship
     Assistants
    Wisconsin Collaborative for         $2,500.00   Corporate Sponsorship
     Healthcare Quality
    Wisconsin Dairyland Chapter         $1,910.00   Corporate Sponsorship
     of HIMSS
    Wisconsin Medical Society             $450.00   Corporate Sponsorship
    Wisconsin Rheumatology              $5,000.00   Corporate Sponsorship
     Association
    Wishes And Dreams for               $2,500.00   Corporate Sponsorship
     Cystic Fibrosis
    Wj Weiser And Associates           $20,000.00   Corporate Sponsorship
    Wj Weiser And Associates           $10,000.00   Corporate Sponsorship
    World Parkinson Coalition          $15,000.00   Educational Grants
     Inc.
    World Parkinson Coalition         $207,000.00   Corporate Sponsorship
     Inc.
    Yale University                  ($10,000.00)   Educational Grants
    Yale University                    $25,000.00   Educational Grants
    Yale University                     $2,500.00   Educational Grants
    Young Survival Coalition           $30,000.00   Corporate Sponsorship
    Zebrafish Disease Models           $10,000.00   Educational Grants
     Society
    Zero The End of Prostate           $10,000.00   Corporate Sponsorship
     Cancer
    Zero The End of Prostate          $250,000.00   Corporate Sponsorship
     Cancer
    Zero The End of Prostate           $15,000.00   Corporate Sponsorship
     Cancer
    Zero The End of Prostate            $2,500.00   Corporate Sponsorship
     Cancer
    ------------------------------------------------------------------------

                          Grants Donations Report--2016
        (Parentheses represent refunds of previously disclosed payments)
                             Report as of 3/31/2017
    ------------------------------------------------------------------------
             Recipient             Payment Amount           Purpose
    ------------------------------------------------------------------------
    50 Hoops                           $10,000.00   Educational Grants
    A And R Educational Grp LLC         $4,000.00   Corporate Sponsorship
    A Runners Love                      $5,000.00   Corporate Sponsorship
    AAALAC International                $5,000.00   Educational Grants
    Academy of Managed Care            $25,000.00   Corporate Sponsorship
     Phmcy
    Academy of Managed Care            $25,000.00   Corporate Sponsorship
     Phmcy
    Academy of Managed Care            $18,000.00   Corporate Sponsorship
     Phmcy
    Academy of Managed Care            $40,000.00   Corporate Sponsorship
     Phmcy
    Academy of Managed Care            $50,000.00   Corporate Sponsorship
     Phmcy
    Advances in Cosmetic And           $75,000.00   Corporate Sponsorship
     Med Dermatology Inc.
    Advances in Cosmetic And           $75,000.00   Corporate Sponsorship
     Med Dermatology Inc.
    Advances in Cosmetic And          $100,000.00   Corporate Sponsorship
     Med Dermatology Inc.
    Adventist Hlth System--            $15,000.00   Corporate Sponsorship
     Sunbelt Inc.
    Adventist Hlth System--            $15,000.00   Corporate Sponsorship
     Sunbelt Inc.
    Advocate Hlth And Hospitals         $2,000.00   Educational Grants
     Corporation
    Advocate Hlth And Hospitals         $2,500.00   Educational Grants
     Corporation
    Aesthetic Dermatology              $25,000.00   Corporate Sponsorship
     Symposia
    AIDS Action Committee               $5,000.00   Corporate Sponsorship
    Aids Drug Assistance                $5,000.00   Charitable Donations
     Programs Advocacy Asoc
    AIDS Foundation of Chicago          $7,500.00   Corporate Sponsorship
    AIDS Foundation of Chicago          $7,500.00   Corporate Sponsorship
    AIDS Foundation of Chicago        ($7,500.00)   Corporate Sponsorship
    AIDS Foundation of Chicago         $75,000.00   Charitable Donations
    AIDS Institute                     $50,000.00   Corporate Sponsorship
    AIDS Institute                     $50,000.00   Corporate Sponsorship
    AIDS Institute                     $30,000.00   Corporate Sponsorship
    AIDS Institute                     $75,000.00   Corporate Sponsorship
    Alabama Asoc of Hlth Plans          $3,000.00   Corporate Sponsorship
    Alabama Dermatology Socty          $35,000.00   Corporate Sponsorship
     The
    Albany Med Colg                     $5,000.00   Educational Grants
    Albany Med Colg                    $10,000.00   Corporate Sponsorship
    Albert Einstein Colg of            $10,000.00   Educational Grants
     Medicine Div of
     Dermatology Attending Asoc
    Albert Einstein College of         $20,000.00   Educational Grants
     Medicine of Yeshiva
     University
    Albert Einstein College of         $10,000.00   Educational Grants
     Medicine of Yeshiva
     University
    Albert Einstein College of          $5,000.00   Educational Grants
     Medicine of Yeshiva
     University
    Albert Einstein College of          $5,000.00   Educational Grants
     Medicine of Yeshiva
     University
    Albert Einstein Hlthcr              $5,750.00   Corporate Sponsorship
     Ntwrk
    Alliance for Aging Research        $30,000.00   Corporate Sponsorship
    Alliance for Aging Research        $25,000.00   Corporate Sponsorship
    Alzheimers Asoc                    $15,000.00   Educational Grants
    Alzheimers Asoc                     $2,500.00   Corporate Sponsorship
    American Academy of                $40,000.00   Charitable Donations
     Dermatology
    American Academy of                $20,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $13,550.00   Charitable Donations
     Dermatology
    American Academy of                $40,000.00   Educational Grants
     Dermatology
    American Academy of              ($60,000.00)   Educational Grants
     Dermatology
    American Academy of               $250,000.00   Corporate Sponsorship
     Dermatology
    American Academy of                $50,000.00   Educational Grants
     Dermatology
    American Academy of                $10,000.00   Charitable Donations
     Dermatology
    American Academy of Family         $15,500.00   Educational Grants
     Phys
    American Academy of                 $9,290.00   Educational Grants
     Neurology Institute
    American Academy of                $80,000.00   Corporate Sponsorship
     Neurology Institute
    American Academy of                $20,720.70   Corporate Sponsorship
     Neurology Institute
    American Academy of                $24,700.00   Educational Grants
     Neurology Institute
    American Academy of                $10,010.00   Corporate Sponsorship
     Neurology Institute
    American Academy of                $50,000.00   Fellowships and
     Neurology Institute                             Scholarships
    American Academy of                 $2,700.00   Corporate Sponsorship
     Neurology Institute
    American Academy of                $22,616.70   Corporate Sponsorship
     Neurology Institute
    American Academy of                 $6,500.00   Corporate Sponsorship
     Ophthalmology AAO
    American Academy of                $15,000.00   Corporate Sponsorship
     Ophthalmology AAO
    American Academy of Phys           $10,000.00   Educational Grants
     Assistants
    American Assoc for Cancer          $50,000.00   Educational Grants
     Research
    American Assoc for Cancer          $20,000.00   Fellowships and
     Research                                        Scholarships
    American Assoc for Cancer          $10,000.00   Educational Grants
     Research
    American Assoc for Cancer          $50,000.00   Educational Grants
     Research
    American Assoc for Cancer          $10,000.00   Educational Grants
     Research
    American Assoc for Cancer          $25,000.00   Charitable Donations
     Research
    American Assoc for Cancer          $20,000.00   Educational Grants
     Research
    American Assoc for Cancer          $10,000.00   Educational Grants
     Research
    American Assoc for Cancer          $10,000.00   Educational Grants
     Research
    American Assoc for Cancer          $15,000.00   Educational Grants
     Research
    American Assoc for Cancer          $15,000.00   Educational Grants
     Research
    American Assoc for Cancer          $15,000.00   Educational Grants
     Research
    American Assoc for Cancer          $50,000.00   Educational Grants
     Research
    American Assoc for Cancer          $15,000.00   Educational Grants
     Research
    American Assoc for Cancer          $10,000.00   Educational Grants
     Research
    American Assoc for Lab             $20,000.00   Charitable Donations
     Animal Scnc Fdtn
    American Assoc for The             $85,000.00   Corporate Sponsorship
     Study of Liver Diseases
    American Assoc of Clinical         $15,000.00   Educational Grants
     Endocrinologists New
     Jersey Chapter
    American Assoc of Clinical         $25,000.00   Educational Grants
     Endocrinologists New
     Jersey Chapter
    American Assoc of Clinical        $328,000.00    Corporate Sponsorship
     Endocrinologists New
     Jersey Chapter
    American Assoc of Phys of          $10,000.00   Corporate Sponsorship
     Indian Origin Arkansas
    American Asosc of Phys of           $5,000.00   Corporate Sponsorship
     Indian Origin Arkansas
    American Association for          $500,000.00   Charitable Donations
     The Study of Liver
     Diseases (AASLD
     Foundation)
    American Association of            $50,000.00   Corporate Sponsorship
     Pharmaceutical Scientists
    American Brain Tumor Asoc           $7,500.00   Corporate Sponsorship
    American Brain Tumor Asoc           $5,000.00   Corporate Sponsorship
    American Brain Tumor Asoc           $5,000.00   Corporate Sponsorship
    American Brain Tumor Asoc          $10,000.00   Educational Grants
    American Brain Tumor Asoc           $7,000.00   Educational Grants
    American Cancer Society             $5,000.00   Corporate Sponsorship
    American Cancer Society             $2,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society            $25,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $5,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $3,500.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $1,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $7,000.00   Corporate Sponsorship
     Cancer Action Network
    American Cancer Society             $5,000.00   Corporate Sponsorship
     Cancer Action Network
    American Chem Socty                 $2,500.00   Educational Grants
    American Chem Socty                 $2,500.00   Educational Grants
    American Chem Socty                 $2,500.00   Educational Grants
    American Chem Socty                 $1,000.00   Educational Grants
    American Childhood Cancer           $2,500.00   Corporate Sponsorship
     Organization
    American Colg of Gastro           $100,000.00   Corporate Sponsorship
    American Colg of Gastro            $15,640.00   Corporate Sponsorship
    American Colg of Gastro            $15,640.00   Corporate Sponsorship
    American Colg of Gastro            $15,640.00   Corporate Sponsorship
    American Colg of Gastro            $41,400.00   Corporate Sponsorship
    American Colg of Gastro            $10,000.00   Educational Grants
    American Colg of Gastro           $500,000.00   Corporate Sponsorship
    American Colg of Gastro            $20,000.00   Corporate Sponsorship
    American Colg of Lab Animal        $30,000.00   Charitable Donations
     Medicine
    American Colg of                   $30,000.00   Corporate Sponsorship
     Obstetricians And
     Gynecologists
    American Colg of                   $32,500.00   Corporate Sponsorship
     Obstetricians And
     Gynecologists
    American Colg of                    $2,500.00   Corporate Sponsorship
     Obstetricians And
     Gynecologists District 1
    American Colg of Rheumlgy       $2,000,000.00   Corporate Sponsorship
     Research And Education
     Fdtn
    American Colg of Rheumlgy       $1,500,000.00   Corporate Sponsorship
     Research And Education
     Fdtn
    American Colg of Toxicology         $1,000.00   Corporate Sponsorship
    American College of                $50,000.00   Educational Grants
     Rheumatology
    American College of                $75,000.00   Corporate Sponsorship
     Rheumatology
    American College of                $95,000.00   Fellowships and
     Rheumatology                                    Scholarships
    American College of                $50,000.00   Educational Grants
     Rheumatology
    American College of                $35,000.00   Educational Grants
     Rheumatology
    American College of                $25,000.00   Educational Grants
     Rheumatology
    American Drug Utilization          $20,000.00   Corporate Sponsorship
     Review Society Adurs
    American Drug Utilization           $6,666.67   Corporate Sponsorship
     Review Society Adurs
    American Drug Utilization           $6,666.67   Corporate Sponsorship
     Review Society Adurs
    American Drug Utilization           $6,666.66   Corporate Sponsorship
     Review Society Adurs
    American Federation for Med         $2,000.00   Educational Grants
     Research
    American Gastro Asoc Inst          $50,000.00   Educational Grants
    American Gastro Asoc Inst         $250,000.00   Educational Grants
    American Gastro Asoc Inst          $33,300.00   Corporate Sponsorship
    American Kdny Fund                  $3,000.00   Corporate Sponsorship
    American Legion National           $10,000.00   Corporate Sponsorship
    American Legion National           $10,000.00   Corporate Sponsorship
     Headquarters
    American Liver Fdtn                 $2,500.00   Corporate Sponsorship
    American Liver Fdtn               $246,500.00   Corporate Sponsorship
    American Liver Fdtn                $10,000.00   Corporate Sponsorship
    American Liver Fdtn                 $2,500.00   Corporate Sponsorship
    American Liver Fdtn                 $2,500.00   Corporate Sponsorship
    American Liver Fdtn                 $5,000.00   Educational Grants
    American Liver Foundation          $35,000.00   Corporate Sponsorship
    American Med Asoc Fdtn             $20,000.00   Corporate Sponsorship
    American Med Grp Asoc               $6,000.00   Corporate Sponsorship
    American Military Partner           $5,000.00   Corporate Sponsorship
     Association
    American Neuro Asoc                 $5,000.00   Educational Grants
    American Neuro Asoc                $25,000.00   Educational Grants
    American Osteopathic Colg          $15,000.00   Corporate Sponsorship
     of Dermatology
    American Pancreatic Asoc           $75,000.00   Educational Grants
    American Pancreatic Asoc           $15,000.00   Patient Support
    American Pancreatic Asoc           $50,000.00   Corporate Sponsorship
    American Parkinson Disease          $5,000.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $1,000.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $3,500.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $1,500.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $2,500.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease            $500.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $5,000.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $3,000.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease          $1,000.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Parkinson Disease         $55,000.00   Corporate Sponsorship
     Association Arizona
     Chapter
    American Pharmacists Asoc           $3,000.00   Corporate Sponsorship
    American Pharmacists Asoc          $13,500.00   Corporate Sponsorship
    American Red Cross of              $10,000.00   Charitable Donations
     Greater Chicago
    American Red Cross of              $50,000.00   Charitable Donations
     Greater Chicago
    American Society for                $1,500.00   Educational Grants
     Experimental
     Neurotherapeutics
    American Socty for Matrix           $1,000.00   Educational Grants
     Biology
    American Socty for Mens            $10,000.00   Corporate Sponsorship
     Hlth The
    American Socty for                  $1,500.00   Educational Grants
     Pharmacology and
     Experimental Thrpt The
     Aspet
    American Socty for                  $5,750.00   Corporate Sponsorship
     Reproductive Medicine
    American Socty for                 $25,000.00   Educational Grants
     Reproductive Medicine
    American Socty for                 $50,000.00   Corporate Sponsorship
     Reproductive Medicine
    American Socty of                  $15,000.00   Corporate Sponsorship
     Anesthesiologists
    American Socty of Clinical         $20,000.00   Educational Grants
     Oncology
    American Socty of                  $52,500.00   Corporate Sponsorship
     Hematology
    American Socty of                  $10,000.00   Educational Grants
     Hematology
    American Socty of                  $40,000.00   Educational Grants
     Hematology
    American Socty of                  $60,000.00   Corporate Sponsorship
     Hematology
    American Socty of                  $10,000.00   Charitable Donations
     Hematology
    American Socty of                  $50,000.00   Educational Grants
     Hematology
    American Socty of Nphro            $40,000.00   Corporate Sponsorship
    American Socty of Nphro             $8,700.00   Corporate Sponsorship
    American Thyroid Asoc Inc.         $35,000.00   Educational Grants
    American Thyroid Asoc Inc.         $10,000.00   Corporate Sponsorship
    American Urological Asoc.          $50,000.00   Educational Grants
     Education and Research
     Inc.
    American Urological Asoc.          $40,000.00   Corporate Sponsorship
     Education and Research
     Inc.
    American Urological Asoc.          $25,000.00   Corporate Sponsorship
     Education and Research
     Inc.
    American Urological Asoc.          $50,000.00   Charitable Donations
     Education and Research
     Inc.
    American Urological Asoc.          $20,000.00   Educational Grants
     Education and Research
     Inc.
    American Urological Asoc.          $75,000.00   Educational Grants
     Education and Research
     Inc.
    American Urological Asoc.           $5,000.00   Corporate Sponsorship
     Fdtn
    American Urological Asoc           $10,000.00   Charitable Donations
     Fdtn
    American Urological Asoc            $6,000.00   Corporate Sponsorship
     Inc. North Ctrl Section
    American Urological Asoc            $6,000.00   Corporate Sponsorship
     Inc. Southeast Section
    American Urological Asoc           $10,000.00   Corporate Sponsorship
     Inc. Western Section
    American Urological Asoc            $6,000.00   Corporate Sponsorship
     South Ctrl Section
    Americans for Med Progress        $100,000.00   Charitable Donations
    Americares Foundation, Inc.        $10,000.00   Charitable Donations
    Americares Foundation, Inc.        $25,000.00   Charitable Donations
    Angel Fdtn                          $5,000.00   Corporate Sponsorship
    Annenberg Center for Health       $750,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $90,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $65,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $25,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $85,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health       $350,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $75,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health       $500,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $25,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health       $500,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health       $200,000.00   Educational Grants
     Sciences at Eisenhower
    Annenberg Center for Health        $75,000.00   Educational Grants
     Sciences at Eisenhower
    Arkansas State Rheumlgy            $10,000.00   Corporate Sponsorship
     Asoc
    Arthritis Foundation                $1,000.00   Educational Grants
    Arthritis Foundation               $35,000.00   Corporate Sponsorship
    Arthritis Foundation               $35,000.00   Educational Grants
    Arthritis Foundation               $22,500.00   Educational Grants
    Arthritis Foundation               $30,000.00   Corporate Sponsorship
    Arthritis Foundation               $20,000.00   Corporate Sponsorship
    Arthritis Foundation               $30,000.00   Corporate Sponsorship
    Arthritis Foundation               $10,000.00   Corporate Sponsorship
    Arthritis Foundation               $15,000.00   Educational Grants
    Arthritis Foundation                $1,500.00   Corporate Sponsorship
    Arthritis Foundation               $25,000.00   Corporate Sponsorship
    Arthritis Foundation                $2,500.00   Corporate Sponsorship
    Arthritis Foundation                $5,000.00   Corporate Sponsorship
    Arthritis Foundation               $10,000.00   Corporate Sponsorship
    Arthritis Foundation               $25,000.00   Corporate Sponsorship
    Arthritis Foundation                $2,500.00   Corporate Sponsorship
    Arthritis Foundation               $20,000.00   Corporate Sponsorship
    Arthritis Foundation               $40,000.00   Corporate Sponsorship
    Arthritis Foundation               $30,000.00   Corporate Sponsorship
    Arthritis Foundation               $35,000.00   Corporate Sponsorship
    Arthritis Foundation               $25,000.00   Corporate Sponsorship
    Arthritis Foundation              $300,000.00   Corporate Sponsorship
    Arthritis Foundation              $259,000.00   Corporate Sponsorship
    Arthritis Foundation              $250,000.00   Corporate Sponsorship
    Arthritis Foundation              $300,000.00   Corporate Sponsorship
    Arthritis Foundation              $175,000.00   Corporate Sponsorship
    Arthritis Patient Srvc             $10,000.00   Charitable Donations
    Arthritis Patient Srvc             $15,000.00   Educational Grants
    Arthritis Patient Srvc             $40,000.00   Educational Grants
    Asco Cancer Fdtn                  $100,000.00   Charitable Donations
    Asco Cancer Fdtn                   $60,000.00   Fellowships and
                                                     Scholarships
    Asco Cancer Fdtn                   $30,500.00   Corporate Sponsorship
    Asco Cancer Fdtn                   $28,000.00   Educational Grants
    Asco Cancer Fdtn                   $28,000.00   Educational Grants
    ASCO Cancer Fdtn                   $28,000.00   Educational Grants
    ASCO Cancer Fdtn                    $5,000.00   Educational Grants
    ASCO Cancer Fdtn                   $25,000.00   Educational Grants
    Asoc De Enfermeria                  $6,000.00   Corporate Sponsorship
     Oncologica Y Hematologica
     De Puerto Rico Inc.
    Asoc De Reumatologos De            $30,000.00   Corporate Sponsorship
     Puerto Rico
    Asoc Latina De Asistencia Y         $1,000.00   Educational Grants
     Prevencion Del Cancer De
     Mama
    Asoc of Univ Tech Managers          $5,000.00   Corporate Sponsorship
    Asociacion De Salud Publica         $5,000.00   Educational Grants
     De Puerto Rico
    Aspen Cancer Conference             $7,500.00   Educational Grants
     Inc.
    Association of Women in            $40,000.00   Corporate Sponsorship
     Rheumatology
    Association of Women in            $40,000.00   Corporate Sponsorship
     Rheumatology
    Atlanta Dermatological Asoc        $10,000.00   Corporate Sponsorship
    Autoimmune Advocacy                 $2,500.00   Corporate Sponsorship
     Alliance
    Baehr Challenge Ltd                 $2,500.00   Corporate Sponsorship
    Balm In Gilead Inc.                $75,000.00   Corporate Sponsorship
    Baylor Colg Medicine Inf          $100,000.00   Fellowships and
     Dis                                             Scholarships
    Baylor Colg Medicine Inf            $3,500.00   Educational Grants
     Dis
    Baylor Hlth Care System            $50,000.00   Fellowships and
     Fdtn                                            Scholarships
    Baylor Scott And White             $20,000.00   Educational Grants
     Health
    Baylor Univ Med Ctr                $25,000.00   Educational Grants
    Baylor Univ Med Ctr                $25,000.00   Educational Grants
    Baylor Univ Med Ctr                $20,000.00   Educational Grants
    Beth Israel Deaconess Med          $40,000.00   Fellowships and
     Ctr                                             Scholarships
    Beth Israel Deaconess Med          $30,000.00   Fellowships and
     Ctr                                             Scholarships
    Beth Israel Deaconess Med          $27,000.00   Fellowships and
     Ctr                                             Scholarships
    Beth Israel Deaconess Med           $7,500.00   Educational Grants
     Ctr
    Beth Israel Deaconess Med           ($592.19)   Fellowships and
     Ctr                                             Scholarships
    Bexar County Physician              $2,500.00   Corporate Sponsorship
     Assistant Society
    Bioconnections LLC                 $30,000.00   Corporate Sponsorship
    Black Hills Arthritis Asoc          $2,200.00   Educational Grants
    Boomer Esiason Fdtn                $25,000.00   Corporate Sponsorship
    Boomer Esiason Fdtn               $400,000.00   Corporate Sponsorship
    Borland Groover Fdtn                  $500.00   Corporate Sponsorship
    Boston Center for                   $5,000.00   Corporate Sponsorship
     Independent Living
    Boston Socty Inc.                   $4,000.00   Corporate Sponsorship
    Boston Socty Inc.                   $4,000.00   Corporate Sponsorship
    Boston Univ Medcn Psychtry         $40,000.00   Fellowships and
                                                     Scholarships
    Boston Univ Medcn Psychtry         $45,000.00   Educational Grants
    Boston Univ Medcn Psychtry         $10,000.00   Educational Grants
    Boston Univ Medcn Psychtry        $100,000.00   Educational Grants
    Boston Univ Medcn Psychtry        ($2,482.00)   Educational Grants
    Boston Univ Medcn Psychtry         $40,000.00   Fellowships and
                                                     Scholarships
    Boston Univ Medcn Psychtry         $85,000.00   Educational Grants
    Brian Grant Fdtn The               $25,000.00   Corporate Sponsorship
    Brian Grant Fdtn The               $30,000.00   Educational Grants
    Brian Grant Fdtn The               $10,000.00   Corporate Sponsorship
    Brigham And Women's               $250,000.00   Educational Grants
     Hospital, Inc.
    Brigham And Women's                $40,000.00   Fellowships and
     Hospital, Inc.                                  Scholarships
    Bucks Montgomery Counties           $1,000.00   Corporate Sponsorship
     Oncology Nursing Socty
    Business Hlth Coalition             $3,300.00   Corporate Sponsorship
     Fdtn
    California Assn Physcn Grps        $20,000.00   Corporate Sponsorship
     Fnd
    California Assn Physcn Grps        $10,000.00   Corporate Sponsorship
     Fnd
    California Chronic Care            $35,000.00   Corporate Sponsorship
     Coalition
    California Inst of Tech             $5,000.00   Fellowships and
                                                     Scholarships
    California Issues forum            $15,000.00   Corporate Sponsorship
    California Life Sciences            $3,000.00   Corporate Sponsorship
     Association
    California Life Sciences            $5,000.00   Corporate Sponsorship
     Association
    California Life Sciences            $1,500.00   Corporate Sponsorship
     Association
    California Pacific Med Ctr          $2,000.00   Corporate Sponsorship
     Fdtn
    California Rheumlgy                 $3,000.00   Corporate Sponsorship
     Alliance
    California Socty of                $10,000.00   Corporate Sponsorship
     Dermatology and
     Dermatology Surgry
    Cancer And Leukemia Grp B          $30,000.00   Educational Grants
     Fdtn
    Cancer Awareness of Nevada          $1,000.00   Corporate Sponsorship
    Cancer Care                        $10,000.00   Educational Grants
    Cancer Care                        $25,000.00   Educational Grants
    Cancer Care                        $50,000.00   Charitable Donations
    Cancer Care                        $20,000.00   Educational Grants
    Cancer Care                        $20,000.00   Educational Grants
    Cancer Care                        $10,000.00   Educational Grants
    Cancer Care                        $10,000.00   Educational Grants
    Cancer Care                       $100,000.00   Corporate Sponsorship
    Cancer Fdtn for New Mexico          $2,500.00   Corporate Sponsorship
    Cancer Molecular Thrpt              $1,500.00   Educational Grants
    Cancer Research Inst                $7,500.00   Educational Grants
    Cancer Support Community           $50,000.00   Corporate Sponsorship
    Cancer Wellness Center              $2,500.00   Corporate Sponsorship
    Carden Jennings Publishing         $15,000.00   Corporate Sponsorship
    Carden Jennings Publishing          $5,000.00   Corporate Sponsorship
    Caribe Gyn                          $5,000.00   Corporate Sponsorship
    Caring Ambassadors Program         $35,000.00   Corporate Sponsorship
    Caring Ambassadors Program        $200,000.00   Charitable Donations
    Caring Ambassadors Program          $2,500.00   Corporate Sponsorship
    Cascade AIDS Project                $5,000.00   Corporate Sponsorship
    CE Outcomes LLC                    $96,770.00   Educational Grants
    Cedars--Sinai Med Ctr              $10,000.00   Educational Grants
    Cedars--Sinai Med Ctr              $40,000.00   Fellowships and
                                                     Scholarships
    Center for Healthcare               $5,000.00   Corporate Sponsorship
     Innovation
    Central Brain Tumor                $20,000.00   Educational Grants
     Registry of The United
     States
    Chesapeake Uro Asoc                 $5,500.00   Corporate Sponsorship
    Chesapeake Uro Asoc                 $7,500.00   Corporate Sponsorship
    Chicago Council On Scnc and        $20,000.00   Corporate Sponsorship
     Technologies
    Chicago Council On Scnc and         $5,000.00   Corporate Sponsorship
     Technologies
    Childrens Digestive Hlth           $85,000.00   Educational Grants
     and Nutrition Fdtn
    Childrens Digestive Hlth           $40,000.00   Fellowships and
     and Nutrition Fdtn                              Scholarships
    Childrens Hosp Corporation          $3,000.00   Corporate Sponsorship
    Chimp Haven                        $25,000.00   Charitable Donations
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chronic Liver Disease Fdtn         $75,000.00   Corporate Sponsorship
    Chronic Liver Disease Fdtn        $500,000.00   Educational Grants
    Chronic Liver Disease Fdtn         $25,000.00   Corporate Sponsorship
    Chronic Liver Disease Fdtn       ($25,824.00)   Educational Grants
    Chronic Lymphoytic Leukemia        $15,000.00   Educational Grants
     Society Inc.
    Chronic Lymphoytic Leukemia        $75,000.00   Educational Grants
     Society Inc.
    Chronic Lymphoytic Leukemia        $50,000.00   Charitable Donations
     Society Inc.
    Chronic Lymphoytic Leukemia        $65,000.00   Educational Grants
     Society Inc.
    Chronic Lymphoytic Leukemia        $10,000.00   Educational Grants
     Society Inc.
    Cincinnati Childrens Hosp          $40,000.00   Fellowships and
     Medic                                           Scholarships
    Cincinnati Childrens Hosp          $22,500.00   Corporate Sponsorship
     Medic
    Cleveland Clnc                     $65,000.00   Educational Grants
    Cleveland Clnc                     $57,000.00   Educational Grants
    Cleveland Clnc                      $5,000.00   Educational Grants
    Cleveland Clnc                     $50,000.00   Educational Grants--
    Cleveland Clnc                      $5,000.00   Educational Grants
    Cleveland Clnc                      $4,000.00   Educational Grants
    Cleveland Clnc                      $5,000.00   Corporate Sponsorship
    Cleveland Clnc                    ($6,743.76)   Educational Grants
    Cleveland Clnc                      $7,500.00   Educational Grants
    Cleveland Clnc                    ($6,093.50)   Educational Grants
    Cleveland Clnc                      $5,000.00   Educational Grants
    Cleveland Clnc                   ($13,210.68)   Educational Grants
    Cleveland Clnc                      $5,000.00   Educational Grants
    Cleveland Clnc Fdtn                $50,000.00   Fellowships and
                                                     Scholarships
    Cleveland Clnc Fdtn                $40,000.00   Fellowships and
                                                     Scholarships
    Clinical Care Optn LLC            $175,000.00   Educational Grants
    Clinical Care Optn LLC             $85,000.00   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC            $173,615.00   Educational Grants
    Clinical Care Optn LLC             $95,000.00   Educational Grants
    Clinical Care Optn LLC            $347,520.00   Educational Grants
    Clinical Care Optn LLC            $126,385.00   Educational Grants
    Clinical Care Optn LLC             $50,000.00   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC           ($75,000.00)   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Coalicion Para El Control          $12,500.00   Corporate Sponsorship
     De Hepatitis En Puerto
     Rico
    Coalition for Prevention of        $10,000.00   Corporate Sponsorship
     Colorectal Cancer In
     Puerto Rico
    Coalition On Positive              $20,000.00   Corporate Sponsorship
     Health Empowerment
    Coalition On Positive              $50,000.00   Charitable Donations
     Health Empowerment
    Coalition On Positive              $10,000.00   Corporate Sponsorship
     Health Empowerment
    Cockerell Educational              $15,000.00   Corporate Sponsorship
     Foundation
    Cold Spring Harbor Lab              $5,000.00   Educational Grants
    Cold Spring Harbor Lab              $1,500.00   Educational Grants
    Colegio Medicos--Cirujanos         $10,000.00   Educational Grants
     Pr
    Collegium Internationale           $10,000.00   Corporate Sponsorship
    Colorado Dietetic Asoc              $1,500.00   Corporate Sponsorship
    Colorado Gerontological             $5,000.00   Corporate Sponsorship
     Society
    Colorado Retina Asoc               $15,000.00   Corporate Sponsorship
    Columbia Univ Med Ctr              $15,000.00   Educational Grants
    Commty Fdtn                         $5,000.00   Corporate Sponsorship
    Commty Fdtn                         $5,000.00   Corporate Sponsorship
    Commty Liver Alliance              $75,000.00   Educational Grants
    Commty Liver Alliance               $5,000.00   Corporate Sponsorship
    Community Access National           $2,500.00   Corporate Sponsorship
     Network
    Community Health                   $10,000.00   Corporate Sponsorship
    Community Initiatives              $75,000.00   Corporate Sponsorship
    Community Initiatives              $25,000.00   Corporate Sponsorship
    Community Initiatives              $30,000.00   Corporate Sponsorship
    Community Liver Alliance            $9,000.00   Corporate Sponsorship
    Community Liver Alliance           $25,000.00   Corporate Sponsorship
    Community Liver Alliance           $19,400.00   Corporate Sponsorship
    Complete Conference Mgmt           $80,000.00   Educational Grants
    Connecticut Advanced Nurse          $5,000.00   Corporate Sponsorship
     Practitioner Socty
    Connecticut Advocates for             $500.00   Corporate Sponsorship
     Parkinsons Inc.
    Connecting To Cure Crohns          $20,000.00   Corporate Sponsorship
     And Colitis
    Consortium of Multiple            $150,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple             $40,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple             $85,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple             $60,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple             $25,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple            $150,000.00   Educational Grants
     Sclerosis Centers
    Continuing Educational            ($2,537.67)   Educational Grants
     Alliance LLC
    Continuing Educational            ($2,537.67)   Educational Grants
     Alliance LLC
    Continuing Educational            $375,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $200,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $375,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $375,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            ($1,250.00)   Educational Grants
     Alliance LLC
    Continuing Educational             $75,000.00   Educational Grants
     Alliance LLC
    Continuing Educational             $99,440.00   Educational Grants
     Alliance LLC
    Cornell Univ Weill Med Colg         $1,500.00   Educational Grants
    Cornell Univ Weill Med Colg        $15,000.00   Educational Grants
    Cornell Univ Weill Med Colg         $3,000.00   Educational Grants
    Cornerstone Hlth Inc.             $150,000.00   Educational Grants
    Cornerstone Hlth Inc.             ($3,750.00)   Educational Grants
    Cornerstone Hlth Inc.              $90,000.00   Educational Grants
    Cornerstone Hlth Inc.              $40,000.00   Educational Grants
    Cornerstone Hlth Inc.              $90,000.00   Educational Grants
    Cornerstone Hlth Inc.              $75,000.00   Educational Grants
    Creighton Univ                     $10,000.00   Educational Grants
    Critical Path Inst                 $25,000.00   Corporate Sponsorship
    Crohns And Colitis                $165,000.00   Corporate Sponsorship
     Foundation
    Crohns And Colitis                $110,000.00   Educational Grants
     Foundation of America
    Crohns And Colitis                $100,000.00   Educational Grants
     Foundation of America
    Crohns And Colitis                $100,000.00   Educational Grants
     Foundation of America
    Crohns And Colitis                $100,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                $100,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $31,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $25,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                 $25,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                    $800.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $10,250.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $50,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $47,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                $114,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $2,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $15,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                  $1,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $15,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                $250,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                $100,000.00   Fellowships and
     Foundation of America                           Scholarships
    Crohns and Colitis                $400,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $80,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                 $40,000.00   Corporate Sponsorship
     Foundation of America
    Crohns and Colitis                 $40,000.00   Educational Grants
     Foundation of America
    Ctrl Florida Phmcy Council         $15,000.00   Educational Grants
     Inc.
    Ctrl Savannah River Area            $1,000.00   Corporate Sponsorship
     Csra Parkinson Support Grp
    Curatio Cme Inst                 ($33,640.17)   Educational Grants
    Cure CF                             $1,500.00   Corporate Sponsorship
    Curepsp Inc.                       $15,000.00   Educational Grants
    Cystic Fibrosis Fdtn--              $1,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn--                $750.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn--              $7,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn--              $1,750.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn--              $1,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn--              $1,000.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn--              $2,500.00   Corporate Sponsorship
     Albany
    Cystic Fibrosis Fdtn                $4,000.00   Corporate Sponsorship
     Maryland Chapter
    Cystic Fibrosis Fdtn                $5,750.00   Corporate Sponsorship
     Maryland Chapter
    Cystic Fibrosis Research            $5,000.00   Corporate Sponsorship
     Fund Emilys Entourage
    Cystic Fibrosis Research           $18,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research            $7,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research            $5,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Research            $3,000.00   Corporate Sponsorship
     Inc.
    Cystic Fibrosis Services              $500.00   Corporate Sponsorship
    Cystic Fibrosis Services              $500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,750.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,250.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,750.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $7,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $7,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,750.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services           $35,000.00   Corporate Sponsorship
    Cystic Fibrosis Services           $15,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,500.00   Corporate Sponsorship
    Cystic Fibrosis Services           $10,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $6,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $3,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,750.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services           $35,000.00   Corporate Sponsorship
    Cystic Fibrosis Services          $750,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $7,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $7,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $7,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $6,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $5,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $2,500.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,000.00   Corporate Sponsorship
    Cystic Fibrosis Services           $10,000.00   Corporate Sponsorship
    Cystic Fibrosis Services            $1,500.00   Corporate Sponsorship
    Dallas fort Worth Business          $5,000.00   Corporate Sponsorship
     Grp On Hlth
    Danville D Elegance Fdtn            $2,500.00   Corporate Sponsorship
    Dava Oncology Lp                   $50,000.00   Corporate Sponsorship
    Dava Oncology Lp                  $150,000.00   Corporate Sponsorship
    David A Winston Health              $5,500.00   Corporate Sponsorship
     Policy
    Davis Phinney Fdtn                 $30,000.00   Educational Grants
    Davis Phinney Fdtn                 $30,000.00   Educational Grants
    Davis Phinney Fdtn                 $20,000.00   Corporate Sponsorship
    Davis Phinney Fdtn                 $30,000.00   Educational Grants
    Davis Phinney Fdtn                 $60,000.00   Educational Grants
    Davis Phinney Fdtn                 $30,000.00   Educational Grants
    Davis Phinney Fdtn                 $40,000.00   Corporate Sponsorship
    Dermatology Education Fdtn         $30,000.00   Corporate Sponsorship
    Dermatology Fdtn                  $135,000.00   Charitable Donations
    Dermatology Fdtn                   $50,000.00   Corporate Sponsorship
    Dermatology Nurses Asoc            $10,000.00   Educational Grants
    Dermatology Nurses Asoc            $25,850.00   Corporate Sponsorship
    Digestive Disease Week             $55,000.00   Corporate Sponsorship
    Digestive Disease Week             $55,000.00   Corporate Sponsorship
    Digestive Health Foundation        $25,000.00   Corporate Sponsorship
    Digestive Health Physicians       $100,000.00   Corporate Sponsorship
     Association
    Direct Relief                      $50,000.00   Charitable Donations
    East Hawaii IPA                     $8,500.00   Corporate Sponsorship
    Elsevier Inc.                      $40,000.00   Educational Grants
    Employers Hlth Colition             $4,000.00   Corporate Sponsorship
     Inc.
    Endocrine Education Inc.           $25,000.00   Educational Grants
    Endocrine Education Inc.           $25,000.00   Educational Grants
    Engineering Conferences             $1,500.00   Educational Grants
     International
    Enviormental Mutagen Socty          $2,500.00   Corporate Sponsorship
    Enzyme Mechanism Conference         $1,500.00   Educational Grants
    Epilepsy Association of             $5,000.00   Corporate Sponsorship
     Central Florida
    Epilepsy Fnd of North-             $20,000.00   Corporate Sponsorship
     Central Illinois Iowa and
     Nebraska
    Epilepsy Foundation of              $5,000.00   Corporate Sponsorship
     Flordia Inc.
    Epilepsy Foundation of             $18,000.00   Corporate Sponsorship
     Michigan
    Epilepsy Foundation of             $20,000.00   Corporate Sponsorship
     Michigan
    Epilepsy Foundation of New         $17,000.00   Corporate Sponsorship
     Jersey
    Escuela De Medicina De             $20,000.00   Educational Grants
     Ponce
    Escuela De Medicina De             $10,000.00   Educational Grants
     Ponce
    Event 360 Inc.                      $8,330.00   Corporate Sponsorship
    Excel Continuing Education          $5,000.00   Educational Grants
    Excellence in Gastro              $100,000.00   Corporate Sponsorship
     Education LLC
    Excellence in Rheumlgy            $100,000.00   Corporate Sponsorship
     Education LLC
    Family Med Ctr Bolingbrook         $13,000.00   Corporate Sponsorship
    Family Med Ctr Bolingbrook          $5,500.00   Corporate Sponsorship
    Fdtn for Biomedical                $25,000.00   Charitable Donations
     Research
    Federation of American              $1,500.00   Educational Grants
     Socty
    Federation of American              $1,500.00   Educational Grants
     Socty
    Federation of American              $1,500.00   Educational Grants
     Socty
    Federation of American              $1,500.00   Educational Grants
     Socty
    Federation of American              $1,500.00   Educational Grants
     Socty
    Federation of American              $1,500.00   Educational Grants
     Socty
    Federation of Clinical             $20,000.00   Educational Grants
     Immunology Socty
    Federation of Clinical             $25,000.00   Educational Grants
     Immunology Socty
    Federation of Clinical             $12,500.00   Educational Grants
     Immunology Socty
    Florida Hlth Care Coalition         $5,000.00   Corporate Sponsorship
    Florida Socty of                   $20,000.00   Corporate Sponsorship
     Dermatology Phys
     Assistants Inc.
    Florida Socty of Rheumlgy          $25,000.00   Corporate Sponsorship
    Focus Med Communications          $100,000.00   Corporate Sponsorship
    Force--Facing Our Risk of          $10,000.00   Corporate Sponsorship
     Cancer Emp
    Force--Facing Our Risk of          $10,000.00   Charitable Donations
     Cancer Emp
    Foster Ocular Immunology           $40,000.00   Corporate Sponsorship
     Socty
    Foundation for Veterans            $20,000.00   Corporate Sponsorship
     Health Care
    Foundation of Consortium of        $12,280.00   Fellowships and
     Multiple Sclerosis Centers                      Scholarships
     CMSC
    Foundation of Consortium of        $25,000.00   Educational Grants
     Multiple Sclerosis Centers
     CMSC
    Foundation of Consortium of        $10,000.00   Charitable Donations
     Multiple Sclerosis Centers
     CMSC
    Friends of Cancer Research         $50,000.00   Corporate Sponsorship
    Friends of Parkinsons               $1,000.00   Corporate Sponsorship
    Friends of The St Louis            $50,000.00   Corporate Sponsorship
     Univ Liver Ctr
    Fund for Public Hlth In New       $200,000.00   Educational Grants
     York
    Fundacion Alfredo Ruiz              $5,000.00   Corporate Sponsorship
    Fundacion Daledale Inc.             $3,000.00   Corporate Sponsorship
    Fundacion De Esclerosis             $3,000.00   Corporate Sponsorship
     Multiple De Puerto Rico
    Fundacion Puertorriquena De         $5,000.00   Corporate Sponsorship
     Enfermedades Reumaticas
    Galien Foundation                  $22,500.00   Corporate Sponsorship
    Galien Foundation                  $30,000.00   Corporate Sponsorship
    Gastro--Intestinal Research        $25,000.00   Corporate Sponsorship
     Fdtn
    Gastro--Intestinal Research        $50,000.00   Corporate Sponsorship
     Fdtn
    Gastrointestinal And Liver         $75,000.00   Educational Grants
     Association of The
     Americas Inc.
    Gateway for Cancer Research        $10,000.00   Charitable Donations
    Georgetown Univ Hosp Phmcy         $50,000.00   Fellowships and
                                                     Scholarships
    Georgia Dermatology Phys           $20,000.00   Corporate Sponsorship
     Assistants
    Georgia Doty Hiv &                 $10,000.00   Educational Grants
     Hepatitis Commty Outreach
     Inc.
    Georgia Prostate Cancer             $2,500.00   Educational Grants
     Coalition The
    Georgia Society of Clinical        $25,000.00   Corporate Sponsorship
     Oncology
    Georgia Socty of                    $8,000.00   Corporate Sponsorship
     Rhematology
    Global Academy for Medical         $18,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $76,500.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $36,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $54,000.00   Corporate Sponsorship
     Education
    Global Academy for Medical         $90,000.00   Corporate Sponsorship
     Education
    Global Alliance for Medical        $10,000.00   Educational Grants
     Education
    Global Alliance for Patient        $30,000.00   Corporate Sponsorship
     Access
    Global Biological Standards         $2,000.00   Educational Grants
     Inst
    Globalization of                   $10,000.00   Corporate Sponsorship
     Pharmaceutics Education
     Ntwrk
    Good Grief                            $500.00   Corporate Sponsorship
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences        $10,000.00   Corporate Sponsorship
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Great Lakes Chapter of The          $1,000.00   Corporate Sponsorship
     American Society for
     Pharmacology And
     Experimental Therapeutics
    Gynecologic Oncology Grp           $35,000.00   Educational Grants
     The
    Gynecologic Oncology Grp           $40,000.00   Educational Grants
     The
    Gynecologic Oncology Grp           $40,000.00   Educational Grants
     The
    Haymarket Med Education           ($2,553.09)   Educational Grants
    Head for The Cure Fdtn              $7,500.00   Corporate Sponsorship
    Healthcare Business Women's         $7,500.00   Corporate Sponsorship
     Association, Inc.
    Healthcare Business Women's         $7,500.00   Corporate Sponsorship
     Association, Inc.
    Healthwell Fdtn                   $507,000.00   Charitable Donations
    Healthy Women                      $30,000.00   Corporate Sponsorship
    Heart to Heart                     $10,000.00   Charitable Donations
     International Inc.
    Heart to Heart                     $50,000.00   Charitable Donations
     International Inc.
    Heb Grocery Company LP              $7,000.00   Corporate Sponsorship
    Henry ford Hlth System              $2,000.00   Corporate Sponsorship
    Henry M Jackson Fdtn                $5,559.67   Corporate Sponsorship
    Henry M Jackson Fdtn                $5,559.67   Corporate Sponsorship
    Henry M Jackson Fdtn                $5,559.66   Corporate Sponsorship
    Henry M Jackson Fdtn               $10,000.00   Educational Grants
    Hep C Connection                    $5,000.00   Corporate Sponsorship
    Hep C Connection                   $25,000.00   Charitable Donations
    Hep C Connection                    $5,000.00   Corporate Sponsorship
    Hepatitis C Asoc                   $25,000.00   Educational Grants
    Hepatitis Education Project        $75,000.00   Charitable Donations
    Hepatitis Education Project        $24,000.00   Corporate Sponsorship
    Hepatitis Education Project        $25,000.00   Corporate Sponsorship
    Hepatitis Foundation              $250,000.00   Corporate Sponsorship
     International
    Hepatitis Foundation                $5,000.00   Corporate Sponsorship
     International
    Herbert Kosten Pancreatic           $2,000.00   Corporate Sponsorship
     Cancer Charitable Fund
    Hidradenitis Suppurativa           $13,550.00   Charitable Donations
     Fdtn
    Hitchcock Fdtn                      $8,000.00   Educational Grants
    Hitchcock Fdtn                     $20,000.00   Educational Grants
    HIV Treaters Med Asoc of           $10,000.00   Educational Grants
     Puerto Rico
    Hlthcr Financial Mgmt Hfma         $50,000.00   Corporate Sponsorship
    Hmp Communications                 $31,000.00   Corporate Sponsorship
    Hmp Communications                 $50,000.00   Corporate Sponsorship
    Hope Fdtn The                      $25,000.00   Educational Grants
    Hope Healthcare Services              $600.00   Corporate Sponsorship
    Houston Area Parkinson              $1,000.00   Corporate Sponsorship
     Society
    Houston Business Coalition          $6,000.00   Corporate Sponsorship
     On Health
    Howard Hanna Children's            $10,000.00   Charitable Donations
     Free Care Fund
    Hubbard Street Dance               $10,000.00   Educational Grants
     Chicago
    Human Growth Fdtn                   $5,000.00   Corporate Sponsorship
    Human Growth Fdtn                  $10,000.00   Charitable Donations
    Human Growth Fdtn                   $4,000.00   Corporate Sponsorship
    Humboldt--Del Norte County          $1,100.00   Educational Grants
     Med Socty
    Humboldt--Del Norte County          $4,000.00   Educational Grants
     Med Socty
    Ibd Remedy Inc.                    $10,000.00   Charitable Donations
    Illinois African American          $15,000.00   Corporate Sponsorship
     Coalition
    Illinois Socty of                  $25,000.00   Corporate Sponsorship
     Dermatology Phys
     Assistants
    Illinois Socty of                  $15,000.00   Corporate Sponsorship
     Dermatology Phys
     Assistants
    Imedex LLC                         $50,000.00   Educational Grants
    Imedex LLC                         $75,000.00   Educational Grants
    Imedex LLC                         $75,000.00   Educational Grants
    Imedex LLC                          $9,000.00   Educational Grants
    Imedex LLC                         $25,000.00   Educational Grants
    Imedex LLC                         $50,000.00   Educational Grants
    Imedex LLC                          ($838.00)   Educational Grants
    Imedex LLC                         $50,000.00   Educational Grants
    Imedex LLC                         $75,000.00   Educational Grants
    Improve Care Now Inc.              $15,000.00   Corporate Sponsorship
    Indian Medical Association            $500.00   Corporate Sponsorship
     of New England
    Indiana Parkinson Fdtn              $1,000.00   Corporate Sponsorship
    Indiana Univ                        ($619.24)   Fellowships and
                                                     Scholarships
    Indiana Univ Fdtn                  $50,000.00   Charitable Donations
    Inflammatory Bowel Disease         $75,000.00   Educational Grants
     Support Fdtn
    Inflammatory Bowel Disease        $200,000.00   Educational Grants
     Support Fdtn
    Inflammatory Bowel Disease         $75,000.00   Educational Grants
     Support Fdtn
    Innovation Development Inst       $250,000.00   Corporate Sponsorship
     Inc.
    Integrated Benefits Inst           $25,000.00   Corporate Sponsorship
     Inc.
    Integrated Med Fdtn                $15,000.00   Charitable Donations
    Interfaith House                    $2,000.00   Charitable Donations
    Intermountain Dermatology          $15,000.00   Educational Grants
     Socty
    International Aids Socty--         $75,000.00   Educational Grants
     USA
    International Aids Socty--         $75,000.00   Educational Grants
     USA
    International Biometric             $4,925.00   Corporate Sponsorship
     Socty Eastern North
     American Region
    International Chinese               $3,000.00   Corporate Sponsorship
     Statistical Asoc
    International Dermatology         $250,000.00   Educational Grants
     Outcome Measures
    International League of            $20,000.00   Charitable Donations
     Asoc for Rheumlgy
    International Medical Corps        $50,000.00   Charitable Donations
    International Organization        $145,000.00   Educational Grants
     of Multiple Sclerosis
     Nurses
    International Organization         $60,000.00   Educational Grants
     of Multiple Sclerosis
     Nurses
    International Parkinson And       $300,000.00   Corporate Sponsorship
     Movemen
    International Socty for             $5,000.00   Educational Grants
     Antiviral Research
    International Socty for The         $3,000.00   Educational Grants
     Study of Xenobiotics
    International Socty for The         $2,500.00   Educational Grants
     Study of Xenobiotics
    International Socty of             $40,000.00   Corporate Sponsorship
     Nphro
    International Socty of              $1,500.00   Educational Grants
     Psychiatric Genetics
    Iraq and Afghanistan               $15,000.00   Corporate Sponsorship
     Veterans
    ISMPP--International Socty         $10,000.00   Corporate Sponsorship
     for Med
    ISMPP--International Socty         $10,000.00   Corporate Sponsorship
     for Med
    Jefferson Med Colg At               $3,000.00   Corporate Sponsorship
     Thomas Jefferson Univ
    Jefferson Med Colg At               $3,000.00   Corporate Sponsorship
     Thomas Jefferson Univ
    Jefferson Med Colg At               $7,500.00   Educational Grants
     Thomas Jefferson Univ
    John P Mcgovern Museum of          $10,000.00   Corporate Sponsorship
     Health And Medical Science
    Johns Hopkins Univ School          $50,000.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School          $20,000.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School           $1,500.00   Corporate Sponsorship
     of Medicine
    Johns Hopkins Univ School          $40,000.00   Fellowships and
     of Medicine                                     Scholarships
    Johns Hopkins Univ School          $99,750.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School          $35,000.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School           $7,000.00   Fellowships and
     of Medicine                                     Scholarships
    Johns Hopkins Univ School          $90,000.00   Educational Grants
     of Medicine
    Johns Hopkins Univ School          $50,000.00   Educational Grants
     of Medicine
    JWC Covenant Inc.                  $25,000.00   Educational Grants
    Kansas Univ Neuro Fdtn             $65,000.00   Educational Grants
    Kelsey Research Fdtn               $35,000.00   Fellowships and
                                                     Scholarships
    Kentuckiana Health                  $2,500.00   Corporate Sponsorship
     Collaborative
    Kentucky Life Sciences              $5,000.00   Corporate Sponsorship
     Foundation
    Keystone Symposia                  $25,000.00   Corporate Sponsorship
    Laboratorio Clinico Toledo          $2,955.00   Patient Support
    Laboratorio Clinico Toledo            $810.00   Patient Support
    Laboratorio Clinico Toledo            $720.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo            $630.00   Patient Support
    Laboratorio Clinico Toledo          $1,440.00   Patient Support
    Laboratorio Clinico Toledo          $1,485.00   Patient Support
    Laboratorio Clinico Toledo          $5,250.00   Patient Support
    Laboratorio Clinico Toledo            $735.00   Patient Support
    Laboratorio Clinico Toledo            $810.00   Patient Support
    Laboratorio Clinico Toledo            $660.00   Patient Support
    Laboratorio Clinico Toledo          $1,875.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo            $765.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $885.00   Patient Support
    Laboratorio Clinico Toledo          $1,740.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $810.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $372.00   Patient Support
    Laboratorio Clinico Toledo          $2,550.00   Patient Support
    Laboratorio Clinico Toledo          $1,470.00   Patient Support
    Laboratorio Clinico Toledo          $1,350.00   Patient Support
    Laboratorio Clinico Toledo          $1,215.00   Patient Support
    Laboratorio Clinico Toledo          $1,080.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo            $645.00   Patient Support
    Laboratorio Clinico Toledo            $204.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $765.00   Patient Support
    Laboratorio Clinico Toledo          $1,905.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo            $585.00   Patient Support
    Laboratorio Clinico Toledo            $885.00   Patient Support
    Laboratorio Clinico Toledo            $870.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $975.00   Patient Support
    Laboratorio Clinico Toledo          $1,080.00   Patient Support
    Laboratorio Clinico Toledo          $1,035.00   Patient Support
    Laboratorio Clinico Toledo            $300.00   Patient Support
    Laboratorio Clinico Toledo            $870.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,305.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $645.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,290.00   Patient Support
    Laboratorio Clinico Toledo          $1,005.00   Patient Support
    Laboratorio Clinico Toledo            $204.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,140.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo            $810.00   Patient Support
    Laboratorio Clinico Toledo            $240.00   Patient Support
    Laboratorio Clinico Toledo          $1,395.00   Patient Support
    Laboratorio Clinico Toledo          $1,275.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo          $1,425.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo            $405.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo            $720.00   Patient Support
    Laboratorio Clinico Toledo            $660.00   Patient Support
    Laboratorio Clinico Toledo            $495.00   Patient Support
    Laboratorio Clinico Toledo          $2,355.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo          $2,295.00   Patient Support
    Laboratorio Clinico Toledo            $915.00   Patient Support
    Lake County Haven                  $10,000.00   Charitable Donations
    Large Uro Grp Prct Asoc            $20,000.00   Corporate Sponsorship
    Large Uro Grp Prct Asoc            $25,000.00   Corporate Sponsorship
    Large Uro Grp Prct Asoc            $25,000.00   Corporate Sponsorship
    Large Uro Grp Prct Asoc            $25,000.00   Corporate Sponsorship
    Large Uro Grp Prct Asoc            $66,400.00   Corporate Sponsorship
    Large Uro Grp Prct Asoc            $25,000.00   Corporate Sponsorship
    Lenox Hill Hosp                    $10,000.00   Educational Grants
    Leukemia and Lymphoma              $10,000.00   Educational Grants
     Society
    Leukemia and Lymphoma              $10,000.00   Corporate Sponsorship
     Society
    Leukemia and Lymphoma              $15,000.00   Corporate Sponsorship
     Society
    Leukemia and Lymphoma               $4,000.00   Corporate Sponsorship
     Society
    Leukemia and Lymphoma             $100,000.00   Corporate Sponsorship
     Society
    Leukemia and Lymphoma               $2,500.00   Corporate Sponsorship
     Society
    Leukemia and Lymphoma             $100,000.00   Charitable Donations
     Society
    Leukemia Research                   $5,000.00   Educational Grants
     Foundation Inc.
    Leukemia Research                   $5,000.00   Corporate Sponsorship
     Foundation Inc.
    Leukemia Research                   $5,000.00   Corporate Sponsorship
     Foundation Inc.
    Leukemia Research                  $50,000.00   Fellowships and
     Foundation Inc.                                 Scholarships
    Leukemia Research                   $5,000.00   Charitable Donations
     Foundation Inc.
    Leukemia Research                   $5,000.00   Educational Grants
     Foundation Inc.
    Leukemia Research                  $10,000.00   Corporate Sponsorship
     Foundation Inc.
    Living Beyond Breast Cancer        $10,000.00   Corporate Sponsorship
    Living Beyond Breast Cancer        $10,000.00   Corporate Sponsorship
    Loyola Stritch School of            $2,000.00   Educational Grants
     Medicine Div of
     Dermatology
    Lung Cancer Alliance               $25,000.00   Corporate Sponsorship
    Lungevity Foundation               $25,000.00   Corporate Sponsorship
    Lungevity Foundation               $25,000.00   Corporate Sponsorship
    Lupus and Allied Diseases           $6,000.00   Corporate Sponsorship
     Association
    Lymphoma Research                   $2,500.00   Corporate Sponsorship
     Foundation
    Lymphoma Research                  $10,000.00   Corporate Sponsorship
     Foundation
    Lymphoma Research                  $10,000.00   Corporate Sponsorship
     Foundation
    Lymphoma Research                   $2,000.00   Corporate Sponsorship
     Foundation
    Lymphoma Research                  $37,500.00   Corporate Sponsorship
     Foundation
    Magee--Womens Research Inst        $10,000.00   Corporate Sponsorship
     And Fdtn
    Magellan Rx Mgmt Inc.              $20,000.00   Corporate Sponsorship
    Magic Fdtn                         $15,000.00   Educational Grants
    Magic Fdtn                         $10,000.00   Charitable Donations
    Massachusetts Association           $5,000.00   Corporate Sponsorship
     for Mental Health
    Massachusetts Inst of Tech          $1,000.00   Charitable Donations
    Massachusetts Prostate              $2,500.00   Educational Grants
     Cancer Coalition Inc.
    Massachusetts Socty for Med         $5,000.00   Educational Grants
     Research
    Massachusetts Socty for Med         $5,000.00   Educational Grants
     Research
    Massachusetts Socty of              $5,000.00   Corporate Sponsorship
     Clinical Oncologists
    Max Foundation                     $45,000.00   Corporate Sponsorship
    Mayo Clnc                          $10,000.00   Educational Grants
    Mayo Clnc                           $2,500.00   Educational Grants
    Mccourt Fdtn Inc.                   $5,000.00   Educational Grants
    Me Strong Inc.                      $2,500.00   Corporate Sponsorship
    Med--LQ LLC                       $125,000.00   Educational Grants
    Med--LQ LLC                       $185,000.00   Educational Grants
    Med--LQ LLC                       $150,000.00   Educational Grants
    Med--LQ LLC                       $167,933.00   Educational Grants
    Med Colg of Wisconsin               $7,500.00   Educational Grants
    Med Colg of Wisconsin              $85,000.00   Educational Grants
    Med Colg of Wisconsin               $2,000.00   Corporate Sponsorship
    Med Colg of Wisconsin              $10,000.00   Educational Grants
    Med Conference Planners            $10,000.00   Corporate Sponsorship
    Med Learning Inst                 $180,000.00   Educational Grants
    Med Learning Inst                  $72,015.00   Educational Grants
    Med Learning Inst                 $100,000.00   Educational Grants
    Med Learning Inst                  $65,000.00   Educational Grants
    Med Learning Inst                  $70,000.00   Educational Grants
    Med Learning Inst                  $40,000.00   Educational Grants
    Med Learning Inst                 $150,000.00   Educational Grants
    Med Learning Inst                  $65,380.00   Educational Grants
    Med Learning Inst                 $125,000.00   Educational Grants
    Medicinal And Bioorganic            $5,000.00   Educational Grants
     Chemistry Fdtn The
    Medscape LLC                      $450,000.00   Educational Grants
    Medscape LLC                      $200,000.00   Educational Grants
    Medscape LLC                      $189,500.00   Educational Grants
    Medscape LLC                      $250,000.00   Educational Grants
    Medscape LLC                      $252,350.00   Educational Grants
    Medscape LLC                      $175,000.00   Educational Grants
    Medscape LLC                      $135,000.00   Educational Grants
    Medscape LLC                      $100,000.00   Educational Grants
    Medscape LLC                      $385,000.00   Educational Grants
    Medscape LLC                      $350,000.00   Educational Grants
    Medscape LLC                      $150,000.00   Educational Grants
    Medscape LLC                      $100,000.00   Educational Grants
    Medscape LLC                      $165,000.00   Educational Grants
    Medscape LLC                      $195,000.00   Educational Grants
    Medscape LLC                       $65,000.00   Educational Grants
    Medscape LLC                       $41,000.00   Educational Grants
    Medscape LLC                      $250,000.00   Educational Grants
    Medscape LLC                      ($2,000.00)   Educational Grants
    Medscape LLC                      $300,000.00   Educational Grants
    Medscape LLC                      $112,500.00   Educational Grants
    Medstar Washington Hosp Ctr        $10,000.00   Educational Grants
    Meeting Designs LLC                $25,000.00   Corporate Sponsorship
    Memorial Sloan Kettering           $10,000.00   Educational Grants
     Cancer Ctr
    Memphis Business Grp On             $5,120.00   Corporate Sponsorship
     Hlth
    Memphis Business Grp On             $5,120.00   Corporate Sponsorship
     Hlth
    Meridian Hospitals                    $400.00   Corporate Sponsorship
     Corporation
    Methodist Hosp The                 $25,000.00   Corporate Sponsorship
    Metropolitan Chicago Breast        $10,000.00   Charitable Donations
     Cancer
    Michael J Fox Fdtn                  $1,000.00   Corporate Sponsorship
    Michael J Fox Fdtn                 $25,000.00   Corporate Sponsorship
    Michael J Fox Fdtn                 $50,000.00   Corporate Sponsorship
    Michael J Fox Fdtn                 $15,000.00   Educational Grants
    Michigan Parkinson                  $2,000.00   Corporate Sponsorship
     Foundation
    Michigan Parkinson                  $4,000.00   Corporate Sponsorship
     Foundation
    Michigan Parkinson                  $2,500.00   Corporate Sponsorship
     Foundation
    Michigan Rheumatism Socty           $5,000.00   Corporate Sponsorship
    Michigan Rheumatism Socty           $5,000.00   Corporate Sponsorship
    Michigan Rheumatism Socty           $5,000.00   Corporate Sponsorship
    Michigan State Univ                 $1,000.00   Charitable Donations
    Michigan State Univ                 $1,000.00   Charitable Donations
    Midwest Business Grp On             $5,000.00   Corporate Sponsorship
     Hlth
    Midwest Pediatric Endocrine         $6,300.00   Corporate Sponsorship
     Socty
    Miles for Cystic Fibrosis          $20,000.00   Charitable Donations
    Miles for Cystic Fibrosis           $5,000.00   Corporate Sponsorship
    Missouri Hepatitis C               $25,000.00   Charitable Donations
     Alliance
    Montana Asoc of Hlth Care           $2,000.00   Corporate Sponsorship
     Purchaser
    Montefiore Med Ctr                 $75,000.00   Educational Grants
    Montefiore Med Ctr                 $50,000.00   Educational Grants
    Montefiore Med Ctr                 $50,000.00   Educational Grants
    Mount Sinai School of              $95,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $40,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $15,000.00   Educational Grants
     Medicine
    Mount Sinai School of             $100,000.00   Educational Grants
     Medicine
    Mount Sinai School of               $2,500.00   Educational Grants
     Medicine
    Mount Sinai School of               $5,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $40,000.00   Educational Grants
     Medicine
    Mount Sinai School of               $1,500.00   Educational Grants
     Medicine
    Mount Sinai School of              $30,000.00   Corporate Sponsorship
     Medicine
    Mount Sinai School of              $15,000.00   Educational Grants
     Medicine
    Mount Sinai School of               $1,500.00   Educational Grants
     Medicine
    Movement Disorder Socty The        $20,000.00   Corporate Sponsorship
    Movement Disorder Socty The        $25,000.00   Corporate Sponsorship
    Movement Disorder Socty The         $9,900.00   Corporate Sponsorship
    Ms Cure Fund, Inc.                 $10,000.00   Educational Grants
    Ms Cure Fund, Inc.                 $50,000.00   Educational Grants
    Ms Cure Fund, Inc.                 $15,000.00   Educational Grants
    Ms Views And News Inc.              $9,000.00   Educational Grants
    Multiple Myeloma Research          $20,000.00   Educational Grants
     Fdtn Inc. The
    Multiple Myeloma Research          $50,000.00   Educational Grants
     Fdtn Inc. The
    Multiple Myeloma Research          $40,000.00   Corporate Sponsorship
     Fdtn Inc. The
    Nashville Cares Inc.                $8,000.00   Corporate Sponsorship
    National Alliance of Mental         $5,000.00   Corporate Sponsorship
     Illness Flordia
    National Alliance of Mental        $15,000.00   Corporate Sponsorship
     Illness Michigan
    National Alliance of Mental         $5,000.00   Corporate Sponsorship
     Illness Tennessee
    National Alliance of Mental         $5,000.00   Corporate Sponsorship
     Illness Washington
    National Alliance of State         $30,000.00   Corporate Sponsorship
     and Territorial AIDS
     Directors
    National Association of             $6,750.00   Corporate Sponsorship
     Hispanic Nurses
    National Association of             $6,750.00   Corporate Sponsorship
     Hispanic Nurses
    National Association of            $25,000.00   Corporate Sponsorship
     Latino Elected & Appointed
     officials Educational Fund
    National Brain Tumor               $15,000.00   Corporate Sponsorship
     Society (Nbts)
    National Brain Tumor               $50,000.00   Charitable Donations
     Society (Nbts)
    National Brain Tumor               $25,000.00   Corporate Sponsorship
     Society, Inc
    National Coalition for             $40,000.00   Corporate Sponsorship
     Cancer
    National Comprehensive             $15,000.00   Corporate Sponsorship
     Cancer Network
    National Comprehensive             $10,000.00   Corporate Sponsorship
     Cancer Network
    National Comprehensive             $15,000.00   Corporate Sponsorship
     Cancer Network
    National Comprehensive             $10,000.00   Corporate Sponsorship
     Cancer Network
    National Comprehensive             $15,000.00   Corporate Sponsorship
     Cancer Network
    National Hemophlia                  $5,000.00   Corporate Sponsorship
     Foundation
    National Minority Quality          $10,000.00   Corporate Sponsorship
     forum Inc.
    National Ms Society Upper           $2,500.00   Corporate Sponsorship
     Midwest Chapter
    National Multiple Sclerosis       $250,000.00   Corporate Sponsorship
     Society
    National Parkinson                  $2,500.00   Corporate Sponsorship
     Foundation Minnesota
    National Parkinson                  $2,500.00   Corporate Sponsorship
     Foundation Minnesota
    National Parkinson                  $1,000.00   Corporate Sponsorship
     Foundation Minnesota
    National Parkinson                  $2,500.00   Corporate Sponsorship
     Foundation Minnesota
    Nationwide Childrens Hosp           $5,000.00   Corporate Sponsorship
     Fdtn
    Natl Academy of Dermatology        $30,000.00   Corporate Sponsorship
     Nurse Practitioners
    Natl Aids Treatment               $300,000.00   Charitable Donations
     Advocacy Project
    Natl Alliance of State And        $100,000.00   Charitable Donations
     Territorial Aids Directors
    Natl Asoc of Managed Care          $30,000.00   Educational Grants
     Phys
    Natl Asoc of Managed Care          $45,000.00   Educational Grants
     Phys
    Natl Asoc of Managed Care          $40,000.00   Educational Grants
     Phys
    Natl Asoc of Managed Care          $25,000.00   Corporate Sponsorship
     Phys
    Natl Asoc of Managed Care          $35,000.00   Educational Grants
     Phys
    Natl Breast Cancer                  $5,000.00   Charitable Donations
     Coalition Fund
    Natl Business Coalition On         $50,000.00   Corporate Sponsorship
     Hlth
    Natl Commission On                 $10,000.00   Educational Grants
     Correctional Hlth Care
    Natl Commission On                  $7,500.00   Corporate Sponsorship
     Correctional Hlth Care
    Natl Commission On                  $7,500.00   Corporate Sponsorship
     Correctional Hlth Care
    Natl Committee for Quality        $100,000.00   Corporate Sponsorship
     Assurance
    Natl Committee for Quality         $95,000.00   Educational Grants
     Assurance
    Natl Comprehensive Cancer          $50,000.00   Charitable Donations
     Ntwrk
    Natl Comprehensive Cancer          $40,000.00   Corporate Sponsorship
     Ntwrk
    Natl Comprehensive Cancer          $50,000.00   Educational Grants
     Ntwrk
    Natl Comprehensive Cancer           $5,000.00   Educational Grants
     Ntwrk
    Natl Comprehensive Cancer          $25,000.00   Educational Grants
     Ntwrk
    Natl Comprehensive Cancer          $25,000.00   Charitable Donations
     Ntwrk
    Natl Comprehensive Cancer          $50,000.00   Educational Grants
     Ntwrk
    Natl Comprehensive Cancer          $50,000.00   Corporate Sponsorship
     Ntwrk
    Natl Comprehensive Cancer          $50,000.00   Educational Grants
     Ntwrk
    Natl Comprehensive Cancer          $40,000.00   Educational Grants
     Ntwrk
    Natl Comprehensive Cancer         $240,000.00   Corporate Sponsorship
     Ntwrk
    Natl Comprehensive Cancer          $75,000.00   Educational Grants
     Ntwrk
    Natl Multiple Sclerosis            $10,000.00   Corporate Sponsorship
     Socty
    Natl Organization of                $5,000.00   Corporate Sponsorship
     Rheumlgy Managers
    Natl Pancreas Fdtn                $200,000.00   Educational Grants
    Natl Pancreas Fdtn                 $85,000.00   Educational Grants
    Natl Pancreas Fdtn                 $85,000.00   Charitable Donations
    Natl Pancreas Fdtn                 $75,000.00   Charitable Donations
    Natl Pancreas Fdtn                 $70,000.00   Educational Grants
    Natl Pancreas Fdtn                  $1,000.00   Corporate Sponsorship
    Natl Pancreas Fdtn                 $75,000.00   Corporate Sponsorship
    Natl Pancreas Fdtn                  $7,500.00   Corporate Sponsorship
    Natl Pancreas Fdtn                  $2,500.00   Corporate Sponsorship
    Natl Pancreas Fdtn                $200,000.00   Educational Grants
    Natl Pancreas Fdtn                 $25,000.00   Corporate Sponsorship
    Natl Pancreas Fdtn                 $75,000.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.           $75,000.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.            $2,500.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.            $5,000.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.            $2,500.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.            $1,000.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.            $1,500.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.           $10,000.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.           $50,000.00   Educational Grants
    Natl Parkinson Fdtn Inc.           $10,000.00   Corporate Sponsorship
    Natl Parkinson Fdtn Inc.           $85,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $25,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $75,000.00   Educational Grants
    Natl Psoriasis Fdtn                $50,000.00   Educational Grants
    Natl Psoriasis Fdtn                $30,000.00   Educational Grants
    Natl Psoriasis Fdtn                $26,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $26,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $26,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $26,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $20,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $10,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $13,550.00   Charitable Donations
    Natl Psoriasis Fdtn                $50,000.00   Educational Grants
    Natl Psoriasis Fdtn                $20,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $50,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $50,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $40,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                 $2,500.00   Corporate Sponsorship
    Natl Psoriasis Fdtn               $150,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $20,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn               $100,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $40,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $30,000.00   Corporate Sponsorship
    Natl Psoriasis Fdtn                $20,000.00   Corporate Sponsorship
    Natl Socty for Cutaneous           $50,000.00   Corporate Sponsorship
     Medicine
    Natl Socty for Cutaneous           $75,000.00   Corporate Sponsorship
     Medicine
    Natl Socty for Cutaneous          $135,000.00   Corporate Sponsorship
     Medicine
    Natl Socty for Cutaneous          $135,000.00   Corporate Sponsorship
     Medicine
    Neuro Challenge Foundation          $7,500.00   Educational Grants
     Inc.
    Neurologic Disease                  $4,995.00   Educational Grants
     Foundation
    New Jersey Academy of             $105,000.00   Educational Grants
     Family Phys
    New Mexico Parkinsons               $3,500.00   Educational Grants
     Disease Coalition
    New York Academy of Scnc            $1,500.00   Educational Grants
    New York Academy of Scnc            $1,500.00   Educational Grants
    New York Socty for                  $2,000.00   Corporate Sponsorship
     Gastrointestinal Endoscopy
    New York State Council of          $11,500.00   Corporate Sponsorship
     Hlth-System Pharmacists
    New York State Rheumlgy            $18,000.00   Corporate Sponsorship
     Socty
    New York Univ School of            $20,000.00   Educational Grants
     Medicine
    New York Univ School of            $10,000.00   Educational Grants
     Medicine
    New York Univ School of             $5,000.00   Educational Grants
     Medicine
    New York Univ School of             $5,000.00   Educational Grants
     Medicine
    New York Univ School of            $10,000.00   Educational Grants
     Medicine
    New York Univ School of            $10,000.00   Educational Grants
     Medicine
    New York Univ School of            $20,000.00   Educational Grants
     Medicine
    Nexus Global Grp Scnc              $10,000.00   Corporate Sponsorship
    Nicole Jarvis Md Parkinsons         $1,000.00   Corporate Sponsorship
     Research Fdtn
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $40,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $15,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.            $100,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $10,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.             $40,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.           ($40,000.00)   Educational Grants
    NL Communications Inc.            $128,000.00   Educational Grants
    NL Communications Inc.            $125,000.00   Educational Grants
    NL Communications Inc.             $75,000.00   Educational Grants
    NL Communications Inc.             $65,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.             $20,000.00   Educational Grants
    North American Ctr for            $390,000.00   Educational Grants
     Continuing Med Education
     (NACCME, LLC)
    North American Ctr for             $90,000.00   Educational Grants
     Continuing Med Education
     (NACCME, LLC)
    North American Ctr for             $90,000.00   Educational Grants
     Continuing Med Education
     (NACCME, LLC)
    North American Ctr for            $100,000.00   Educational Grants
     Continuing Med Education
     (NACCME, LLC)
    North American Socty for           $31,000.00   Educational Grants
     Pediatric Gastro
     Hepatology And Nutrition
    North American Socty for           $40,000.00   Fellowships and
     Pediatric Gastro                                Scholarships
     Hepatology And Nutrition
    North Dakota Pharmacists            $2,500.00   Corporate Sponsorship
     Asoc
    North Dakota Society of             $1,750.00   Corporate Sponsorship
     Health System Pharmacists
    North Eastern Section of            $3,000.00   Corporate Sponsorship
     The American Chemical
     Society, Inc.
    North Memorial Commty Fdtn          $2,500.00   Corporate Sponsorship
    Northeast Business Grp On           $5,000.00   Corporate Sponsorship
     Hlth
    Northeast Business Grp On           $5,000.00   Corporate Sponsorship
     Hlth
    Northwest Health Law                $1,000.00   Corporate Sponsorship
     Advocates
    Northwest Kdny Centers              $2,500.00   Corporate Sponsorship
    Northwest Parkinsons Fdtn           $7,000.00   Educational Grants
    Northwest Parkinsons Fdtn           $5,000.00   Corporate Sponsorship
    Northwest Parkinsons Fdtn           $5,000.00   Educational Grants
    Northwestern Memorial Fdtn          $8,000.00   Educational Grants
    Northwestern Univ                  $25,000.00   Corporate Sponsorship
    Northwestern Univ                  $50,000.00   Fellowships and
                                                     Scholarships
    Northwestern Univ                   $5,000.00   Educational Grants
    Northwestern Univ                   $5,000.00   Educational Grants
    Northwestern Univ                   $2,000.00   Educational Grants
    Norton Hlthcr Inc.                  $3,000.00   Corporate Sponsorship
    Ocular Immunology And               $2,500.00   Corporate Sponsorship
     Uveitis Fdtn
    Ohio Asoc of Rheumlgy              $10,000.00   Corporate Sponsorship
    Ohio Gastro Socty                   $5,000.00   Corporate Sponsorship
    Omnia Education Inc.               $95,000.00   Educational Grants
    Oncology Nursing Socty             $15,000.00   Educational Grants
    Oncology Nursing Socty             $38,500.00   Corporate Sponsorship
    Open Doors Commty School            $2,000.00   Charitable Donations
    Oregon Hlth & Scnc Univ            $10,000.00   Educational Grants
    Oregon Hlth & Scnc Univ             $2,000.00   Educational Grants
    Oregon Hlth & Scnc Univ             $5,000.00   Educational Grants
    Oregon Hlth & Scnc Univ            $10,000.00   Educational Grants
    Oregon State University             $7,500.00   Corporate Sponsorship
     Foundation
    Organic Reactions Catalysis         $1,000.00   Educational Grants
     Socty
    Ostomy Asoc of Greater              $1,000.00   Corporate Sponsorship
     Chicago
    Ounce of Prevention Fund           $10,000.00   Charitable Donations
    Pacific Dermatologic Asoc          $10,000.00   Corporate Sponsorship
    Pacific Dermatologic Asoc          $20,000.00   Corporate Sponsorship
    Pack Hlth LLC                      $91,375.00   Educational Grants
    Pack Hlth LLC                     $175,000.00   Educational Grants
    Pack Hlth LLC                     $127,800.00   Educational Grants
    Pack Hlth LLC                     $108,875.00   Educational Grants
    Pancreas Club The                  $10,000.00   Educational Grants
    Pancreatic Cancer Action            $1,250.00   Corporate Sponsorship
     Ntwrk Inc.
    Pancreatic Cancer Action            $1,250.00   Corporate Sponsorship
     Ntwrk Inc.
    Pancreatic Cancer Action           $25,000.00   Corporate Sponsorship
     Ntwrk Inc.
    Pancreatic Cancer Action          $234,000.00   Corporate Sponsorship
     Ntwrk Inc.
    Park Nicollet                       $1,000.00   Corporate Sponsorship
    Parkinson Alliance Inc.             $1,000.00   Corporate Sponsorship
    Parkinson And Movement             $15,000.00   Educational Grants
     Disorder All
    Parkinson And Movement              $1,250.00   Corporate Sponsorship
     Disorder All
    Parkinson And Movement             $50,000.00   Educational Grants
     Disorder All
    Parkinson Asoc of The               $8,000.00   Educational Grants
     Rockies
    Parkinson Asoc of The               $6,000.00   Educational Grants
     Rockies
    Parkinson Association of              $500.00   Corporate Sponsorship
     Alabama
    Parkinson Association of              $500.00   Corporate Sponsorship
     Central Florida Inc.
    Parkinson Council                  $20,000.00   Corporate Sponsorship
    Parkinson Fdtn of The Natl         $10,000.00   Educational Grants
     Capital Area
    Parkinson Foundation of             $1,000.00   Corporate Sponsorship
     Oklahoma
    Parkinson Foundation of             $1,500.00   Corporate Sponsorship
     Oklahoma
    Parkinson Institute                 $5,000.00   Corporate Sponsorship
    Parkinson Ntwrk of Arizona          $2,500.00   Corporate Sponsorship
    Parkinson Society of                  $500.00   Corporate Sponsorship
     Greenville Area
    Parkinson Study Group              $10,000.00   Educational Grants
    Parkinson Support Center of         $2,500.00   Corporate Sponsorship
     Kentuciana
    Parkinson Support Center of         $5,000.00   Corporate Sponsorship
     Kentuciana
    Parkinson Wellness Recovery         $1,000.00   Corporate Sponsorship
    Parkinsons And Movement             $2,500.00   Corporate Sponsorship
     Disorder Foundation
    Parkinsons Asoc of Western          $1,500.00   Corporate Sponsorship
     Michigan
    Parkinsons Disease Fdtn            $25,000.00   Educational Grants
    Parkinsons Disease Fdtn            $50,000.00   Educational Grants
    Parkinsons Disease Fdtn             $7,500.00   Corporate Sponsorship
    Parkinsons Outreach                 $1,000.00   Corporate Sponsorship
     Association
    Parkinsons Resources of             $5,000.00   Corporate Sponsorship
     Oregon
    Parkinsons Resources of             $5,000.00   Corporate Sponsorship
     Oregon
    Parkinsons Unity Walk              $50,000.00   Corporate Sponsorship
    Parkinsons Unity Walk              $64,000.00   Corporate Sponsorship
    Partners Hlthcr System           ($10,000.00)   Educational Grants
    Partnership for A Drug Free        $50,000.00   Charitable Donations
     America
    Partnership for Quality Med         $2,000.00   Charitable Donations
     Donations Pqmd
    Partnership for Quality Med         $1,000.00   Charitable Donations
     Donations Pqmd
    Patient Access Ntwrk Fdtn       $8,400,000.00   Charitable Donations
    Patient Access Ntwrk Fdtn         $260,000.00   Charitable Donations
    Patient Access Ntwrk Fdtn         $557,000.00   Charitable Donations
    Patient Empowerment Ntwrk          $75,000.00   Educational Grants
    Patient Empowerment Ntwrk          $40,000.00   Educational Grants
    Patient Empowerment Ntwrk          $22,500.00   Educational Grants
    Patient Empowerment Ntwrk          $20,000.00   Educational Grants
    Patient Empowerment Ntwrk          $22,500.00   Educational Grants
    Patient Empowerment Ntwrk          $35,000.00   Educational Grants
    Patient Empowerment Ntwrk          $20,000.00   Educational Grants
    Patient Empowerment Ntwrk          $35,000.00   Educational Grants
    Patient Empowerment Ntwrk          $10,000.00   Educational Grants
    Patient Power LLC                  $90,000.00   Corporate Sponsorship
    Pediatric Endocrinology             $6,000.00   Corporate Sponsorship
     Nursing Socty
    Pediatric Endocrinology            $10,000.00   Charitable Donations
     Nursing Socty
    Pediatric Splts of Virginia         $2,000.00   Corporate Sponsorship
     LLC
    Pennsylvania Academy of            $13,550.00   Corporate Sponsorship
     Dermatology And
     Dermatologic Surgry
    Pennsylvania Socty of              $10,000.00   Corporate Sponsorship
     Gastro
    Pennsylvania State Univ            $15,000.00   Educational Grants
    Pennsylvania State Univ            $15,000.00   Educational Grants
    Pennsylvania State Univ          ($36,337.33)   Educational Grants
    Pennsylvania State Univ            $20,000.00   Educational Grants
    Phmcy Quality Alliance             $12,500.00   Educational Grants
    Phoenix Childrens Hosp              $1,000.00   Corporate Sponsorship
    Phys Education Resource            $25,000.00   Educational Grants
    Phys Education Resource            $75,000.00   Educational Grants
    Phys Education Resource            $25,000.00   Educational Grants
    Phys Education Resource            $25,000.00   Educational Grants
    Phys Education Resource            $25,000.00   Educational Grants
    Phys Education Resource            $50,000.00   Educational Grants
    Phys Education Resource            $50,000.00   Educational Grants
    Phys Education Resource            $50,000.00   Educational Grants
    Phys Education Resource            $75,000.00   Educational Grants
    Phys Education Resource            $50,000.00   Educational Grants
    Pins for Parkinsons                   $500.00   Corporate Sponsorship
    Pittsburgh Business Grp On          $3,800.00   Corporate Sponsorship
     Hlth
    Pittsburgh Business Grp On          $3,800.00   Corporate Sponsorship
     Hlth
    President And Fellows of            $6,000.00   Educational Grants
     Harvard Colg
    Prevent Cancer Fdtn                $25,000.00   Charitable Donations
    Prime Education Inc.              $100,000.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Education Inc.              $218,348.25   Educational Grants
    Prime Education Inc.              $500,000.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Oncology Inc.                $85,000.00   Educational Grants
    Prime Oncology Inc.               $142,376.00   Educational Grants
    Prime Oncology Inc.                $50,000.00   Educational Grants
    Prime Oncology Inc.                $75,000.00   Educational Grants
    Prime Oncology Inc.                $85,000.00   Educational Grants
    Princeton Univ Trustees            $50,000.00   Fellowships and
                                                     Scholarships
    Proce Inc.                         $15,000.00   Educational Grants
    Project Access Now                  $3,500.00   Corporate Sponsorship
    Project Inform Inc.                $75,000.00   Charitable Donations
    Project Inform Inc.                $30,000.00   Corporate Sponsorship
    Projects In Knowledge Inc.        $100,000.00   Educational Grants
    Promedica International Cme        $15,000.00   Educational Grants
    Promis Hlth Organization            $5,000.00   Educational Grants
    Prostate Cancer Foundation          $4,000.00   Corporate Sponsorship
     Chicago
    Prostate Cancer Research           $10,000.00   Educational Grants
     Inst
    Prostate Cancer Research           $15,000.00   Corporate Sponsorship
     Inst
    Prostate Hlth Education            $15,000.00   Educational Grants
     Ntwrk
    Prostate Hlth Education            $10,000.00   Educational Grants
     Ntwrk
    Prostate Net Inc. The              $15,000.00   Educational Grants
    Prostaware                          $1,000.00   Corporate Sponsorship
    Puerto Rico Academy of             $16,000.00   Corporate Sponsorship
     Family Phys
    Puerto Rico Asoc of Gastro         $15,000.00   Educational Grants
    Puerto Rico Asoc of Gastro         $30,000.00   Corporate Sponsorship
    Puerto Rico Asoc of Gastro          $6,500.00   Educational Grants
    Purdue Univ                       $200,000.00   Educational Grants
    Purdue Univ                       $250,000.00   Educational Grants
    Purdue Univ                      ($60,000.00)   Educational Grants
    Regents of The Univ of             $10,000.00   Educational Grants
     California The
    Regents of The Univ of              $5,000.00   Educational Grants
     California The
    Regents of The Univ of             $40,000.00   Fellowships and
     California The                                  Scholarships
    Regents of The Univ of              $5,000.00   Educational Grants
     California The
    Regents of The Univ of             $15,000.00   Educational Grants
     California The
    Regents of The Univ of             $50,000.00   Fellowships and
     California The                                  Scholarships
    Regents of The Univ of              $2,500.00   Educational Grants
     California The
    Regents of The Univ of             $10,000.00   Educational Grants
     California The
    Regents of The Univ of              $5,000.00   Educational Grants
     Michigan
    Regents of The Univ of             $10,000.00   Corporate Sponsorship
     Michigan
    Regents of The Univ of              $1,000.00   Educational Grants
     Michigan
    Regional Osteopathic Med          $165,000.00   Educational Grants
     Education
    Renal Phys Asoc                    $30,000.00   Corporate Sponsorship
    Respiratory Hlth Asoc of            $4,050.00   Corporate Sponsorship
     Metro Chicago
    Rheumatism Socty of The            $15,000.00   Corporate Sponsorship
     District of Columbia The
    Rheumatology Association of         $5,000.00   Corporate Sponsorship
     Nevada
    Rheumlgy Alliance of               $25,000.00   Corporate Sponsorship
     Louisiana
    Rheumlgy Nurses Socty              $80,000.00   Educational Grants
    Rheumlgy Nurses Socty              $31,875.00   Corporate Sponsorship
    Rheumlgy Nurses Socty               $5,000.00   Corporate Sponsorship
    Rheumlgy Nurses Socty              $25,000.00   Educational Grants
    Rheumlgy Nurses Socty              $44,625.00   Corporate Sponsorship
    Riverside Medical Clinic            $7,500.00   Educational Grants
     Charitable Foundation
    Robert Michael Educational        $123,500.00   Educational Grants
     Inst LLC
    Robert Michael Educational         $80,000.00   Educational Grants
     Inst LLC
    Rock Steady Boxing                    $500.00   Corporate Sponsorship
    Rocky Mountain Ms Center            $5,000.00   Educational Grants
    Rush Univ Med Ctr                  $50,000.00   Educational Grants
    Rush Univ Med Ctr                  $75,000.00   Educational Grants
    Rush Univ Med Ctr                  $35,000.00   Educational Grants
    Rutgers The State Univ of          $60,000.00   Educational Grants
     New Jersey
    Rutgers The State Univ of          $25,000.00   Educational Grants
     New Jersey
    Rutgers The State Univ of          $50,000.00   Educational Grants
     New Jersey
    Rutgers University                  $1,500.00   Educational Grants
     Foundation
    Safety Pharmacology Socty           $2,000.00   Educational Grants
    Saint Anthony Hosp Fdtn             $1,500.00   Educational Grants
    San Francisco Neuro Socty           $1,500.00   Educational Grants
    San Francisco Retina                $5,000.00   Educational Grants
     Foundation
    San Juan Bautista Med              $40,000.00   Fellowships and
                                                     Scholarships
    Scott And White Healthcare          $1,000.00   Corporate Sponsorship
     Foundation
    Scripps Hlth                        $5,000.00   Educational Grants
    Scripps Hlth                       $50,000.00   Educational Grants
    Scripps Hlth                        $5,000.00   Educational Grants
    Scripps Hlth                        $5,000.00   Educational Grants
    Scripps Hlth                       $50,000.00   Educational Grants
    Scripps Hlth                       $25,000.00   Educational Grants
    Scripps Research Inst.              $5,000.00   Fellowships and
                                                     Scholarships
    Scripps Research Inst.              $2,000.00   Educational Grants
    Seattle Science Foundation          $7,500.00   Educational Grants
    Sexual Medicine Socty of         ($25,000.00)   Educational Grants
     North Am
    Sexual Medicine Socty of          $225,000.00   Corporate Sponsorship
     North America Inc.
    Share                              $10,000.00   Patient Support
    Sheknows LLC                       $43,000.00   Corporate Sponsorship
    Smith Wholesale Drug                $9,000.00   Corporate Sponsorship
     Company
    Sociedad Dermatologica De          $15,000.00   Corporate Sponsorship
     Puerto Rico
    Sociedad Dermatologica De          $35,000.00   Corporate Sponsorship
     Puerto Rico
    Sociedad Pr Endocrinologia         $15,000.00   Corporate Sponsorship
     Y Diabetologia
    Sociedad Puertorriquena             $8,000.00   Corporate Sponsorship
     Pediatria
    Society for Mucosal                 $1,500.00   Educational Grants
     Immunology
    Society for Neuro-Oncology         $10,000.00   Educational Grants
    Society for Neuro-Oncology        $107,400.00   Corporate Sponsorship
    Society for Neuro-Oncology         $25,000.00   Corporate Sponsorship
    Society of Nuclear Medicine         $5,000.00   Corporate Sponsorship
     and Molecular Imaging
    Socty for Immunotherapy of          $5,000.00   Educational Grants
     Cancer
    Socty for Leukocyte Biology         $1,500.00   Educational Grants
    Socty for Neuroscience              $2,500.00   Educational Grants
    Socty for Translational            $10,000.00   Educational Grants
     Oncology
    Socty of Dermatology Phys          $45,000.00   Corporate Sponsorship
     Assistants
    Socty of Dermatology Phys          $20,000.00   Corporate Sponsorship
     Assistants
    Socty of Dermatology Phys          $40,000.00   Corporate Sponsorship
     Assistants
    Socty of Investigative             $30,000.00   Educational Grants
     Dermatology
    Socty of Toxicologic                $1,000.00   Corporate Sponsorship
     Pathology
    Socty of Toxicologic               $15,000.00   Corporate Sponsorship
     Pathology
    Socty of Toxicology                   $450.00   Corporate Sponsorship
    Socty of Toxicology                 $2,500.00   Corporate Sponsorship
    South Carolina Alliance of          $5,000.00   Corporate Sponsorship
     Hlth Plans
    South Carolina                      $5,000.00   Corporate Sponsorship
     Dermatological Asoc
    South Dakota Parkinson                $500.00   Corporate Sponsorship
     Foundation
    South Texas Asoc of                $40,000.00   Corporate Sponsorship
     Rheumatologists
    Southeastern Consortium for        $10,000.00   Corporate Sponsorship
     Dermatology
    Splty Pharma Education Ctr         $49,750.00   Educational Grants
    St Louise Regional Hosp           ($2,000.00)   Educational Grants
    State of Maryland                  $40,000.00   Fellowships and
                                                     Scholarships
    State of Maryland                   $5,500.00   Educational Grants
    State of Maryland                  $23,000.00   Educational Grants
    Super Jake Fdtn The                $25,000.00   Charitable Donations
    Susan G Komen Philadelphia          $3,500.00   Educational Grants
    Take A Breather Foundation         $10,000.00   Corporate Sponsorship
    Take A Breather Foundation          $2,500.00   Corporate Sponsorship
    Take A Breather Foundation         $15,000.00   Corporate Sponsorship
    Tarsus Cardio Inc. Dba             $35,000.00   Corporate Sponsorship
     South Beach Symposium
    Team Fox North Texas                $1,000.00   Corporate Sponsorship
    Tennessee Dermatology Socty         $4,000.00   Corporate Sponsorship
    Tennessee Disability                $5,000.00   Corporate Sponsorship
     Coalition
    Tennessee Disability                $2,500.00   Corporate Sponsorship
     Coalition
    Tennessee Nurses                    $6,000.00   Corporate Sponsorship
     Association
    Teratology Socty                    $2,000.00   Corporate Sponsorship
    Texas Academy of Family             $2,500.00   Corporate Sponsorship
     Physicians
    Texas Medical Association           $3,000.00   Corporate Sponsorship
    Texas Medical Association          $10,000.00   Corporate Sponsorship
    Texas Neuro Socty                   $5,000.00   Corporate Sponsorship
    Texas Osteopathic Medical           $3,000.00   Corporate Sponsorship
     Association
    Texas Urological Socty              $4,500.00   Corporate Sponsorship
    Texas Urological Socty              $4,500.00   Corporate Sponsorship
    The Endocrine Socty                $25,000.00   Educational Grants
    The Endocrine Socty                $25,000.00   Educational Grants
    The Endocrine Socty                $25,000.00   Educational Grants
    The International Psoriasis        $25,000.00   Educational Grants
     Council
    Trinity Christian Colg Asoc         $1,000.00   Charitable Donations
    Trustees of The Univ of            $10,000.00   Educational Grants
     Pennsylvania
    Tufts Med Ctr                       $2,500.00   Corporate Sponsorship
    Tufts Univ                        ($4,580.00)   Educational Grants
    Tulane Univ Hlth Scnc Ctr          $20,000.00   Corporate Sponsorship
    UC Regents Maxillofacial           $20,000.00   Educational Grants
     Prosthetics Clnc
    UC Regents Maxillofacial           $10,000.00   Educational Grants
     Prosthetics Clnc
    UC Regents Maxillofacial           $40,000.00   Fellowships and
     Prosthetics Clnc                                Scholarships
    UC Regents Maxillofacial            $5,000.00   Educational Grants
     Prosthetics Clnc
    UC Regents Maxillofacial           $15,000.00   Educational Grants
     Prosthetics Clnc
    Ultimate Med Academy Med          $150,000.00   Educational Grants
     Learning Grp LLC
    Ultimate Med Academy Med          $198,790.00   Educational Grants
     Learning Grp LLC
    Ultimate Med Academy Med           $98,600.00   Educational Grants
     Learning Grp LLC
    Ultimate Med Academy Med          $389,100.00   Educational Grants
     Learning Grp LLC
    UMA Education Inc. DBA             $90,000.00   Educational Grants
     Global Education Grp
    Umass Amherst                       $5,000.00   Corporate Sponsorship
    Umass Fdtn                          $2,500.00   Charitable Donations
    United Spinal Association          $75,000.00   Corporate Sponsorship
     Inc.
    United States Adult Cystic          $7,500.00   Educational Grants
     Fibrosis Asoc Inc.
    United Way of Ctrl                  $1,250.00   Corporate Sponsorship
     Massachusetts
    United Way of Ctrl                  $5,000.00   Corporate Sponsorship
     Massachusetts
    Univ Connecticut Derm              $12,000.00   Fellowships and
                                                     Scholarships
    Univ Connecticut Derm               ($130.91)   Fellowships and
                                                     Scholarships
    Univ Hlth Srvc At Stony            $20,000.00   Educational Grants
     Point Inc.
    Univ Hosp Cleveland Med            $15,000.00   Fellowships and
                                                     Scholarships
    Univ Hosp of Brooklyn              $16,000.00   Educational Grants
    Univ of Alabama At                  $8,000.00   Educational Grants
     Birmingham
    Univ of Alabama At                 $40,000.00   Fellowships and
     Birmingham                                      Scholarships
    Univ of California--San            $50,000.00   Fellowships and
     Francisco                                       Scholarships
    Univ of California--San             $5,000.00   Educational Grants
     Francisco
    Univ of California--San            $10,000.00   Educational Grants
     Francisco
    Univ of California Berkeley        $20,000.00   Educational Grants
    Univ of California Berkeley        $45,000.00   Corporate Sponsorship
    Univ of California Berkeley        $50,000.00   Corporate Sponsorship
    Univ of California Irvine           $5,000.00   Fellowships and
                                                     Scholarships
    Univ of California Irvine           $5,000.00   Educational Grants
    Univ of Chicago                    $10,000.00   Charitable Donations
    Univ of Chicago                    $10,000.00   Educational Grants
    Univ of Cincinnati                 $85,000.00   Educational Grants
    Univ of Cincinnati                 $75,000.00   Educational Grants
    Univ of Cincinnati                 $60,000.00   Educational Grants
    Univ of Cincinnati                $250,000.00   Educational Grants
    Univ of Cincinnati                $130,000.00   Educational Grants
    Univ of Cincinnati                 $30,000.00   Educational Grants
    Univ of Colorado Denver             $3,500.00   Educational Grants
     School of Medicine
    Univ of Florida                    $15,898.00   Educational Grants
    Univ of Florida                    $75,000.00   Educational Grants
    Univ of Florida Fdtn                  $500.00   Corporate Sponsorship
    Univ of Florida Fdtn               $40,000.00   Fellowships and
                                                     Scholarships
    Univ of Illinios                   $40,000.00   Fellowships and
                                                     Scholarships
    Univ of Illinois Fdtn               $1,000.00   Charitable Donations
    Univ of Illinois Fdtn               $1,000.00   Charitable Donations
    Univ of Kansas Hosp                $50,000.00   Fellowships and
                                                     Scholarships
    Univ of Kansas Hosp                $45,000.00   Educational Grants
    Univ of Louisville Research        $75,000.00   Educational Grants
     Fdtn
    Univ of Louisville Research        $15,000.00   Educational Grants
     Fdtn
    Univ of Louisville Research         $5,000.00   Educational Grants
     Fdtn
    Univ of Louisville Research         $1,500.00   Educational Grants
     Fdtn
    Univ of Maryland Baltimore          $5,000.00   Fellowships and
                                                     Scholarships
    Univ of Maryland Baltimore          $1,000.00   Charitable Donations
     Fdtn
    Univ of Massachusetts Med           $1,000.00   Charitable Donations
     School
    Univ of Massachusetts Med           $2,500.00   Educational Grants
     School
    Univ of Minnesota Regents           $1,500.00   Educational Grants
    Univ of Minnesota Regents           $1,000.00   Educational Grants
    Univ of Nebraska Med Ctr           $20,000.00   Educational Grants
    Univ of Nebraska Med Ctr            $7,500.00   Educational Grants
    ------------------------------------------------------------------------

                          Grants Donations Report--2017
        (Parentheses represent refunds of previously disclosed payments)
                             Report as of 3/31/2018
    ------------------------------------------------------------------------
             Recipient             Payment Amount            Purpose
    ------------------------------------------------------------------------
    50 Hoops                           $10,000.00   Educational Grants
    A and R Educational Group           $4,500.00   Corporate Sponsorships
     LLC
    A and R Educational Group          $20,000.00   Corporate Sponsorships
     LLC
    Academia Medica Del Sur             $8,000.00   Corporate Sponsorships
    Academia Puertorriquena DE          $3,000.00   Corporate Sponsorships
     Neurologia
    Academy of Managed Care            $25,000.00   Corporate Sponsorships
     Pharmacy
    Academy of Managed Care            $15,000.00   Corporate Sponsorships
     Pharmacy
    Academy of Physician                $2,500.00   Corporate Sponsorships
     Assistants, Tennessee
    Advanced Urology Institute         $10,000.00   Corporate Sponsorships
     Education and General Fund
    Advances in Cosmetic and           $75,000.00   Corporate Sponsorships
     Med Dermatology Inc.
    Advances in Cosmetic and          $100,000.00   Corporate Sponsorships
     Med Dermatology Inc.
    Advances in Cosmetic and           $75,000.00   Corporate Sponsorships
     Med Dermatology Inc.
    Advocate Bromenn Medical            $2,000.00   Educational Grants
     Center
    Advocate Bromenn Medical            $2,500.00   Educational Grants
     Center
    Aesthetic Dermatology              $35,000.00   Corporate Sponsorships
     Symposia
    Aesthetic Dermatology              $25,000.00   Corporate Sponsorships
     Symposia
    AIDS Connecticut                    $2,500.00   Corporate Sponsorships
    AIDS Connecticut                    $2,500.00   Corporate Sponsorships
    AIDS Foundation of Chicago         $25,000.00   Charitable Donations
    AIDS Institute                     $36,000.00   Corporate Sponsorships
    Alabama Dermatology Society        $50,000.00   Corporate Sponsorships
    Alabama Dermatology Society        $50,000.00   Corporate Sponsorships
    Alaska Rheumatology                 $5,000.00   Corporate Sponsorships
     Alliance
    Alliance for Aging Research         $5,000.00   Corporate Sponsorships
    Alliance for Patient Access        $30,000.00   Corporate Sponsorships
    Alzheimers Association             $10,000.00   Corporate Sponsorships
     Greater Illinois Chapter
    Alzheimers Association              $2,500.00   Corporate Sponsorships
     Greater Illinois Chapter
    Alzheimers Association              $5,000.00   Corporate Sponsorships
     Greater Illinois Chapter
    Alzheimers Disease and            $133,750.00   Corporate Sponsorships
     Related Disorders
     Association Inc.
    American Academy of                $50,000.00   Charitable Donations
     Dermatology
    American Academy of                $65,000.00   Corporate Sponsorships
     Dermatology
    American Academy of                $35,000.00   Corporate Sponsorships
     Dermatology
    American Academy of                $25,000.00   Charitable Donations
     Dermatology
    American Academy of                $40,000.00   Educational Grants
     Dermatology
    American Academy of                $25,000.00   Corporate Sponsorships
     Dermatology
    American Academy of                $15,000.00   Charitable Donations
     Dermatology
    American Academy of                $37,500.00   Corporate Sponsorships
     Dermatology
    American Academy of                $50,000.00   Educational Grants
     Dermatology
    American Academy of               $300,000.00   Corporate Sponsorships
     Dermatology
    American Academy of Family         $17,000.00   Educational Grants
     Physicians
    American Academy of                $75,000.00   Corporate Sponsorships
     Neurology Institute
    American Academy of                $30,000.00   Educational Grants
     Neurology Institute
    American Academy of                $53,400.00   Corporate Sponsorships
     Neurology Institute
    American Academy of                $50,000.00   Fellowships and
     Neurology Institute                             Scholarships
    American Academy of                $30,000.00   Corporate Sponsorships
     Neurology Institute
    American Academy of                $14,000.00   Corporate Sponsorships
     Pediatrics
    American Academy of                $10,000.00   Educational Grants
     Physician Assistants
    American Academy of                $16,000.00   Educational Grants
     Physician Assistants
    American Association of            $20,000.00   Corporate Sponsorships
     Clinical Endocrinologists
     New Jersey Chapter
    American Association of            $18,000.00   Educational Grants
     Clinical Endocrinologists
     New Jersey Chapter
    American Association of            $10,000.00   Corporate Sponsorships
     Physicians of Indian
     Origin Arkansas
    American Association of            $10,000.00   Corporate Sponsorships
     Physicians of Indian
     Origin Arkansas
    American Association for          ($2,205.00)   Educational Grants
     Accreditation of
     Laboratory Animal Care
     International
    American Association for           $25,000.00   Fellowships and
     Cancer Research                                 Scholarships
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Charitable Donations
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $15,000.00   Educational Grants
     Cancer Research
    American Association for           $15,000.00   Educational Grants
     Cancer Research
    American Association for           $15,000.00   Educational Grants
     Cancer Research
    American Association for           $15,000.00   Educational Grants
     Cancer Research
    American Association for           $75,000.00   Educational Grants
     Cancer Research
    American Association for           $20,000.00   Charitable Donations
     Laboratory Animal Science
    American Association for            $5,000.00   Educational Grants
     Laboratory Animal Science
     New England Branch
    American Association for            $3,150.00   Corporate Sponsorships
     The Study of Liver Disease
    American Association of             $7,400.00   Corporate Sponsorships
     Gynecologic Laparoscopists
     Inc
    American Association of            $59,500.00   Corporate Sponsorships
     Gynecologic Laparoscopists
     Inc
    American Association of            $50,000.00   Corporate Sponsorships
     Pharmaceutical Scientists
    American Autoimmune Related        $40,000.00   Corporate Sponsorships
    American Brain Tumor               $30,000.00   Educational Grants
     Association
    American Brain Tumor               $10,000.00   Educational Grants
     Association
    American Brain Tumor               $15,000.00   Educational Grants
     Association
    American Brain Tumor               $15,000.00   Corporate Sponsorships
     Association
    American Brain Tumor                $7,500.00   Corporate Sponsorships
     Association
    American Cancer Society            $10,000.00   Corporate Sponsorships
    American Cancer Society             $1,500.00   Corporate Sponsorships
    American Cancer Society             $3,500.00   Corporate Sponsorships
    American Cancer Society            $50,000.00   Corporate Sponsorships
    American Cancer Society             $5,000.00   Corporate Sponsorships
     Action Network Connecticut
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Action Network North
     Carolina
    American Cancer Society             $5,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $5,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society            $10,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $5,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society            $10,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $5,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $3,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $7,500.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $7,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society            $10,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $3,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society            $25,000.00   Corporate Sponsorships
     Cancer Action Network
    American Cancer Society             $2,500.00   Corporate Sponsorships
     Cancer Action Network
    American Chemist Society            $2,500.00   Educational Grants
    American Chemist Society            $1,000.00   Educational Grants
    American Chemist Society            $3,000.00   Educational Grants
    American College of Chest          $35,000.00   Educational Grants
     Physicians
    American College of                 $5,000.00   Educational Grants
     Clinical Pharmacology
    American College of                $10,000.00   Patient Support
     Endocrinology
    American College of                $15,000.00   Educational Grants
     Gastroenterology
    American College of               $100,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $90,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $30,000.00   Charitable Donations
     Laboratory Animal Medicine
    American College of                 $5,000.00   Educational Grants
     Obstetricians and
     Gynecologists
    American College of                $15,000.00   Corporate Sponsorships
     Osteopathic Obstetricians
     and Gynecologists
    American College of                $15,000.00   Corporate Sponsorships
     Osteopathic Obstetricians
     and Gynecologists
    American College of                $57,000.00   Corporate Sponsorships
     Physician Foundation
    American College of                 $1,000.00   Corporate Sponsorships
     Physicians West Virginia
     Chapter
    American College of                $10,000.00   Corporate Sponsorships
     Rheumatology
    American College of                $80,000.00   Fellowships and
     Rheumatology                                    Scholarships
    American College of                $25,000.00   Educational Grants
     Rheumatology
    American College of                $20,000.00   Educational Grants
     Rheumatology
    American College of                $37,500.00   Educational Grants
     Rheumatology
    American College of                $17,600.00   Educational Grants
     Rheumatology
    American College of               $150,000.00   Corporate Sponsorships
     Rheumatology
    American College of             $2,000,000.00   Corporate Sponsorships
     Rheumatology Research and
     Education Foundation
    American College of               $500,000.00   Corporate Sponsorships
     Rheumatology Research and
     Education Foundation
    American Congress of               $10,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $12,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $12,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $12,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $13,250.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $50,000.00   Educational Grants
     Obstetricians and
     Gynecologists
    American Congress of                $5,000.00   Educational Grants
     Obstetricians and
     Gynecologists
    American                           $12,500.00   Charitable Donations
     Gastroenterological
     Association Institute
    American                            $5,000.00   Corporate Sponsorships
     Gastroenterological
     Association Institute
    American                           $40,000.00   Educational Grants
     Gastroenterological
     Association Institute
    American                           $75,000.00   Educational Grants
     Gastroenterological
     Association Institute
    American Kidney Fund                $5,000.00   Corporate Sponsorships
    American Legion National           $25,000.00   Corporate Sponsorships
    American Liver Foundation         $275,000.00   Corporate Sponsorships
    American Liver Foundation          $25,000.00   Corporate Sponsorships
    American Liver Foundation          $10,000.00   Corporate Sponsorships
    American Liver Foundation           $5,000.00   Educational Grants
    American Liver Foundation           $5,000.00   Educational Grants
    American Liver Foundation           $2,500.00   Corporate Sponsorships
    American Liver Foundation           $1,000.00   Corporate Sponsorships
    American Liver Foundation           $2,500.00   Corporate Sponsorships
    American Liver Foundation           $2,500.00   Corporate Sponsorships
    American Liver Foundation           $1,500.00   Corporate Sponsorships
    American Lung Association         $100,000.00   Corporate Sponsorships
    American Lung Association           $5,000.00   Corporate Sponsorships
     of The Northeast
    American Lung Association           $5,000.00   Corporate Sponsorships
     of The Northeast
    American Lung Association           $7,500.00   Corporate Sponsorships
     of The Northeast
    American Med Group                 $10,000.00   Corporate Sponsorships
     Associate
    American Med Group                 $10,000.00   Corporate Sponsorships
     Associate
    American Med Group                 $20,000.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Med Group                  $4,940.00   Corporate Sponsorships
     Associate
    American Neuro Associate           $40,000.00   Educational Grants
    American Pancreatic                $25,000.00   Patient Support
     Associate
    American Pancreatic                $75,000.00   Educational Grants
     Associate
    American Parkinson Disease         $20,000.00   Educational Grants
     Association
    American Parkinson Disease          $3,500.00   Corporate Sponsorships
     Association
    American Parkinson Disease         $62,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $5,500.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $3,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $2,500.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $5,000.00   Corporate Sponsorships
     Association
    American Red Cross of              $10,000.00   Charitable Donations
     Greater Chicago
    American Society for                $2,000.00   Educational Grants
     Pharmacology and
     Experimental Therapeutics
    American Society for               $10,000.00   Corporate Sponsorships
     Reproductive Medicine
    American Society for                $3,000.00   Corporate Sponsorships
     Reproductive Medicine
    American Society for               $15,000.00   Corporate Sponsorships
     Reproductive Medicine
    American Society of Colon          $35,000.00   Educational Grants
     and Rectal Surgns
    American Society of                $50,000.00   Fellowships and
     Hematology                                      Scholarships
    American Society of                $20,000.00   Educational Grants
     Hematology
    American Society of                $60,000.00   Educational Grants
     Hematology
    American Society of                $50,000.00   Educational Grants
     Hematology
    American Society of Nphro          $35,000.00   Corporate Sponsorships
    American Society of Nphro         $160,000.00   Educational Grants
    American Statistical                $2,000.00   Educational Grants
     Associate
    American Statistical                $2,500.00   Educational Grants
     Associate
    American Thyroid Associate         $30,000.00   Educational Grants
     Inc.
    American Urological                $50,000.00   Charitable Donations
     Associate Education and
     Research Inc.
    American Urological                $20,000.00   Educational Grants
     Associate Education and
     Research Inc.
    American Urological                $50,000.00   Educational Grants
     Associate Education and
     Research Inc.
    American Urological                $50,000.00   Educational Grants
     Associate Education and
     Research Inc.
    American Urological                $13,500.00   Corporate Sponsorships
     Associate Inc Western
     Section
    American Urological                $25,000.00   Charitable Donations
     Association
    American Urological                 $6,000.00   Corporate Sponsorships
     Association
    American Urological                 $2,000.00   Corporate Sponsorships
     Association
    American Urological                $10,000.00   Corporate Sponsorships
     Association
    American Urological                 $6,000.00   Corporate Sponsorships
     Association
    American Urological                $10,000.00   Charitable Donations
     Association
    American Urological                 $6,000.00   Corporate Sponsorships
     Association
    American Urological                 $1,500.00   Corporate Sponsorships
     Association
    Americans for Med Progress         $90,000.00   Charitable Donations
    Americares Foundation              $12,000.00   Charitable Donations
    American Hepato-Pancreato-         $30,000.00   Corporate Sponsorships
     Biliary Association
    Angel Foundation                    $2,500.00   Corporate Sponsorships
    Arizona State Association           $3,500.00   Corporate Sponsorships
     of Physician Assistants
    Arizona United Rheumatology        $25,000.00   Corporate Sponsorships
     Alliance--Aura
    Arkansas State Rheumatology        $10,000.00   Corporate Sponsorships
     Association Inc.
    Arkansas Technology                 $1,000.00   Charitable Donations
     University Foundation
    Arthritis Foundation                $5,000.00   Charitable Donations
    Arthritis Foundation                $5,000.00   Educational Grants
    Arthritis Foundation                $2,000.00   Corporate Sponsorships
    Arthritis Foundation               $30,000.00   Corporate Sponsorships
    Arthritis Foundation               $10,000.00   Corporate Sponsorships
    Arthritis Foundation                $4,000.00   Educational Grants
    Arthritis Foundation                $5,000.00   Educational Grants
    Arthritis Foundation               $20,000.00   Educational Grants
    Arthritis Foundation               $20,000.00   Educational Grants
    Arthritis Foundation                $3,000.00   Educational Grants
    Arthritis Foundation               $50,000.00   Corporate Sponsorships
    Arthritis Foundation                $2,500.00   Educational Grants
    Arthritis Foundation                $2,500.00   Corporate Sponsorships
    Arthritis Foundation                $3,000.00   Corporate Sponsorships
    Arthritis Foundation               $10,000.00   Corporate Sponsorships
    Arthritis Foundation                $2,500.00   Corporate Sponsorships
    Arthritis Foundation                $3,000.00   Corporate Sponsorships
    Arthritis Foundation                $2,000.00   Corporate Sponsorships
    Arthritis Foundation               $50,000.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Educational Grants
    Arthritis Foundation              $250,000.00   Corporate Sponsorships
    Arthritis Foundation              $300,000.00   Corporate Sponsorships
    Arthritis Foundation              $300,000.00   Corporate Sponsorships
    Arthritis Foundation              $259,000.00   Corporate Sponsorships
    Arthritis Foundation Inc.          $50,000.00   Corporate Sponsorships
    Arthritis Patient Services          $2,400.00   Educational Grants
    Arthritis Patient Services          $5,000.00   Educational Grants
    Arthritis Patient Services         $65,000.00   Educational Grants
    ARVO Foundation for Eye             $5,000.00   Fellowships and
     Research                                        Scholarships
    ASCO Cancer Foundation            $100,000.00   Patient Support
    ASCO Cancer Foundation             $20,000.00   Educational Grants
    ASCO Cancer Foundation             $28,000.00   Educational Grants
    ASCO Cancer Foundation             $10,000.00   Educational Grants
    ASCO Cancer Foundation             $10,000.00   Educational Grants
    ASCO Cancer Foundation             $15,000.00   Educational Grants
    ASCO Cancer Foundation             $15,000.00   Educational Grants
    ASCO Cancer Foundation             $15,000.00   Educational Grants
    ASCO Cancer Foundation             $30,000.00   Educational Grants
    ASCO Cancer Foundation             $30,000.00   Educational Grants
    ASCO Cancer Foundation             $30,000.00   Educational Grants
    ASCO Cancer Foundation             $56,000.00   Educational Grants
    ASCO Cancer Foundation             $60,000.00   Educational Grants
    ASCO Cancer Foundation             $75,000.00   Educational Grants
    ASCO Cancer Foundation             $34,500.00   Corporate Sponsorships
    ASCO Cancer Foundation             $13,275.00   Educational Grants
    ASCO Cancer Foundation             $26,000.00   Educational Grants
    Asembia                            $60,000.00   Corporate Sponsorships
    ASHP Foundation                    $75,000.00   Fellowships and
                                                     Scholarships
    Associate DE                       $10,000.00   Corporate Sponsorships
     Gastroenterologia Y
     Hepatologia Pediatrica DE
     Puerto Rico Aghppr
    Associate DE Reumatologos           $7,500.00   Corporate Sponsorships
     DE Puerto Rico
    Associate DE Reumatologos          $15,000.00    Corporate Sponsorships
     DE Puerto Rico
    Associate of Physician             $25,000.00   Corporate Sponsorships
     Assistants in Oncology
     Inc.
    Associate of Physician              $7,500.00   Corporate Sponsorships
     Assistants in Oncology
     Inc.
    Associate of Physician              $7,500.00   Corporate Sponsorships
     Assistants in Oncology
     Inc.
    Associate of Professors of         $50,000.00   Corporate Sponsorships
     Gyn and Obstetrician
    Associate of Professors of          $5,000.00   Corporate Sponsorships
     Gyn and Obstetrician
    Associate of Professors of         $75,000.00   Educational Grants
     Gyn and Obstetrician
    Associate of Reproductive          $50,000.00   Educational Grants
     Health Professionals
    Associate of Univ                   $5,000.00   Corporate Sponsorships
     Technology Managers
    Association of Community           $15,000.00   Corporate Sponsorships
     Cancer Centers (ACCC)
    Association of Community          $150,000.00   Corporate Sponsorships
     Cancer Centers (ACCC)
    Association of Women in            $40,000.00   Corporate Sponsorships
     Rheumatology
    Association of Women in            $30,000.00   Corporate Sponsorships
     Rheumatology
    Association of Women in            $75,000.00   Corporate Sponsorships
     Rheumatology
    Atlanta Dermatology and            $10,000.00   Corporate Sponsorships
     Pathology Associates, PC
    Autoimmune Advocacy                 $3,000.00   Corporate Sponsorships
     Alliance
    Auxiliary of Robert Wood            $5,000.00   Corporate Sponsorships
     Johnson University
     Hospital
    Baehr Challenge Ltd                 $1,000.00   Corporate Sponsorships
    Ball State University               $1,000.00   Charitable Donations
     Foundation
    Baylor College Medicine             $5,000.00   Educational Grants
     Infusion Dis
    Baylor College Medicine             $3,600.00   Fellowships and
     Infusion Dis                                    Scholarships
    Baylor Health Care System          $40,000.00   Fellowships and
     Foundation                                      Scholarships
    Baylor Scott and White              $5,000.00   Educational Grants
     Health
    Baylor Scott and White             $30,000.00   Educational Grants
     Health
    Bendcare                          $410,000.00   Corporate Sponsorships
    Beth Israel Deaconess            ($16,526.70)   Educational Grants
     Medical Center
    Beth Israel Deaconess              $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    Beth Israel Deaconess              $30,000.00   Fellowships and
     Medical Center                                  Scholarships
    Beth Israel Deaconess              $35,000.00   Fellowships and
     Medical Center                                  Scholarships
    Beth Israel Deaconess              $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    Beth Israel Deaconess               $3,000.00   Educational Grants
     Medical Center
    Beth Israel Deaconess             ($1,751.70)   Educational Grants
     Medical Center
    Beth Israel Med Center             $25,000.00   Fellowships and
                                                     Scholarships
    Bioconnections LLC                 $50,000.00   Corporate Sponsorships
    Biotechnology Industry              $8,000.00   Corporate Sponsorships
     Organization
    Board of Trustees of The            $3,000.00   Corporate Sponsorships
     Leland Stanford Junior
     Univ
    Board of Trustees of The            $1,500.00   Educational Grants
     Univ of Illinois
    Bonnie J Addario Lung               $5,000.00   Corporate Sponsorships
     Cancer Foundation
    Bonnie J Addario Lung              $25,000.00   Corporate Sponsorships
     Cancer Foundation
    Boomer Esiason Foundation          $25,000.00   Corporate Sponsorships
    Borland Groover Clinic              $1,000.00   Corporate Sponsorships
    Borland Groover Clinic                $750.00   Corporate Sponsorships
    Borland Groover Clinic              $1,000.00   Corporate Sponsorships
    Boston College School of            $7,500.00   Corporate Sponsorships
     Nursing
    Boston Society Inc.                 $3,000.00   Educational Grants
    Boston Taiwanese                    $2,500.00   Educational Grants
     Biotechnology Association
     Inc.
    Brain Support Network Inc.          $5,000.00   Educational Grants
    Breast Friends                      $1,000.00   Corporate Sponsorships
    Breastcancer.Org                    $5,000.00   Educational Grants
    Brian Grant Foundation            $150,000.00   Educational Grants
    Brian Grant Foundation              $1,500.00   Corporate Sponsorships
    Brigham and Women's                 $7,000.00   Educational Grants
     Hospital, Inc.
    Brigham and Women's                $40,000.00   Fellowships and
     Hospital, Inc.                                  Scholarships
    Broad Institute                     $5,000.00   Corporate Sponsorships
    California Associate of             $3,500.00   Corporate Sponsorships
     Physician Groups
    California Associate of            $25,000.00   Corporate Sponsorships
     Physician Groups
    California Chronic Care            $25,000.00   Corporate Sponsorships
     Coalition
    California Chronic Care            $10,000.00   Corporate Sponsorships
     Coalition
    California Life Sciences            $5,000.00   Corporate Sponsorships
     Association
    California Life Sciences            $5,500.00   Corporate Sponsorships
     Association
    California Neurology                $5,000.00   Educational Grants
     Society
    California Neurology                $5,000.00   Educational Grants
     Society
    California Society of              $10,000.00   Corporate Sponsorships
     Dermatology and
     Dermatology Surgry
    California Society of              $10,000.00   Corporate Sponsorships
     Dermatology and
     Dermatology Surgry
    California Society of              $10,000.00   Corporate Sponsorships
     Dermatology and
     Dermatology Surgry
    Cancer and Leukemia Group B        $50,000.00   Educational Grants
     Foundation
    Cancer and Leukemia Group B        $30,000.00   Educational Grants
     Foundation
    Cancer and Leukemia Group B        $50,000.00   Educational Grants
     Foundation
    Cancer Awareness of Nevada          $1,000.00   Corporate Sponsorships
    Cancer Care                        $10,000.00   Educational Grants
    Cancer Care                        $50,000.00   Charitable Donations
    Cancer Care                        $15,000.00   Educational Grants
    Cancer Care                        $25,000.00   Educational Grants
    Cancer Care                       $100,000.00   Corporate Sponsorships
    Cancer Care                       $150,000.00   Educational Grants
    Cancer Care                       $150,000.00   Educational Grants
    Cancer Care                        $90,000.00   Educational Grants
    Cancer Care                        $50,000.00   Educational Grants
    Cancer Care                       $100,000.00   Educational Grants
    Cancer Care                        $65,000.00   Corporate Sponsorships
    Cancer Molecular Thrpt              $5,000.00   Educational Grants
    Cancer Support Community           $75,000.00   Educational Grants
    Cancer Support Community           $25,000.00   Educational Grants
    Cancer Support Community           $50,000.00   Educational Grants
    Cancer Wellness Center              $5,000.00   Corporate Sponsorships
    Cardinal Health                   $170,000.00   Corporate Sponsorships
    Cardinal Health                    $60,000.00   Corporate Sponsorships
    Caribe Gyn                          $5,000.00   Corporate Sponsorships
    Caribe Gyn                         $17,000.00   Corporate Sponsorships
    Caring Ambassadors Program         $75,000.00   Charitable Donations
     Inc.
    Caring Ambassadors Program         $15,000.00   Patient Support
     Inc.
    Carti Foundation                   $10,000.00   Corporate Sponsorships
    Cascade AIDS Project                $5,000.00   Corporate Sponsorships
    Cedars--Sinai Med Center           $40,000.00   Fellowships and
                                                     Scholarships
    Cedars--Sinai Med Center           $10,000.00   Educational Grants
    Central Brain Tumor                $25,000.00   Educational Grants
     Registry of The United
     States
    Central Brain Tumor                $25,000.00   Educational Grants
     Registry of The United
     States
    Central Savannah River Area         $1,000.00   Corporate Sponsorships
     Csra Parkinson Support
     Group
    Chicago Urological Soctiey         $12,000.00   Corporate Sponsorships
    Childrens Hospital Corp             $5,000.00   Educational Grants
    Childrens Hospital of              $10,000.00   Corporate Sponsorships
     Philadelphia
    Childrens Treehouse                $10,000.00   Patient Support
     Foundation
    Chimp Haven                        $20,000.00   Charitable Donations
    Chinese American Society of         $5,000.00   Corporate Sponsorships
     Nuclear Medicine and
     Molecular Imaging
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chris Elliott Fund                  $5,000.00   Charitable Donations
    Chris Elliott Fund                  $5,000.00   Charitable Donations
    Chronic Liver Disease              $50,000.00   Corporate Sponsorships
     Foundation
    Chronic Liver Disease             $300,000.00   Educational Grants
     Foundation
    Chronic Liver Disease             $200,000.00   Educational Grants
     Foundation
    Chronic Liver Disease             $247,350.00   Educational Grants
     Foundation
    Chronic Liver Disease             $226,945.00   Educational Grants
     Foundation
    Chronic Liver Disease              $25,000.00   Corporate Sponsorships
     Foundation
    Chronic Lymphocytic                $75,000.00   Corporate Sponsorships
     Leukemia Society Inc.
    Chronic Lymphoytic Leukemia        $22,825.00   Educational Grants
     Society Inc.
    Chronic Lymphoytic Leukemia        $50,000.00   Charitable Donations
     Society Inc.
    Chronic Lymphoytic Leukemia        $75,000.00   Educational Grants
     Society Inc.
    Chronic Lymphoytic Leukemia        $50,000.00   Educational Grants
     Society Inc.
    Chronic Lymphoytic Leukemia        $50,000.00   Educational Grants
     Society Inc.
    Cincinnati Childrens               $40,000.00   Fellowships and
     Hospital Medical Center                         Scholarships
    Cincinnati Childrens               $25,000.00   Corporate Sponsorships
     Hospital Medical Center
    City of Hope National Med           $5,000.00   Corporate Sponsorships
     Center
    Cleveland Clinic                   $65,000.00   Educational Grants
    Cleveland Clinic                   $65,000.00   Educational Grants
    Cleveland Clinic                    $5,000.00   Educational Grants
    Cleveland Clinic                   $10,000.00   Corporate Sponsorships
    Cleveland Clinic                   $50,000.00   Educational Grants
    Cleveland Clinic                   $20,000.00   Corporate Sponsorships
    Cleveland Clinic                    $5,000.00   Educational Grants
    Cleveland Clinic                   $55,000.00   Fellowships and
                                                     Scholarships
    Cleveland Clinic                   $40,000.00   Fellowships and
                                                     Scholarships
    Cleveland Clinic                  ($4,853.56)   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $15,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $2,500.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $15,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                  ($6,652.23)   Educational Grants
     Educational Foundation
    Cleveland Clinic                  ($5,410.94)   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $65,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic Minority          $40,000.00   Fellowships and
     Mens Health Center                              Scholarships
    Clinical Care Optn LLC             $50,000.00   Educational Grants
    Clinical Care Optn LLC             $50,000.00   Educational Grants
    Clinical Care Optn LLC             $60,000.00   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC             $95,560.00   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Clinical Care Optn LLC             $95,000.00   Educational Grants
    Clinical Care Optn LLC            $150,000.00   Educational Grants
    Cll Global Research                $35,000.00   Educational Grants
     Foundation
    Cll Global Research                $20,000.00   Educational Grants
     Foundation
    Cll Global Research                $35,000.00   Educational Grants
     Foundation
    Coalition for Prevention of        $10,000.00   Corporate Sponsorships
     Colorectal Cancer in
     Puerto Rico
    Coalition of Positive              $40,000.00   Educational Grants
     Health Empowerment
    Coalition of Texans With            $5,000.00   Corporate Sponsorships
     Disabilities
    Coalition On Positive               $5,000.00   Corporate Sponsorships
     Health Empower
    Cockerell Educational              $25,000.00   Corporate Sponsorships
     Foundation
    Cody Dieruf Benefit                 $5,000.00   Patient Support
     Foundation
    Cold Spring Harbor                  $2,500.00   Educational Grants
     Laboratory
    Collaborative Alliance for          $6,000.00   Fellowships and
     Pancreatic Education and                        Scholarships
     Research
    Collaborative Alliance for         $30,000.00   Educational Grants
     Pancreatic Education and
     Research
    Collaborative Alliance for          $1,750.00   Corporate Sponsorships
     Pancreatic Education and
     Research
    Colorado Gerontological             $5,000.00   Corporate Sponsorships
     Society
    Columbia Univ Med Center            $5,000.00   Educational Grants
    Community Access National           $2,500.00   Corporate Sponsorships
     Network
    Community Center                   $15,000.00   Corporate Sponsorships
    Community Center                   $10,000.00   Corporate Sponsorships
    Community Foundation                $5,000.00   Corporate Sponsorships
    Community Foundation                $5,000.00   Corporate Sponsorships
    Community Initiatives             $150,000.00   Corporate Sponsorships
    Community Initiatives              $30,000.00   Corporate Sponsorships
    Community Initiatives              $25,000.00   Corporate Sponsorships
    Community Liver Alliance           $20,000.00   Corporate Sponsorships
    Community Liver Alliance            $5,000.00   Corporate Sponsorships
    Community Liver Alliance            $9,000.00   Corporate Sponsorships
    Community Liver Alliance            $3,000.00   Corporate Sponsorships
    Community Liver Alliance            $5,000.00   Corporate Sponsorships
    Complex Mechanisms of               $1,500.00   Educational Grants
     Disease Aging and Trauma
     (Cmdat) Research
     Foundation
    Connecticut Advanced Nurse          $2,000.00   Corporate Sponsorships
     Practitioner Society
    Connecticut Advocates for           $2,500.00   Corporate Sponsorships
     Parkinsons
    Connecticut Peer Review             $3,000.00   Corporate Sponsorships
     Organization--Qualidigm
    Connecting To Cure Crohns          $10,000.00   Corporate Sponsorships
     and Colitis
    Consortium of Multiple             $50,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple             $55,000.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple             $85,000.00   Educational Grants
     Sclerosis Centers
    Continuing Educational             $95,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $149,000.00   Educational Grants
     Alliance LLC
    Continuing Educational             $99,550.00   Educational Grants
     Alliance LLC
    Continuing Educational            ($1,050.00)   Educational Grants
     Alliance LLC
    Continuing Educational            $200,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $121,165.00   Educational Grants
     Alliance LLC
    Continuing Med Education           $85,000.00   Educational Grants
     Outfitters LLC
    Cornell Univ Weill Med             $15,000.00   Educational Grants
     College
    Cornell Univ Weill Med              $3,000.00   Educational Grants
     College
    Cornerstone Health                  $3,000.00   Corporate Sponsorships
     Enablement Strategic
     Solutions, LLC
    Cornerstone Health Inc.            $75,000.00   Educational Grants
    Cornerstone Health Inc.            $50,000.00   Educational Grants
    Cradles To Crayons Inc.               $300.00   Charitable Donations
    Creighton Univ                     $15,000.00   Educational Grants
    Crohns and Colitis                 $25,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                 $25,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $60,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $80,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                $200,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                  $3,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $3,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $12,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $14,250.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $20,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                $150,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $25,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                $100,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $15,000.00   Fellowships and
     Foundation of America                           Scholarships
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $20,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $10,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                $150,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $25,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $85,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                $400,000.00   Corporate Sponsorships
     Foundation of America
    Cure Cf                             $1,000.00   Corporate Sponsorships
    Curepsp Inc.                       $30,000.00   Educational Grants
    Curepsp Inc.                       $10,000.00   Educational Grants
    Curepsp Inc.                       $20,000.00   Corporate Sponsorships
    Curesearch for Childrens           $10,000.00   Charitable Donations
     Cancer
    Curesearch for Childrens           $15,000.00   Corporate Sponsorships
     Cancer
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $9,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation            $250.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation            $500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $6,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $7,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation        $750,000.00   Corporate Sponsorships
    Cystic Fibrosis Research            $5,000.00   Corporate Sponsorships
     Fund Emilys Entourage
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research            $3,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research            $5,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research            $7,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $18,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorships
     Inc.
    Danville D Elegance                 $5,000.00   Corporate Sponsorships
     Foundation
    Dava Oncology Lp                   $25,000.00   Corporate Sponsorships
    Dava Oncology Lp                   $10,000.00   Corporate Sponsorships
    Davis Phinney Foundation            $5,000.00   Corporate Sponsorships
    Davis Phinney Foundation           $30,000.00   Educational Grants
    Davis Phinney Foundation           $10,000.00   Corporate Sponsorships
    Davis Phinney Foundation           $30,000.00   Educational Grants
    Davis Phinney Foundation            $2,500.00   Corporate Sponsorships
    Davis Phinney Foundation           $20,000.00   Educational Grants
    Davis Phinney Foundation           $30,000.00   Educational Grants
    DBC Pri-Med LLC                   $165,000.00   Corporate Sponsorships
    Deep South Cancer                  $10,000.00   Corporate Sponsorships
     Foundation
    Deep South Cancer                   $5,000.00   Corporate Sponsorships
     Foundation
    Deep South Cancer                   $5,000.00   Corporate Sponsorships
     Foundation
    Dermatology Education              $75,000.00   Corporate Sponsorships
     Foundation
    Dermatology Education              $75,000.00   Corporate Sponsorships
     Foundation
    Dermatology Education              $50,000.00   Corporate Sponsorships
     Foundation
    Dermatology Education              $50,000.00   Corporate Sponsorships
     Foundation
    Dermatology Education              $50,000.00   Corporate Sponsorships
     Foundation
    Dermatology Foundation            $135,000.00   Charitable Donations
    Dermatology Foundation             $50,000.00   Corporate Sponsorships
    Dermatology Univ LLC               $75,000.00   Corporate Sponsorships
    Digestive Disease Week             $31,500.00   Corporate Sponsorships
    Digestive Health Foundation        $25,000.00   Corporate Sponsorships
    Diversity and Leadership            $6,000.00   Corporate Sponsorships
     Inc.
    Doctor Solomon Carter             ($4,919.07)   Fellowships and
     Fuller Mental Health                            Scholarships
     Center
    Donate Life Coalition of           $10,000.00   Charitable Donations
     Michigan
    Duke Univ                           $5,000.00   Educational Grants
    Duke Univ                        ($16,360.00)   Educational Grants
    Eastern Virginia Medical            $5,000.00   Educational Grants
     School
    Economic Alliance for               $2,500.00   Corporate Sponsorships
     Michigan
    Eicosanoid Research                 $2,500.00   Educational Grants
     Foundation
    Eisenhower Desert                  $25,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                 $250,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $50,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $85,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $25,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $30,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $50,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                 $500,000.00   Educational Grants
     Orthopedic Center
    El Centro Regional Medical          $6,000.00   Corporate Sponsorships
     Center F
    Elsevier Inc.                      $50,000.00   Educational Grants
    Employers Health Coalition          $7,500.00   Corporate Sponsorships
    Endocrine Society                  $25,000.00   Educational Grants
    Endocrine Society                  $50,000.00   Educational Grants
    Endocrine Society                  $50,000.00   Corporate Sponsorships
    Endocrine Society                  $25,000.00   Educational Grants
    Endometriosis Foundation of        $10,000.00   Charitable Donations
     America
    Epilepsy Association of            $10,000.00   Corporate Sponsorships
     Central Florida
    Epilepsy Foundation                 $5,000.00   Corporate Sponsorships
    Escuela DE Medicina DE             $10,000.00   Educational Grants
     Ponce
    Excellence in Rheumatology        $100,000.00   Corporate Sponsorships
     Education LLC
    Family Med Center                   $7,500.00   Corporate Sponsorships
     Bolingbrook
    Federation of American              $2,000.00   Educational Grants
     Society for Experimental
     Biology Faseb
    Federation of American              $5,000.00   Corporate Sponsorships
     Society for Experimental
     Biology Faseb
    Federation of American              $2,000.00   Corporate Sponsorships
     Society for Experimental
     Biology Faseb
    Federation of American              $5,000.00   Corporate Sponsorships
     Society for Experimental
     Biology Faseb
    Federation of Clinical             $20,000.00   Educational Grants
     Immunology Society
    Federation of Clinical             $25,000.00   Educational Grants
     Immunology Society
    Feinstein Institute for Med       $150,000.00   Educational Grants
     Research
    Florida Cancer Specialists         $34,500.00   Corporate Sponsorships
     Foundation
    Florida Chapter of America          $2,500.00   Corporate Sponsorships
     Academy of Pediatrics
    Florida Chapter, American           $5,000.00   Corporate Sponsorships
     College of Phyician
     Services
    Florida Hospital Orlando           $10,000.00   Corporate Sponsorships
    Florida Society of                 $22,600.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgry
    Florida Society of                 $25,500.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgery
    Florida Society of                 $60,000.00   Corporate Sponsorships
     Dermatology Physician
     Assistants Inc.
    Florida Society of                 $65,000.00   Corporate Sponsorships
     Dermatology Physician
     Assistants Inc.
    Florida Society of                 $35,000.00   Corporate Sponsorships
     Rheumatology
    Florida Society of                  $2,500.00   Corporate Sponsorships
     Rheumatology Inc.
    Florida Society of                  $3,000.00   Corporate Sponsorships
     Rheumatology Inc.
    Focus Med Communications          $150,000.00   Corporate Sponsorships
    Focus Med Communications            $5,000.00   Corporate Sponsorships
    Foster Ocular Immunology           $33,000.00   Corporate Sponsorships
     Society
    Foundation for Biomedical          $50,000.00   Charitable Donations
     Research
    Foundation of Consortium of         $5,450.00   Fellowships and
     Multiple Sclerosis Centers                      Scholarships
     Cmsc
    Foundation of Consortium of        $32,000.00   Fellowships and
     Multiple Sclerosis Centers                      Scholarships
     Cmsc
    Free To Breathe                    $25,000.00   Educational Grants
    Free To Breathe                    $50,000.00   Corporate Sponsorships
    Free To Breathe                    $40,000.00   Educational Grants
    Friends of Cancer Research         $40,000.00   Corporate Sponsorships
    Friends of The St Louis            $50,000.00   Corporate Sponsorships
     Univ Liver Center
    Fundacion Alfredo Ruiz              $5,000.00   Corporate Sponsorships
    Fundacion Daledale Inc.               $500.00   Corporate Sponsorships
    Fundacion Puertorriquena DE        $12,500.00   Educational Grants
     Pacientes Consult
     Endometriosis
    Funk Zitiello Foundation            $4,000.00   Corporate Sponsorships
    Gastrointestinal Research          $50,000.00   Corporate Sponsorships
     Foundation
    Gateway for Cancer Research        $10,000.00   Charitable Donations
    Geneva Foundation                  $10,000.00   Educational Grants
    George Washington Univ              $5,000.00   Corporate Sponsorships
    George Washington Univ              $5,000.00   Corporate Sponsorships
     Hospital
    George Washington Univ              $3,000.00   Corporate Sponsorships
     Hospital
    George Washington Univ             $10,000.00   Corporate Sponsorships
     Hospital
    Georgetown Univ                     $7,000.00   Educational Grants
    Georgetown Univ                    $50,000.00   Fellowships and
                                                     Scholarships
    Georgia Society of                 $50,000.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgery
    Gildas Club Chicago                $10,000.00   Charitable Donations
    Give for A Smile                    $1,000.00   Corporate Sponsorships
    Global Academy for Medical         $36,000.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $15,000.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $90,000.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $35,000.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $58,500.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $76,500.00   Corporate Sponsorships
     Education
    Global Healthy Living              $75,000.00   Corporate Sponsorships
     Foundation
    Global Healthy Living              $75,000.00   Corporate Sponsorships
     Foundation
    Global Healthy Living             $150,000.00   Corporate Sponsorships
     Foundation
    Global Oncology                     $5,000.00   Corporate Sponsorships
    Global Resource for                $25,000.00   Educational Grants
     Advancing Cancer Education
    Global Virus Network Inc.           $7,500.00   Educational Grants
    Global Virus Network Inc.           $8,000.00   Educational Grants
    Good Grief                            $500.00   Corporate Sponsorships
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $3,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Great Lakes Chapter of The          $1,000.00   Corporate Sponsorships
     American Society for
     Pharmacology and
     Experimental Therapeutics
    Group for Research and             $15,000.00   Corporate Sponsorships
     Assessment of Psoriasis
     and Psoriatic Arthritis
    Grupo de Apoyo de Ninos y           $1,000.00   Corporate Sponsorships
     Adolescentes Consult
     Reumatologia
    Grupo de Apoyo de Ninos y           $3,000.00   Corporate Sponsorships
     Adolescentes Consult
     Reumatologia
    Gynecologic Oncology Group         $40,000.00   Educational Grants
    Gynecologic Oncology Group         $25,000.00   Educational Grants
    H Lee Moffitt Cancer Center         $5,000.00   Educational Grants
     and Research Institute
    H Lee Moffitt Cancer Center         $7,500.00   Educational Grants
     and Research Institute
    Halo House Foundation               $5,000.00   Corporate Sponsorships
    Harborside Press                   $38,000.00   Corporate Sponsorships
    Harborside Press                   $20,000.00   Corporate Sponsorships
    Healthcare 21 Business             $16,000.00   Corporate Sponsorships
     Coalition
    Healthcare 21 Business              $1,000.00   Corporate Sponsorships
     Coalition
    Healthy Women                      $30,000.00   Corporate Sponsorships
    Healthy Women                      $45,000.00   Corporate Sponsorships
    Heart to Heart                     $10,000.00   Charitable Donations
     International Inc.
    Heb Grocery Co Lp                   $7,000.00   Corporate Sponsorships
    Hematology Oncology                 $5,000.00   Educational Grants
     Pharmacy Associate
    Hematology Oncology                 $5,000.00   Educational Grants
     Pharmacy Associate
    Henry Ford Health System            $5,000.00   Educational Grants
    Henry M Jackson Foundation         $10,000.00   Educational Grants
    Hep C Connection                   $10,000.00   Corporate Sponsorships
    Hepatitis C Association            $25,000.00   Educational Grants
    Hepatitis C Association            $20,000.00   Educational Grants
    Hepatitis C Mentor and             $10,000.00   Educational Grants
     Support Group The
    Hepatitis Education Project       $100,000.00   Charitable Donations
    Hidradenitis Suppurativa           $27,500.00   Corporate Sponsorships
     Foundation
    Hitchcock Foundation              ($2,685.00)   Educational Grants
    Hitchcock Foundation                $8,000.00   Educational Grants
    Hitchcock Foundation               $20,000.00   Educational Grants
    Hitchcock Foundation                $8,000.00   Educational Grants
    HMP Communications                 $10,000.00   Corporate Sponsorships
    HMP Communications                 $60,000.00   Corporate Sponsorships
    Hope Foundation                    $40,000.00   Fellowships and
                                                     Scholarships
    Hope Foundation                    $25,000.00   Educational Grants
    Hospital of the University         $60,000.00   Educational Grants
     of Pennsylvania
    Hospital of the University          $5,000.00   Educational Grants
     of Pennsylvania
    Hospital of the University         $10,000.00   Educational Grants
     of Pennsylvania
    Houston Area Parkinson              $5,000.00   Corporate Sponsorships
     Society
    Houston Business Coalition         $11,000.00   Corporate Sponsorships
     On Health
    Howard Brown Health Center          $2,500.00   Corporate Sponsorships
    Howard Hanna Children's            $10,000.00   Charitable Donations
     Free Care Fund
    Hubbard Street Dance               $20,000.00   Educational Grants
     Chicago
    Human Growth Foundation            $10,000.00   Corporate Sponsorships
    Human Growth Foundation            $10,000.00   Corporate Sponsorships
    Humboldt--Del Norte County          $4,000.00   Educational Grants
     Medical Society
    IBD Horizons                       $80,000.00   Educational Grants
    IBD Horizons                        $4,000.00   Corporate Sponsorships
    IBD Horizons                       $25,000.00   Corporate Sponsorships
    IBD Horizons                       $25,000.00   Corporate Sponsorships
    IBD Remedy Inc.                     $5,000.00   Fellowships and
                                                     Scholarships
    IBD Remedy Inc.                    $20,000.00   Patient Support
    Illinois Cancercare                 $3,000.00   Corporate Sponsorships
     Foundation
    Illinois Society of                $40,000.00   Corporate Sponsorships
     Dermatology Physician
     Assistants
    Illinois Society of                $20,000.00   Corporate Sponsorships
     Dermatology Physician
     Assistants
    Imedex LLC                        $200,000.00   Educational Grants
    Imedex LLC                         $10,000.00   Educational Grants
    Imedex LLC                         $10,000.00   Educational Grants
    Imedex LLC                         $50,000.00   Educational Grants
    Imedex LLC                         $50,000.00   Educational Grants
    Imedex LLC                         $50,000.00   Educational Grants
    Imedex LLC                        ($3,596.00)   Educational Grants
    Imedex LLC                          ($247.00)   Educational Grants
    Imedex LLC                        $114,000.00   Corporate Sponsorships
    Imedex LLC                         $45,750.00   Corporate Sponsorships
    Impact Education LLC               $75,000.00   Educational Grants
    Indian Doc Associate of             $2,500.00   Corporate Sponsorships
     Houston
    Indiana Parkinson                   $2,500.00   Corporate Sponsorships
     Foundation
    Indiana Parkinson                   $2,500.00   Corporate Sponsorships
     Foundation
    Indiana Univ                       $65,000.00   Educational Grants
    Indiana Univ                       $10,000.00   Charitable Donations
    Indiana Urological                  $5,000.00   Corporate Sponsorships
     Association
    Infectious Diseases Society        $10,000.00   Educational Grants
     of America
    Inflammatory Bowel Disease         $50,000.00   Educational Grants
     Support Foundation
    Innovation Foundation Inc.         $55,000.00   Corporate Sponsorships
    Integra Life Science              $500,000.00   Educational Grants
     Service
    Integrated Benefits                $25,000.00   Corporate Sponsorships
     Institute Inc.
    Integrated Med Foundation          $15,000.00   Charitable Donations
    Integrated Med Foundation           $5,000.00   Corporate Sponsorships
    Integrated Med Foundation           $4,500.00   Corporate Sponsorships
    International Aids Society--       $50,000.00   Educational Grants
     Usa
    International Aids Society--       $75,000.00   Educational Grants
     Usa
    International Alliance for          $5,000.00   Educational Grants
     Biological Standardization
    International Association          $25,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Association          $95,150.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Association         $264,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Association          $75,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Association          $75,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Cancer               $10,000.00   Corporate Sponsorships
     Advocacy Netwk
    International Chinese              $10,000.00   Corporate Sponsorships
     Statistical Associate
    International Dermatology          $70,000.00   Corporate Sponsorships
     Outcome Measures
    International Dermatology         $150,000.00   Corporate Sponsorships
     Outcome Measures
    International League of            $20,000.00   Charitable Donations
     Associate for Rheumlgy
    International Medical Corps         $5,000.00   Charitable Donations
    International Pelvic Pain          $21,000.00   Corporate Sponsorships
     Society
    International Physician            $90,000.00   Corporate Sponsorships
     Ntwrk Dba International
     Oncology Ntwrk
    International Physician            $50,000.00   Corporate Sponsorships
     Ntwrk Dba International
     Oncology Ntwrk
    International Physician            $75,000.00   Corporate Sponsorships
     Ntwrk Dba International
     Oncology Ntwrk
    International Society for           $5,000.00   Educational Grants
     Antiviral Research
    International Society for           $3,000.00   Educational Grants
     The Study of Xenobiotics
    International Society of           $86,420.00   Corporate Sponsorships
     Nephrology
    Iraq And Afghanistan               $15,000.00   Corporate Sponsorships
     Veterans
    Jefferson Med College at           $10,000.00   Educational Grants
     Thomas Jefferson Univ
    Jefferson Med College at            $3,000.00   Corporate Sponsorships
     Thomas Jefferson Univ
    Jefferson Med College at            $5,000.00   Educational Grants
     Thomas Jefferson Univ
    Jewish Hospital                     $7,500.00   Corporate Sponsorships
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology            $1,500.00   Corporate Sponsorships
     Ventures
    Johns Hopkins Technology            $6,500.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Univ School          $25,000.00   Corporate Sponsorships
     of Medicine
    Johns Hopkins Univ School          $20,000.00   Educational Grants
     of Medicine
    Jonathan Wood and Associate        $10,000.00   Corporate Sponsorships
    JWC Covenant Inc.                  $50,000.00   Educational Grants
    Kansas Univ Endowment               $1,000.00   Charitable Donations
     Association
    Keystone Symposia                  $25,000.00   Corporate Sponsorships
    Keystone Symposia                  $25,000.00   Corporate Sponsorships
    Kidney Foundation Inc..             $5,000.00   Corporate Sponsorships
     Northeast
    Laboratorio Clinico Toledo            $735.00   Patient Support
    Laboratorio Clinico Toledo          $1,185.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $450.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $270.00   Patient Support
    Laboratorio Clinico Toledo          $1,545.00   Patient Support
    Laboratorio Clinico Toledo            $552.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo          $2,085.00   Patient Support
    Laboratorio Clinico Toledo          $6,000.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo          $2,250.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $390.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,035.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo          $1,185.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,515.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,950.00   Patient Support
    Laboratorio Clinico Toledo            $735.00   Patient Support
    Laboratorio Clinico Toledo            $735.00   Patient Support
    Laboratorio Clinico Toledo            $555.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $855.00   Patient Support
    Laboratorio Clinico Toledo          $1,020.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $990.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $3,000.00   Patient Support
    Laboratorio Clinico Toledo            $360.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $510.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $2,595.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $450.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo          $1,035.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,860.00   Patient Support
    Laboratorio Clinico Toledo          $1,080.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,005.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo          $1,290.00   Patient Support
    Laboratorio Clinico Toledo            $450.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,050.00   Patient Support
    Laboratorio Clinico Toledo          $1,380.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $690.00   Patient Support
    Laboratorio Clinico Toledo            $720.00   Patient Support
    Laboratorio Clinico Toledo            $739.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $885.00   Patient Support
    Laboratorio Clinico Toledo          $1,035.00   Patient Support
    Laboratorio Clinico Toledo          $3,000.00   Patient Support
    Laboratorio Clinico Toledo            $240.00   Patient Support
    Laboratorio Clinico Toledo          $2,220.00   Patient Support
    Lake County Haven                  $10,000.00   Charitable Donations
    Large Urology Group                $25,000.00   Corporate Sponsorships
     Practice Associate
    Large Urology Group                $66,400.00   Corporate Sponsorships
     Practice Associate
    Large Urology Group                $20,000.00   Corporate Sponsorships
     Practice Associate
    Latino Center On Aging              $5,000.00   Corporate Sponsorships
    Lenox Hill Hospital                $10,000.00   Educational Grants
    Leukemia and Lymphoma           $1,267,000.00   Charitable Donations
     Society
    Leukemia and Lymphoma              $50,000.00   Educational Grants
     Society
    Leukemia and Lymphoma               $5,000.00   Corporate Sponsorships
     Society
    Leukemia and Lymphoma              $25,000.00   Educational Grants
     Society
    Leukemia and Lymphoma              $15,000.00   Corporate Sponsorships
     Society
    Leukemia and Lymphoma              $50,000.00   Educational Grants
     Society
    Leukemia and Lymphoma               $2,500.00   Corporate Sponsorships
     Society
    Leukemia and Lymphoma              $75,000.00   Educational Grants
     Society
    Leukemia and Lymphoma              $32,500.00   Corporate Sponsorships
     Society
    Leukemia and Lymphoma              $50,000.00   Educational Grants
     Society
    Leukemia and Lymphoma              $30,000.00   Corporate Sponsorships
     Society
    Leukemia and Lymphoma             $100,000.00   Corporate Sponsorships
     Society
    Leukemia and Lymphoma              $10,000.00   Corporate Sponsorships
     Society
    Leukemia Research                  $50,000.00   Fellowships and
     Foundation                                      Scholarships
    Leukemia Research                   $5,000.00   Patient Support
     Foundation
    Leukemia Research                   $5,000.00   Educational Grants
     Foundation
    Leukemia Research                   $3,000.00   Corporate Sponsorships
     Foundation
    Liver Health Connection            $75,000.00   Fellowships and
                                                     Scholarships
    Liver Health Connection             $5,000.00   Corporate Sponsorships
    Livestrong Foundation              $10,000.00   Patient Support
    Lone Star Parkinson Society           $500.00   Corporate Sponsorships
    Louisiana Urological                $5,000.00   Corporate Sponsorships
     Society
    Loyola Stritch School of            $1,000.00   Charitable Donations
     Medicine Division of
     Dermatology
    Loyola Stritch School of            $1,000.00   Charitable Donations
     Medicine Division of
     Dermatology
    Lung Cancer Alliance               $25,000.00   Corporate Sponsorships
    Lung Cancer Alliance              $100,000.00   Corporate Sponsorships
    Lung Cancer Alliance               $50,000.00   Corporate Sponsorships
    Lung Cancer Alliance               $50,000.00   Corporate Sponsorships
    Lung Cancer Research               $50,000.00   Charitable Donations
     Foundation
    Lung Cancer Research               $25,000.00   Charitable Donations
     Foundation
    Lungevity Foundation               $50,000.00   Educational Grants
    Lungevity Foundation                $5,000.00   Corporate Sponsorships
    Lungevity Foundation                $2,500.00   Corporate Sponsorships
    Lungevity Foundation               $25,000.00   Corporate Sponsorships
    Lungevity Foundation               $75,000.00   Corporate Sponsorships
    Lupus and Allied Diseases           $6,000.00   Corporate Sponsorships
     Association
    Lupus and Allied Diseases          $25,000.00   Corporate Sponsorships
     Association
    Lupus and Allied Diseases          $35,000.00   Corporate Sponsorships
     Association
    Lupus Foundation New                $5,000.00   Corporate Sponsorships
     England, Inc.
    Lupus Foundation of Florida         $5,000.00   Corporate Sponsorships
     Inc.
    Lupus Research Alliance,           $15,000.00   Corporate Sponsorships
     Inc.
    Lymphoma Research                   $5,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $40,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $10,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $10,000.00   Corporate Sponsorships
     Foundation
    MS Cure Fund Inc.                  $15,000.00   Educational Grants
    Magellan Rx Management Inc.        $20,000.00   Corporate Sponsorships
    March of Dimes Foundation           $5,000.00   Charitable Donations
    Massachusetts Association           $4,000.00   Corporate Sponsorships
     for Mental Health
    Massachusetts General              $40,000.00   Fellowships and
     Hospital                                        Scholarships
    Massachusetts General              $10,000.00   Corporate Sponsorships
     Hospital for Children
    Massachusetts General              $85,000.00   Corporate Sponsorships
     Hospital for Children
    Massachusetts Prostate              $2,500.00   Educational Grants
     Cancer Coalition
    Massachusetts Society for           $7,500.00   Educational Grants
     Med Research
    Massachusetts Society of            $5,000.00   Corporate Sponsorships
     Clinical Oncologists
    ME Strong Inc.                      $2,500.00   Corporate Sponsorships
    Med--LQ LLC                        $50,000.00   Educational Grants
    Med College of Wisconsin            $2,000.00   Corporate Sponsorships
    Med College of Wisconsin            $1,000.00   Corporate Sponsorships
    Med Univ of South Carolina          $5,000.00   Educational Grants
     Foundation
    Medical Learning Institute         $33,790.00   Educational Grants
    Medical Learning Institute         $75,000.00   Educational Grants
    Medical Learning Institute         $42,300.00   Educational Grants
    Medical Learning Institute        $116,850.00   Educational Grants
    Medical Univ of South              $10,000.00   Educational Grants
     Carolina
    Medina Community Clinic             $1,000.00   Corporate Sponsorships
    Medscape LLC                       $50,000.00   Educational Grants
    Medscape LLC                      $125,000.00   Educational Grants
    Medscape LLC                      $175,000.00   Educational Grants
    Medscape LLC                      $200,000.00   Educational Grants
    Medscape LLC                      $212,000.00   Educational Grants
    Medscape LLC                      $235,500.00   Educational Grants
    Medscape LLC                      $565,100.00   Educational Grants
    Medscape LLC                       $38,000.00   Educational Grants
    Medscape LLC                       $52,500.00   Educational Grants
    Medscape LLC                      $300,000.00   Educational Grants
    Medscape LLC                       $33,500.00   Educational Grants
    Memorial Sloan Kettering           $25,000.00   Educational Grants
     Cancer Center
    Memphis Business Group On           $5,100.00   Corporate Sponsorships
     Health
    Mens Health and Wellness            $1,500.00   Corporate Sponsorships
     Center
    Mercy Med Center Inc.               $3,250.00   Corporate Sponsorships
    Mercy Med Center Inc.               $3,250.00   Corporate Sponsorships
    Methodist Hospital                 $25,000.00   Corporate Sponsorships
    Methodist Hospital                  $1,000.00   Corporate Sponsorships
    Michael J Fox Foundation            $1,000.00   Corporate Sponsorships
    Michael J Fox Foundation           $50,000.00   Corporate Sponsorships
    Michigan Institute of               $5,000.00   Corporate Sponsorships
     Urology, PC
    Michigan Parkinson                 $10,000.00   Corporate Sponsorships
     Foundation
    Michigan Parkinson                  $1,000.00   Corporate Sponsorships
     Foundation
    Michigan Rheumatism Society        $25,000.00   Corporate Sponsorships
    Mid America MS Achievement          $2,000.00   Corporate Sponsorships
     Center
    Midwest Business Group on           $2,500.00   Corporate Sponsorships
     Health
    Midwest Business Group on           $2,500.00   Corporate Sponsorships
     Health
    Miles for Cystic Fibrosis           $2,500.00   Corporate Sponsorships
    Minnesota Urological                $5,000.00   Corporate Sponsorships
     Society
    Missouri Hepatitis C               $20,000.00   Educational Grants
     Alliance
    Mount Sinai School of              $10,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $40,000.00   Fellowships and
     Medicine                                        Scholarships
    Mount Sinai School of              $30,000.00   Corporate Sponsorships
     Medicine
    Mount Sinai School of              $40,000.00   Educational Grants
     Medicine
    Movement Disorder Society           $1,000.00   Corporate Sponsorships
    Movement Disorder Society          $20,000.00   Educational Grants
    Movement Disorder Society         $321,500.00   Corporate Sponsorships
    Movement Disorder Society          $12,000.00   Educational Grants
    Movement Disorder Society          $11,000.00   Corporate Sponsorships
    MS Views and News Inc.              $5,000.00   Educational Grants
    Multiple Myeloma Research          $10,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $25,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $15,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $50,000.00   Fellowships and
     Foundation Inc.                                 Scholarships
    Multiple Sclerosis                  $5,000.00   Patient Support
     Foundation Inc.
    Musella Foundation for             $25,000.00   Charitable Donations
     Brain Tumor Research and
     Information Inc.
    Nashville Cares Inc.                $8,000.00   Corporate Sponsorships
    National Academy of                $30,000.00   Corporate Sponsorships
     Dermatology Nurse
     Practitioners
    National Aids Treatment           $300,000.00   Patient Support
     Advocacy Project
    National Alliance of Mental         $5,000.00   Corporate Sponsorships
     Illness Flordia
    National Alliance of Mental         $7,500.00   Corporate Sponsorships
     Illness Tennessee
    National Alliance of State         $10,000.00   Corporate Sponsorships
     and Territorial AIDS
     Directors
    National Alliance of State         $50,000.00   Charitable Donations
     and Territorial Aids
     Directors
    National Animal Interest           $20,000.00   Charitable Donations
     Alliance
    National Associate of              $45,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $10,500.00   Corporate Sponsorships
     Managed Care Physician
    National Associate of              $20,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $25,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $45,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $20,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $35,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $10,500.00   Corporate Sponsorships
     Managed Care Physician
    National Associate of              $10,000.00   Charitable Donations
     Pediatric Nurse
     Practitioners
    National Association of             $2,500.00   Corporate Sponsorships
     Hispanic Nurses
    National Association of            $25,000.00   Corporate Sponsorships
     Latino Elected and
     Appointed officials
     Education Fund
    National Brain Tumor               $50,000.00   Patient Support
     Society (Nbts)
    National Brain Tumor               $25,000.00   Corporate Sponsorships
     Society, Inc.
    National Breast Cancer              $5,000.00   Patient Support
     Coalition Fund
    National Business Coalition         $7,500.00   Corporate Sponsorships
     On Health
    National Business Group On         $25,000.00   Corporate Sponsorships
     Health
    National Coalition for             $40,000.00   Corporate Sponsorships
     Cancer
    National Coalition for              $2,500.00   Corporate Sponsorships
     Cancer
    National Commission On             $10,000.00   Educational Grants
     Correctional Health Care
    National Committee of             $125,000.00   Corporate Sponsorships
     Quality Assurance
    National Community                 $25,000.00   Corporate Sponsorships
     Dispensing Associate NCODA
    National Community                 $30,000.00   Corporate Sponsorships
     Dispensing Associate NCODA
    National Community                 $35,000.00   Corporate Sponsorships
     Dispensing Associate NCODA
    National Comprehensive             $90,898.00   Educational Grants
     Cancer Network
    National Comprehensive             $25,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $10,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $25,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $50,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $25,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $50,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $75,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $55,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $50,000.00   Charitable Donations
     Cancer Network
    National Comprehensive             $15,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $75,000.00   Educational Grants
     Cancer Network
    National Federation of              $5,000.00   Corporate Sponsorships
     Independent
    National Foundation for The      ($81,525.67)   Educational Grants
     Centers for Disease
     Control and Prevention
    National Hispanic Council          $25,000.00   Corporate Sponsorships
     On Aging
    National Kdny Foundation          $292,054.00   Educational Grants
     Inc.
    National Medical                    $7,500.00   Educational Grants
     Association
    National Minority Quality          $25,000.00   Corporate Sponsorships
     forum
    National Multiple Sclerosis        $10,000.00   Corporate Sponsorships
     Society
    National Multiple Sclerosis         $2,500.00   Corporate Sponsorships
     Society
    National Multiple Sclerosis         $2,000.00   Corporate Sponsorships
     Society
    National Multiple Sclerosis        $25,000.00   Corporate Sponsorships
     Society-Greater Illinois
     Chapter
    National Organization of            $5,000.00   Corporate Sponsorships
     Rheumatology Managers
    National Pancreas                  $80,000.00   Charitable Donations
     Foundation
    National Pancreas                  $80,000.00   Charitable Donations
     Foundation
    National Pancreas                  $85,000.00   Educational Grants
     Foundation
    National Pancreas                 $190,000.00   Educational Grants
     Foundation
    National Pancreas                   $3,500.00   Corporate Sponsorships
     Foundation
    National Pancreas                   $1,000.00   Corporate Sponsorships
     Foundation
    National Pancreas                  $85,000.00   Charitable Donations
     Foundation
    National Pancreas                  $85,000.00   Educational Grants
     Foundation
    National Parkinson                  $2,500.00   Corporate Sponsorships
     Foundation Inc.
    National Parkinson                  $1,250.00   Corporate Sponsorships
     Foundation Inc.
    National Parkinson                 $85,000.00   Corporate Sponsorships
     Foundation Inc.
    National Parkinson                 $45,000.00   Educational Grants
     Foundation Inc.
    National Parkinson                 $50,000.00   Educational Grants
     Foundation Inc.
    National Parkinson                  $5,000.00   Corporate Sponsorships
     Foundation Inc.
    National Psoriasis                 $50,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $25,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $35,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $50,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $35,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $15,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $10,000.00   Educational Grants
     Foundation
    National Psoriasis                 $75,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $25,000.00   Educational Grants
     Foundation
    National Psoriasis                 $15,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $10,000.00   Educational Grants
     Foundation
    National Psoriasis                 $15,000.00   Educational Grants
     Foundation
    National Psoriasis                 $50,000.00   Educational Grants
     Foundation
    National Psoriasis                 $35,000.00   Educational Grants
     Foundation
    National Psoriasis                  $5,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $50,000.00   Educational Grants
     Foundation
    National Psoriasis                 $25,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                $100,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                $150,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $20,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $30,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $30,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $30,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $35,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $40,000.00   Corporate Sponsorships
     Foundation
    National Society for               $50,000.00   Corporate Sponsorships
     Cutaneous Medicine
    National Society for              $140,000.00   Corporate Sponsorships
     Cutaneous Medicine
    National Society for              $150,000.00   Corporate Sponsorships
     Cutaneous Medicine
    Neuro Challenge Foundation         $25,000.00   Corporate Sponsorships
     Inc.
    Neurologic Disease                  $4,995.00   Educational Grants
     Foundation
    New England Dermatological         $75,000.00   Corporate Sponsorships
     Society
    New England Immunology              $2,000.00   Corporate Sponsorships
     Conference Inc.
    New England Quality Care            $5,000.00   Corporate Sponsorships
     Alliance
    New Venture Fund                   $10,000.00   Educational Grants
    New York Academy of Science         $2,500.00   Educational Grants
    New York Academy of Science         $5,000.00   Corporate Sponsorships
    New York Med Colllege              $50,000.00   Educational Grants
     office of Continuing Med
     Education
    New York Society for               $55,000.00   Corporate Sponsorships
     Gastrointestinal Endoscopy
    New York State Rheumlgy            $18,000.00   Corporate Sponsorships
     Society
    New York State Rheumlgy            $22,500.00   Corporate Sponsorships
     Society
    Nexus Global Group Science          $5,000.00   Corporate Sponsorships
    Nicole T. Jarvis, M.D.,             $2,500.00   Corporate Sponsorships
     PLLC
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $40,000.00   Educational Grants
    NL Communications Inc.             $20,000.00   Educational Grants
    NL Communications Inc.             $40,000.00   Educational Grants
    NL Communications Inc.             $20,000.00   Educational Grants
    NL Communications Inc.             $65,000.00   Educational Grants
    NL Communications Inc.             $75,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $30,000.00   Educational Grants
    NL Communications Inc.             $75,000.00   Educational Grants
    North American Center for         $375,025.00   Educational Grants
     Continuing Med Education
    North American Center for          $90,000.00   Educational Grants
     Continuing Med Education
    North American Society for         $15,000.00   Educational Grants
     Pediatric Gastroenterology
     Hepatology and Nutrition
    North Carolina Biosciences          $2,000.00   Corporate Sponsorships
     Organization
    North Dakota Pharmacists            $2,500.00   Corporate Sponsorships
     Association
    Northeast Business Group On        $15,000.00   Corporate Sponsorships
     Health
    Northeast Business Group On        $15,000.00   Corporate Sponsorships
     Health
    Northeastern University             $1,000.00   Charitable Donations
    Northern Illinois                   $1,000.00   Charitable Donations
     University Foundation
    Northwest Health Law                $1,000.00   Corporate Sponsorships
     Advocates
    Northwest Indiana                   $1,000.00   Corporate Sponsorships
     Parkinsons
    Northwest Kidney Centers            $2,500.00   Corporate Sponsorships
    Northwest Parkinsons                $5,000.00   Educational Grants
     Foundation
    Northwest Parkinsons               $14,900.00   Corporate Sponsorships
     Foundation
    Northwestern Univ                  $25,000.00   Corporate Sponsorships
    Northwestern Univ                  $50,000.00   Fellowships and
                                                     Scholarships
    Norton Healthcare                   $3,000.00   Corporate Sponsorships
     Foundation
    Norwich University                  $1,000.00   Charitable Donations
    NYU School of Medicine              $5,000.00   Educational Grants
    NYU School of Medicine             $10,000.00   Educational Grants
    NYU School of Medicine              $7,500.00   Educational Grants
    NYU School of Medicine             $10,000.00   Educational Grants
    NYU School of Medicine             $20,000.00   Educational Grants
    Ocular Immunology and               $5,000.00   Corporate Sponsorships
     Uveitis Foundation
    Ocular Immunology and              $15,000.00   Corporate Sponsorships
     Uveitis Foundation
    Ohio Association of                $10,000.00   Corporate Sponsorships
     Rheumatology
    Ohio Gastroenterology               $1,250.00   Corporate Sponsorships
     Society
    Ohio Gastroenterology               $1,250.00   Corporate Sponsorships
     Society
    Ohio Gastroenterology               $2,500.00   Corporate Sponsorships
     Society
    Omnia Education Inc.               $98,000.00   Educational Grants
    Omnia Education Inc.              $350,000.00   Educational Grants
    Oncology Nursing Society           $20,200.00   Corporate Sponsorships
    Oradian Inc.                       $75,000.00   Corporate Sponsorships
    Oregon Health and Science           $3,500.00   Corporate Sponsorships
     Univ
    Oregon Health and Science          $20,000.00   Educational Grants
     Univ
    Oregon Health and Science           $5,000.00   Educational Grants
     Univ
    Oregon Health and Science           $3,000.00   Educational Grants
     Univ
    Oregon Health and Science          $20,000.00   Educational Grants
     Univ
    Osmania Gandhi Kakatiya             $2,500.00   Corporate Sponsorships
     Medical Alumni Association
     of America
    Pacific Dermatologic               $20,000.00   Corporate Sponsorships
     Association
    Pacific Dermatologic               $20,000.00   Corporate Sponsorships
     Association
    Pack Center LLC                    $22,575.00   Educational Grants
    Pack Center LLC                   $175,000.00   Educational Grants
    Pack Health LLC                   $119,750.00   Educational Grants
    Pack Health LLC                    $80,000.00   Educational Grants
    Pack Health LLC                    $79,750.00   Educational Grants
    Pack Health LLC                    $50,000.00   Educational Grants
    Pack Health LLC                    $42,875.00   Educational Grants
    Pack Health LLC                    $42,875.00   Educational Grants
    Pack Center LLC                   $100,000.00   Educational Grants
    Pancreas Club                      $10,000.00   Educational Grants
    Pancreatic Cancer Action           $50,000.00   Educational Grants
     Network
    Pancreatic Cancer Action          $282,000.00   Corporate Sponsorships
     Network
    Park Nicollet Foundation            $1,000.00   Corporate Sponsorships
    Parkinson and Movement             $20,000.00   Educational Grants
     Disorder Alliance
    Parkinson and Movement              $4,000.00   Corporate Sponsorships
     Disorder Alliance
    Parkinson and Movement              $2,500.00   Corporate Sponsorships
     Disorder Alliance
    Parkinson Association               $1,000.00   Corporate Sponsorships
    Parkinson Association               $5,000.00   Corporate Sponsorships
    Parkinson Council                  $25,000.00   Corporate Sponsorships
    Parkinson Foundation                $2,500.00   Corporate Sponsorships
    Parkinson Foundation                $5,000.00   Corporate Sponsorships
    Parkinson Foundation               $10,000.00   Educational Grants
    Parkinson Foundation                $2,500.00   Corporate Sponsorships
    Parkinson Study Group              $20,000.00   Educational Grants
    Parkinson Study Group              $15,000.00   Corporate Sponsorships
    Parkinson Study Group               $2,716.00   Fellowships and
                                                     Scholarships
    Parkinson Support Center of         $5,000.00   Corporate Sponsorships
     Kentuciana
    Parkinson Support Center of         $5,000.00   Corporate Sponsorships
     Kentuciana
    Parkinsons and Movement             $1,500.00   Corporate Sponsorships
     Disorder Foundation
    Parkinsons Association              $1,000.00   Corporate Sponsorships
    Parkinsons Association              $8,000.00   Educational Grants
    Parkinsons Association              $8,000.00   Educational Grants
    Parkinson's Awareness               $1,500.00   Corporate Sponsorships
     Association of Central
     Indiana
    Parkinsons Disease                  $5,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                 $10,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Institute                $5,000.00   Corporate Sponsorships
    Parkinson's Nebraska                $1,000.00   Corporate Sponsorships
    Parkinsons Outreach                 $1,000.00   Corporate Sponsorships
     Association
    Partnership for Quality Med         $2,000.00   Charitable Donations
     Donations Pqmd
    Patient Access Network            $287,000.00   Charitable Donations
     Foundation
    Patient Access Network          $2,284,000.00   Charitable Donations
     Foundation
    Patient Access Network         $10,000,000.00   Charitable Donations
     Foundation
    Patient Access Network          $7,577,000.00   Charitable Donations
     Foundation
    Patient Access Network         $15,000,000.00   Charitable Donations
     Foundation
    Patient Empowerment Ntwrk          $40,000.00   Educational Grants
    Patient Empowerment Ntwrk          $25,000.00   Educational Grants
    Patient Empowerment Ntwrk          $30,000.00   Educational Grants
    Patient Empowerment Ntwrk          $30,000.00   Educational Grants
    Patient Empowerment Ntwrk          $30,000.00   Educational Grants
    Patient Empowerment Ntwrk          $20,000.00   Educational Grants
    Patient Empowerment Ntwrk          $15,000.00   Educational Grants
    Patient Empowerment Ntwrk          $20,000.00   Educational Grants
    Patient Empowerment Ntwrk          $35,000.00   Educational Grants
    Pcec Prostrate Conditions           $2,500.00   Corporate Sponsorships
     Education Council
    Pediatric Endocrine Society         $3,750.00   Corporate Sponsorships
    Pediatric Endocrine Society        $50,000.00   Corporate Sponsorships
    Pediatric Endocrinology             $2,500.00   Corporate Sponsorships
     Nursing Society
    Pediatric Endocrinology            $17,000.00   Corporate Sponsorships
     Nursing Society
    Pediatric Ibd Foundation           $10,000.00   Corporate Sponsorships
    Peerview Institute for            ($2,000.00)   Educational Grants
     Medical Education
    Pennsylvania Academy of            $10,000.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgry
    Pennsylvania Biotechnology          $3,000.00   Corporate Sponsorships
     Association
    Pennsylvania Prostate               $5,000.00   Educational Grants
     Cancer Coalition
    Pennsylvania Society of             $5,000.00   Corporate Sponsorships
     Gastroenterology
    People To People Health            $20,000.00   Charitable Donations
     Foundation
    People To People Health            $20,000.00   Charitable Donations
     Foundation
    Performrx                           $5,000.00   Corporate Sponsorships
    Pharmaceutical Research and        $20,000.00   Corporate Sponsorships
     Manufacturers of America
    Philadelphia Research and           $5,500.00   Educational Grants
     Education Foundation
    Phrmct Care Management             $73,000.00   Corporate Sponsorships
     Associate
    Phrmct Care Management             $88,000.00   Corporate Sponsorships
     Associate
    Phrmct Care Management             $73,000.00   Corporate Sponsorships
     Associate
    Physicians Education               $25,000.00   Educational Grants
     Resource LLC
    Physicians Education               $75,000.00   Educational Grants
     Resource LLC
    Physicians Education               $50,000.00   Educational Grants
     Resource LLC
    Physicians Education               $50,000.00   Educational Grants
     Resource LLC
    Pink Door Nonprofit                 $2,400.00   Corporate Sponsorships
     Organization
    Pins for Parkinsons                   $500.00   Corporate Sponsorships
    Pittsburgh Business Group          $13,000.00   Corporate Sponsorships
     On Health
    Pittsburgh Business Group          $13,000.00   Corporate Sponsorships
     On Health
    Postgraduate Institute for         $59,725.00   Educational Grants
     Medicine
    Presbyterian Healthcare             $5,000.00   Corporate Sponsorships
     Foundation
    President and Fellows of            $1,500.00   Educational Grants
     Harvard College
    Prevent Cancer Foundation          $25,000.00   Charitable Donations
    Prevent Cancer Foundation         $100,000.00   Corporate Sponsorships
    Prevent Cancer Foundation           $5,000.00   Corporate Sponsorships
    Prime Education Inc.              $150,000.00   Educational Grants
    Prime Education Inc.              $225,000.00   Educational Grants
    Prime Education Inc.              $190,000.00   Educational Grants
    Prime Education Inc.              $244,000.00   Educational Grants
    Prime Education Inc.              $332,620.00   Educational Grants
    Prime Education Inc.              $100,000.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Education Inc.              $100,000.00   Educational Grants
    Prime Education Inc.              $106,400.00   Educational Grants
    Prime Education Inc.              $128,902.00   Educational Grants
    Prime Oncology Inc.                $25,000.00   Educational Grants
    Prime Oncology Inc.               $155,125.00   Educational Grants
    Prime Oncology Inc.                $75,000.00   Educational Grants
    Prime Oncology Inc.               $154,150.00   Educational Grants
    Primo Education LLC                $50,000.00   Educational Grants
    Princeton Univ Trustees            $50,000.00   Educational Grants
    Project Inform                     $75,000.00   Charitable Donations
    Project Inform, Inc.               $30,000.00   Corporate Sponsorships
    Project Spark Foundation            $1,500.00   Corporate Sponsorships
    Projects in Knowledge Inc.        $125,000.00   Educational Grants
    Projects in Knowledge Inc.         $80,000.00   Educational Grants
    Projects in Knowledge Inc.        $150,000.00   Educational Grants
    Prostate Cancer Foundation          $4,000.00   Corporate Sponsorships
     Chicago
    Prostate Cancer                     $5,000.00   Patient Support
     International
    Prostate Cancer Research           $15,000.00   Corporate Sponsorships
     Instutute
    Prostate Health Education           $7,500.00   Educational Grants
     Network
    Prostate Health Education           $5,000.00   Educational Grants
     Network
    Prostaware                          $1,500.00   Corporate Sponsorships
    Psoriasis and Psoriatic           $100,000.00   Corporate Sponsorships
     Arthritis Clinics
     Multicenter Advancement
     Network
    Psoriasis and Psoriatic           $100,000.00   Corporate Sponsorships
     Arthritis Clinics
     Multicenter Advancement
     Network
    Puerto Rico Associate of           $20,000.00   Educational Grants
     Gastroenterology
    Puerto Rico Associate of           $40,000.00   Corporate Sponsorships
     Gastroenterology
    Puerto Rico Associate of           $10,000.00   Educational Grants
     Gastroenterology
    Purdue Univ College of             $50,000.00   Educational Grants
     Pharmacy
    Purdue Univ College of            $175,000.00   Educational Grants
     Pharmacy
    Recovery Idaho                      $1,000.00   Corporate Sponsorships
    Regents of The Univ of             $40,000.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of             $55,000.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of              ($658.85)   Educational Grants
     California
    Regents of The Univ of              $5,000.00   Educational Grants
     California
    Regents of The Univ of             $10,000.00   Educational Grants
     California
    Regents of The Univ of              $5,000.00   Educational Grants
     California
    Regents of The Univ of             $20,000.00   Educational Grants
     California
    Regents of The Univ of              $5,000.00   Educational Grants
     Michigan
    Regents of The Univ of             $20,000.00   Corporate Sponsorships
     Michigan
    Regents of the University           $5,000.00   Educational Grants
     of Minnesota
    Rehabilitation and                  $2,500.00   Corporate Sponsorships
     Community
    Renal Physician Associate          $30,000.00   Corporate Sponsorships
    Research Institute at               $7,500.00   Corporate Sponsorships
     Nationwide Childrens
     Hospital
    Research Institute for Fox          $5,000.00   Corporate Sponsorships
     Chase Cancer Center
    Rheumatology Association of         $7,500.00   Corporate Sponsorships
     Iowa
    Rheumatology Association of         $5,000.00   Corporate Sponsorships
     Iowa
    Rheumatology Association of         $7,500.00   Corporate Sponsorships
     Iowa
    Rheumatology Association of        $10,000.00   Corporate Sponsorships
     Minnesota and The Dakotas
    Rheumatology Nurses Society        $75,000.00   Educational Grants
    Rheumatology Nurses Society        $20,000.00   Educational Grants
    Rheumatology Nurses Society        $46,325.00   Corporate Sponsorships
    Rheumatology Nurses Society        $75,000.00   Educational Grants
    Rheumatology Nurses Society        $75,000.00   Educational Grants
    Rheumatology Nurses Society        $21,250.00   Corporate Sponsorships
    Rheumatology Nurses Society        $45,000.00   Corporate Sponsorships
    Rheumlgy Alliance of               $25,000.00   Corporate Sponsorships
     Louisiana
    Riverside Family Medicine           $2,500.00   Educational Grants
     Residency The
    Riverside Medical Clinic           $10,000.00   Educational Grants
     Charitable Foundation
    Robert Michael Educational        $150,000.00   Educational Grants
     Institute LLC
    Rock Steady Boxing                    $500.00   Corporate Sponsorships
    Rocky Mountain MS Center            $5,000.00   Educational Grants
    Rocky Mountain MS Center           $10,000.00   Educational Grants
    Rocky Mountain MS Center            $5,000.00   Educational Grants
    Rocky Mountain MS Center            $5,000.00   Educational Grants
    Rocky Mountain MS Center           $10,000.00   Educational Grants
    Roger Williams Medical             $40,000.00   Fellowships and
     Center                                          Scholarships
    Roger Williams Medical              $5,000.00   Educational Grants
     Center
    Rotary Club of Downtown             $1,000.00   Corporate Sponsorships
     Macon
    Rush Univ Medical Center            $5,000.00   Educational Grants
    Rush Univ Medical Center            $7,500.00   Educational Grants
    Rush Univ Medical Center           $75,000.00   Educational Grants
    Rush Univ Medical Center            $5,000.00   Charitable Donations
    Rush Univ Medical Center           $75,000.00   Educational Grants
    Rush Univ Medical Center           $75,000.00   Educational Grants
    Rutgers Univ Foundation             $1,000.00   Charitable Donations
    Sacramento Gastrointestinal         $1,500.00   Corporate Sponsorships
     Education and Research
    Safety Pharmacology Society         $5,000.00   Educational Grants
    San Francisco Aids                 $10,000.00   Charitable Donations
     Foundation
    San Francisco Public Center        $75,000.00   Charitable Donations
     Foundation
    San Francisco Retina                $5,000.00   Educational Grants
     Foundation
    San Francisco Retina                $5,000.00   Educational Grants
     Foundation
    San Juan Bautista Medical          $40,000.00   Fellowships and
     Center                                          Scholarships
    Scott and White Healthcare          $1,000.00   Corporate Sponsorships
     Foundation
    Scripps Health                      $5,000.00   Educational Grants
    Scripps Health                      $5,000.00   Educational Grants
    Scripps Health                     $50,000.00   Educational Grants
    Scripps Research Institute          $2,000.00   Educational Grants
    Seattle Science Foundation          $2,500.00   Educational Grants
    Seattle Science Foundation          $8,500.00   Educational Grants
    Seton Family of Hospitals          $40,000.00   Fellowships and
                                                     Scholarships
    Sexual Medicine Society of          $5,000.00   Corporate Sponsorships
     North America
     Foundation(Smsna)
    Sexual Medicine Society of        $225,000.00   Corporate Sponsorships
     North America
     Foundation(Smsna)
    Shanti Project Inc.                $10,000.00   Patient Support
    Share                               $5,000.00   Educational Grants
    Share                              $10,000.00   Charitable Donations
    Sharsheret                         $10,000.00   Educational Grants
    Sheknows LLC                      $102,500.00   Corporate Sponsorships
    Sheknows LLC                       $57,500.00   Corporate Sponsorships
    Sheknows LLC                      $200,000.00   Corporate Sponsorships
    Sinai Health System                $10,000.00   Charitable Donations
    Sociedad Dermatologica de          $35,000.00   Patient Support
     Puerto Rico
    Sociedad PR Endocrinologia         $15,000.00   Corporate Sponsorships
     y Diabetologia
    Sociedad Puertorriquena             $2,000.00   Corporate Sponsorships
     Pediatria
    Sociedad Puertorriquena             $9,500.00   Corporate Sponsorships
     Pediatria
    Sociedad Puertorriquena            $14,000.00   Corporate Sponsorships
     Pediatria
    Society for Clinical               $15,000.00   Corporate Sponsorships
     Research Sites Inc.
    Society for Clinical Trials         $2,000.00   Corporate Sponsorships
    Society for Leukocyte               $2,500.00   Educational Grants
     Biology
    Society for Mucosal                 $2,500.00   Educational Grants
     Immunology
    Society for Neuro-Oncology         $50,000.00   Educational Grants
    Society for Neuro-Oncology         $55,000.00   Corporate Sponsorships
    Society for Neuroscience            $2,000.00   Educational Grants
    Society for Neuroscience            $5,000.00   Educational Grants
    Society for Womens Health          $15,000.00   Corporate Sponsorships
     Research
    Society for Womens Health         $150,000.00   Corporate Sponsorships
     Research
    Society of Dermatology             $40,000.00   Corporate Sponsorships
     Physician Assistants
    Society of Dermatology             $45,000.00   Corporate Sponsorships
     Physician Assistants
    Society of Dermatology             $40,000.00   Corporate Sponsorships
     Physician Assistants
    Society of Dermatology             $40,000.00   Corporate Sponsorships
     Physician Assistants
    Society of Investigative           $30,000.00   Educational Grants
     Dermatology
    Society of Nuclear Medicine         $5,000.00   Corporate Sponsorships
     and Molecular Imaging
    Socty for Gynecologic              $10,000.00   Corporate Sponsorships
     Investigation
    Socty for Immunotherapy of         $50,000.00   Corporate Sponsorships
     Cancer
    South Carolina Alliance of          $6,000.00   Corporate Sponsorships
     Health Plans
    South Dakota Parkinson              $1,500.00   Corporate Sponsorships
     Foundation
    South Texas Association of         $30,000.00   Corporate Sponsorships
     Rheumatologists
    South Texas Association of         $40,000.00   Corporate Sponsorships
     Rheumatologists
    Spondylitis Association of         $40,000.00   Educational Grants
     America
    Spondylitis Association of         $20,000.00   Educational Grants
     America
    Spondyloarthritis Research         $70,000.00   Corporate Sponsorships
     and Treatment Network
     Spartan
    Stage One Family Theatre            $5,000.00   Corporate Sponsorships
    State of Maryland                  $40,000.00   Educational Grants
    State of Pennsylvania              $25,065.00   Educational Grants
    State of Pennsylvania              $90,000.00   Educational Grants
    State of Pennsylvania              $25,000.00   Educational Grants
    State of Pennsylvania              $25,000.00   Educational Grants
    Summit for Stem Cellular            $2,500.00   Corporate Sponsorships
     Foundation
    Surviveit                          $10,000.00   Educational Grants
    Susan G Komen Breast Cancer        $10,000.00   Charitable Donations
     Foundation Inc.
    Swedish Medical Center              $5,000.00   Educational Grants
     First Hill Campus
    Take A Breather Foundation          $5,000.00   Corporate Sponsorships
    Take A Breather Foundation         $20,000.00   Corporate Sponsorships
    Talem Health Inc.                 $150,000.00   Educational Grants
    Tarsus Cardiology Inc. Dba         $35,000.00   Corporate Sponsorships
     South Beach Symposium
    Tennessee Disability                $7,500.00   Corporate Sponsorships
     Coalition
    Texas Academy of Family             $2,500.00   Corporate Sponsorships
     Physicians
    Texas Neuro Society                 $5,000.00   Corporate Sponsorships
    Texas Society for                   $2,000.00   Corporate Sponsorships
     Gastroenterology and
     Endoscopy
    Texas Society for                   $2,000.00   Corporate Sponsorships
     Gastroenterology and
     Endoscopy
    Texas Society for                   $2,000.00   Corporate Sponsorships
     Gastroenterology and
     Endoscopy
    Texas Urological Society            $6,000.00   Corporate Sponsorships
    Texas Urological Society            $6,000.00   Corporate Sponsorships
    Thomas Jefferson University       ($4,242.75)   Educational Grants
    Thomas Jefferson University         $5,000.00   Corporate Sponsorships
    Transcelerate Biopharma         $1,500,000.00   Corporate Sponsorships
     Inc.
    Trustees of Boston Univ D/B/      $200,000.00   Educational Grants
     A
    Trustees of Boston Univ D/B/        $1,500.00   Educational Grants
     A
    Trustees of Boston Univ D/B/       $10,000.00   Educational Grants
     A
    Trustees of Dartmouth               $1,000.00   Charitable Donations
     College--Administration
    Trustees of Tufts College           $1,000.00   Charitable Donations
    Trustees of Tufts College           $1,000.00   Charitable Donations
    Tufts Medical Center               $50,000.00   Fellowships and
                                                     Scholarships
    Tufts Medical Center               $10,000.00   Educational Grants
    UC Regents Maxillofacial           $10,000.00   Educational Grants
     Prosthetics Clinic
    UC Regents Maxillofacial           $40,000.00   Fellowships and
     Prosthetics Clinic                              Scholarships
    UC Regents Maxillofacial            $5,000.00   Educational Grants
     Prosthetics Clinic
    UC Regents Maxillofacial           $15,000.00   Educational Grants
     Prosthetics Clinic
    UCSF Medical Center at             $50,000.00   Educational Grants
     Parnassus
    Ultimate Medical Academy          $225,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $175,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $225,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $200,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $213,500.00   Educational Grants
     LLC
    Ultimate Medical Academy          $249,250.00   Educational Grants
     LLC
    Ultimate Medical Academy          ($5,370.00)   Educational Grants
     LLC
    Ultimate Medical Academy          $250,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $149,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $250,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $213,500.00   Educational Grants
     LLC
    Ultimate Medical Academy          $115,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $289,810.00   Educational Grants
     LLC
    UMA Education Inc. Dba            $375,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba            $200,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba             $38,800.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba             $80,000.00   Educational Grants
     Global Education Group
    UMASS Memorial Foundation           $2,500.00   Corporate Sponsorships
     Inc.
    United Rheumatology                $36,000.00   Corporate Sponsorships
    United Rheumatology               $205,000.00   Corporate Sponsorships
    United States Adult Cystic          $5,000.00   Educational Grants
     Fibrosis Association Inc.
    Univ Health Service at              $1,166.00   Corporate Sponsorships
     Stony Point Inc.
    Univ Health Service at              $1,167.00   Corporate Sponsorships
     Stony Point Inc.
    Univ Health Service at              $1,167.00   Corporate Sponsorships
     Stony Point Inc.
    Univ Health Service at              $5,000.00   Educational Grants
     Stony Point Inc.
    Univ Health Service at             $20,000.00   Educational Grants
     Stony Point Inc.
    Univ Hospital of Brooklyn         ($5,527.00)   Educational Grants
    Univ of California                 $30,000.00   Corporate Sponsorships
     Berkeley--Administration
    Univ of California,                $55,000.00   Fellowships and
     Riverside Student Health                        Scholarships
     Services
    Univ of Chicago                    $10,000.00   Educational Grants
    Univ of Chicago                     $5,000.00   Educational Grants
    Univ of Chicago                     $5,000.00   Educational Grants
    Univ of Chicago                    $65,000.00   Educational Grants
    Univ of Chicago                    $80,000.00   Educational Grants
    Univ of Chicago                   $140,000.00   Educational Grants
    Univ of Chicago                    $20,000.00   Corporate Sponsorships
    Univ of Chicago                    $15,000.00   Charitable Donations
    Univ of Chicago                    $10,000.00   Educational Grants
    Univ of Chicago                    $30,000.00   Educational Grants
    Univ of Cincinnati                 $60,000.00   Educational Grants
    Univ of Cincinnati                 $75,000.00   Educational Grants
    Univ of Cincinnati                $195,000.00   Educational Grants
    Univ of Cincinnati                 $80,000.00   Educational Grants
    Univ of Cincinnati                $250,000.00   Educational Grants
    Univ of Cincinnati                $454,420.00   Educational Grants
    Univ of Cincinnati                 $25,000.00   Educational Grants
    Univ of Cincinnati                ($1,212.00)   Educational Grants
    Univ of Cincinnati                 $60,000.00   Educational Grants
    Univ of Cincinnati                 $75,000.00   Educational Grants
    Univ of Cincinnati                  $5,000.00   Educational Grants
     Foundation--Sunflower Fund
    Univ of Colorado Denver            $25,000.00   Fellowships and
     School of Medicine                              Scholarships
    Univ of Colorado Denver             $4,000.00   Educational Grants
     School of Medicine
    Univ of Florida Foundation          $5,000.00   Educational Grants
    Univ of Florida Foundation            $500.00   Corporate Sponsorships
    Univ of Florida Foundation         $55,000.00   Fellowships and
                                                     Scholarships
    Univ of Illinios                    $2,000.00   Educational Grants
    Univ of Illinois                    $1,000.00   Corporate Sponsorships
    Univ of Illinois Foundation         $5,000.00   Corporate Sponsorships
    Univ of Illinois Foundation         $5,000.00   Corporate Sponsorships
    Univ of Illinois Foundation         $1,000.00   Charitable Donations
    Univ of Louisville Research        $60,000.00   Educational Grants
     Foundation
    Univ of Louisville Research        $98,000.00   Educational Grants
     Foundation
    Univ of Louisville Research        $47,725.00   Educational Grants
     Foundation
    Univ of Louisville Research         $1,000.00   Educational Grants
     Foundation
    Univ of Maryland Baltimore         $10,000.00   Educational Grants
     Foundation Inc.
    Univ of Maryland Baltimore         $10,000.00   Corporate Sponsorships
     Foundation Inc.
    Univ of Miami                      $50,000.00   Fellowships and
                                                     Scholarships
    Univ of Miami                      $10,000.00   Educational Grants
    Univ of Miami Dept of              $10,000.00   Corporate Sponsorships
     Dermatology
    Univ of Nebraska Med Center       $150,000.00   Educational Grants
    Univ of Nebraska Med Center           $675.00   Corporate Sponsorships
    Univ of Nebraska Med Center        $68,900.00   Educational Grants
    Univ of Nebraska Med Center        $25,000.00   Educational Grants
    Univ of Nebraska Med Center        $25,000.00   Educational Grants
    Univ of Nebraska Med Center         $5,000.00   Educational Grants
    Univ of Nebraska Med Center         $7,500.00   Educational Grants
    Univ of Nebraska Med Center         $5,000.00   Corporate Sponsorships
    Univ of New Mexico                  $5,000.00   Corporate Sponsorships
     Foundation
    Univ of North Carolina at          $40,000.00   Fellowships and
     Chapel Hill                                     Scholarships
    Univ of North Carolina at         ($5,463.46)   Educational Grants
     Chapel Hill
    Univ of North Carolina at        ($40,000.00)   Fellowships and
     Chapel Hill                                     Scholarships
    Univ of Pittsburgh                  $2,200.00   Educational Grants
    Univ of Pittsburgh                 $10,000.00   Educational Grants
    Univ of Pittsburgh                 $15,000.00   Educational Grants
    Univ of Pittsburgh                  $2,500.00   Corporate Sponsorships
    Univ of Pittsburgh                 $15,000.00   Educational Grants
    Univ of Rhode Island                $2,500.00   Educational Grants
     Foundation
    Univ of South Alabama               $1,500.00   Corporate Sponsorships
     College of Medicine
    Univ of South Florida              $25,000.00   Educational Grants
     Health Professions
     Conferencing Corp
    Univ of Southern California        $25,000.00   Educational Grants
    Univ of Southern California        $50,000.00   Fellowships and
                                                     Scholarships
    Univ of Southern California        $78,500.00   Fellowships and
                                                     Scholarships
    Univ of Tennessee Obgyn           ($1,758.03)   Educational Grants
     Center
    Univ of Tennessee Obgyn             $2,000.00   Corporate Sponsorships
     Center
    Univ of Texas Health               $16,032.00   Corporate Sponsorships
     Science Center at San
     Antonio
    Univ of Texas Health               $75,000.00   Educational Grants
     Science Center at San
     Antonio
    Univ of Texas Health                $3,000.00   Educational Grants
     Science Center at San
     Antonio
    Univ of Texas M D Anderson         $10,000.00   Educational Grants
     Cancer Center
    Univ of Texas Southwestern         $55,000.00   Fellowships and
     Med Center                                      Scholarships
    Univ of Texas Southwestern          $2,000.00   Educational Grants
     Med Center
    Univ of Texas Southwestern         $55,000.00   Educational Grants
     Med Center
    Univ of The State of New           $50,000.00   Educational Grants
     York Univ at Buffalo
    Univ of Toledo                      $2,000.00   Educational Grants
    Universidad Central Del             $7,500.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $11,205.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $12,000.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $12,000.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del             ($308.75)   Educational Grants
     Caribe School of Medicine
    Universidad Central Del             $7,500.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $15,000.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $15,000.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $24,939.25   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $10,000.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del            $15,000.00   Educational Grants
     Caribe School of Medicine
    Universidad Central Del           ($3,795.00)   Educational Grants
     Caribe School of Medicine
    Universidad Central Del           ($3,460.75)   Educational Grants
     Caribe School of Medicine
    University of Alabama at            ($186.25)   Educational Grants
     Birmingham Hospital
    University of Alabama at           $40,000.00   Fellowships and
     Birmingham Hospital                             Scholarships
    University of California           $40,000.00   Fellowships and
     Irvine                                          Scholarships
    University of California           $40,000.00   Fellowships and
     Irvine                                          Scholarships
    University of Colorado              $1,000.00   Charitable Donations
     Foundation
    University of Connecticut          $12,000.00   Fellowships and
     Health Science Center                           Scholarships
    University of Connecticut          $40,000.00   Fellowships and
     Health Science Center                           Scholarships
    University of Connecticut           ($774.73)   Fellowships and
     Health Science Center                           Scholarships
    University of Edinburgh Usa         $1,000.00   Charitable Donations
     Development Trust Inc.
    University of Illinois--           $82,092.00   Fellowships and
     office of Business and                          Scholarships
     Financial Services
    University of Illinois--           $79,559.00   Fellowships and
     office of Business and                          Scholarships
     Financial Services
    University of Rochester            $40,000.00   Fellowships and
                                                     Scholarships
    University of Sheffield in          $1,000.00   Charitable Donations
     America Inc.
    University of Washington           $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    University of Washington            ($255.67)   Educational Grants
     Medical Center
    Upstage Lung Cancer                 $5,000.00   Charitable Donations
    Urology Center of Colorado         $10,000.00   Corporate Sponsorships
     Foundation
    US Too International               $25,000.00   Corporate Sponsorships
    US Too International                $1,500.00   Corporate Sponsorships
    Valley Childrens Hospital           $4,000.00   Educational Grants
     Foundation
    Valley Medial Center                $5,000.00   Corporate Sponsorships
     Foundation
    Vanderbilt Univ By and              $5,000.00   Corporate Sponsorships
     Through Its Medical Center
    Vanderbilt Univ By and             $12,500.00   Fellowships and
     Through Its Medical Center                      Scholarships
    Vanderbilt Univ By and              $5,000.00   Educational Grants
     Through Its Medical Center
    Vanderbilt Univ By and             $10,000.00   Educational Grants
     Through Its Medical Center
    VHA Inc.                           $35,000.00   Corporate Sponsorships
    Vindico Med Education              $25,000.00   Educational Grants
    Vindico Med Education              $50,000.00   Educational Grants
    Vindico Med Education              $95,000.00   Educational Grants
    Vindico Med Education              $75,000.00   Educational Grants
    Vindico Med Education              $50,000.00   Educational Grants
    Virginia Association of             $2,500.00   Corporate Sponsorships
     Health Plans
    Virginia Commonwealth Univ          $2,500.00   Corporate Sponsorships
     School of Medicine
    Washington and Lee                  $1,000.00   Charitable Donations
     University
    Washington Hospital Center         $10,000.00   Educational Grants
     Corp
    Washington Rheumatology            $50,000.00   Corporate Sponsorships
     Alliance
    Washington Univ in St Louis         $5,000.00   Educational Grants
    Washington Univ in St Louis         $1,600.00   Fellowships and
                                                     Scholarships
    Washington Univ in St Louis        $40,000.00   Fellowships and
                                                     Scholarships
    Webmd Global LLC                    ($500.00)   Educational Grants
    Webmd Global LLC                   $75,000.00   Educational Grants
    Webmd Global LLC                  $146,500.00   Educational Grants
    Webmd Global LLC                  $340,000.00   Educational Grants
    Webmd Global LLC                  $100,000.00   Educational Grants
    Webmd Global LLC                  $150,000.00   Educational Grants
    Webmd Global LLC                  $105,000.00   Educational Grants
    Webmd Global LLC                   $90,000.00   Educational Grants
    Webmd Global LLC                  $150,000.00   Educational Grants
    Webmd Global LLC                  $300,000.00   Educational Grants
    Webmd Global LLC                  $600,000.00   Educational Grants
    Webmd Global LLC                  $250,000.00   Educational Grants
    Western Pennsylvania                $5,000.00   Fellowships and
     Hospital forbes Regional                        Scholarships
     Campus
    Western Pennsylvania              ($1,502.07)   Fellowships and
     Hospital forbes Regional                        Scholarships
     Campus
    Western States Pharmacy             $3,250.00   Corporate Sponsorships
     Conference for Pharmacy
     Residents Fellowships and
     Preceptors
    Wisconsin Chapter of The            $5,000.00   Corporate Sponsorships
     American College of
     Healthcare Executives
    Wisconsin Collaborative for         $2,650.00   Corporate Sponsorships
     Healthcare Quality
    Wisconsin Dairyland Chapter         $2,000.00   Corporate Sponsorships
     of Healthcare Information
     and Management Systems
     Society (HIMSS)
    Wisconsin Rheumatology             $10,000.00   Corporate Sponsorships
     Association
    Wj Weiser Association               $5,000.00   Corporate Sponsorships
     Management Inc.
    World Parkinson Coalition           $5,000.00   Charitable Donations
     Inc.
    Yale Univ                           $5,000.00   Educational Grants
    Young Survival Coalition           $25,000.00   Corporate Sponsorships
    Zebrafish Disease Models           $10,000.00   Educational Grants
     Society
    Zero The Project To End           $270,000.00   Corporate Sponsorships
     Prostate Cancer
    Zero The Project To End            $12,000.00   Corporate Sponsorships
     Prostate Cancer
    ------------------------------------------------------------------------

                        Grants and Donations Report--2018
        (Parentheses represent refunds of previously disclosed payments)
                             Report as of 3/31/3019
    ------------------------------------------------------------------------
             Recipient             Payment Amount            Purpose
    ------------------------------------------------------------------------
    50 Hoops                           $25,000.00   Educational Grants
    50 Hoops                           $10,000.00   Patient Support
    A and R Educational Group          $80,350.00   Corporate Sponsorships
     LLC
    A and R Educational Group           $4,500.00   Corporate Sponsorships
     LLC
    AAPS                               $50,000.00   Corporate Sponsorships
    Aasld Foundation (American        $500,000.00   Charitable Donations
     Association for The Study
     of Liver Disease)
    Aasld Foundation (American        $250,000.00   Charitable Donations
     Association for The Study
     of Liver Disease)
    Academia Puertorriquena DE          $4,500.00   Corporate Sponsorships
     Neurologia
    Academic Cme LLC                   $45,000.00   Educational Grants
    Academy of Managed Care            $40,000.00   Corporate Sponsorships
     Pharmacy
    Academy of Managed Care            $27,000.00   Corporate Sponsorships
     Pharmacy
    Academy of Managed Care            $32,000.00   Corporate Sponsorships
     Pharmacy
    Academy of Managed Care            $30,000.00   Corporate Sponsorships
     Pharmacy
    Advanced Medical Education          $2,500.00   Corporate Sponsorships
     Consultants, Corp.
    Advanced Urology Institute         $10,000.00   Corporate Sponsorships
     Education and General Fund
    Advances in Cosmetic and           $75,000.00   Corporate Sponsorships
     Med Dermatology Inc.
    Advances in Cosmetic and           $75,000.00   Corporate Sponsorships
     Med Dermatology Inc.
    Advances in Cosmetic and           $75,000.00   Corporate Sponsorships
     Med Dermatology Inc.
    Adventist Health System--          $15,000.00   Corporate Sponsorships
     Sunbelt Inc.
    Aesthetic Dermatology               $7,500.00   Corporate Sponsorships
     Symposia
    AIDS Connecticut                    $5,000.00   Corporate Sponsorships
    AIDS Foundation of Chicago         $10,000.00   Corporate Sponsorships
    AIDS Foundation of Chicago         $10,000.00   Charitable Donations
    AIDS Institute                     $10,000.00   Corporate Sponsorships
    AIDS Institute                      $7,500.00   Corporate Sponsorships
    AIDS Support Network                $2,000.00   Corporate Sponsorships
    Aimed Alliance                     $20,000.00   Corporate Sponsorships
    Alabama Academy of                  $1,200.00   Corporate Sponsorships
     Neurology
    Alabama Associate of Center         $5,000.00   Corporate Sponsorships
     Plans
    Alabama Dermatology Society        $50,000.00   Corporate Sponsorships
    Alabama Society of                    $750.00   Corporate Sponsorships
     Dermatology Professionals
    Albert Einstein College of         $10,000.00   Educational Grants
     Medicine Division of
     Dermatology
    Albert Einstein College of         $50,000.00   Educational Grants
     Medicine of Yeshiva Univ
    Albert Einstein College of         $45,000.00   Educational Grants
     Medicine of Yeshiva Univ
    Alliance for Aging Research         $5,000.00   Corporate Sponsorships
    Alsac St Jude Childrens            $15,000.00   Charitable Donations
     Research Hospital
    Alzheimers Association              $2,500.00   Corporate Sponsorships
     Greater Illinois Chapter
    Alzheimers Disease and            $100,000.00   Corporate Sponsorships
     Related Disorders
     Association Inc.
    Alzheimers Disease and             $10,000.00   Charitable Donations
     Related Disorders
     Association Inc.
    American Academy of                $40,000.00   Educational Grants
     Dermatology
    American Academy of                $10,000.00   Charitable Donations
     Dermatology
    American Academy of                 $7,500.00   Corporate Sponsorships
     Dermatology
    American Academy of               $300,000.00   Corporate Sponsorships
     Dermatology
    American Academy of                $50,000.00   Charitable Donations
     Dermatology
    American Academy of                $50,000.00   Educational Grants
     Dermatology
    American Academy of Family         $19,000.00   Educational Grants
     Physicians
    American Academy of                $30,000.00   Educational Grants
     Neurology Institute
    American Academy of                $40,050.00   Corporate Sponsorships
     Neurology Institute
    American Academy of                $38,220.00   Corporate Sponsorships
     Neurology Institute
    American Academy of               $100,000.00   Fellowships and
     Neurology Institute                             Scholarships
    American Academy of                $16,470.00   Corporate Sponsorships
     Neurology Institute
    American Academy of                $24,112.40   Corporate Sponsorships
     Ophthalmology Aao
    American Academy of                $15,000.00   Corporate Sponsorships
     Pediatrics
    American Academy of                $14,000.00   Corporate Sponsorships
     Pediatrics
    American Academy of                $95,000.00   Educational Grants
     Physician Assistants
    American Association of             $5,000.00   Educational Grants
     Clinical Endocrinologists
     New Jersey Chapter
    American Association of            $18,000.00   Educational Grants
     Clinical Endocrinologists
     New Jersey Chapter
    American Association for            $5,000.00   Educational Grants
     Accreditation of
     Laboratory Animal Care
     International (Aaalac
     International
    American Association for           $40,000.00   Fellowships and
     Cancer Research                                 Scholarships
    American Association for           $25,000.00   Patient Support
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Charitable Donations
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for           $20,000.00   Educational Grants
     Cancer Research
    American Association for            $5,000.00   Educational Grants
     Cancer Research
    American Association for           $10,000.00   Educational Grants
     Cancer Research
    American Association for            $5,000.00   Educational Grants
     Cancer Research
    American Association for            $5,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $25,000.00   Educational Grants
     Cancer Research
    American Association for           $75,000.00   Educational Grants
     Cancer Research
    American Association for           $20,000.00   Charitable Donations
     Laboratory Animal Science
    American Association for           $10,000.00   Charitable Donations
     The Study of Liver Disease
    American Association of           $200,000.00   Patient Support
     Clinical Endocrinologists
     Inc.
    American Association of            $15,200.00   Corporate Sponsorships
     Gynecologic Laparoscopists
     Inc.
    American Association of            $50,000.00   Educational Grants
     Nurse Practitioners
    American Brain Tumor               $50,000.00   Fellowships and
     Association                                     Scholarships
    American Brain Tumor                $2,500.00   Charitable Donations
     Association
    American Brain Tumor               $10,000.00   Patient Support
     Association
    American Brain Tumor               $10,000.00   Corporate Sponsorships
     Association
    American Brain Tumor               $60,000.00   Corporate Sponsorships
     Association
    American Brain Tumor                $3,400.00   Corporate Sponsorships
     Association
    American Brain Tumor               $10,000.00   Patient Support
     Association
    American Brain Tumor               $10,000.00   Patient Support
     Association
    American Brain Tumor                $5,000.00   Corporate Sponsorships
     Association
    American Brain Tumor               $50,000.00   Fellowships and
     Association                                     Scholarships
    American Brain Tumor               $22,500.00   Corporate Sponsorships
     Association
    American Brain Tumor               $25,000.00   Corporate Sponsorships
     Association
    American Brain Tumor               $50,000.00   Corporate Sponsorships
     Association
    American Cancer Society             $5,000.00   Corporate Sponsorships
    American Cancer Society             $1,500.00   Corporate Sponsorships
    American Cancer Society            $10,000.00   Corporate Sponsorships
    American Cancer Society            $10,000.00   Charitable Donations
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society            $10,000.00   Corporate Sponsorships
    American Cancer Society             $5,000.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $5,000.00   Corporate Sponsorships
    American Cancer Society            $10,000.00   Corporate Sponsorships
    American Cancer Society             $5,000.00   Corporate Sponsorships
    American Cancer Society             $5,000.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $2,500.00   Corporate Sponsorships
    American Cancer Society             $5,000.00   Corporate Sponsorships
    American Cancer Society            $12,000.00   Corporate Sponsorships
    American Cancer Society             $3,500.00   Corporate Sponsorships
    American Cancer Society            $10,000.00   Corporate Sponsorships
    American Cancer Society            $50,000.00   Corporate Sponsorships
    American Cancer Society            $50,000.00   Corporate Sponsorships
    American Chemist Society            $3,000.00   Educational Grants
    American Chemist Society            $2,500.00   Educational Grants
    American Chemist Society            $1,500.00   Educational Grants
    American Chemist Society            $3,000.00   Educational Grants
    American College of                $10,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $90,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $90,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $60,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $60,000.00   Corporate Sponsorships
     Gastroenterology
    American College of               $450,000.00   Charitable Donations
     Gastroenterology
    American College of               $100,000.00   Corporate Sponsorships
     Gastroenterology
    American College of               $125,000.00   Corporate Sponsorships
     Gastroenterology
    American College of                $30,000.00   Charitable Donations
     Laboratory Animal Medicine
    American College of                $32,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American College of                $25,000.00   Corporate Sponsorships
     Osteopathic Family
     Physicians of California
    American College of                $35,000.00   Corporate Sponsorships
     Osteopathic Obstetricians
     and Gynecologists
    American College of                $57,000.00   Corporate Sponsorships
     Physician Foundation
    American College of                $25,000.00   Educational Grants
     Rheumatology
    American College of                $70,000.00   Corporate Sponsorships
     Rheumatology
    American College of                $25,000.00   Educational Grants
     Rheumatology
    American College of                $35,000.00   Educational Grants
     Rheumatology
    American College of                $50,000.00   Educational Grants
     Rheumatology
    American College of                $50,000.00   Corporate Sponsorships
     Rheumatology
    American College of             $2,000,000.00   Corporate Sponsorships
     Rheumatology Research and
     Education Foundation
    American Congress of                $3,000.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of                $9,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $10,000.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of                $2,250.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists
    American Congress of               $25,000.00   Educational Grants
     Obstetricians and
     Gynecologists--Hawaii
     Section District Viii
    American Congress of               $32,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists--Hawaii
     Section District Viii
    American Congress of               $15,000.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists--Hawaii
     Section District Viii
    American Congress of               $38,400.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists--Hawaii
     Section District Viii
    American Congress of                $2,500.00   Corporate Sponsorships
     Obstetricians and
     Gynecologists Montana
     Section
    American                          $278,000.00   Educational Grants
     Gastroenterological
     Association Institute
    American                           $46,325.00   Corporate Sponsorships
     Gastroenterological
     Association Institute
    American                           $50,000.00   Corporate Sponsorships
     Gastroenterological
     Association Institute
    American                           $90,000.00   Corporate Sponsorships
     Gastroenterological
     Association Institute
    American                          $200,000.00   Educational Grants
     Gastroenterological
     Association Institute
    American                           $40,000.00   Educational Grants
     Gastroenterological
     Association Institute
    American Gastrointestinal         ($2,094.95)   Educational Grants
     Association
    American Kdny Fund                  $5,000.00   Corporate Sponsorships
    American Liver Foundation         $300,000.00   Corporate Sponsorships
    American Liver Foundation           $1,000.00   Corporate Sponsorships
    American Liver Foundation           $7,500.00   Corporate Sponsorships
    American Liver Foundation           $2,500.00   Corporate Sponsorships
    American Liver Foundation          $10,000.00   Educational Grants
    American Liver Foundation           $2,500.00   Corporate Sponsorships
    American Liver Foundation           $5,000.00   Corporate Sponsorships
    American Liver Foundation          $50,000.00   Educational Grants
    American Liver Foundation          $86,000.00   Corporate Sponsorships
    American Liver Foundation          $25,000.00   Educational Grants
    American Med Group                  $5,022.40   Corporate Sponsorships
     Associate
    American Med Group                  $5,022.40   Corporate Sponsorships
     Associate
    American Med Group                  $5,022.40   Corporate Sponsorships
     Associate
    American Med Group                  $5,022.40   Corporate Sponsorships
     Associate
    American Med Group                  $5,022.40   Corporate Sponsorships
     Associate
    American Military Partner          $25,000.00   Corporate Sponsorships
     Association
    American Military Partner          $25,000.00   Corporate Sponsorships
     Association
    American National Red Cross         $1,000.00   Corporate Sponsorships
     and Its Constituent
     Chapters and Branches
    American Neuro Associate           $40,000.00   Educational Grants
    American Pancreatic                $25,000.00   Charitable Donations
     Associate
    American Pancreatic                $75,000.00   Educational Grants
     Associate
    American Pancreatic                $60,000.00   Corporate Sponsorships
     Associate
    American Pancreatic                $70,000.00   Corporate Sponsorships
     Associate
    American Parkinson Disease          $3,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $5,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease         $75,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease         $25,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $2,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $5,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease          $4,000.00   Corporate Sponsorships
     Association
    American Parkinson Disease         $10,000.00   Educational Grants
     Association
    American Pharmacists               $15,000.00   Corporate Sponsorships
     Association (Apha)
    American Red Cross of              $10,000.00   Charitable Donations
     Greater Chicago
    American Society for               $40,000.00   Corporate Sponsorships
     Reproductive Medicine
    American Society for               $10,000.00   Corporate Sponsorships
     Reproductive Medicine
    American Society for                $6,000.00   Corporate Sponsorships
     Reproductive Medicine
    American Society of                $17,500.00   Corporate Sponsorships
     Anesthesiologists
    American Society of                $15,000.00   Educational Grants
     Hematology
    American Society of               $544,550.00   Corporate Sponsorships
     Hematology
    American Society of                $60,000.00   Educational Grants
     Hematology
    American Society of                $50,000.00   Fellowships and
     Hematology                                      Scholarships
    American Society of                $20,000.00   Educational Grants
     Hematology
    American Society of                $50,000.00   Educational Grants
     Hematology
    American Statistical               $26,500.00   Corporate Sponsorships
     Associate
    American Thyroid Associate         $30,000.00   Educational Grants
     Inc.
    American Uroligical                 $3,500.00   Corporate Sponsorships
     Associate Northeastern
     Section
    American Urological                $25,000.00   Corporate Sponsorships
     Associate Education and
     Research Inc.
    American Urological                $50,000.00   Charitable Donations
     Associate Education and
     Research Inc.
    American Urological                $20,000.00   Educational Grants
     Associate Education and
     Research Inc.
    American Urological                $50,000.00   Educational Grants
     Associate Education and
     Research Inc.
    American Urological                $10,000.00   Corporate Sponsorships
     Associate Inc. Western
     Section
    American Urological                $35,000.00   Corporate Sponsorships
     Associate Inc. Western
     Section
    American Urological                 $2,000.00   Corporate Sponsorships
     Association--New York
     Section
    American Urological                $25,000.00   Corporate Sponsorships
     Association--Southeast
     Section
    American Urological                 $5,800.00   Corporate Sponsorships
     Association--Southeast
     Section
    American Urological                $10,000.00   Charitable Donations
     Association Foundation
    Americans for Med Progress         $90,000.00   Charitable Donations
    Americas Hepato--Pancreato--       $35,750.00   Corporate Sponsorships
     Biliary A
    Angel Foundation                    $5,000.00   Corporate Sponsorships
    Angel Foundation                   $10,000.00   Corporate Sponsorships
    Angela Hospice Homecare             $2,500.00   Charitable Donations
    Answer2cancer                       $3,000.00   Corporate Sponsorships
    Arizona State Association           $3,500.00   Corporate Sponsorships
     of Physician Assistants
    Arizona United Rheumatology        $10,000.00   Corporate Sponsorships
     Alliance--Aura
    Arkansas Prostate Cancer            $2,000.00   Corporate Sponsorships
     Foundation
    Arkansas Rheumatology              $10,000.00   Corporate Sponsorships
     Association
    Arkansas Urology Society            $1,250.00   Corporate Sponsorships
    Arthritis Foundation              $100,000.00   Fellowships and
                                                     Scholarships
    Arthritis Foundation               $25,000.00   Corporate Sponsorships
    Arthritis Foundation              $175,000.00   Corporate Sponsorships
    Arthritis Foundation               $40,000.00   Corporate Sponsorships
    Arthritis Foundation                $2,000.00   Corporate Sponsorships
    Arthritis Foundation               $25,000.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Charitable Donations
    Arthritis Foundation                $2,500.00   Patient Support
    Arthritis Foundation                $5,000.00   Patient Support
    Arthritis Foundation               $30,000.00   Corporate Sponsorships
    Arthritis Foundation               $25,000.00   Corporate Sponsorships
    Arthritis Foundation               $10,500.00   Patient Support
    Arthritis Foundation               $20,000.00   Patient Support
    Arthritis Foundation               $10,000.00   Charitable Donations
    Arthritis Foundation                $7,500.00   Patient Support
    Arthritis Foundation               $30,000.00   Corporate Sponsorships
    Arthritis Foundation                $2,500.00   Corporate Sponsorships
    Arthritis Foundation               $10,000.00   Corporate Sponsorships
    Arthritis Foundation                $1,595.00   Patient Support
    Arthritis Foundation                $1,650.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Corporate Sponsorships
    Arthritis Foundation               $10,000.00   Corporate Sponsorships
    Arthritis Foundation               $10,000.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Corporate Sponsorships
    Arthritis Foundation                $2,500.00   Corporate Sponsorships
    Arthritis Foundation                  $300.00   Corporate Sponsorships
    Arthritis Foundation                $2,500.00   Corporate Sponsorships
    Arthritis Foundation                $3,000.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Corporate Sponsorships
    Arthritis Foundation              $250,000.00   Corporate Sponsorships
    Arthritis Foundation              $400,000.00   Corporate Sponsorships
    Arthritis Foundation                $5,000.00   Educational Grants
    Arthritis Foundation               $40,000.00   Corporate Sponsorships
    Arthritis Foundation               $25,000.00   Corporate Sponsorships
    Arthritis Foundation              $259,000.00   Corporate Sponsorships
    Arthritis Foundation              $100,000.00   Fellowships and
                                                     Scholarships
    Arthritis Foundation                $2,000.00   Corporate Sponsorships
    Arthritis Foundation              $175,000.00   Corporate Sponsorships
    Arthritis Foundation              $300,000.00   Corporate Sponsorships
    Arthritis Patient Services         $19,500.00   Charitable Donations
    Arts of Healing Foundation          $2,500.00   Corporate Sponsorships
    ASCO Conquer Cancer               $100,000.00   Charitable Donations
     Foundation
    ASCO Conquer Cancer                $40,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $60,000.00   Fellowships and
     Foundation                                      Scholarships
    ASCO Conquer Cancer                $75,000.00   Fellowships and
     Foundation                                      Scholarships
    ASCO Conquer Cancer                $30,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $30,000.00   Fellowships and
     Foundation                                      Scholarships
    ASCO Conquer Cancer                $10,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $30,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $30,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $60,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $50,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer                $25,000.00   Educational Grants
     Foundation
    ASCO Conquer Cancer               $100,000.00   Charitable Donations
     Foundation
    ASCO Conquer Cancer                $30,000.00   Fellowships and
     Foundation                                      Scholarships
    ASCO Conquer Cancer                $60,000.00   Fellowships and
     Foundation                                      Scholarships
    ASCO Conquer Cancer                $75,000.00   Fellowships and
     Foundation                                      Scholarships
    ASCO Conquer Cancer                $22,000.00   Educational Grants
     Foundation
    ASHP Foundation                    $75,000.00   Fellowships and
                                                     Scholarships
    Aspen Cancer Conference            $10,000.00   Educational Grants
     Inc.
    Associate de Enfermeria             $6,700.00   Corporate Sponsorships
     Oncologica y Hematologica
     de Puerto Rico Inc.
    Associate de                       $10,000.00   Corporate Sponsorships
     Gastroenterologia y
     Hepatologia Pediatrica de
     Puerto Rico Aghppr
    Associate de Hematologia y          $5,000.00   Corporate Sponsorships
     Oncologia Medica de Puerto
     Rico
    Associate de Hematologia y         $12,000.00   Corporate Sponsorships
     Oncologia Medica de Puerto
     Rico
    Associate de Hematologia y          $3,000.00   Corporate Sponsorships
     Oncologia Medica de Puerto
     Rico
    Associate de Hematologia y         $11,000.00   Corporate Sponsorships
     Oncologia Medica de Puerto
     Rico
    Associate de Reumatologos          $15,000.00   Corporate Sponsorships
     de Puerto Rico
    Associate Medicos Pediatras         $6,500.00   Corporate Sponsorships
     Region Este Ampre
    Associate Medicos Pediatras         $6,500.00   Corporate Sponsorships
     Region Este Ampre
    Associate of Physician              $2,950.00   Corporate Sponsorships
     Assistants in Oncology
     Inc.
    Associate of Physician             $35,000.00   Corporate Sponsorships
     Assistants in Oncology
     Inc.
    Associate of Professors of         $50,000.00   Corporate Sponsorships
     Gyn and Obstetrician
    Association of Community           $30,000.00   Educational Grants
     Cancer Centers (Accc)
    Association of                      $5,000.00   Corporate Sponsorships
     Frontotemporal
     Degeneration
    Association of Idaho                $1,500.00   Corporate Sponsorships
     Rheumatologists Inc.
    Association of Physicians           $1,500.00   Corporate Sponsorships
     of Pakistani Descent of
     North America (Appna)--New
     York Chapter
    Association of VA                  $15,500.00   Corporate Sponsorships
     Hematology Oncology
    Association of Women in            $40,000.00   Corporate Sponsorships
     Rheumatology
    Association of Women in            $40,000.00   Corporate Sponsorships
     Rheumatology
    Awesome Enablers LLC              $250,000.00   Corporate Sponsorships
    Awesome Enablers LLC              $250,000.00   Corporate Sponsorships
    Baylor College Medicine           $100,000.00   Fellowships and
     Infusion Dis                                    Scholarships
    Baylor Scott and White              $5,000.00   Educational Grants
     Health
    Bellaire Crohns and Colitis        $15,000.00   Corporate Sponsorships
     Foundation
    Bellaire Crohns and Colitis         $5,000.00   Corporate Sponsorships
     Foundation
    Bellaire Crohns and Colitis       $400,000.00   Corporate Sponsorships
     Foundation
    Bendcare                          $434,000.00   Corporate Sponsorships
    Beth Israel Deaconess              $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    Beth Israel Deaconess              $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    Beth Israel Deaconess               $3,500.00   Educational Grants
     Medical Center
    Betty and Milton Katz               $1,500.00   Corporate Sponsorships
     Jewish Community Center
    Bexar County Physician              $6,250.00   Corporate Sponsorships
     Assistant Society
    Big Brothers Big Sisters of        $20,000.00   Charitable Donations
     Metro Chicago
    Bio Ascend LLC                     $50,000.00   Corporate Sponsorships
    Bio Ascend LLC                     $25,000.00   Corporate Sponsorships
    Biomod Foundation                   $1,500.00   Corporate Sponsorships
    Biotechnology Industry            $155,000.00   Corporate Sponsorships
     Organization
    Biotechnology Industry            $290,000.00   Corporate Sponsorships
     Organization
    Biotechnology Industry             $25,000.00   Corporate Sponsorships
     Organization
    Biotechnology Industry             $56,000.00   Corporate Sponsorships
     Organization
    Black Health Matters                $5,000.00   Corporate Sponsorships
    Board of Trustees of The            $1,500.00   Corporate Sponsorships
     Univ of Illinois
    Bonnie J Addario Lung              $50,000.00   Patient Support
     Cancer Foundation
    Bonnie J Addario Lung               $5,000.00   Corporate Sponsorships
     Cancer Foundation
    Borland Groover Clinic                $750.00   Corporate Sponsorships
    Boston College School of           $10,000.00   Corporate Sponsorships
     Nursing
    Boston Society Inc.                 $3,000.00   Educational Grants
    Boston Taiwanese                    $2,500.00   Educational Grants
     Biotechnology Association
     Inc.
    Brian Grant Foundation             $85,000.00   Educational Grants
    Brian Grant Foundation             $15,000.00   Corporate Sponsorships
    Brigham and Women's                 $7,000.00   Educational Grants
     Hospital, Inc.
    Business Health Coalition           $5,000.00   Corporate Sponsorships
     Foundation
    California Associate of            $10,000.00   Corporate Sponsorships
     Physician Groups
    California Life Sciences           $20,000.00   Corporate Sponsorships
     Association
    California Life Sciences            $1,500.00   Corporate Sponsorships
     Association
    Cancer and Leukemia Group B        $30,000.00   Educational Grants
     Foundation
    Cancer and Leukemia Group B        $50,000.00   Fellowships and
     Foundation                                      Scholarships
    Cancer Care                        $25,000.00   Charitable Donations
    Cancer Care                        $75,000.00   Charitable Donations
    Cancer Care                        $25,000.00   Educational Grants
    Cancer Care                        $25,000.00   Educational Grants
    Cancer Care                       $100,000.00   Educational Grants
    Cancer Care                       $100,000.00   Educational Grants
    Cancer Foundation for New           $2,500.00   Corporate Sponsorships
     Mexico
    Cancer Foundation for New           $2,500.00   Corporate Sponsorships
     Mexico
    Cancer Molecular Thrpt              $5,000.00   Educational Grants
    Cancer Research Institute          $10,000.00   Educational Grants
    Cancer Research Institute          $40,000.00   Corporate Sponsorships
    Cancer Support Community           $75,000.00   Educational Grants
    Cancer Support Community           $75,000.00   Educational Grants
    Cancer Wellness Center              $5,000.00   Corporate Sponsorships
    Cancercare Co-Payment           $5,000,000.00   Charitable Donations
     Assistance Foundation
    Captis Health                       $3,000.00   Corporate Sponsorships
    Cardinal Health                   $100,000.00   Corporate Sponsorships
    Cardinal Health                   $105,000.00   Corporate Sponsorships
    Carevive Systems, Inc.             $75,000.00   Educational Grants
    Carevive Systems, Inc.             $75,000.00   Educational Grants
    Carevive Systems, Inc.             $75,000.00   Educational Grants
    Carevive Systems, Inc.            $125,000.00   Educational Grants
    Caring Ambassadors Program          $5,000.00   Corporate Sponsorships
     Inc.
    Caring Ambassadors Program         $10,000.00   Corporate Sponsorships
     Inc.
    Caring Ambassadors Program         $10,000.00   Corporate Sponsorships
     Inc.
    Caring Ambassadors Program         $50,000.00   Charitable Donations
     Inc.
    Caring Ambassadors Program         $10,000.00   Charitable Donations
     Inc.
    Carti Foundation                   $10,000.00   Corporate Sponsorships
    Cascade Aids Project                $5,000.00   Corporate Sponsorships
    Case Western Reserve Univ          $20,000.00   Fellowships and
                                                     Scholarships
    Cedar Rapids Metro                  $2,000.00   Corporate Sponsorships
     Parkinsons Association
    Cedars--Sinai Med Center           $40,000.00   Fellowships and
                                                     Scholarships
    Cedars--Sinai Med Center            $8,000.00   Educational Grants
    Central Brain Tumor                $30,000.00   Educational Grants
     Registry of The United
     States
    Central Savannah River Area         $1,000.00   Corporate Sponsorships
     Csra Parkinson Support
     Group
    Chicago Gynecological               $8,000.00   Corporate Sponsorships
     Society
    Chicago Urological Soctiey         $12,000.00   Corporate Sponsorships
    Childrens Digestive Health         $42,428.00   Corporate Sponsorships
     and Nutrition Foundation
    Childrens Hospital of               $2,000.00   Corporate Sponsorships
     Wisconsin
    Children's Skin Disease               $600.00   Corporate Sponsorships
     Foundation
    Childrens Treehouse                $10,000.00   Charitable Donations
     Foundation
    Chimp Haven                        $15,000.00   Charitable Donations
    Chinese American                    $3,600.00   Corporate Sponsorships
     Biopharmaceutical Society
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chris Elliott Fund                 $10,000.00   Charitable Donations
    Chris Elliott Fund                 $25,000.00   Corporate Sponsorships
    Chris Elliott Fund                 $50,000.00   Charitable Donations
    Chris Elliott Fund                 $40,000.00   Educational Grants
    Chris Elliott Fund                 $10,000.00   Corporate Sponsorships
    Chris Elliott Fund                 $10,000.00   Corporate Sponsorships
    Chris Elliott Fund                 $20,000.00   Corporate Sponsorships
    Chris Elliott Fund                 $20,000.00   Corporate Sponsorships
    Chris Elliott Fund                 $25,000.00   Corporate Sponsorships
    Chris Elliott Fund                 $10,000.00   Corporate Sponsorships
    Christ Hospital Foundation          $5,000.00   Corporate Sponsorships
    Chronic Liver Disease             $450,000.00   Educational Grants
     Foundation
    Chronic Liver Disease              $75,000.00   Corporate Sponsorships
     Foundation
    Chronic Liver Disease              $75,000.00   Corporate Sponsorships
     Foundation
    Chronic Liver Disease              $90,000.00   Corporate Sponsorships
     Foundation
    Chronic Lymphoytic Leukemia        $50,000.00   Charitable Donations
     Society Inc.
    Chronic Lymphoytic Leukemia        $25,075.00   Patient Support
     Society Inc.
    Chronic Lymphoytic Leukemia        $75,000.00   Patient Support
     Society Inc.
    Chronic Lymphoytic Leukemia        $50,000.00   Patient Support
     Society Inc.
    Chronic Lymphoytic Leukemia        $35,000.00   Patient Support
     Society Inc.
    Chronic Lymphoytic Leukemia        $75,000.00   Patient Support
     Society Inc.
    Cincinnati Childrens               $40,000.00   Fellowships and
     Hospital Medical Center                         Scholarships
    City of Hope National Med          $50,000.00   Educational Grants
     Center
    Cleveland Clinic                  ($3,131.07)   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                 ($13,876.68)   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $50,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                  ($7,563.37)   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $50,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $20,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                    $5,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $50,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $50,000.00   Educational Grants
     Educational Foundation
    Cleveland Clinic                   $25,000.00   Corporate Sponsorships
     Educational Foundation
    Cleveland Clinic Foundation        $55,000.00   Fellowships and
                                                     Scholarships
    Cleveland Clinic Minority          $25,000.00   Corporate Sponsorships
     Mens Health Center
    Clinical Care Optn LLC              $5,000.00   Educational Grants
    Clinical Care Optn LLC             $35,000.00   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Clinical Care Optn LLC             $35,000.00   Educational Grants
    Clinical Care Optn LLC             $50,000.00   Educational Grants
    Clinical Care Optn LLC             $35,000.00   Educational Grants
    Clinical Care Optn LLC           ($35,000.00)   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Clinical Care Optn LLC            $120,000.00   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC             $25,000.00   Educational Grants
    Clinical Care Optn LLC             $50,000.00   Educational Grants
    Clinical Care Optn LLC             $50,000.00   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Clinical Care Optn LLC             $75,000.00   Educational Grants
    Clinical Care Optn LLC             $95,000.00   Educational Grants
    CLL Global Research                $35,000.00   Patient Support
     Foundation
    CLL Global Research                $35,000.00   Educational Grants
     Foundation
    Club DE oficiales DE LA               $495.00   Charitable Donations
     Policia DE Puerto Rico
     Inc.
    Coalition for Prevention of         $5,000.00   Corporate Sponsorships
     Colorectal Cancer in
     Puerto Rico
    Coalition of Texans With            $5,000.00   Corporate Sponsorships
     Disabilities
    Coalition of Texans With            $5,000.00   Corporate Sponsorships
     Disabilities
    Cockerell Educational              $25,000.00   Corporate Sponsorships
     Foundation
    Cockerell Educational              $30,000.00   Corporate Sponsorships
     Foundation
    Cody Dieruf Benefit                 $5,000.00   Charitable Donations
     Foundation
    Colegio DE Farmaceuticos DE         $4,000.00   Corporate Sponsorships
     Puerto Rico
    Colegio DE Farmaceuticos DE         $5,000.00   Corporate Sponsorships
     Puerto Rico
    Colegio DE Profesionales DE         $2,000.00   Corporate Sponsorships
     LA Enfermeria DE Puerto
     Rico Inc.
    Colegio DE Profesionales DE         $3,000.00   Corporate Sponsorships
     LA Enfermeria DE Puerto
     Rico Inc.
    Colegio DE Profesionales DE         $3,000.00   Corporate Sponsorships
     LA Enfermeria DE Puerto
     Rico Inc.
    Collaborative Alliance for         $30,000.00   Educational Grants
     Pancreatic Education and
     Research (Caper)
    Collaborative Alliance for         $30,000.00   Fellowships and
     Pancreatic Education and                        Scholarships
     Research (Caper)
    Collaborative Alliance for          $6,000.00   Fellowships and
     Pancreatic Education and                        Scholarships
     Research (Caper)
    College of American                 $5,065.00   Corporate Sponsorships
     Pathologists
    College of Lake County              $1,000.00   Charitable Donations
    Colorado American Congress         $10,000.00   Corporate Sponsorships
     of Obstetrician Gyn
     Colorado Section
    Columbia Univ Med Center            $5,000.00   Educational Grants
    Columbia Univ Med Center           $75,000.00   Fellowships and
                                                     Scholarships
    Community Center                   $10,000.00   Corporate Sponsorships
    Community Center                   $10,000.00   Corporate Sponsorships
    Community Foundation                $5,000.00   Corporate Sponsorships
    Community Foundation                $1,500.00   Corporate Sponsorships
    Community Initiatives              $40,000.00   Corporate Sponsorships
    Community Initiatives              $25,000.00   Patient Support
    Community Initiatives               $1,500.00   Charitable Donations
    Community Liver Alliance           $15,000.00   Corporate Sponsorships
    Community Liver Alliance              $500.00   Corporate Sponsorships
    Community Liver Alliance            $1,500.00   Corporate Sponsorships
    Community Oncology Alliance        $20,000.00   Corporate Sponsorships
    Connecticut Dermatology             $3,722.25   Corporate Sponsorships
     Society
    Connecticut Dermatology             $3,500.00   Corporate Sponsorships
     Society
    Connecting To Cure Crohns          $10,000.00   Corporate Sponsorships
     and Colitis
    Consortium of Multiple             $59,150.00   Educational Grants
     Sclerosis Centers
    Consortium of Multiple              ($452.00)   Educational Grants
     Sclerosis Centers
    Consortium of Multiple              ($341.36)   Educational Grants
     Sclerosis Centers
    Continuing Educational            $350,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $375,000.00   Educational Grants
     Alliance LLC
    Continuing Educational              ($623.00)   Educational Grants
     Alliance LLC
    Continuing Educational            $200,000.00   Educational Grants
     Alliance LLC
    Continuing Educational             $75,000.00   Educational Grants
     Alliance LLC
    Continuing Educational            $300,000.00   Educational Grants
     Alliance LLC
    Cornell Univ Weill Med             $15,000.00   Educational Grants
     College
    Cornell Univ Weill Med              $3,000.00   Educational Grants
     College
    Cornerstone Health Inc.            $90,000.00   Educational Grants
    Cornerstone Health Inc.            $50,000.00   Educational Grants
    Cradles To Crayons Inc.               $300.00   Charitable Donations
    Cristo Rey St Martin                $7,500.00   Corporate Sponsorships
     College Prep
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $15,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $20,000.00   Charitable Donations
     Foundation of America
    Crohns and Colitis                 $40,000.00   Patient Support
     Foundation of America
    Crohns and Colitis                $150,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $90,000.00   Patient Support
     Foundation of America
    Crohns and Colitis                $250,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $25,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $3,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $3,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $25,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $25,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $25,000.00   Educational Grants
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $7,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $25,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $1,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $3,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $2,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $5,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                  $7,500.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $10,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                 $25,000.00   Corporate Sponsorships
     Foundation of America
    Crohns and Colitis                $250,000.00   Educational Grants
     Foundation of America
    Curators of The Univ of             $1,000.00   Charitable Donations
     Missouri
    Curepsp Inc.                        $5,000.00   Corporate Sponsorships
    Curepsp Inc.                        $2,500.00   Patient Support
    Curepsp Inc.                       $30,000.00   Corporate Sponsorships
    Curepsp Inc.                       $45,500.00   Corporate Sponsorships
    Curepsp Inc.                       $30,000.00   Charitable Donations
    Curesearch for Childrens           $15,000.00   Charitable Donations
     Cancer
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation         $25,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,750.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation            $500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation         $10,000.00   Charitable Donations
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $6,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $7,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $7,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $4,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation            $250.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $7,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $8,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation         $12,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation        $161,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $5,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation            $500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation            $750.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $1,000.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $2,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation          $3,500.00   Corporate Sponsorships
    Cystic Fibrosis Foundation         $10,000.00   Charitable Donations
    Cystic Fibrosis Foundation        $750,000.00   Corporate Sponsorships
    Cystic Fibrosis Research            $5,000.00   Corporate Sponsorships
     Fund Emilys Entourage
    Cystic Fibrosis Research           $20,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research            $3,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research            $6,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research            $7,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $10,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $12,000.00   Corporate Sponsorships
     Inc.
    Cystic Fibrosis Research           $12,000.00   Corporate Sponsorships
     Inc.
    Dade County Medical                 $5,000.00   Educational Grants
     Association
    Dahshu                              $5,000.00   Corporate Sponsorships
    Dallas Area Parkinsonism            $2,500.00   Corporate Sponsorships
     Society
    Dana Farber Cancer                 $25,000.00   Educational Grants
     Institute
    Dana Farber Cancer                $100,000.00   Corporate Sponsorships
     Institute, Inc.
    Dava Oncology LP                   $37,500.00   Corporate Sponsorships
    Davis Phinney Foundation           $30,000.00   Patient Support
    Davis Phinney Foundation           $80,000.00   Corporate Sponsorships
    Davis Phinney Foundation           $30,000.00   Patient Support
    Davis Phinney Foundation           $15,000.00   Patient Support
    Davis Phinney Foundation           $15,000.00   Educational Grants
    Davis Phinney Foundation           $15,000.00   Educational Grants
    Davis Phinney Foundation           $15,000.00   Educational Grants
    Dermatologic Society of           $100,000.00   Corporate Sponsorships
     Greater New York
    Dermatology Education              $50,000.00   Corporate Sponsorships
     Foundation
    Dermatology Foundation            $135,000.00   Charitable Donations
    Dermatology Foundation             $50,000.00   Corporate Sponsorships
    Dermatology Nurses                 $18,000.00   Corporate Sponsorships
     Associate
    Dermatology PA Foundation           $2,700.00   Corporate Sponsorships
    Digestive Disease Week             $32,400.00   Corporate Sponsorships
    Digestive Disease Week             $80,000.00   Corporate Sponsorships
    Digestive Disease Week            $255,300.00   Corporate Sponsorships
    Digestive Health Foundation        $50,000.00   Corporate Sponsorships
    Direct Relief                      $25,000.00   Charitable Donations
    Direct Relief                  $10,000,000.00   Charitable Donations
    Direct Relief                  $25,000,000.00   Charitable Donations
    Direct Relief                   $5,000,000.00   Charitable Donations
    Direct Relief                  $10,000,000.00   Charitable Donations
    Doctor Solomon Carter              $10,000.00   Educational Grants
     Fuller Mental Health
     Center
    Doctor Solomon Carter              $50,000.00   Educational Grants
     Fuller Mental Health
     Center
    Drew University Health              $2,500.00   Educational Grants
     Services
    Drexel Unviersity                  $55,000.00   Fellowships and
                                                     Scholarships
    Drugs for Neglected                $10,000.00   Charitable Donations
     Diseases Initiative North
     America Inc.
    East Tennessee Foundation           $1,500.00   Corporate Sponsorships
    Ecog Research and Education        $20,000.00   Educational Grants
     Foundation Inc.
    Ecog Research and Education        $20,000.00   Educational Grants
     Foundation Inc.
    Economic Alliance for               $5,000.00   Corporate Sponsorships
     Michigan
    Eisenhower Desert                ($30,000.00)   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $75,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                 $300,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $95,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $90,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                 $563,360.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $50,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $35,100.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                 $250,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                 $475,000.00   Educational Grants
     Orthopedic Center
    Eisenhower Desert                  $50,000.00   Educational Grants
     Orthopedic Center
    Embarcadero Lions Club of           $2,500.00   Corporate Sponsorships
     Sacramento
    Employers Health Coalition          $5,000.00   Corporate Sponsorships
    Endocrine Education Inc.           $25,000.00   Educational Grants
    Endocrine Society                  $25,000.00   Educational Grants
    Endocrine Society                  $25,000.00   Educational Grants
    Endocrine Society                ($10,928.00)   Educational Grants
    Endocrine Society                  $20,000.00   Educational Grants
    Endometriosis Associate            $50,000.00   Charitable Donations
    Endometriosis Foundation of        $30,000.00   Corporate Sponsorships
     America
    Enzyme Mechanism Conference         $2,500.00   Educational Grants
    Epilepsy Association of             $7,500.00   Corporate Sponsorships
     Central Florida
    Epilepsy Foundation                $15,000.00   Corporate Sponsorships
    Epilepsy Foundation of              $5,000.00   Corporate Sponsorships
     Florida
    Epilepsy Foundation of             $10,000.00   Corporate Sponsorships
     Michigan
    Ethiopian Community                 $2,000.00   Corporate Sponsorships
     Association of Greater
     Philadelphia
    Excellence in                     $100,000.00   Corporate Sponsorships
     Gastroenterology Education
     LLC
    Excellence in                     $110,000.00   Corporate Sponsorships
     Gastroenterology Education
     LLC
    Excellence in Rheumatology        $100,000.00   Corporate Sponsorships
     Education LLC
    Family Reach Foundation         $5,000,000.00   Charitable Donations
    Federation of American              $2,000.00   Educational Grants
     Society for Experimental
     Biology Faseb
    Federation of American              $2,000.00   Educational Grants
     Society for Experimental
     Biology Faseb
    Federation of American              $2,000.00   Educational Grants
     Society for Experimental
     Biology Faseb
    Federation of American              $2,000.00   Educational Grants
     Society for Experimental
     Biology Faseb
    Federation of Clinical             $20,000.00   Educational Grants
     Immunology Society
    Federation of Clinical             $20,000.00   Educational Grants
     Immunology Society
    Federation of Clinical             $12,500.00   Educational Grants
     Immunology Society
    Federation of Clinical             $20,000.00   Fellowships and
     Immunology Society                              Scholarships
    Feed My Starving Children             $500.00   Charitable Donations
    Feinstein Institute for Med       $243,900.00   Educational Grants
     Research
    Fibroid Foundation                 $90,000.00   Charitable Donations
    Fibroid Foundation                 $95,000.00   Charitable Donations
    Florida Academy of Family          $18,000.00   Corporate Sponsorships
     Physicians
    Florida Atlantic University         $1,000.00   Charitable Donations
     Foundation Inc.
    Florida Coalition                  $10,000.00   Corporate Sponsorships
    Florida Gastroenterological         $7,500.00   Corporate Sponsorships
     Society
    Florida Society of                 $70,000.00   Corporate Sponsorships
     Dermatology Physician
     Assistants Inc.
    Florida Society of                 $50,000.00   Corporate Sponsorships
     Rheumatology Inc.
    Florida Society of                  $5,000.00   Corporate Sponsorships
     Rheumatology Inc.
    Focus Med Communications           $35,000.00   Corporate Sponsorships
    Focus Med Communications          $135,000.00   Corporate Sponsorships
    Footsteps for Fertility             $1,000.00   Corporate Sponsorships
     Foundation
    Force--Facing Our Risk of           $5,000.00   Charitable Donations
     Cancer Emp
    Forsyth Area Striders Team            $500.00   Corporate Sponsorships
    Foundation Fighting                 $2,500.00   Corporate Sponsorships
     Blindness
    Foundation for Biomedical          $50,000.00   Charitable Donations
     Research
    Foundation for The National         $5,000.00   Corporate Sponsorships
     Institute of Health
    Foundation of Consortium of        $17,500.00   Fellowships and
     Multiple Sclerosis Centers                      Scholarships
     Cmsc
    Foundation of Consortium of        $40,000.00   Educational Grants
     Multiple Sclerosis Centers
     Cmsc
    Foundation of Consortium of        $32,875.00   Patient Support
     Multiple Sclerosis Centers
     Cmsc
    Franklin and Marshall               $1,000.00   Charitable Donations
     College
    French American Chemical            $3,000.00   Educational Grants
     Society
    Friends of Cancer Research         $25,000.00   Charitable Donations
    Friends of Cancer Research         $25,000.00   Corporate Sponsorships
    Friends of Cancer Research         $25,000.00   Corporate Sponsorships
    Friends of The St Louis            $50,000.00   Corporate Sponsorships
     Univ Liver Center
    Fundacion Puertorriquena DE        $17,960.00   Educational Grants
     Pacientes Consult
     Endometriosis
    Gastrointestinal and Liver        $150,000.00   Corporate Sponsorships
     Association of The
     Americas Inc.
    Gastrointestinal Health            $90,000.00   Corporate Sponsorships
     Foundation Inc.
    Gateway for Cancer Research        $10,000.00   Charitable Donations
    Genesis Healthcare                  $3,000.00   Corporate Sponsorships
     Foundation
    George Washington Univ              $3,000.00   Corporate Sponsorships
    Georgia Academy of Family           $3,500.00   Corporate Sponsorships
     Physicians
    Georgia Dermatology                $50,000.00   Corporate Sponsorships
     Physican Assistants
    Georgia Society of                  $7,500.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgery
    Georgia Society of                 $75,000.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgery
    Gildas Club Chicago                $10,000.00   Charitable Donations
    Global Academy for Medical         $20,000.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $43,750.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $40,500.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $76,500.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $58,500.00   Corporate Sponsorships
     Education
    Global Academy for Medical         $76,500.00   Corporate Sponsorships
     Education
    Global Healthy Living              $45,000.00   Corporate Sponsorships
     Foundation
    Global Healthy Living              $75,000.00   Corporate Sponsorships
     Foundation
    Global Oncology                     $5,000.00   Corporate Sponsorships
    Good Grief                            $500.00   Corporate Sponsorships
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $3,000.00   Educational Grants
    Gordon Research Conferences         $1,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $3,000.00   Educational Grants
    Gordon Research Conferences         $1,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $2,000.00   Educational Grants
    Gordon Research Conferences         $1,000.00   Educational Grants
    Gordon Research Conferences         $2,500.00   Educational Grants
    Grand Traverse Area                 $1,500.00   Corporate Sponsorships
     Parkinsons Support Group
    Gynecologic Oncology Group         $10,000.00   Educational Grants
    Gynecologic Oncology Group         $25,000.00   Educational Grants
    Gynecologic Oncology Group          $5,500.00   Educational Grants
    Gynecologic Oncology Group         $40,000.00   Educational Grants
    H Lee Moffitt Cancer Center         $7,500.00   Educational Grants
     and Research Institute
    Halo House Foundation              $10,000.00   Corporate Sponsorships
    Hamil Kerr Challenge                  $500.00   Corporate Sponsorships
    Harborside Press                   $30,400.00   Corporate Sponsorships
    Harborside Press                   $80,000.00   Corporate Sponsorships
    Hartford Hospital                   $5,000.00   Corporate Sponsorships
    Healthcare 21 Business              $1,500.00   Corporate Sponsorships
     Coalition
    Healthwell Foundation             $220,000.00   Charitable Donations
    Healthy Women                      $30,000.00   Corporate Sponsorships
    Heart To Heart                     $15,000.00   Charitable Donations
     International Inc.
    Heart To Heart                      $1,000.00   Charitable Donations
     International Inc.
    Heart To Heart                      $5,000.00   Charitable Donations
     International Inc.
    Henry M Jackson Foundation         $10,000.00   Educational Grants
    Hepatitis C Association            $20,000.00   Educational Grants
    Hepatitis C Mentor and             $20,000.00   Patient Support
     Support Group The
    Hepatitis Education Project        $25,000.00   Corporate Sponsorships
    Hermanas Carmelitas Teresas           $393.79   Charitable Donations
     DE San Jose, Inc.
    Hidradenitis Suppurativa           $10,000.00   Charitable Donations
     Foundation
    HIV Treaters Med Associate          $7,500.00   Corporate Sponsorships
     of Puerto Rico
    HMP Communications                 $15,000.00   Corporate Sponsorships
    HMP Communications                 $70,000.00   Corporate Sponsorships
    Hope Foundation                    $25,000.00   Educational Grants
    Hospital of the University         $10,000.00   Educational Grants
     of Pennsylvania
    Hospital of the University         $75,000.00   Educational Grants
     of Pennsylvania
    Hospital of the University          $5,000.00   Educational Grants
     of Pennsylvania
    Hospital of the University         $10,000.00   Educational Grants
     of Pennsylvania
    Howard Hanna Children's            $10,000.00   Charitable Donations
     Free Care Fund
    Hubbard Street Dance               $10,000.00   Educational Grants
     Chicago
    Human Growth Foundation             $5,000.00   Corporate Sponsorships
    Human Growth Foundation             $2,000.00   Corporate Sponsorships
    Hunt for A Cure                     $1,250.00   Corporate Sponsorships
    Huntsman Cancer Foundation            $500.00   Corporate Sponsorships
    Huntsman Cancer Foundation          $2,000.00   Corporate Sponsorships
    Huntsman Cancer Foundation          $2,500.00   Corporate Sponsorships
    IASLC Foundation                   $50,000.00   Fellowships and
                                                     Scholarships
    IBD Horizons                        $2,500.00   Corporate Sponsorships
    IBD Horizons                        $2,500.00   Corporate Sponsorships
    IBD Horizons                       $50,000.00   Corporate Sponsorships
    Illinois Academy of Family          $4,500.00   Educational Grants
     Physicians
    Illinois Cancercare                 $2,500.00   Corporate Sponsorships
     Foundation
    Illinois Society of                $65,000.00   Corporate Sponsorships
     Dermatology Physician
     Assistants
    Imedex LLC                         $75,000.00   Educational Grants
    Imedex LLC                        ($1,119.00)   Educational Grants
    Imedex LLC                         $25,000.00   Educational Grants
    Imedex LLC                         $30,000.00   Educational Grants
    Imedex LLC                          ($991.00)   Educational Grants
    Imedex LLC                         $40,000.00   Educational Grants
    Imedex LLC                         $75,000.00   Educational Grants
    Imedex LLC                         $40,000.00   Educational Grants
    Imedex LLC                        $114,000.00   Corporate Sponsorships
    Imerman Angels                      $1,500.00   Charitable Donations
    Immune Deficiency                   $9,900.00   Corporate Sponsorships
     Foundation
    Impact Education LLC               $75,000.00   Educational Grants
    Impact Education LLC               $95,000.00   Educational Grants
    Improve Care Now Inc.              $12,500.00   Corporate Sponsorships
    Improve Care Now Inc.             $100,000.00   Patient Support
    Improve Care Now Inc.              $12,500.00   Corporate Sponsorships
    Improve Care Now Inc.              $12,500.00   Corporate Sponsorships
    Improve Care Now Inc.              $12,500.00   Corporate Sponsorships
    Indian Doc Associate of             $5,000.00   Corporate Sponsorships
     Houston
    Indiana Parkinson                   $4,250.00   Corporate Sponsorships
     Foundation
    Indy Hematology Education          $30,000.00   Corporate Sponsorships
     Inc.
    Indy Hematology Education          $19,000.00   Corporate Sponsorships
     Inc.
    Infectious Disease of              $10,000.00   Patient Support
     Puerto Rico
    Innovation Foundation Inc.         $55,000.00   Corporate Sponsorships
    Institute for Medical and          $15,000.00   Educational Grants
     Nursing Education
    Integrated Med Foundation          $15,000.00   Charitable Donations
    Integrated Med Foundation           $9,500.00   Corporate Sponsorships
    Intellisphere LLC                   $7,000.00   Corporate Sponsorships
    Intellisphere LLC                  $15,500.00   Corporate Sponsorships
    Intellisphere LLC                  $10,500.00   Corporate Sponsorships
    Intellisphere LLC                  $16,000.00   Corporate Sponsorships
    Intellisphere LLC                  $18,500.00   Corporate Sponsorships
    Intellisphere LLC                  $12,500.00   Corporate Sponsorships
    Internaltional Society for         $17,500.00   Corporate Sponsorships
     Pharmacoeconomics and
     Outcomes Research
    International Association         $311,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Association          $15,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Association          $75,000.00   Corporate Sponsorships
     for The Study of Lung
     Cancer
    International Biometric             $3,875.00   Corporate Sponsorships
     Society Eastern North
     American Region
    International Dermatology          $70,000.00   Corporate Sponsorships
     Outcome Measures
    International Dermatology          $70,000.00   Corporate Sponsorships
     Outcome Measures
    International Medical Corps         $5,000.00   Charitable Donations
    International Meyoloma            $100,000.00   Corporate Sponsorships
     Foundation
    International Meyoloma             $15,000.00   Corporate Sponsorships
     Foundation
    International Meyoloma             $25,000.00   Charitable Donations
     Foundation
    International Meyoloma             $10,000.00   Educational Grants
     Foundation
    International Myeloma              $50,000.00   Corporate Sponsorships
     Society (IMS)
    International Organization         $50,000.00   Patient Support
     of Multiple Sclerosis
     Nurses
    International Pelvic Pain          $23,000.00   Corporate Sponsorships
     Society
    International Pelvic Pain           $5,000.00   Corporate Sponsorships
     Society
    International Physician            $75,000.00   Corporate Sponsorships
     Ntwrk Dba International
     Oncology Ntwrk
    International Physician            $95,000.00   Corporate Sponsorships
     Ntwrk Dba International
     Oncology Ntwrk
    International Physician            $75,000.00   Corporate Sponsorships
     Ntwrk Dba International
     Oncology Ntwrk
    International Psoriasis            $25,000.00   Corporate Sponsorships
     Council
    International Psoriasis            $50,000.00   Corporate Sponsorships
     Council
    International Society for           $5,000.00   Educational Grants
     Antiviral Research
    It Takes Guts                       $1,000.00   Corporate Sponsorships
    Johns Hopkins Technology           $50,000.00   Educational Grants
     Ventures
    Johns Hopkins Technology           $20,000.00   Educational Grants
     Ventures
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology            $2,500.00   Corporate Sponsorships
     Ventures
    Johns Hopkins Technology           $75,000.00   Educational Grants
     Ventures
    Johns Hopkins Technology           $25,000.00   Educational Grants
     Ventures
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology           $40,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology           $70,000.00   Corporate Sponsorships
     Ventures
    Johns Hopkins Technology           $50,000.00   Fellowships and
     Ventures                                        Scholarships
    Johns Hopkins Technology           $10,000.00   Educational Grants
     Ventures
    Johns Hopkins University          ($3,916.11)   Educational Grants
    Johns Hopkins University          ($2,784.14)   Educational Grants
    JWC Covenant Inc.                  $50,000.00   Educational Grants
    Kansas Univ Endowment              $40,000.00   Educational Grants
     Association
    Kelsey Research Foundation         $40,000.00   Fellowships and
                                                     Scholarships
    Kentucky Rural Health              $35,000.00   Corporate Sponsorships
     Association
    Kentucky Rural Health              $25,000.00   Corporate Sponsorships
     Association
    Kentucky Rural Health               $5,000.00   Corporate Sponsorships
     Association
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo          $1,095.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo          $2,250.00   Patient Support
    Laboratorio Clinico Toledo          $5,325.00   Patient Support
    Laboratorio Clinico Toledo            $465.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $315.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo          $2,295.00   Patient Support
    Laboratorio Clinico Toledo            $348.00   Patient Support
    Laboratorio Clinico Toledo            $435.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,050.00   Patient Support
    Laboratorio Clinico Toledo            $372.00   Patient Support
    Laboratorio Clinico Toledo            $255.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $825.00   Patient Support
    Laboratorio Clinico Toledo            $345.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,125.00   Patient Support
    Laboratorio Clinico Toledo            $255.00   Patient Support
    Laboratorio Clinico Toledo            $480.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $705.00   Patient Support
    Laboratorio Clinico Toledo            $885.00   Patient Support
    Laboratorio Clinico Toledo          $1,695.00   Patient Support
    Laboratorio Clinico Toledo            $480.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $915.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo          $3,000.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo            $360.00   Patient Support
    Laboratorio Clinico Toledo          $1,290.00   Patient Support
    Laboratorio Clinico Toledo            $900.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo          $1,500.00   Patient Support
    Laboratorio Clinico Toledo            $930.00   Patient Support
    Laboratorio Clinico Toledo          $1,200.00   Patient Support
    Laboratorio Clinico Toledo            $675.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $750.00   Patient Support
    Laboratorio Clinico Toledo            $360.00   Patient Support
    Laboratorio Clinico Toledo          $1,680.00   Patient Support
    Laboratorio Clinico Toledo            $525.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $375.00   Patient Support
    Laboratorio Clinico Toledo            $990.00   Patient Support
    Laboratorio Clinico Toledo          $1,830.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Laboratorio Clinico Toledo            $600.00   Patient Support
    Lahey Hospital and Medical          $3,000.00   Corporate Sponsorships
     Center
    Lake County Crisis Center           $5,000.00   Charitable Donations
    Lake County Haven                  $10,000.00   Charitable Donations
    Large Urology Group                $66,400.00   Corporate Sponsorships
     Practice Associate
    Large Urology Group                $20,000.00   Corporate Sponsorships
     Practice Associate
    Large Urology Group                $20,000.00   Corporate Sponsorships
     Practice Associate
    Large Urology Group                 $5,000.00   Corporate Sponsorships
     Practice Associate
    Leukemia and Lymphoma              $50,000.00   Patient Support
     Society Inc.
    Leukemia and Lymphoma               $5,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma               $5,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma             $100,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma             $100,000.00   Educational Grants
     Society Inc.
    Leukemia and Lymphoma               $2,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma               $5,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma              $95,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma              $70,000.00   Corporate Sponsorships
     Society Inc.
    Leukemia and Lymphoma              $50,000.00   Educational Grants
     Society Inc.
    Leukemia and Lymphoma              $50,000.00   Educational Grants
     Society Inc.
    Leukemia and Lymphoma               $3,500.00   Corporate Sponsorships
     Society Inc.
    Leukemia Research                  $50,000.00   Fellowships and
     Foundation Inc.                                 Scholarships
    Leukemia Research                  $10,000.00   Corporate Sponsorships
     Foundation Inc.
    Leukemia Research                   $5,000.00   Charitable Donations
     Foundation Inc.
    Leukemia Research                   $5,000.00   Educational Grants
     Foundation Inc.
    Leukemia Research                  $50,000.00   Fellowships and
     Foundation Inc.                                 Scholarships
    Linkage To Health Inc.             $25,000.00   Educational Grants
    Liver Health Connection            $40,000.00   Educational Grants
    Liver Health Connection             $5,000.00   Corporate Sponsorships
    Livestrong Foundation              $10,000.00   Charitable Donations
    Loma Linda University              $10,000.00   Educational Grants
     School of Medicine
    Lung Cancer Alliance               $25,000.00   Corporate Sponsorships
    Lung Cancer Research               $25,000.00   Charitable Donations
     Foundation
    Lung Cancer Research               $20,000.00   Corporate Sponsorships
     Foundation
    Lungevity Foundation                $5,000.00   Corporate Sponsorships
    Lungevity Foundation               $25,000.00   Charitable Donations
    Lungevity Foundation               $10,000.00   Corporate Sponsorships
    Lungevity Foundation               $10,000.00   Educational Grants
    Lupus and Allied Diseases          $15,000.00   Corporate Sponsorships
     Association, Inc.
    Lymphoma Research                  $10,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $25,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $40,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $10,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $15,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $25,000.00   Corporate Sponsorships
     Foundation
    Lymphoma Research                  $50,000.00   Corporate Sponsorships
     Foundation
    Magellan Rx Management Inc.        $10,000.00   Corporate Sponsorships
    March of Dimes Foundation           $5,000.00   Corporate Sponsorships
    Massachusetts General              $30,000.00   Educational Grants
     Hospital
    Massachusetts General              $40,000.00   Fellowships and
     Hospital                                        Scholarships
    Massachusetts Society for          $10,000.00   Charitable Donations
     Med Research
    Mayo Clinic                         $7,500.00   Corporate Sponsorships
    Mayo Clinic Scottsdale              $8,000.00   Educational Grants
     Pharmacy
    Mayo Clinic Scottsdale             $10,000.00   Educational Grants
     Pharmacy
    Mckesson Specialty Health          $60,000.00   Corporate Sponsorships
     Pharmaceuticals and
     Biotechnology Solutions
    Mckesson Specialty Health          $25,000.00   Corporate Sponsorships
     Pharmaceuticals and
     Biotechnology Solutions
    Mckesson Specialty Health          $65,000.00   Corporate Sponsorships
     Pharmaceuticals and
     Biotechnology Solutions
    ME Strong Inc.                      $5,000.00   Corporate Sponsorships
    Med--LQ LLC                        $75,000.00   Educational Grants
    Med--LQ LLC                        $75,000.00   Educational Grants
    Med--LQ LLC                        $75,000.00   Educational Grants
    Med Conference Planners             $7,500.00   Corporate Sponsorships
    Med Educator Consortium            $10,000.00   Corporate Sponsorships
    Med Univ of South Carolina          $2,500.00   Educational Grants
     Foundation
    Medical Education Resources        $20,000.00   Corporate Sponsorships
    Medical Learning Institute        $148,000.00   Educational Grants
    Medical Learning Institute         $95,000.00   Educational Grants
    Medical Learning Institute         $55,495.00   Educational Grants
    Medical Learning Institute         $50,000.00   Educational Grants
    Medical Learning Institute          ($715.00)   Educational Grants
    Medical Oncology                   $20,000.00   Corporate Sponsorships
     Association of Southern
     California
    Medical Univ of South               $1,250.00   Corporate Sponsorships
     Carolina
    Medical Univ of South               $1,250.00   Corporate Sponsorships
     Carolina
    Medical Univ of South               $7,500.00   Corporate Sponsorships
     Carolina
    Medicinal and Bioorganic            $5,000.00   Educational Grants
     Chemistry Foundation The
    Medina Community Clinic             $1,000.00   Corporate Sponsorships
    Medscape LLC                      ($7,703.00)   Educational Grants
    Medscape LLC                      ($2,475.00)   Educational Grants
    Medscape LLC                        ($205.88)   Educational Grants
    Medstar Georgetown                    $800.00   Corporate Sponsorships
     Transplant Institute
     Fairfax
    Medstar Health Inc.                $10,000.00   Educational Grants
    Meeting Designs LLC                $20,000.00   Corporate Sponsorships
    Memorial Hermann Foundation         $1,500.00   Corporate Sponsorships
    Memorial Hermann Foundation         $5,000.00   Corporate Sponsorships
    Memorial Sloan Kettering           $25,000.00   Educational Grants
     Cancer Center
    Merriam LLC Dba World Class        $73,085.00   Educational Grants
     Cme
    Metavivor Research and              $4,000.00   Charitable Donations
     Support, Inc.
    Methodist Dallas Med Center         $5,000.00   Corporate Sponsorships
     Irb
    Methodist Hospital                 $25,000.00   Corporate Sponsorships
    Metropolitan Chicago Breast         $5,000.00   Charitable Donations
     Cancer
    Michael J Fox Foundation           $10,000.00   Corporate Sponsorships
    Michael J Fox Foundation            $1,000.00   Corporate Sponsorships
    Michael J Fox Foundation          $600,000.00   Corporate Sponsorships
    Michael J Fox Foundation           $25,000.00   Corporate Sponsorships
    Michael J Fox Foundation           $25,000.00   Corporate Sponsorships
    Michigan Parkinson                  $5,000.00   Corporate Sponsorships
     Foundation
    Michigan Parkinson                  $3,000.00   Corporate Sponsorships
     Foundation
    Michigan Rheumatism Society        $25,000.00   Corporate Sponsorships
    Midwest Business Group On           $3,000.00   Corporate Sponsorships
     Health
    Midwest Parkinsons                  $1,000.00   Corporate Sponsorships
     Initiative
    Miles for Cystic Fibrosis           $2,500.00   Corporate Sponsorships
    Miles for Cystic Fibrosis          $15,000.00   Charitable Donations
    Minnesota Urological                $5,000.00   Corporate Sponsorships
     Society
    Mississippi Arthritis and          $10,000.00   Corporate Sponsorships
     Rheumatism Society
    Missouri Hepatitis C               $25,000.00   Educational Grants
     Alliance
    MIT Medical Obstetrics and         $10,000.00   Charitable Donations
     Gynecology
    Montana Academy of                  $1,500.00   Corporate Sponsorships
     Ophthalmology
    Montefiore Med Center              $40,000.00   Fellowships and
                                                     Scholarships
    Mount Sinai School of               $2,500.00   Educational Grants
     Medicine
    Mount Sinai School of              $30,000.00   Corporate Sponsorships
     Medicine
    Mount Sinai School of              $10,000.00   Educational Grants
     Medicine
    Mount Sinai School of              $40,000.00   Educational Grants
     Medicine
    Mountain Area Center                $1,200.00   Corporate Sponsorships
     Education Center
    Movement Disorder Society           $2,500.00   Educational Grants
    Movement Disorder Society          $10,000.00   Educational Grants
    Movement Disorder Society          $25,000.00   Corporate Sponsorships
    Movement Disorder Society          $25,000.00   Corporate Sponsorships
    Movement Disorder Society          $15,000.00   Corporate Sponsorships
    Movement Disorder Society         $208,750.00   Corporate Sponsorships
    Movement Disorder Society          $50,000.00   Corporate Sponsorships
    Multiple Myeloma Research          $25,000.00   Patient Support
     Foundation Inc.
    Multiple Myeloma Research          $50,000.00   Patient Support
     Foundation Inc.
    Multiple Myeloma Research          $10,000.00   Patient Support
     Foundation Inc.
    Multiple Myeloma Research          $20,000.00   Patient Support
     Foundation Inc.
    Multiple Myeloma Research          $25,000.00   Corporate Sponsorships
     Foundation Inc.
    Multiple Myeloma Research          $55,000.00   Fellowships and
     Foundation Inc.                                 Scholarships
    Multiple Myeloma Research          $20,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $20,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $75,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $50,000.00   Educational Grants
     Foundation Inc.
    Multiple Myeloma Research          $75,000.00   Educational Grants
     Foundation Inc.
    Musella Foundation for             $10,000.00   Corporate Sponsorships
     Brain Tumor Research and
     Information Inc.
    Nami Oregon                         $2,250.00   Corporate Sponsorships
    Nami Oregon                         $2,250.00   Corporate Sponsorships
    Nami Tennessee                      $2,500.00   Corporate Sponsorships
    National Academy of                $30,000.00   Corporate Sponsorships
     Dermatology Nurse
     Practitioners
    National Academy of Science        $85,000.00   Corporate Sponsorships
    National AIDS Treatment           $300,000.00   Charitable Donations
     Advocacy Project (NATAP)
    National Alliance of               $20,000.00   Corporate Sponsorships
     Healthcare Purchaser
     Coalitions
    National Alliance of State        $100,000.00   Corporate Sponsorships
     and Territorial Aids
     Directors
    National Alliance of State         $50,000.00   Charitable Donations
     and Territorial Aids
     Directors
    National Animal Interest           $15,000.00   Charitable Donations
     Alliance
    National Associate of              $45,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $20,000.00   Educational Grants
     Managed Care Physician
    National Associate of              $45,000.00   Educational Grants
     Managed Care Physician
    National Association of               $300.00   Charitable Donations
     Area Agencies On Aging
     (N4a)
    National Association of             $6,600.00   Corporate Sponsorships
     Community Health Centers
     Nachc
    National Association of            $10,000.00   Charitable Donations
     School Nurses Inc.
    National Brain Tumor                $5,700.00   Charitable Donations
     Society Inc.
    National Brain Tumor               $25,000.00   Corporate Sponsorships
     Society Inc.
    National Brain Tumor               $50,000.00   Charitable Donations
     Society Inc.
    National Brain Tumor               $50,000.00   Educational Grants
     Society Inc.
    National Brain Tumor               $50,000.00   Corporate Sponsorships
     Society Inc.
    National Coalition for             $50,000.00   Corporate Sponsorships
     Cancer Survivorship
    National Coalition for              $2,500.00   Corporate Sponsorships
     Cancer Survivorship
    National Coalition for              $2,500.00   Corporate Sponsorships
     Cancer Survivorship
    National Coalition for             $25,000.00   Corporate Sponsorships
     Cancer Survivorship
    National Coalition for             $25,000.00   Corporate Sponsorships
     Cancer Survivorship
    National Community                 $80,000.00   Corporate Sponsorships
     Dispensing Associate Ncoda
    National Comprehensive             $15,000.00   Corporate Sponsorships
     Cancer Network
    National Comprehensive             $15,000.00   Corporate Sponsorships
     Cancer Network
    National Comprehensive             $40,000.00   Corporate Sponsorships
     Cancer Network
    National Comprehensive             $30,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $60,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $75,000.00   Educational Grants
     Cancer Network
    National Comprehensive              $5,000.00   Corporate Sponsorships
     Cancer Network
    National Comprehensive             $25,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $50,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $55,000.00   Educational Grants
     Cancer Network
    National Comprehensive             $40,000.00   Patient Support
     Cancer Network Foundation
    National Comprehensive            $100,000.00   Fellowships and
     Cancer Network Foundation                       Scholarships
    National Comprehensive             $40,000.00   Patient Support
     Cancer Network Foundation
    National Comprehensive             $25,000.00   Patient Support
     Cancer Network Foundation
    National Comprehensive             $40,000.00   Patient Support
     Cancer Network Foundation
    National Comprehensive             $50,000.00   Charitable Donations
     Cancer Network Foundation
    National Comprehensive            $100,000.00   Fellowships and
     Cancer Network Foundation                       Scholarships
    National Eczema Association        $10,000.00   Corporate Sponsorships
    National Health Council            $50,000.00   Corporate Sponsorships
    National Minority Quality          $75,000.00   Corporate Sponsorships
     forum Inc.
    National Minority Quality          $75,000.00   Corporate Sponsorships
     forum Inc.
    National Multiple Sclerosis        $10,000.00   Corporate Sponsorships
     Society
    National Pancreas                 $150,000.00   Educational Grants
     Foundation
    National Pancreas                  $75,000.00   Corporate Sponsorships
     Foundation
    National Pancreas                  $75,000.00   Charitable Donations
     Foundation
    National Pancreas                  $70,000.00   Corporate Sponsorships
     Foundation
    National Partnership for            $5,000.00   Corporate Sponsorships
     Women and Families Inc.
    National Psoriasis                 $50,000.00   Fellowships and
     Foundation                                      Scholarships
    National Psoriasis                 $15,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $25,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $50,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                  $5,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $50,000.00   Educational Grants
     Foundation
    National Psoriasis                 $35,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $25,000.00   Educational Grants
     Foundation
    National Psoriasis                $150,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $30,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $15,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $50,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $75,000.00   Fellowships and
     Foundation                                      Scholarships
    National Psoriasis                 $30,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $40,000.00   Corporate Sponsorships
     Foundation
    National Psoriasis                 $40,000.00   Corporate Sponsorships
     Foundation
    National Society for               $55,000.00   Corporate Sponsorships
     Cutaneous Medicine
    National Society for               $80,000.00   Corporate Sponsorships
     Cutaneous Medicine
    National Society for              $225,000.00   Corporate Sponsorships
     Cutaneous Medicine
    National Society for              $160,000.00   Corporate Sponsorships
     Cutaneous Medicine
    New England Immunology              $2,500.00   Corporate Sponsorships
     Conference Inc.
    New Jersey Academy of             ($7,440.00)   Educational Grants
     Family Physicians
    New York Academy of Science         $3,500.00   Educational Grants
    New York Academy of Science         $5,000.00   Educational Grants
    New York Academy of Science         $5,000.00   Educational Grants
    New York Academy of Science         $2,500.00   Educational Grants
    New York Cancer Foundation         $10,000.00   Corporate Sponsorships
    New York University School        ($5,000.00)   Educational Grants
     of Medicine
    Nikki Mitchell Foundation           $7,500.00   Corporate Sponsorships
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $75,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.            $225,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.             $55,000.00   Educational Grants
    NL Communications Inc.             $30,000.00   Educational Grants
    NL Communications Inc.             $85,000.00   Educational Grants
    NL Communications Inc.             $35,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.             $75,000.00   Educational Grants
    NL Communications Inc.             $45,000.00   Educational Grants
    NL Communications Inc.             $75,000.00   Educational Grants
    NL Communications Inc.             $20,000.00   Educational Grants
    NL Communications Inc.             $30,000.00   Educational Grants
    NL Communications Inc.             $50,000.00   Educational Grants
    NL Communications Inc.             $25,000.00   Educational Grants
    NL Communications Inc.             $60,000.00   Educational Grants
    NL Communications Inc.            $125,000.00   Educational Grants
    NL Communications Inc.            $145,000.00   Educational Grants
    North American Center for         $375,000.00   Educational Grants
     Continuing Med Education
    North American Society for          $5,000.00   Corporate Sponsorships
     Pediatric and Adolescent
     Gynecology
    North American Society for         $25,000.00   Educational Grants
     Pediatric Gastroenterology
     Hepatology and Nutrition
    North Carolina Academy of         $235,500.00   Educational Grants
     Family Physcians
    North Carolina Academy of          $10,000.00   Corporate Sponsorships
     Family Physcians
    North Carolina Oncology             $5,000.00   Corporate Sponsorships
     Management Society
    North Carolina Society of           $5,000.00   Corporate Sponsorships
     Eye Physicians and
     Surgeons
    North Dakota Pharmacists            $2,500.00   Corporate Sponsorships
     Association
    Northeast Business Group On        $10,000.00   Corporate Sponsorships
     Health
    Northeast Business Group On         $7,500.00   Corporate Sponsorships
     Health
    Northeast Kidney Foundation         $5,000.00   Corporate Sponsorships
     Inc.
    Northern California Society        $20,000.00   Corporate Sponsorships
     for Clinical
     Gastroenterology
    Northwell Health                   $10,000.00   Corporate Sponsorships
    Northwest Parkinsons                $5,000.00   Patient Support
     Foundation
    Northwest Parkinsons                $5,000.00   Patient Support
     Foundation
    Northwestern Univ                  $50,000.00   Fellowships and
                                                     Scholarships
    Northwestern Univ                   $5,000.00   Corporate Sponsorships
    Northwestern Univ                   $5,000.00   Educational Grants
    Northwestern Univ                   $3,000.00   Educational Grants
    Northwestern Univ                   $3,000.00   Fellowships and
                                                     Scholarships
    Northwestern Univ                  $10,000.00   Corporate Sponsorships
    Nutrition4kids, LLC                $75,000.00   Patient Support
    Nutrition4kids, LLC               $100,000.00   Patient Support
    NYU School of Medicine              $7,500.00   Educational Grants
    NYU School of Medicine             $40,000.00   Fellowships and
                                                     Scholarships
    NYU School of Medicine             $10,000.00   Educational Grants
     Cardiothoracic Surgery
    NYU School of Medicine              $7,500.00   Educational Grants
     Cardiothoracic Surgery
    Ochsner Clinic Foundation          $10,000.00   Corporate Sponsorships
    Ocular Immunology and              $65,000.00   Corporate Sponsorships
     Uveitis Foundation
    Ohio Association of                 $1,300.00   Corporate Sponsorships
     Community Health Centers
    Ohio Association of                $10,000.00   Corporate Sponsorships
     Rheumatology
    Ohio Gastroenterology               $5,000.00   Corporate Sponsorships
     Society
    Ohio Gastroenterology               $3,000.00   Corporate Sponsorships
     Society
    Ohio State Univ                     $3,500.00   Educational Grants
    Omnia Education Inc.              $231,475.00   Educational Grants
    Oncology Nursing Society           $38,500.00   Corporate Sponsorships
    Oncology Nursing Society            $9,100.00   Corporate Sponsorships
    Oregon Health and Science           $3,000.00   Patient Support
     Univ
    Oregon Health and Science          $12,000.00   Corporate Sponsorships
     Univ
    Oregon Health and Science          $10,000.00   Educational Grants
     Univ
    Our Brain Bank                     $50,000.00   Corporate Sponsorships
    Pacific Business Group On          $15,000.00   Corporate Sponsorships
     Health
    Pacific Business Group On           $6,250.00   Corporate Sponsorships
     Health
    Pacific Business Group On           $6,250.00   Corporate Sponsorships
     Health
    Pacific Business Group On           $6,250.00   Corporate Sponsorships
     Health
    Pacific Business Group On           $6,250.00   Corporate Sponsorships
     Health
    Pacific Dermatologic               $20,000.00   Corporate Sponsorships
     Association
    Pacific Dermatologic               $30,000.00   Corporate Sponsorships
     Association
    Pack Center LLC                   $242,750.00   Patient Support
    Pack Center LLC                   $200,000.00   Patient Support
    Pack Center LLC                    $13,100.00   Educational Grants
    Pack Center LLC                   $125,500.00   Educational Grants
    Pack Center LLC                   $110,225.00   Educational Grants
    Pack Center LLC                   $151,700.00   Educational Grants
    Pancreatic Cancer Action           $50,000.00   Educational Grants
     Network
    Para LA Naturaleza Inc.               $500.00   Charitable Donations
    Park Nicollet Foundation            $1,000.00   Corporate Sponsorships
    Park Nicollet Foundation            $1,000.00   Corporate Sponsorships
    Parkinson Alliance                  $1,000.00   Corporate Sponsorships
    Parkinson and Movement             $10,000.00   Patient Support
     Disorder Alliance
    Parkinson and Movement             $15,000.00   Patient Support
     Disorder Alliance
    Parkinson and Movement             $50,000.00   Patient Support
     Disorder Alliance
    Parkinson and Movement            $100,000.00   Corporate Sponsorships
     Disorder Alliance
    Parkinson and Movement             $15,000.00   Patient Support
     Disorder Alliance
    Parkinson and Movement             $10,000.00   Educational Grants
     Disorder Alliance
    Parkinson Association of            $1,000.00   Corporate Sponsorships
     Alabama
    Parkinson Association of            $1,250.00   Corporate Sponsorships
     Greater Daytona Beach
     Pagdb
    Parkinson Association of            $1,000.00   Corporate Sponsorships
     Northern California
    Parkinson Association of            $1,000.00   Corporate Sponsorships
     The Carolinas
    Parkinson Association of            $1,000.00   Corporate Sponsorships
     The Carolinas
    Parkinson Council                  $25,000.00   Corporate Sponsorships
    Parkinson Foundation of             $1,000.00   Corporate Sponsorships
     Oklahoma
    Parkinson Foundation of The        $10,000.00   Patient Support
     National Capital Area
    Parkinson Foundation of The        $10,000.00   Patient Support
     National Capital Area
    Parkinson Foundation of The         $2,500.00   Corporate Sponsorships
     National Capital Area
    Parkinson Foundation                $5,000.00   Corporate Sponsorships
     Western Pennsylvania
    Parkinson Ntwrk of Arizona            $500.00   Corporate Sponsorships
    Parkinson Support Center of        $10,000.00   Corporate Sponsorships
     Kentuciana
    Parkinson Support Center of         $2,500.00   Corporate Sponsorships
     Kentuciana
    Parkinson's Association of          $1,000.00   Corporate Sponsorships
     San Diego
    Parkinson's Association of         $17,000.00   Corporate Sponsorships
     San Diego
    Parkinsons Association of           $7,500.00   Patient Support
     The Rockies
    Parkinsons Awareness                $1,250.00   Corporate Sponsorships
     Association of Central
     Indiana
    Parkinsons Disease                  $2,500.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                  $5,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                 $25,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                  $5,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                $135,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                  $2,500.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                 $10,000.00   Corporate Sponsorships
     Foundation
    Parkinsons Disease                  $4,500.00   Corporate Sponsorships
     Foundation
    Parkinson's Nebraska                $1,000.00   Corporate Sponsorships
    Parkinson's Nebraska                $1,000.00   Corporate Sponsorships
    Parkinsons Unity Walk              $54,000.00   Corporate Sponsorships
    Partnership for A Drug Free        $75,000.00   Charitable Donations
     America
    Partnership for Cures              $60,000.00   Patient Support
    Partnership for Quality Med         $1,000.00   Charitable Donations
     Donations Pqmd
    Partnership for Quality Med         $5,000.00   Charitable Donations
     Donations Pqmd
    Patient Access Network          $1,200,000.00   Charitable Donations
     Foundation
    Patient Access Network         $12,007,000.00   Charitable Donations
     Foundation
    Patient Access Network          $5,000,000.00   Charitable Donations
     Foundation
    Patient Access Network         $10,000,000.00   Charitable Donations
     Foundation
    Patient Access Network         $11,200,000.00   Charitable Donations
     Foundation
    Patient Access Network         $11,022,000.00   Charitable Donations
     Foundation
    Patient Access Network         $30,000,000.00   Charitable Donations
     Foundation
    Patient Empowerment Ntwrk          $20,000.00   Patient Support
    Patient Empowerment Ntwrk          $40,000.00   Patient Support
    Patient Empowerment Ntwrk          $10,000.00   Patient Support
    Patient Empowerment Ntwrk          $10,000.00   Patient Support
    Patient Empowerment Ntwrk          $20,000.00   Patient Support
    Patient Empowerment Ntwrk          $20,000.00   Patient Support
    Patient Empowerment Ntwrk          $30,000.00   Patient Support
    Patient Empowerment Ntwrk          $10,000.00   Charitable Donations
    Patient Empowerment Ntwrk          $20,000.00   Patient Support
    PD Gladiators                      $10,000.00   Corporate Sponsorships
    PD Gladiators                      $10,000.00   Charitable Donations
    Pediatric Specialists of            $2,500.00   Corporate Sponsorships
     Virginia LLC
    Peerview Institute for              $5,000.00   Educational Grants
     Medical Education
    Pennsylvania Academy of            $10,000.00   Corporate Sponsorships
     Dermatology and
     Dermatologic Surgry
    Pennsylvania Prostate               $1,000.00   Corporate Sponsorships
     Cancer Coalition
    Pennsylvania Society of            $10,000.00   Corporate Sponsorships
     Gastroenterology
    Pennsylvania Society of             $5,000.00   Corporate Sponsorships
     Gastroenterology
    People To People Health            $15,000.00   Charitable Donations
     Foundation
    People To People Health            $20,000.00   Charitable Donations
     Foundation
    Pharmacy Benefit Management         $7,500.00   Corporate Sponsorships
     Institute
    Pharmacy Benefit Management         $5,500.00   Corporate Sponsorships
     Institute
    Phoenix Obgyn Society               $2,000.00   Corporate Sponsorships
    Phoenix Rheumatology               $10,000.00   Corporate Sponsorships
     Association
    Phrmct Care Management             $95,000.00   Corporate Sponsorships
     Associate
    Physicians Continuing              $42,000.00   Corporate Sponsorships
     Education
    Physicians Education               $42,550.00   Educational Grants
     Resource LLC
    Physicians Education               $50,000.00   Educational Grants
     Resource LLC
    Physicians Education               $85,000.00   Educational Grants
     Resource LLC
    Physicians Education              $100,000.00   Educational Grants
     Resource LLC
    Physicians Education               $40,000.00   Educational Grants
     Resource LLC
    Physicians Education               $50,000.00   Educational Grants
     Resource LLC
    Physicians Education               $75,000.00   Educational Grants
     Resource LLC
    Pinnacle Clinical Research          $5,000.00   Corporate Sponsorships
    Pins for Parkinsons                   $500.00   Corporate Sponsorships
    Platformq Health Education,       $125,000.00   Educational Grants
     LLC
    Postgraduate Healthcare            $25,000.00   Educational Grants
     Education LLC
    Postgraduate Institute for         $50,000.00   Educational Grants
     Medicine
    Postgraduate Institute for        $350,000.00   Educational Grants
     Medicine
    Presbyterian Healthcare             $5,000.00   Corporate Sponsorships
     Foundation
    President and Fellows of           $12,000.00   Educational Grants
     Harvard College
    President and Fellows of           $20,000.00   Corporate Sponsorships
     Harvard College
    President and Fellows of           $30,000.00   Educational Grants
     Harvard College
    President and Fellows of           $11,500.00   Educational Grants
     Harvard College
    President and Fellows of            $3,000.00   Educational Grants
     Harvard College
    President and Fellows of         ($18,400.00)   Educational Grants
     Harvard College
    Prevent Cancer Foundation          $25,000.00   Corporate Sponsorships
    Prevent Cancer Foundation         $100,000.00   Corporate Sponsorships
    Prime Education Inc.              $120,000.00   Educational Grants
    Prime Education Inc.              $225,000.00   Educational Grants
    Prime Education Inc.              $150,000.00   Educational Grants
    Prime Education Inc.              $199,725.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Education Inc.              $295,217.00   Educational Grants
    Prime Education Inc.               $93,930.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Education Inc.              $274,830.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Education Inc.              $200,000.00   Educational Grants
    Prime Oncology Inc.               $150,000.00   Educational Grants
    Prime Oncology Inc.                $85,000.00   Educational Grants
    Prime Oncology Inc.                $81,260.00   Educational Grants
    Prime Oncology Inc.                $86,320.00   Educational Grants
    Prime Oncology Inc.               $222,410.00   Educational Grants
    Prime Oncology Inc.                $75,000.00   Educational Grants
    Prime Oncology Inc.                $75,000.00   Educational Grants
    Prime Oncology LLC               ($21,072.00)   Educational Grants
    Primo Education LLC                $15,000.00   Corporate Sponsorships
    Project Inform                     $50,000.00   Charitable Donations
    Project Inform                     $10,000.00   Corporate Sponsorships
    Projects in Knowledge Inc.        $125,000.00   Educational Grants
    Projects in Knowledge Inc.         $78,000.00   Educational Grants
    Promis Health Organization         $10,000.00   Educational Grants
    Prostate Cancer Foundation          $1,400.00   Corporate Sponsorships
     Chicago
    Prostate Cancer                     $5,000.00   Charitable Donations
     International
    Prostate Cancer Research           $15,000.00   Corporate Sponsorships
     Instutute
    Prostaware                          $1,500.00   Corporate Sponsorships
    Prostaware                          $1,500.00   Corporate Sponsorships
    Providence Health and              $20,000.00   Patient Support
     Services Southern
     California
    Psoriasis and Psoriatic           $100,000.00   Corporate Sponsorships
     Arthritis Clinics
     Multicenter Advancement
     Network
    Puerto Rico Associate of          ($1,088.60)   Educational Grants
     Gastroenterology
    Puerto Rico Associate of            $5,000.00   Corporate Sponsorships
     Gastroenterology
    Puerto Rico Associate of           $30,000.00   Corporate Sponsorships
     Gastroenterology
    Puerto Rico Associate of           $20,000.00   Educational Grants
     Gastroenterology
    Puerto Rico Nephrology              $3,500.00   Corporate Sponsorships
     Society Inc.
    Puerto Rico Obstetrician            $1,400.00   Corporate Sponsorships
     and Gyn Inc.
    Puerto Rico Obstetrician           $17,000.00   Corporate Sponsorships
     and Gyn Inc.
    Puerto Rico Obstetrician            $5,000.00   Corporate Sponsorships
     and Gyn Inc.
    Purdue Univ College of             $50,000.00   Educational Grants
     Pharmacy
    Purdue Univ College of            $200,000.00   Educational Grants
     Pharmacy
    Purdue Univ College of           ($18,852.35)   Educational Grants
     Pharmacy
    Purdue Univ College of            $150,000.00   Educational Grants
     Pharmacy
    Randolph College                    $1,000.00   Charitable Donations
    Regents of The Univ of              $5,000.00   Educational Grants
     California
    Regents of The Univ of             $40,000.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of             $40,000.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of             $17,612.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of              $2,500.00   Patient Support
     California
    Regents of The Univ of             $55,000.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of             $40,000.00   Fellowships and
     California                                      Scholarships
    Regents of The Univ of             $10,000.00   Educational Grants
     California
    Regents of The Univ of             $25,000.00   Corporate Sponsorships
     California
    Regents of The Univ of             $10,000.00   Educational Grants
     California
    Regents of The Univ of             $20,000.00   Corporate Sponsorships
     Michigan
    Regents of The Univ of              $1,000.00   Educational Grants
     Michigan
    Regents of The Univ of              $1,000.00   Corporate Sponsorships
     Michigan
    Respiratory Health                  $4,050.00   Corporate Sponsorships
     Association of
     Metropolitan Chicago
    Respiratory Health                  $4,050.00   Corporate Sponsorships
     Association of
     Metropolitan Chicago
    Respiratory Health                  $4,050.00   Corporate Sponsorships
     Association of
     Metropolitan Chicago
    Revolutionizing Atopic             $35,000.00   Corporate Sponsorships
     Dermatitis
    Rheumatology Association of        $10,000.00   Corporate Sponsorships
     Minnesota and The Dakotas
    Rheumatology Nurses Society        $87,500.00   Educational Grants
    Rheumlgy Alliance of               $25,000.00   Corporate Sponsorships
     Louisiana
    Rheumnow                          $105,000.00   Corporate Sponsorships
    Rheumnow                           $60,000.00   Corporate Sponsorships
    Richmond County Medical             $2,500.00   Corporate Sponsorships
     Society
    Riverside Medical Clinic           $10,000.00   Patient Support
     Charitable Foundation
    Rocky Mountain MS Center            $5,000.00   Patient Support
    Ronald Mcdonald House          $60,000,000.00   Charitable Donations
     Charities, Inc.
    Ronald Mcdonald House          $20,000,000.00   Charitable Donations
     Charities, Inc.
    Ronald Mcdonald House          $20,000,000.00   Charitable Donations
     Charities, Inc.
    Roswell Park Alliance               $5,000.00   Educational Grants
     Foundation
    Rotary Club of Downtown             $1,000.00   Corporate Sponsorships
     Macon
    Runx1 Foundation                    $2,500.00   Educational Grants
    Rush University Medical            $65,000.00   Educational Grants
     Center
    Rush University Medical            $75,000.00   Educational Grants
     Center
    Rush University Medical             $5,000.00   Charitable Donations
     Center
    Rush University Medical               $300.00   Charitable Donations
     Center
    Rush University Medical            $95,000.00   Educational Grants
     Center
    Rush University Medical            $85,000.00   Educational Grants
     Center
    Rush University Medical           $113,550.00   Educational Grants
     Center
    Rush University Medical            $75,000.00   Educational Grants
     Center
    Safety Pharmacology Society         $5,000.00   Educational Grants
    Samaritan Daytop Village            $2,500.00   Corporate Sponsorships
    San Francisco Aids                 $10,000.00   Charitable Donations
     Foundation
    San Francisco Public Center       $100,000.00   Charitable Donations
     Foundation
    San Francisco Retina                $5,000.00   Educational Grants
     Foundation
    San Juan Bautista Medical          $40,000.00   Fellowships and
     Center                                          Scholarships
    Scripps Health                     $10,000.00   Corporate Sponsorships
    Scripps Health                     $66,500.00   Corporate Sponsorships
    Scripps Health                     $20,000.00   Educational Grants
    Seattle Science Foundation          $8,500.00   Educational Grants
    Shanti                             $10,000.00   Charitable Donations
    Share                               $7,500.00   Charitable Donations
    Sociedad Dermatologica de          $20,000.00   Corporate Sponsorships
     Puerto Rico
    Sociedad Dermatologica de          $15,000.00   Corporate Sponsorships
     Puerto Rico
    Sociedad PR Endocrinologia         $15,000.00   Corporate Sponsorships
     y Diabetologia
    Sociedad Puertorriquena             $5,000.00   Corporate Sponsorships
     Pediatria
    Society for Clinical Trials         $2,000.00   Corporate Sponsorships
    Society for Leukocyte               $2,000.00   Educational Grants
     Biology
    Society for Neuro-Oncology         $50,000.00   Corporate Sponsorships
    Society for Neuro-Oncology         $20,000.00   Educational Grants
    Society for Neuro-Oncology         $39,140.00   Educational Grants
    Society for Neuro-Oncology         $58,000.00   Educational Grants
    Society for Neuro-Oncology         $50,000.00   Corporate Sponsorships
    Society for Physician              $10,000.00   Charitable Donations
     Assistants in Pediatrics
    Society for Womens Health          $25,000.00   Corporate Sponsorships
     Research
    Society of Dermatology             $50,000.00   Corporate Sponsorships
     Physician Assistants
    Society of Dermatology             $40,000.00   Corporate Sponsorships
     Physician Assistants
    Society of Gynecologic             $27,500.00   Corporate Sponsorships
     Surgeons
    Society of Investigative           $30,000.00   Educational Grants
     Dermatology
    Socty for Gynecologic              $10,000.00   Corporate Sponsorships
     Investigation
    Socty for Immunotherapy of         $50,000.00   Corporate Sponsorships
     Cancer
    Socty for Immunotherapy of          $5,000.00   Educational Grants
     Cancer
    Socty for Immunotherapy of         $25,000.00   Corporate Sponsorships
     Cancer
    South Carolina Alliance of          $6,000.00   Corporate Sponsorships
     Health Plans
    South Dakota Parkinson              $2,500.00   Corporate Sponsorships
     Foundation
    South Dakota Parkinson              $1,000.00   Corporate Sponsorships
     Foundation
    South Sound Care Foundation         $3,250.00   Corporate Sponsorships
    Southern California Society       $100,000.00   Corporate Sponsorships
     of Gastroenterology
    Spondylitis Association of         $20,000.00   Patient Support
     America
    Spondylitis Association of         $40,000.00   Patient Support
     America
    Spondylitis Association of         $17,750.00   Educational Grants
     America
    Spondyloarthritis Research         $70,000.00   Corporate Sponsorships
     and Treatment Network
     Spartan
    St. Barnabas Hospital               $1,300.00   Fellowships and
                                                     Scholarships
    St. Jude Childrens Research    $30,000,000.00   Charitable Donations
     Hospital
    St. Jude Childrens Research    $20,000,000.00   Charitable Donations
     Hospital
    St. Lukes Hospital                  $2,500.00   Corporate Sponsorships
    State of West Virginia              $2,500.00   Corporate Sponsorships
     Rheumatology Society
    Super Jake Foundation The          $25,000.00   Charitable Donations
    Susan G Komen Colorado              $5,000.00   Corporate Sponsorships
    Susan G Komen Colorado              $5,000.00   Corporate Sponsorships
    Talem Health Inc.                  $95,000.00   Educational Grants
    Talem Health Inc.                 $235,820.00   Educational Grants
    Tarsus Cardiology Inc. Dba         $35,000.00   Corporate Sponsorships
     South Beach Symposium
    Texas Academy of Family             $2,500.00   Corporate Sponsorships
     Physicians
    Texas Academy of Family             $2,500.00   Corporate Sponsorships
     Physicians Foundation
    Texas Healthcare and                $5,000.00   Corporate Sponsorships
     Bioscience
    Texas Indo-American                 $5,000.00   Corporate Sponsorships
     Physicians Society
    Texas Medical Association           $5,000.00   Corporate Sponsorships
    Texas Osteopathic Medical           $3,000.00   Corporate Sponsorships
     Association Foundation
    Thomas Jefferson University         $5,000.00   Educational Grants
    Thomas Jefferson University         $3,000.00   Corporate Sponsorships
    Thomas Jefferson University         $3,000.00   Corporate Sponsorships
    Thomas Jefferson University         $3,000.00   Corporate Sponsorships
    Thomas Jefferson University         $5,000.00   Corporate Sponsorships
    Translational Research in           $5,000.00   Educational Grants
     Oncology US Inc.
    Trinity International               $1,000.00   Charitable Donations
     College
    Tufts Medical Center              ($1,190.13)   Educational Grants
    Tufts Medical Center                ($513.14)   Educational Grants
    UC Regents Maxillofacial           $10,000.00   Educational Grants
     Prosthetics Clinic
    UC Regents Maxillofacial           $40,000.00   Fellowships and
     Prosthetics Clinic                              Scholarships
    UC Regents Maxillofacial           $15,000.00   Educational Grants
     Prosthetics Clinic
    Ultimate Medical Academy          ($4,043.06)   Educational Grants
     LLC
    Ultimate Medical Academy          $174,700.00   Educational Grants
     LLC
    Ultimate Medical Academy           $50,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          ($2,344.80)   Educational Grants
     LLC
    Ultimate Medical Academy          $150,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $100,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $125,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          ($5,138.86)   Educational Grants
     LLC
    Ultimate Medical Academy          ($3,284.05)   Educational Grants
     LLC
    Ultimate Medical Academy          ($2,134.44)   Educational Grants
     LLC
    Ultimate Medical Academy          ($9,000.00)   Educational Grants
     LLC
    Ultimate Medical Academy            ($885.32)   Educational Grants
     LLC
    Ultimate Medical Academy          $245,000.00   Educational Grants
     LLC
    Ultimate Medical Academy           $95,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $500,000.00   Educational Grants
     LLC
    Ultimate Medical Academy          $349,450.00   Educational Grants
     LLC
    UMA Education Inc. Dba             $50,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba            $375,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba            $225,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba             $43,358.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba            $163,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba            $166,000.00   Educational Grants
     Global Education Group
    UMA Education Inc. Dba             $10,000.00   Educational Grants
     Global Education Group
    UMASS Memorial Foundation           $2,500.00   Corporate Sponsorships
     Inc.
    United Medical Center               $2,280.00   Educational Grants
    United Rheumatology               $225,000.00   Corporate Sponsorships
    United Spinal Association          $12,500.00   Corporate Sponsorships
     Inc.
    United Spinal Association          $12,500.00   Corporate Sponsorships
     Inc.
    United States Adult Cystic          $5,000.00   Patient Support
     Fibrosis Association Inc.
    United States and Canadian         $30,000.00   Corporate Sponsorships
     Academy of Pathology
    United States Renal Care           $20,000.00   Corporate Sponsorships
     Inc.
    Unity Health Care, Inc.             $7,500.00   Corporate Sponsorships
    Univ Connecticut                  ($2,054.94)   Educational Grants
     Dermatology
    Univ Connecticut                   $40,000.00   Fellowships and
     Dermatology                                     Scholarships
    Univ Health Service at             $20,000.00   Educational Grants
     Stony Point Inc.
    Univ Health Service at            $120,000.00   Corporate Sponsorships
     Stony Point Inc.
    Univ Health Service at            $120,000.00   Corporate Sponsorships
     Stony Point Inc.
    Univ of Chicago                     $8,000.00   Educational Grants
    Univ of Chicago                    $50,000.00   Patient Support
    Univ of Chicago                    $10,000.00   Educational Grants
    Univ of Chicago                    $15,000.00   Educational Grants
    Univ of Chicago                    $25,000.00   Educational Grants
    Univ of Chicago                   ($2,097.00)   Educational Grants
    Univ of Chicago                   $125,000.00   Educational Grants
    Univ of Chicago                     $5,000.00   Corporate Sponsorships
    Univ of Chicago                    $10,000.00   Corporate Sponsorships
    Univ of Chicago                     $5,000.00   Educational Grants
    Univ of Chicago                     $5,000.00   Corporate Sponsorships
    Univ of Chicago                    $20,000.00   Corporate Sponsorships
    Univ of Chicago                    $18,000.00   Educational Grants
    Univ of Chicago                   ($7,232.53)   Educational Grants
    Univ of Chicago                     $1,000.00   Charitable Donations
    Univ of Chicago                    $10,000.00   Educational Grants
    Univ of Chicago                    $45,000.00   Educational Grants
    Univ of Chicago                    $10,000.00   Educational Grants
    Univ of Cincinnati               ($68,461.18)   Educational Grants
    Univ of Cincinnati                 $25,000.00   Corporate Sponsorships
    Univ of Cincinnati                 $60,000.00   Educational Grants
    Univ of Cincinnati                 $60,000.00   Educational Grants
    Univ of Cincinnati                 $75,000.00   Educational Grants
    Univ of Colorado Denver            $20,000.00   Fellowships and
     School of Medicine                              Scholarships
    Univ of Connecticut Health         $12,000.00   Fellowships and
     Center, John Dempsey                            Scholarships
     Hospital
    Univ of Florida Foundation         $60,000.00   Fellowships and
                                                     Scholarships
    Univ of Illinois Foundation         $1,000.00   Charitable Donations
    Univ of Louisville                 $15,000.00   Corporate Sponsorships
    Univ of Louisville Research        $60,000.00   Educational Grants
     Foundation
    Univ of Louisville Research        $50,000.00   Educational Grants
     Foundation
    Univ of Louisville Research        $60,000.00   Educational Grants
     Foundation
    Univ of Maryland Baltimore         $10,000.00   Patient Support
     Foundation Inc.
    Univ of Maryland Baltimore          $5,000.00   Educational Grants
     Foundation Inc.
    Univ of Massachusetts Med           $2,500.00   Corporate Sponsorships
     School
    Univ of Miami                      $20,000.00   Corporate Sponsorships
    Univ of Miami                      $40,000.00   Fellowships and
                                                     Scholarships
    Univ of Miami                      $10,000.00   Corporate Sponsorships
    Univ of Minnesota Regents           $2,000.00   Educational Grants
    Univ of Nebraska Med Center       $100,000.00   Corporate Sponsorships
    Univ of Nebraska Med Center        $50,000.00   Educational Grants
    Univ of Nebraska Med Center        $35,000.00   Educational Grants
    Univ of Nebraska Med Center       $150,000.00   Educational Grants
    Univ of Nebraska Med Center       $125,000.00   Educational Grants
    Univ of Nebraska Med Center       $128,860.00   Educational Grants
    Univ of Nebraska Med Center           $600.00   Corporate Sponsorships
    Univ of Nebraska Med Center        $10,000.00   Corporate Sponsorships
    Univ of Nebraska Med Center        $25,000.00   Corporate Sponsorships
    Univ of Nebraska Med Center        $30,000.00   Educational Grants
    Univ of Nebraska Med Center         $7,500.00   Educational Grants
    Univ of New Mexico Health          $10,000.00   Educational Grants
     Science Center Dept of
     Pediatrics Neonatology
     Division
    Univ of Pittsburgh                 $15,000.00   Educational Grants
    Univ of Pittsburgh                  $2,200.00   Educational Grants
    Univ of Pittsburgh                 $20,000.00   Educational Grants
    Univ of South Florida Board        $37,500.00   Fellowships and
     of Trustees                                     Scholarships
    Univ of South Florida              $25,000.00   Educational Grants
     Health Professions
     Conferencing Corp
    Univ of Southern California         $1,500.00   Educational Grants
    Univ of Southern California        $25,000.00   Educational Grants
    Univ of Southern California         $7,097.77   Fellowships and
                                                     Scholarships
    Univ of Southern California        $81,500.00   Fellowships and
                                                     Scholarships
    Univ of Texas at Austin             $5,000.00   Educational Grants
    Univ of Texas Health               $16,032.00   Corporate Sponsorships
     Science Center at San
     Antonio
    Univ of Texas Health               $75,000.00   Educational Grants
     Science Center at San
     Antonio
    Univ of Toledo                      $2,000.00   Patient Support
    Univ of Utah                       $40,000.00   Fellowships and
                                                     Scholarships
    Univ of Wisconsin--Madison          $1,500.00   Educational Grants
    Univeristy of Chicago              $15,000.00   Charitable Donations
     Cancer Research Foundation
    Universidad Central Del           ($2,283.00)   Educational Grants
     Caribe School of Medicine
    Universidad DE Puerto Rico         $30,000.00   Fellowships and
                                                     Scholarships
    Universidad DE Puerto Rico         $59,783.50   Corporate Sponsorships
    Universidad DE Puerto Rico         $30,000.00   Fellowships and
                                                     Scholarships
    University Health Services         $75,000.00   Educational Grants
    University Health Services          $5,000.00   Educational Grants
    University Health Services         $25,000.00   Educational Grants
    University of Alabama at           $40,000.00   Fellowships and
     Birmingham Hospital                             Scholarships
    University of California           $40,000.00   Fellowships and
     Irvine                                          Scholarships
    University of California            $6,000.00   Corporate Sponsorships
     San Francisco Foundation
    University of Illinois--           $15,821.60   Fellowships and
     Office of Business and                          Scholarships
     Financial Services
    University of Illinois--           $75,138.40   Fellowships and
     Office of Business and                          Scholarships
     Financial Services
    University of North                $40,000.00   Fellowships and
     Carolina at Chapel Hill                         Scholarships
    University of North                 $1,000.00   Charitable Donations
     Carolina at Chapel Hill
    University of Rochester             $5,000.00   Educational Grants
    University of South Florida       ($9,615.55)   Educational Grants
     Foundation
    University of Texas                $55,000.00   Fellowships and
     Southwestern Medical                            Scholarships
     Center
    University of Texas                $75,000.00   Fellowships and
     Southwestern Medical                            Scholarships
     Center
    University of Washington           $40,000.00   Fellowships and
     Medical Center                                  Scholarships
    University of Wisconsin LA          $1,000.00   Charitable Donations
     Crosse Foundation Inc.
    Urogpo, LLC                        $35,000.00   Corporate Sponsorships
    Urological Association of          $10,000.00   Corporate Sponsorships
     Physician Assistants
    Urology Center of Colorado         $10,000.00   Corporate Sponsorships
     Foundation
    US Too International                $1,500.00   Corporate Sponsorships
    US Too International               $25,750.00   Corporate Sponsorships
    Vanderbilt Univ By and            $190,000.00   Educational Grants
     Through Its Medical Center
    Vanderbilt Univ By and             $10,000.00   Educational Grants
     Through Its Medical Center
    Vanderbilt Univ By and              $5,000.00   Educational Grants
     Through Its Medical Center
    Vanderbilt Urology Society          $3,000.00   Corporate Sponsorships
    Veritas Meeting Solutions           $4,500.00   Corporate Sponsorships
    VHA Inc.                           $35,000.00   Corporate Sponsorships
    Vida Global Foundation              $1,500.00   Corporate Sponsorships
    Vietnamese American                 $3,000.00   Corporate Sponsorships
     Healthcare Professionals
     Association of Georgia
    Vindico Med Education              $50,000.00   Educational Grants
    Vindico Med Education             $200,000.00   Educational Grants
    Vindico Med Education              $50,000.00   Educational Grants
    Vindico Med Education              $75,000.00   Educational Grants
    Vindico Med Education              $50,000.00   Educational Grants
    Vindico Med Education              $49,000.00   Educational Grants
    Vindico Med Education              $50,000.00   Educational Grants
    Vindico Med Education              $50,000.00   Educational Grants
    Virginia Academy of                 $1,750.00   Corporate Sponsorships
     Physician Assistants
    Virginia Commonwealth               $7,500.00   Corporate Sponsorships
     University School of
     Medicine
    Virginia Council of Nurse           $1,493.94   Corporate Sponsorships
     Practitioners
    Wake Forest Univ                   $40,000.00   Fellowships and
                                                     Scholarships
    Wall Las Memorias                  $10,000.00   Corporate Sponsorships
    Wartburg College                    $1,000.00   Charitable Donations
    Washington International            $2,500.00   Corporate Sponsorships
     Trade Foundation
    Washington International            $2,500.00   Corporate Sponsorships
     Trade Foundation
    Washington International            $2,500.00   Corporate Sponsorships
     Trade Foundation
    Washington International            $2,500.00   Corporate Sponsorships
     Trade Foundation
    Washington Univ in St Louis         ($263.21)   Fellowships and
                                                     Scholarships
    Washington Univ in St Louis         $6,000.00   Educational Grants
    Washington Univ in St Louis         $1,500.00   Corporate Sponsorships
    Washington Univ in St Louis         $1,600.00   Fellowships and
                                                     Scholarships
    Washington Univ in St Louis      ($17,777.79)   Educational Grants
    We Care in Inflammatory            $25,000.00   Charitable Donations
     Bowel Disease
    WebMD Global LLC                   $90,000.00   Educational Grants
    WebMD Global LLC                  $209,983.00   Educational Grants
    WebMD Global LLC                  $209,983.00   Educational Grants
    WebMD Global LLC                  $209,983.00   Educational Grants
    WebMD Global LLC                   $50,000.00   Educational Grants
    WebMD Global LLC                   $63,500.00   Educational Grants
    WebMD Global LLC                   $81,500.00   Educational Grants
    WebMD Global LLC                   $95,000.00   Educational Grants
    WebMD Global LLC                  $348,000.00   Educational Grants
    WebMD Global LLC                  $151,000.00   Educational Grants
    WebMD Global LLC                  $172,000.00   Educational Grants
    WebMD Global LLC                  $200,000.00   Educational Grants
    WebMD Global LLC                   $75,000.00   Educational Grants
    WebMD Global LLC                  ($1,500.00)   Educational Grants
    WebMD Global LLC                  ($1,142.14)   Educational Grants
    WebMD Global LLC                  $100,000.00   Educational Grants
    WebMD Global LLC                   $65,000.00   Educational Grants
    WebMD Global LLC                  $182,500.00   Educational Grants
    WebMD Global LLC                  $150,000.00   Educational Grants
    WebMD Global LLC                   $75,000.00   Educational Grants
    WebMD Global LLC                  $350,000.00   Educational Grants
    WebMD Global LLC                  $100,000.00   Educational Grants
    WebMD Global LLC                  $113,500.00   Educational Grants
    WebMD Global LLC                  $200,000.00   Educational Grants
    WebMD Global LLC                  $227,000.00   Educational Grants
    WebMD Global LLC                  $150,000.00   Educational Grants
    WebMD Global LLC                  $350,000.00   Educational Grants
    WebMD Global LLC                  $120,000.00   Educational Grants
    WebMD Global LLC                  $136,150.00   Educational Grants
    WebMD Global LLC                  $215,000.00   Educational Grants
    WebMD Global LLC                  $319,770.00   Educational Grants
    West Virginia Community             $5,000.00   Corporate Sponsorships
     Voices
    Wisconsin Collaborative for         $3,750.00   Corporate Sponsorships
     Healthcare Quality
    Wisconsin Rheumatology             $10,000.00   Corporate Sponsorships
     Association
    Wisconsin Rheumatology             $10,000.00   Corporate Sponsorships
     Association
    Wisconsin Section American          $2,000.00   Corporate Sponsorships
     Congress Obstetrics and
     Gynecologist Acog
    Women in Government                 $2,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $2,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $7,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $7,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                $10,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                $10,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $2,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $2,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $2,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $5,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $7,000.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                 $2,500.00   Corporate Sponsorships
     Foundation Ltd
    Women in Government                $10,000.00   Corporate Sponsorships
     Foundation Ltd
    World Parkinson Coalition          $50,000.00   Fellowships and
     Inc.                                            Scholarships
    Worldwide Endomarch                 $5,000.00   Corporate Sponsorships
    Worldwide Endomarch                 $3,000.00   Corporate Sponsorships
    Yale Univ                           $5,000.00   Educational Grants
    Zebrafish Disease Models            $5,000.00   Educational Grants
     Society
    Zero The Project To End            $15,000.00   Corporate Sponsorships
     Prostate Cancer
    Zero The Project To End           $270,000.00   Corporate Sponsorships
     Prostate Cancer
    Zero The Project To End            $10,000.00   Corporate Sponsorships
     Prostate Cancer
    Zero The Project To End            $12,000.00   Corporate Sponsorships
     Prostate Cancer
    Zero The Project To End           $270,000.00   Corporate Sponsorships
     Prostate Cancer
    ------------------------------------------------------------------------

                                                                            Exhibit 2
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                          Organization Legal Name                              2014             2015             2016             2017             2018
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ALBERT B. SABIN VACCINE INSTITUTE, INC.                                   203,302.00                        835,251.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ALS THERAPY DEVELOPMENT FOUNDATION INC.                                                      5,159.91
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ALZHEIMER'S DISEASE AND RELATED DISORDERS ASSOCIATION, INC.                                                  10,000.00        10,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    AMERICAN CANCER SOCIETY, INC.                                                                                 1,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    AMERICAN RED CROSS                                                         50,000.00        20,000.00        80,000.00     1,425,000.00       775,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    AMERICARES FOUNDATION, INC.                                               100,000.00        50,000.00        25,000.00       250,000.00       400,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    APNA GHAR, INC. (OUR HOME)                                                                                                                     50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ASIAN UNIVERSITY FOR WOMEN SUPPORT FOUNDATION                              50,000.00        50,000.00        50,000.00        50,000.00        50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ASTRAEA FOUNDATION, INC.                                                                                                                       75,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BAYLOR COLLEGE OF MEDICINE INTERNATIONAL PEDIATRIC AIDS INITIATIVE      2,220,337.00     2,477,111.00     1,660,000.00     1,610,000.00     1,610,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BEACON PLACE NFP                                                                           100,000.00       100,000.00       125,000.00       150,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BERNARD P. FLORIANI FOUNDATION                                                              50,000.00        75,000.00       110,000.00       420,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BIG BROTHERS BIG SISTERS OF METROPOLITAN CHICAGO                                                                                               40,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BOYS AND GIRLS CLUB OF LAKE COUNTY                                                          10,000.00        10,000.00        10,000.00        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CARING AMBASSADORS PROGRAM, INC.                                          253,282.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CASA LAKE COUNTY                                                                            25,000.00        25,000.00        25,000.00        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CATALYSIS LLC                                                                                                                                          -
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CENTER FOR NEIGHBORHOOD ENTERPRISE                                                                           50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CENTRAIDE OF GREATER MONTREAL (Matching Grants--Canada)                                                      11,000.00        11,000.00        19,600.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CHICAGO CARES INC.                                                                         314,504.00        18,000.00        15,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CHICAGO HORTICULTURAL SOCIETY                                                                                                                  50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CHICAGO HOUSE AND SOCIAL SERVICE AGENCY                                                                                                        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CHICAGO TOOLBANK                                                                                                               5,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CHINESE AMERICAN SERVICE LEAGUE                                                                                                                50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CHOCOLATE CHIPS ASSOCIATION                                                                                                                    10,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CITY OF NORTH CHICAGO                                                                                         5,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    COMMUNITY ACTION PARTNERSHIP OF LAKE COUNTY                                                                 150,400.00       141,875.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CRADLES TO CRAYONS, INC.                                                                                                                      515,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CRISTO REY ST. MARTIN COLLEGE PREP                                                                                                             50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    DAVIS PHINNEY FOUNDATION                                                                                        120.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    IDIRECT RELIEF                                                          1,865,000.00     1,941,111.00     1,325,000.00     2,115,000.00       850,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    DRESS FOR SUCCESS WORLDWIDECENTRAL                                                                                                             90,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ERIE FAMILY HEALTH CENTER, INC.                                           100,000.00        55,000.00        50,000.00        50,000.00        50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FAMILY REACH FOUNDATION                                                    100,00.00       300,000.00       320,000.00       300,000.00       300,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FEEDING AMERICA                                                                                                              225,000.00        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FIELD MUSEUM OF NATURAL HISTORY                                                                                                                30,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FISHER HOUSE FOUNDATION, INC.                                                                                                                 750,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FONDOS UNIDOS DE PUERTO RICO, INC.                                                                                                            136,400.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FOOD BANK OF EASTERN MICHIGAN                                                                                10,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    GILDA'S CLUB CHICAGO                                                                                                          25,000.00        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    GLOBAL HEALTH CORPS                                                        50,000.00       100,000.00       100,000.00       100,000.00       100,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    GLOBEMED NFP                                                               50,000.00        75,000.00        75,000.00        75,000.00        75,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    HABITAT FOR HUMANITY INTERNATIONAL                                                                                                            530,200.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    HABITAT FOR HUMANITY, LAKE COUNTY IL, INC.                                                                                                    125,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    HANDS ON ORLANDO, INC                                                                                                                         150,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    HEALTHREACH, INC.
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    HEART TO HEART INTERNATIONAL, INC.                                                                           35,000.00       535,000.00       310,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    HISPANIC SCHOLARSHIP FUND                                                                                                                      50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ILLINOIS SCIENCE AND TECHNOLOGY INSTITUTE                                                                    70,000.00        40,000.00        80,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    IMPACTING VETERANS LIVES, INC.--MIDWEST VETERANS CLOSET                                                                                        50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    IMSA FUND FOR ADVANCEMENT OF EDUCATION                                    133,000.00       133,000.00        40,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    INDIANA UNIVERSITY                                                      1,150,000.00     1,100,000.00     1,100,000.00     1,100,000.00     1,100,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    INTERNATIONAL MEDICAL CORPS                                               100,000.00       350,000.00        25,000.00       450,000.00       550,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    JK GROUP, INC. (Matching Grants)
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    JUNIOR ACHIEVEMENT OF CHICAGO                                                                                33,500.00        50,000.00        50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    KABOOM!                                                                                                                      342,582.00       397,081.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    KIDS RANK                                                                                                                                      25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    KOHL CHILDREN'S MUSEUM                                                                                      495,500.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    KOHL CHILDREN'S MUSEUM OF GREATER CHICAGO                                  44,615.00                                         154,000.00       154,300.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    LAKE COUNTY CARES                                                                           22,145.00        22,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    LAKE COUNTY CRISIS CENTER FOR THE PREVENTION AND TREATMENT OF                               10,000.00        10,000.00        10,000.00        25,000.00
     DOMESTIC VIOLENCE, INC.
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    LAKE COUNTY VETERANS AND FAMILY SERVICES FOUNDATION                                                                                            50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    MAP INTERNATIONAL                                                         313,800.00       412,907.00       460,000.00       510,000.00       325,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    MASSACHUSETTS BIOTECHNOLOGY EDUCATION FOUNDATION                           40,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    MEMORIAL SLOAN KETTERING CANCER CENTER                                    100,000.00       100,000.00       100,000.00       100,000.00       100,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    MIDWEST ATHLETES AGAINST CHILDHOOD CANCER, INC                                                                  865.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    MOTHERS TRUST FOUNDATION                                                                                                                       25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NATIONAL AUDUBON SOCIETY, INC.                                            12 ,500.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NATIONAL INVENTORS HALL OF FAME, INC.                                     225,000.00       225,000.00       153,900.00       176,000.00       259,725.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NATIONAL MULTIPLE SCLEROSIS SOCIETY                                                                             350.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NICASA, NFP
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NORTH CHICAGO COMMUNITY PARTNERS                                          246,833.00       237,889,00       642,500.00       730,000.00       750,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NORTH CHICAGO COMMUNITY UNIT SCHOOL DISTRICT 187                                           100,600.00       165,000.00                        828,430.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NORTHERN ILLINOIS FOOD BANK                                                14,400.00        15,000.00        25,000.00        30,000.00        55,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    PADS LAKE COUNTY, INC.                                                     10,000.00        10,000.00        10,000.00        10,000.00        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    PARTNERS IN HEALTH                                                        100,000.00                        300,000.00       383,335.00       688,925.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    POINTS OF LIGHT FOUNDATION                                                                                  545,800.00       708,000.00       954,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    PRAIRIE STATE LEGAL SERVICES, INC.                                                          25,000.00        25,000.00        25,000.00        25,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    PROJECT HOPE--THE PEOPLE-TO-PEOPLE HEALTH FOUNDATION, INC.                                                                   250,000.00       100,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    READING POWER, INC.                                                        10,000.00        40,000.00        58,000.00       260,000.00       300,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ROSALIND FRANKLIN UNIVERSITY OF MEDICINE AND SCIENCE                       10,000.00        65,120.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    SHEDD AQUARIUM                                                                                                                50,000.00        50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    SIEMPRE UNIDOS                                                             60,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    SILICON VALLEY COMMUNITY FOUNDATION (Matching Grants)                   2,763,823.52     3,059,133.44       504,232.72
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    STRENGTHEN ORLANDO, INC.                                                                                      6,515.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    TAPROOT FOUNDATION                                                                                                                            200,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    TEAM RUBICON                                                                                                                                  375,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    TEXAS CHILDREN'S HOSPITAL                                                                                                     50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    THE ALS ASSOCIATION GREATER CHICAGO CHAPTER                                                                                                     5,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    THE FULLER CENTER FOR HOUSING HERO PROJECT LAKE COUNTY                                                                                         60,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    THE HEART OF AMERICA FOUNDATION                                           726,910.00     1,019,652.00     1,327,500.00     2,050,000.00     1,993,300.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    THE SCRIPPS RESEARCH INSTITUTE                                                                                                                290,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    TPA NETWORK INCORPORATED                                                                                      2,285.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    TRAVIS MANION FOUNDATION                                                                                                                      100,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    UNITED WAY OF CENTRAL MASSACHUSETTS                                                                          44,000.00        45,000.00        61,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    UNITED WAY OF LAKE COUNTY                                                  80,000.00        80,000.00        70,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    UNIVERSTIY OF CHICAGO                                                   1,000,000.00     1,000,000.00     1,000,000.00     1,000,000.00     1,000.000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    UNIVERSITY OF NOTRE DAME                                                                                                                       50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    WARRIORS AND QUIET WATERS FOUNDATION, INC.                                                                                                     50,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    WILLIAM MARSH RICE UNIVERSITY                                              94,300.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    WOUNDED WARRIOR PROJECT                                                                                                                       750,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    WPS60                                                                                                       110,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    YBLC, INC.                                                                 15,000.00        15,000.00        15,000.00
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    YOUR CAUSE HOLDINGS, LLC (Matching Grants)                                                                2,805,067.87     4,120,115.28     7,012,295.67
    --------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                           12,292,102.52    13,593,332.35    15,187,786.59    19,856.907.28    26,850,256.67
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    Note: Matching Grants are listed by Organizations that manage the program and not by the ultimate re

                  Prepared Statement of Hon. Chuck Grassley,
                            a U.S. Senator From Iowa
        I want to welcome the witnesses and thank them for being here.

        The information they share will help inform the committee as it
    addresses the issue of high prescription drug prices.

        America has a problem with the high cost of prescription medicines.

        Whether it's about the EpiPen, insulin, or other prescriptions, in
    the thousands of letters I've received, Iowans have made clear that
    high drug prices are hurting them.

        I've heard about people skipping doses of their prescription drugs
    to make them last until the next paycheck.

        I'm not a doctor, but rationing one's medicine doesn't sound like a
    safe prescription for health and wellness.

        Others have told me about leaving their prescription on the
    pharmacy counter because it cost too much.

        There is no question that researchers and doctors have developed
    treatments and cures for diseases where there were once none.

        And, such innovations take time and money.

        But, we're all trying to understand the sticker shock that many
    drugs generate. Especially when some of those drugs have been around
    for a long time.

        There is a balance between incentivizing innovation and keeping
    prices affordable for consumers and taxpayers.

        Like all systems, things can get out of balance.

        The good news is, we are here to discuss solutions.

        In fact, we are here today thanks to our system of checks and
    balances.

        Congress has a constitutional responsibility to be a meaningful
    check on the spending of taxpayer money.

        That responsibility includes not just holding hearings, but also
    holding the private sector and the government accountable through
    oversight.

        Just like a doctor has to properly diagnose a disease before it can
    be treated, Congress needs to understand what's going on in the drug
    pricing supply chain in order to respond in a measured and effective
    way.

        As a part of that fact-finding, as of last Friday, Ranking Member
    Wyden and I launched an inquiry into the high cost of insulin.

        This hearing is not about scapegoating any one group regarding high
    drug costs.

        That's why we're holding a series of bipartisan hearings on the
    issue.

        Without a doubt, drug pricing is a complex issue.

        But I think we should all be asking: Should it be so complex?

        We cannot allow anyone to hide behind the current complexities to
    shield the true cost of a drug.

        And, we shouldn't turn a blind eye to industry practices that
    thwart the laws and regulations designed to promote competition and
    generic drug entry in the market.

        Health and Human Services Secretary Alex Azar, FDA Commissioner
    Scott Gottlieb and the Federal Trade Commission have identified a
    number of tactics that undermine competition--like withholding samples,
    pay for delay, product-hopping, and rebate bundling, just to name a
    few.

        While these agencies are taking enforcement action or looking at
    regulatory changes, we here in Congress are exploring legislative
    options to deter companies from engaging in these practices that keep
    drug prices high for patients.

        Today, we expect open, honest answers from the pharmaceutical
    industry to figure out how we got here and see what ideas they have to
    make things better.

        One of the first things we need to talk about is list price.

        Secretary Azar has said that pharmaceutical companies believe that
    the list price is meaningless.

        In fact, some of your testimony today will echo that.

        However, for a patient taking a drug that has no competition, the
    list price is meaningful.

        For seniors on Part D who are paying co-insurance as a percentage
    of list price, the list price is meaningful.

        For people who have high deductible plans and pay thousands of
    dollars towards list price, the list price is meaningful.

        For pharmacy benefit managers, providing drugs with a high list
    price can be more attractive than providing a less expensive drug.

        Therefore, for taxpayers, the list price is meaningful.

        We've all seen the finger pointing. Every link in the supply chain
    has gotten skilled at that.

        But, like most Americans, I'm sick and tired of the blame game.

        It's time for solutions.

        One way or another, we're going to get some clarity.

        The American people deserve straight answers and real solutions.

        On that note, I want to remind each of you that it's a crime under
    title 18, U.S. Code, section 1001 to provide false testimony to
    Congress.

        Thank you for coming. I look forward to your testimony.

                                     ______

                     Prepared Statement of Pascal Soriot,
                      Chief Executive Officer, AstraZeneca
                                  i. overview
        AstraZeneca appreciates the opportunity to engage with the
    committee on the important topic of drug pricing in the United States.
    We would like to emphasize our commitment to addressing these
    challenges and the important issues raised by the committee regarding
    drug pricing and affordability.

        AstraZeneca is a global, science-led biopharmaceutical company that
    focuses on the discovery, development and commercialization of
    prescription medicines, primarily for the treatment of diseases in
    three main therapy areas: Oncology; Cardiovascular; Renal and
    Metabolism; and Respiratory. We are also selectively active in the
    areas of autoimmunity, neuroscience, and infection. We are proud to
    call Wilmington, DE home to our North American headquarters. We are
    equally proud that one of our three global Research and Development
    (``R&D'') headquarters is located in Gaithersburg, MD.

        We are honored to contribute to improving the lives of millions of
    patients in the U.S. and across the globe. This statement is focused on
    four points explaining AstraZeneca's purpose, core values, and vision
    for the future:

              First, we are a science-led organization, as reflected in
            our continued investment in R&D and our success in introducing
            new treatments. Continuing to develop treatments that deliver
            long-term benefits to patients and the overall health of the
            U.S. population requires society's commitment to supporting
            investment in innovation through purchasing our medicines for
            the duration of patent protection at a responsible price that
            allows for the recoupment of the investment and risk associated
            with innovation.

              Second, we believe medicines are part of the solution to
            controlling health-care costs. They not only improve patient
            outcomes and increase quality of life, but also reduce
            downstream costs by keeping people healthy and out of the
            hospital. This contribution to reducing overall health-care
            costs should be considered when discussing drug pricing.

              Third, we recognize that we are only able to improve the
            lives of patients if they are able to take our medicines as
            prescribed. To that end, we are committed to sustaining and
            improving patient access and affordability.

              Fourth, we recognize that the current state of drug pricing
            in the U.S. health-care system is not sustainable and that
            patients are facing increasingly high out-of-pocket costs. We
            believe that these issues must be addressed urgently, and we
            hope to be a constructive partner in finding solutions.
                   ii. benefits of innovation and r&d funding
        Science is at the core of what we do, and we are focused on being
    at the forefront of scientific innovation to deliver tomorrow's
    treatments and cures. Since 2017, the Food and Drug Administration
    (``FDA'') has approved 18 AstraZeneca products or significant
    indications, and five of our products have received breakthrough
    therapy designation. Breakthrough therapy designation is designed
    specifically for the expedited development and review of drugs for
    serious or life-threatening conditions, and these designations
    highlight how critical our work is to patient health in the U.S. For
    example, our oncology medicine CALQUENCE was granted breakthrough
    therapy designation for certain patients with mantle cell lymphoma and
    tezepelumab received such a designation for certain patients with
    severe asthma.

        In order to achieve these results, we reinvest a significant
    percentage of our revenues in research to identify the next generation
    of life-changing medicines. Over the past several years, we have worked
    tirelessly to rebuild our R&D pipeline. We now have approximately 8,900
    employees in our R&D organization working at sites across the world.
    Our financial commitment to R&D has been significant. In 2018 alone, we
    spent nearly $6 billion on R&D, or 28 percent of our total product
    sales--a commitment to R&D that well exceeds the average spending of
    our research-based peers.\1\ Over the past six years, even as our
    revenues declined, we continued to make substantial investments in both
    R&D and acquiring products for our pipeline. In 2018, these investments
    have only just started to contribute to growth of our company.
    ---------------------------------------------------------------------------
        \1\ Pharmaceutical Research and Manufacturers of America (PhRMA).
    PhRMA Annual Membership Survey (2018). https://www.phrma.org/report/
    2018-phrma-annual-membership-survey.

        These results are possible only if society makes a commitment to
    support innovation so that treatments can be developed to the benefit
    ---------------------------------------------------------------------------
    of society as a whole for years to come.

        The development of new drug therapies requires society to make an
    up-front investment through purchasing our medicines during the patent
    protection period at a responsible price we charge, and then at a very
    substantially reduced price for an indefinite period after patent
    expiry when generics are introduced. Thus, long-term improvements in
    healthcare derived from new medicines can only be achieved if society
    is willing to pay a responsible price for a certain number of years
    that allows for the recoupment of the investment and risk involved in
    pharmaceutical innovation. Improvements in patient health and reduction
    of overall health-care costs over the long term are a direct result of
    this commitment to support innovation.

        For example, in the U.S., we have seen incredible progress in
    reducing cardiovascular disease morbidity and mortality. Between 2000
    and 2014, age-adjusted mortality rates for cardiovascular and heart
    disease declined by approximately 35 percent; several factors have
    contributed to this decline, but the development of new medicines,
    including cholesterol-lowering medicines like statins, has played an
    important role.\2\ To take an AstraZeneca example, CRESTOR, a statin,
    was approved by the FDA in 2003. A study of CRESTOR showed that it
    reduced cardiovascular mortality and morbidity over the lifetime of the
    patient compared to the standard of care, resulting in economic
    value.\3\
    ---------------------------------------------------------------------------
        \2\ Sidney S, Quesenberry CP, Jr, Jaffe MG, Sorel M, et al. Recent
    trends in cardiovascular mortality in the United States and public
    health goals. JAMA Cardiol. 2016;1(5):594-599. doi: 10.1001/
    jamacardio.2016.1326.
        \3\ Ohsfeldt RL, Gandhi SK, Smolen LJ, et al. Cost effectiveness of
    rosuvastatin in patients at risk of cardiovascular disease based on
    findings from the JUPITER trial. J Med Econ. 2010;13(3):428-37. doi:
    10.3111/13696998.2010.499758.

        It is important to note that there are significant risks involved
    in developing new therapies. Only approximately 12 percent of therapies
    entering clinical study are approved, and the average cost of
    development approaches $2.6 billion.\4\ In 2018, return on R&D
    investment among larger biopharmaceutical manufacturers fell to 1.9
    percent, its lowest point since 2010.\5\ If we are not successful, we
    lose our investment in the therapy. Although we are proud of our
    success rate, we know that setbacks are inevitable when pushing the
    boundaries of science. For example, in 2018, we announced with our
    partner Lilly the discontinuation of Phase III clinical trials of
    lanabecestat, an investigational treatment for Alzheimer's disease.
    Such results are disappointing, but are an integral part of the nature
    of scientific discovery.
    ---------------------------------------------------------------------------
        \4\ DiMasi JA, Grabowski HG, Hansen RA. Innovation in the
    pharmaceutical industry: new estimates of R&D costs. J Health Econ.
    2016;47:20-33. doi: 10.1016/j.jhealeco.2016.01.012.
        \5\ Deloitte Centre for Health Solutions. Unlocking R&D
    Productivity: Measuring the return from pharmaceutical innovation 2018.
    https://www2.deloitte.com/us/en/pages/life-sciences-and-health-care/
    articles/measuring-return-from-pharmaceutical-innovation.html.

        Given the risks involved in developing a medicine, strong
    intellectual property (``IP'') protections and exclusivity for
    innovator products are a key component to ensuring that manufacturers
    continue to develop therapies that benefit society as a whole. While
    they create incentives to innovate, it is important to note that IP
    protections and exclusivity for innovator therapies do not generally
    prevent other competitor therapies from entering a given class,
    allowing robust competition to exist; for example, there are seven
    ---------------------------------------------------------------------------
    different statin molecules approved in the marketplace.

        Once these protections expire, generic and biosimilar competitors
    can enter the market, which further increases competition. Again,
    taking CRESTOR as example, since 2016 when it lost exclusivity, over 16
    generic forms have been approved and are available in the market today,
    driving prices down very substantially. We strongly support this
    construct and policy efforts to encourage competition. We describe
    these proposals in section V of this statement.

        Finally, it is also worth noting that a significant portion of our
    R&D occurs here in the U.S. We invest more than $2.7 billion annually
    in U.S.-based R&D work, employing approximately 2,700 people in our
    science units within our R&D centers in Maryland, Massachusetts, and
    California. Our approach to R&D is consistent with our broader and
    long-standing commitment to U.S. jobs in research and manufacturing.
    Our largest footprint is in this country, with 12,800 employees
    throughout the U.S. Additionally, we recently completed a $200 million
    expansion in our Frederick, MD facility where biologics, including
    FASENRA for certain patients with severe asthma, and our immuno-
    oncology therapy, IMFINZI, are manufactured. This sustained investment
    in R&D leads to the creation of high-quality jobs and generates
    economic value in the U.S.

        To summarize, because we have put science and research at the
    center of our company, we have had more success in our R&D pipeline
    than ever before, delivering long-term healthcare benefits. This
    success, however, is only possible if society remains committed to
    supporting investment in innovation.
                            iii. value of medicines
        The investments we make in researching and developing new therapies
    cannot occur in a vacuum. We must also ensure that our medicines bring
    value to patients, payers, and the health-care system as a whole.

        We are only able to stand behind the value of our medicines if that
    value is carefully and appropriately defined. In the health-care
    industry and as part of policymaking, there is frequent reflection on
    the meaning of ``value.'' We believe value must be assessed
    holistically and include all costs related to the treatment of a given
    condition. In particular, we must consider improvements in clinical
    outcomes and quality of life as well as reduction of hospitalizations
    and other medical costs.

        Additionally, the future savings that prescription medicines can
    bring to the healthcare system by preventing more costly interventions
    should not be overlooked as their value is considered. A recent study
    in Health Affairs of total Medicare spending per beneficiary from 1999
    to 2012 found that the spending growth rate slowed to just 1.1 percent
    per year on average since 2005. The study found that half of the total
    slowdown was attributable to reduced spending growth on cardiovascular
    diseases and events, like heart attacks and related conditions.
    Increased medication use for conditions like hypertension, high
    cholesterol, and diabetes explained half of that effect. The authors
    noted that while large, even this impact of medications is likely to be
    understated.\6\
    ---------------------------------------------------------------------------
        \6\ Cutler D, Ghosh K, et al., Explaining the Slowdown in Medical
    Spending Growth Among the Elderly, 1999-2012. Health Affairs. February
    2019. doi: 10.1377/hlthaff.2018.05372.

        One of our own therapies--BRILINTA--is an example of a medicine
    used in the cardiovascular setting that brings value to both patients
    and the broader health-care system. This oral antiplatelet therapy is
    indicated to reduce the rate of cardiovascular death, heart attack, and
    stroke in patients with acute coronary syndrome (``ACS'') or a history
    of heart attacks. For at least the first 12 months following the
    diagnosis of ACS, BRILINTA has been shown to be superior to
    clopidogrel, a generic oral antiplatelet. In addition, in patients with
    ACS, BRILINTA in combination with aspirin resulted in 21 percent
    reduction in cardiovascular mortality compared to clopidogrel in
    combination with aspirin.\7\
    ---------------------------------------------------------------------------
        \7\ Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus
    clopidogrel in patients with acute coronary syndromes. N Engl J Med.
    2009;361(11):1045-57. doi: 10.1056/NEJMoa0904327.

        In addition, BRILINTA in combination with aspirin also resulted in
    lower medical care costs compared to clopidogrel in combination with
    aspirin. The lower medical costs are driven primarily by fewer hospital
    readmissions and cardiovascular revascularization interventions--
    resulting in medical care cost offsets of approximately $1,000 per
    patient per year.\8\ This represents countless hours of patient time
    better spent with family and friends than in the hospital.
    ---------------------------------------------------------------------------
        \8\ Data on file. 2134602; AstraZeneca Pharmaceuticals LP.

        Another example of the value that medicines can provide relates to
    the relationship between diabetes and heart failure. In 2015, an
    estimated 30.2 million adults in the U.S. had diabetes, with the vast
    majority (90-95 percent) having type 2 diabetes.\9\ Up to 50 percent of
    patients with type 2 diabetes may develop heart failure.\10\ The
    prevalence of heart failure in the U.S. is expected to increase from
    5.8 million in 2012 to 8.5 million in 2030.\11\ The total cost of heart
    failure, which includes direct and indirect costs, is projected to
    increase from $31 billion in 2012 to $70 billion in 2030, with the
    majority of these costs (80 percent) related to hospitalization.\12\
    ---------------------------------------------------------------------------
        \9\ Centers for Disease Control and Prevention (CDC). National
    Diabetes Statistics Report, 2017. https://www.cdc.gov/diabetes/pdfs/
    data/statistics/national-diabetes-statistics-report.pdf.
        \10\ American Diabetes Association. CV Disease and risk management:
    standards of medical care in diabetes--2019. Diabetes Care.
    2019;42(Suppl 1);S103-S123. doi: 10.2337/dc19-S010.
        \11\ Heidenreich P, Albert N, Allen L, et al. Forecasting the
    impact of heart failure in the United States: a policy statement from
    the American Heart Association. Circ Heart Fail. 2013;6:606-619. doi:
    10.1161/HHF.0b013e318291329a.
        \12\ Id.

        Our oral type 2 diabetes product FARXIGA is a sodium-glucose
    cotransporter 2 (SGLT2) inhibitor. This newest class of oral diabetes
    medication has consistently demonstrated cardiovascular benefits for
    diabetes patients that are absent in older diabetes treatments, further
    supporting the importance of biopharmaceutical innovation. A recent
    cardiovascular outcomes trial demonstrated that FARXIGA significantly
    reduced the risk for hospitalization for heart failure or
    cardiovascular death.\13\ With initial hospitalizations and
    readmissions for heart failure in the Medicare population exceeding
    $10,000 for each event in the U.S., it can be readily observed where
    these new therapies can help further reduce total cost of care in the
    most at-risk patient populations.\14\
    ---------------------------------------------------------------------------
        \13\ Wiviott SD, Raz I, Bonaca MP, et al. for the DECLARE-TIMI 58
    Investigators. Dapagliflozin and cardiovascular outcomes in type 2
    diabetes [published online ahead of print November 10, 2018]. N Engl J
    Med. 2018. http://dx.doi.org/10.1056/NEJMoa1812389. Accessed November
    10, 2018.
        \14\ Ziaeian B, Heidenreich PA, Xu H, et al. Medicare expenditures
    by race/ethnicity after hospitalization for heart failure with
    preserved ejection fraction. JACC Heart Fail. 2018;6:388-97. doi:
    10.1016/j.jchf.2017.12.007.

        In highly complex conditions, the measure of value and
    effectiveness can be more multifaceted. In cancer, for example, there
    are several end-points to measure effectiveness, such as progression-
    free survival and overall survival. To account for this complexity,
    cost-effectiveness studies for cancer therapies can measure the value
    in providing the medication earlier in the course of treatment. An
    example from our portfolio is IMFINZI--currently the only FDA-approved
    immunotherapy for the treatment of patients with unresectable stage III
    non-small cell lung cancer whose cancer has not progressed following
    platinum-based concurrent chemoradiation therapy. Before IMFINZI,
    patients in this setting underwent a period of ``watch and wait'' after
    chemoradiation,\15\ and for up to 89 percent of these patients their
    cancer was likely to spread further.\16\ Based on the PACIFIC trial,
    IMFINZI may reduce the risk of death for these patients by nearly a
    third.\17\
    ---------------------------------------------------------------------------
        \15\ Postmus PE, Kerr KM, Oudkerk M, et al. Early and locally
    advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice
    Guidelines for diagnosis, treatment and follow-up. Annals of Oncol.
    Published online July 1, 2017. doi: 10.1093/annonc/mdx222.
        \16\ Albain KS, Swann RS, Rusch VW, et al. Radiotherapy Plus
    Chemotherapy With or Without Surgical Resection for Stage III Non-Small
    Cell Lung Cancer. Lancet. Published online August 1, 2009. doi: 0.1016/
    S0140-6736(09)60737-6.
        \17\ Antonia SJ, Villegas A, Daniel D, et al. Overall survival with
    durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med.
    2018;379(24):2342-2350. doi: 10.1056/NEJMoa1809697. Epub 2018 Sep 25.

        In a recent analysis, use of IMFINZI was found to be cost-effective
    in comparison to the previous ``watch and wait'' approach to treatment.
    This cost-effectiveness analysis, published in the Journal of the
    American Medical Association in December 2018, indicates that although
    IMFINZI consolidation therapy increased national cancer spending,
    treating earlier in the course of cancer progression may provide
    significant value.\18\
    ---------------------------------------------------------------------------
        \18\ Criss SD, Mooradian MJ, Sheehan DF, et al. Cost-effectiveness
    and Budgetary Consequence Analysis of Durvalumab Consolidation Therapy
    vs. No Consolidation Therapy After Chemoradiotherapy in Stage III Non-
    Small Cell Lung Cancer in the Context of the U.S. Health Care System.
    JAMA Oncol. Published online December 13, 2018. doi: 10.1001/
    jamaoncol.2018.5449.

        For a drug therapy to bring the most value to patients and the
    health-care system, it is imperative that the therapy is reaching the
    right patients at the right point in their treatment journeys. At
    AstraZeneca, we are focused on improving outcomes for patients on a
    personalized level by identifying the most appropriate treatments.
    Approximately 90 percent of our pipeline now has a precision medicine
    approach and reflects the broad range of cutting-edge technologies,
    tissue diagnostics, next-generation sequencing and point of care
    diagnostics we have introduced. By more precisely matching patients
    with the right medicine, we bring greater value to payers and the
    health-care system and help to ensure that patients receive the
    ---------------------------------------------------------------------------
    specific therapy that is most appropriate for their treatment needs.

        Finally, the concept of value is a key component in our pricing
    determinations. AstraZeneca has always taken a thoughtful approach to
    pricing, and we continue to do so, considering many factors. In
    addition to our significant R&D investments, we consider clinical
    value, size of patient population, government/payer coverage
    requirements, patient affordability, competition and other market
    conditions. We remain committed to pricing responsibly and making our
    medicines available and affordable to patients.
               iv. commitment to patient access and affordability
        Although we are thoughtful in our approach to pricing, we know that
    patients continue to face challenges at the pharmacy counter. We fully
    recognize that drug therapies cannot bring value to the health-care
    system or to patients unless they can access the medicines they need.

        Our commitment to affordable access translates into a number of
    resources and programs that have helped make our medicines available to
    patients.
    A. AstraZeneca Savings and Affordability Programs
        To ensure that patients in the U.S. are aware of our affordability
    programs, we were the first company to include messages about these
    programs in all of our U.S. television advertisements. Since 2005,
    every televised advertisement has reminded viewers: ``If you can't
    afford your medication, AstraZeneca may be able to help.''

        We stand behind this statement. Forty years ago, we were one of the
    first manufacturers in our industry to establish a patient assistance
    program to help low-
    income patients obtain certain medicines free of charge. Through our
    ``AZ&Me'' program, we have provided prescription drug savings to more
    than four million patients in the U.S. and Puerto Rico between 2008 and
    2018.

        In addition to AZ&Me, we offer extensive copay savings programs to
    help eligible, commercially insured patients reduce copay costs at the
    pharmacy. These copay savings programs are unfortunately not available
    to Part D patients and this has created challenges for this population,
    reducing adherence to important lifesaving or life-improving
    treatments.
    B. Value-Based Agreements
        We are also working closely with payers and health systems to
    explore innovative solutions to improve access and affordability that
    demonstrate the value our medicines bring to patients and the health-
    care system. For several years, AstraZeneca has been exploring these
    types of solutions through value-based agreements where we are willing
    to work with health-care stakeholders to tie payment to patient
    outcomes.

        To date, we have entered into approximately 40 value-based
    agreements across our therapeutic areas with a variety of payers,
    making AstraZeneca a leader in the field of value-based agreements. As
    an example, AstraZeneca agreed with Express Scripts that for IRESSA, an
    oral treatment for certain types of lung cancer, we will fully
    reimburse Express Scripts for discontinued use before the third fill,
    including if discontinuation occurs because patients did not respond to
    treatment.

        While most of these agreements have been focused on securing
    patient access to our medicines and delivering better patient outcomes,
    where payers are willing, we are also looking to more directly address
    patient out-of-pocket affordability through these innovative
    arrangements.

        As an example, last month, we announced the initiation of a value-
    based agreement for University of Pittsburgh Medical Center (``UPMC'')
    Medicare patients who are prescribed BRILINTA. This value-based
    contract, which was effective as of January 1, 2019, is groundbreaking
    in two ways. First, the contract lowers the out-of-pocket costs for a
    UPMC Medicare Part D patient to approximately $10 for a 30-day supply.
    Second, what UPMC pays for BRILINTA will vary based on patient
    outcomes, tying the cost of the drug to its real-world clinical
    performance.

        We are currently exploring another value-based agreement in
    Medicare Part D. In addition to having a significant outcomes-based
    component, this arrangement would reduce patient out-of-pocket costs.
    This type of agreement allows patients to access their medicines at a
    lower out-of-pocket cost and payers to control their overall health-
    care costs through paying for outcomes.

        However, there remain significant operational and regulatory
    hurdles to the broader implementation of value-based agreements.
    Operational challenges include capturing appropriate data and other
    capabilities on the part of payers that are needed to successfully
    execute these arrangements. For example, value-based agreements
    typically require plans to have systems in place to report measures
    like adherence and readmissions. While many payers and health systems
    are evolving to meet the needs of the changing health-care environment,
    greater investments need to be made in data capabilities. In addition,
    policy and regulations must advance to support value-based agreements
    in becoming a standard approach to reimbursement.

        We believe that there are steps the government can take to address
    these challenges to help encourage the timely adoption of value-based
    agreements, including in public sector programs like Medicare. These
    recommendations are described in more detail in section V of this
    statement. Through the partnership of payers and policymakers, we look
    forward to a future where implementation of value-based agreements
    across public and private payers is widespread.
    C. Discounts and Rebates
        Finally, we negotiate rebates and discounts with payers and
    pharmacy benefit managers (``PBMs'')--including in Medicare Part D--to
    help ensure that our therapies have the most robust access possible.
    Without providing these discounts and rebates, many life-savings
    medicines would not be placed on plan formularies and therefore would
    be largely unavailable to the patients who need them most. Our
    estimates for 2018 show that across our products, our average rebate is
    nearly 50 percent of our gross revenues in the U.S. Taking BRILINTA as
    an example, approximately one third of gross revenue is provided back
    in rebates. For most of our diabetes therapies, rebates well exceed 50
    percent of gross revenues.

        Over the past several years, discounts and rebates for our
    therapies have increased overall, both in the commercial sector and
    Part D. In recent years, in our primary care portfolio, which includes
    the majority of our therapies, we have seen flat to declining net
    effective prices to AstraZeneca for most of our products. Taking
    CRESTOR as an example, in the 5-year period before it lost exclusivity,
    even though list price increased, in 2011, CRESTOR's average net
    effective price earned by AstraZeneca was $2.52 per day (one pill per
    day). In 2016 when CRESTOR lost exclusivity, the average net effective
    price was again $2.52.

        However, discounts and rebates do not necessarily translate to
    lower cost-sharing for patients. There are a series of factors that
    impact a patient's out-of-pocket costs, including individual insurance
    plan benefit design (copayments, coinsurance, and deductibles),
    formulary placement, provider access, and assistance programs or
    savings offers. As a science-led, patient-focused company, the fact
    that many patients struggle with out-of-pocket costs despite the
    discount and rebates we provide stands counter to our mission of
    improving patient health.
                v. the path forward: evolving the current system
        Despite rapidly increasing rebate amounts, affordability of drug
    therapies is an increasingly significant public policy and public
    health issue. We agree that the current system is not sustainable--for
    patients, payers, and society as a whole--and we are committed to
    engaging across stakeholders to develop a new paradigm that improves
    affordability and access for patients while ensuring that manufacturers
    can continue to develop innovative therapies.

        To achieve these goals of improving affordability and supporting
    innovation, we must progress from a volume-based to a value-based
    health-care system. We continue to be forward-leaning in this regard,
    and we encourage other stakeholders to join us in the effort to deliver
    and pay for health care, including drug therapies, in a more
    affordable, efficient, and effective way.

        An important step is to evolve the current system of paying for and
    delivering drug therapies to one in which patients more directly
    benefit from the discounts and rebates we provide. Specifically, we
    believe that patient cost-sharing should be more aligned to a product's
    net price as opposed to its list price, as is the case today.

        However, as we look ahead to the future, even more must be done to
    improve patient affordability and to truly build a health-care system
    based on the value of therapies provided to patients.
    A. Value-Based Agreements Should Be the Future Standard
        First, in a future system, the default approach should be that
    pricing and reimbursement for drug therapies are tied to patient
    outcomes and the value the particular therapy provides. As such, it is
    imperative that manufacturers and payers--including Part D plans--
    engage in value-based agreements similar to the IRESSA and BRILINTA
    examples referenced previously. Policies to encourage these
    arrangements and to reduce or eliminate existing challenges will be
    essential to their long-term success. To that end, AstraZeneca
    appreciates the support of Senators Warner and Cassidy for value-based
    agreements, as demonstrated by their requests for input on the Patient
    Affordability Value and Efficiency (``PAVE'') Act. This draft
    legislation would promote the development of value-based agreements by
    offering increased flexibility for manufacturers to enter into such
    arrangements, including with Medicare Part D plans.

        In addition to the policies outlined in the PAVE Act, there are
    other ways that the government could facilitate value-based agreements.
    For example, the Department of Health and Human Services (``HHS'')
    should consider how its recent proposed rule regarding PBM rebates can
    be structured to protect existing and future value-based agreements. We
    appreciate that HHS solicited comments on this topic, and we look
    forward to sharing our perspective in our written comments to the
    proposal. In addition, to encourage utilization of agreements that best
    address the government's goals, we recommend that HHS develop a
    prioritized list of clinical outcomes measures for manufacturers and
    payers to consider when developing outcomes-based agreements.

        Over the past several years, we have engaged with HHS, and
    specifically the Center for Medicare and Medicaid Innovation
    (``CMMI''), to advance specific models involving our therapies in the
    Medicare program. To date, we have not been able to execute on a model
    with HHS or CMMI and the feedback we have received is that company-
    specific models are challenging to implement. We look forward to
    continued dialogue on these issues, and we hope to work with HHS, CMMI
    and other stakeholders to develop a scalable framework in which
    innovative models can be implemented in an appropriate way.
    B. All Patients, Including Medicare Patients, Should Benefit From
            Reduced Cost-Sharing
        Second, a future system should be designed to ensure that all
    patients benefit from lower cost-sharing, including those patients
    taking drug therapies on the Part D specialty tier. A recent study
    found that rates of prescription abandonment and delayed initiation of
    oral cancer therapies increase as cost-sharing amounts rise.\19\ Such a
    result reflects the need for a restructuring of the current benefit
    design for specialty products.
    ---------------------------------------------------------------------------
        \19\ Doshi JA, Li P, Petit AR, et al. Association of Patient Out-
    of-Pocket Costs With Prescription Abandonment and Delay in Fills of
    Novel Oral Anticancer Agents. J Clin Oncol. 2018; 36(5): 476-482. doi:
    10.1200/JCO.2017.74.5091.

        Under one potential approach, a portion of manufacturer discounts
    could be used to fund a reduction in cost-sharing for patients facing
    the highest cost-sharing amounts. This could be accomplished by
    establishing a monthly or annual out-of-pocket cap, which would give
    patients greater certainty in the total amount of out-of-pocket costs
    they could face. The cap would provide a safety-net for patients that
    could be funded by a portion of the discounts provided across all Part
    D products. Such an approach would help ensure that more patients
    benefit from the discounts manufacturers provide.
    C. Use of Biosimilars Should Be Supported
        Third, we believe that competition is a key component to reducing
    costs, and that is why we support expanded use of biosimilars in the
    U.S. As a global company, we operate in countries, particularly those
    in the European Union, where biosimilar competition is particularly
    robust. We support a similarly vigorous biosimilars market in the U.S.

        We therefore appreciate the efforts of the FDA to increase the
    availability of biosimilars in the U.S., including the FDA's
    development of a Biosimilars Action Plan. We support efforts to
    streamline and improve the efficiency of the biosimilars approval
    pathway for the benefit of patients.

        We also support reimbursement policies that facilitate the uptake
    of biosimilars. Such policies include Medicare reimbursement rates that
    ensure that biosimilars can compete on equal footing with innovator
    products.
                d. market-based competition should be maintained
        Finally, it is imperative to maintain market-based competition
    between manufacturers and between plans. Market-based competition plays
    an important role in keeping costs down. This is how the lifecycle of
    innovator therapies works today when competitors enter the market and
    generic medicines become available over time.

        The competitive market in the U.S. also provides patients with
    access to innovative medicines faster. For example, American patients
    have access to cancer medicines about 2 years earlier than patients in
    other countries, including Germany, France, and the U.K.\20\ This
    timely access to new cancer therapies is correlated with improved
    survival rates; from 1997 to 2012, rates of cancer mortality fell by 20
    percent in the U.S., compared to a 15 percent reduction in the U.K.\21\
    Additionally, nearly 90 percent of newly launched medicines from 2011
    to 2017 were available in the U.S., compared to just two-thirds in the
    U.K., half in Canada and France, and one-third in Australia; and of 14
    new diabetes medicines launched over that period, only one was
    available in France.\22\ Given the benefits brought to patients by new
    antidiabetic agents such as SGLT2 inhibitors (reduction in heart
    failure and hospitalizations for heart failure), U.S. patients and
    payers greatly benefit from the earlier introduction of these
    innovative medicines.
    ---------------------------------------------------------------------------
        \20\ PhRMA analysis of IMS Consulting Group ``Patient Access to
    Innovative Oncology Medicines Across Developed Markets.'' June 2016.
        \21\ World Health Organization (WHO). WHO mortality database.
    http://www.who.int/healthinfo/mortality_data/en. PhRMA analysis of WHO
    mortality database, using age--specific death rates.
        \22\ PhRMA analysis of IQVIA Analytics.

        While the current system needs reform, some of the benefits to the
    current structure are the speed of access and reimbursement of new
    medicines and the robust nature of the negotiations between
    manufacturers and PBMs, which in turn creates competition between
    manufacturers. As the system evolves, it is important that this ability
    to compete is maintained. Therefore, there must be flexibility to
    continue to negotiate net price by product and indication, among other
    ---------------------------------------------------------------------------
    factors.

        This flexibility is necessary not only to maintain competition, but
    also to facilitate additional innovations in the way drugs are priced
    and reimbursed. For example, variable discounts could be used to reduce
    cost-sharing for patients over time as they remain adherent to their
    medications. Additionally, we support the concept of indication-based
    pricing, which recognizes that the value of a drug therapy with more
    than one indication may vary based on indication. Indication-based
    pricing would allow greater competition among manufacturers based on
    the clinical efficacy of their therapies on an indication-by-indication
    basis. Allowing discounts to vary based on the indication for which a
    therapy is prescribed will be key to facilitating indication-based
    pricing.

        Finally, we would like to acknowledge that the coverage and
    reimbursement policies in Medicare Part B have been criticized for not
    sufficiently encouraging price competition for physician-administered
    drug therapies. We are supportive of reforms in the Medicare Part B
    program to address these concerns. Such reforms could include an
    inflation penalty if a manufacturer's price increase exceeds a certain
    threshold, as well as steps to ensure that the government and Medicare
    patients more directly benefit from the discounts and rebates provided
    in the commercial sector. Similar to the suggestion above on creating a
    Part D out-of-pocket cap funded by a portion of manufacturer discounts,
    the savings generated from an inflation penalty and increased
    competition in Part B could be used to fund an out-of-pocket cap for
    Medicare Part B patients.

        Competition is a fundamental requirement to reducing costs over
    time, both in Medicare Part B and Part D. Flexibility in the future
    system will be necessary to maintain competition and to explore
    additional innovations in the pricing and reimbursement of drug
    therapies. We must also be willing to work together to improve the
    efficiency of the Part B program. We look forward to working with
    policymakers and other stakeholders to shape the future system to
    accomplish these goals.
                                 vi. conclusion
        Although there is no single solution to the challenges we face, we
    welcome the opportunity to speak with you about ways to evolve our
    health-care system. We share your concern that many patients are facing
    challenges with out-of-pocket costs, and we are committed to working
    towards solutions that support patient access and affordability while
    sustaining innovation. AstraZeneca, along with many others in the
    pharmaceutical industry, is innovating to discover and develop
    tomorrow's cures and treatments, and we know we need to be a
    constructive partner to find solutions to ensure that patients benefit
    from the therapies we develop.

                                     ______

              Questions Submitted for the Record to Pascal Soriot
                   Questions Submitted by Hon. Chuck Grassley
        Question. At the hearing, you testified that AstraZeneca does not
    withhold samples from generic manufacturers in order to block generic
    versions of your drug from entering the market. You also expressed your
    support for the ``Creating and Restoring Equal Access to Equivalent
    Samples Act,'' also known as the CREATES Act. However, the FDA has a
    list on its website which identifies reference listed drug (RLD) access
    inquiries where brand manufacturers may have prevented generic
    companies from obtaining samples of products necessary to support FDA
    approval. AstraZeneca is on this FDA list. This would appear to
    contradict your testimony at the hearing that AstraZeneca has not
    withheld samples of their products to delay generic competition.

        Could you please explain in detail why AstraZeneca is on the FDA
    list?

        Answer. AstraZeneca appreciates the opportunity to address the
    question of one of our medicines, BRILINTA (ticagrelor) appearing on
    the Reference Listed Drug Access Inquiries list (RLD List). We would
    first like to state that AstraZeneca supports allowing generic
    manufacturers access to samples. Withholding or otherwise blocking such
    access is inconsistent with that position. Our internal review has not
    identified any unanswered, delayed, or outstanding requests for samples
    of BRILINTA by any generic manufacturers.

        It is our understanding that BRILINTA was included on the RLD List
    based on a single inquiry received by the FDA. Unfortunately, the RLD
    List does not identify the company that reportedly requested
    information (or samples) from AstraZeneca, the date the information was
    requested, or any other information that would allow AstraZeneca to
    better understand or further investigate the circumstances of this
    inquiry. On its website, the FDA does advise that it has ``not
    independently investigated or confirmed the access limitations
    described in the inquiries received.'' \1\ Given this limitation, the
    listing of an inquiry on the RLD List does not mean that the FDA has in
    fact determined that access to samples by generic manufacturers was
    limited or withheld for the medicines identified. Indeed, based on our
    internal review, we have not identified any circumstances that
    substantiate the inquiry received by the FDA relating to BRILINTA.
    ---------------------------------------------------------------------------
        \1\ Reference Listed Drug (RLD) Access Inquiries, U.S. Food and
    Drug Administration, https://www.fda.gov/Drugs/
    DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/
    ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm (last updated Feb. 7, 2019).

        Question. Could you please explain in detail the discrepancy
    ---------------------------------------------------------------------------
    between your testimony and the FDA list?

        Answer. AstraZeneca is not aware of any instances where the company
    has withheld or otherwise blocked access to samples by generic
    manufacturers. Based on our internal review, AstraZeneca is not aware
    of any unanswered, delayed, or outstanding requests for samples of
    BRILINTA by any generic manufacturers.

        In addition, BRILINTA is and has always been available via normal
    commercial distribution channels (i.e., wholesalers) since its U.S.
    launch. It has never had a restricted distribution program.

        Finally, more than 15 generic manufacturers have applied for
    regulatory approval from the FDA for the manufacture of generic
    ticagrelor and some, like Watson/Teva, have received tentative
    approvals from the FDA. Because conducting bioequivalence studies with
    the branded medicine is an FDA pre-approval requirement, it is clear
    that these generic manufacturers are not having difficulty accessing
    branded ticagrelor for their studies.

        In light of the context provided above, it is unclear why any
    generic manufacturer would be unable to obtain a sample of BRILINTA for
    their purposes or why an inquiry was lodged with the FDA related to
    this medicine.

        Question. Has AstraZeneca ever blocked access to samples?

        Answer. AstraZeneca is not aware of instances where the company has
    refused to sell samples or has otherwise blocked access to samples by
    generic manufacturers.

        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant.

        If the HHS proposed rule is finalized, can you assure the committee
    that your company will offer up-front discounts? If not, why?

        Answer. If the HHS proposed rule is finalized largely as proposed,
    AstraZeneca intends to comply with its requirements and use point-of-
    sale discounts.

        Question. Please describe how you expect your company to respond to
    the HHS proposed rule to eliminate safe harbor protection for back-end
    rebates in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. Assuming the HHS rebate rule is finalized largely as
    proposed, AstraZeneca intends to comply with its requirements and use
    point-of-sale discounts. Our goal is to maintain net prices broadly in
    line with today, recognizing our ability to do so may be dependent on
    external factors and market response such as how plans evolve their
    benefit design and the total degree of transparency under the new
    model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector, and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. Our arrangements in Part D do not include a market share
    component.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

        Answer. Below you will find our estimated relative payer split of
    Gross Product Sales in the U.S., for the year ending December 31, 2018.

    ------------------------------------------------------------------------
           Total Products
    -----------------------------   Sales $ Millions     Proportion of Total
                Payer                                         Business
    ------------------------------------------------------------------------
    Medicaid                                 1,826,337                 11.0%
    ------------------------------------------------------------------------
    Fed Gov't (VA, DOD, CDC,                 2,986,585                 18.1%
     PHS)
    ------------------------------------------------------------------------
    GPO/LTC                                  1,362,663                  8.2%
    ------------------------------------------------------------------------
    Commercial                               5,019,907                 30.4%
    ------------------------------------------------------------------------
    Medicare Part D                          3,514,858                 21.3%
    ------------------------------------------------------------------------
    Tricare                                     70,799                  0.4%
    ------------------------------------------------------------------------
    Non-Contracted Sales/Other               1,756,851                 10.6%
    ------------------------------------------------------------------------
        Total                               16,538,000               100.0%
    ------------------------------------------------------------------------

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees? To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. AstraZeneca does not utilize consultants or lobbyists to
    promote medicines at State Pharmacy and Therapeutics (P&T) Committees.
    However, AstraZeneca Medical Affairs personnel may engage in peer-to-
    peer medical discussions with members of the medical community
    including Medicaid P&T committee members.

        AstraZeneca has comprehensive internal policies that oversee
    interactions between AstraZeneca employees and government officials.
    Federal and state laws and regulations also govern lobbying activities,
    and AstraZeneca complies with the attendant disclosure requirements.

        Question. Please describe how the costs of patient assistance
    programs are accounted for within your company's financial statements.
    Please also describe the types of market information, such as
    prescribing and use patterns, that your company collects from different
    types of patient assistance programs and patient hub services.

        Answer. AZ&MeTM Prescription Savings Program (Patient
    Assistance Program):

        In furtherance of its objective of ensuring patient access,
    AstraZeneca was one of the first manufacturers in the industry to
    establish a patient assistance program to facilitate access to certain
    medicines for uninsured and underinsured low-income patients. This
    program, known as AZ&Me, provides eligible patients with medicines at
    no cost.

        We account for the costs of medicines provided through the AZ&Me
    program as a component of our Operating Expenses.

        In connection with the AZ&Me program, AstraZeneca collects general
    program enrollment data such as number of patients in the program and
    medicine provided.

        Access 360TM (Patient Hub):

        AstraZeneca's patient hub, Access 360, is a reimbursement support
    program that provides patients and their healthcare providers with
    limited access and reimbursement support for AstraZeneca specialty care
    medicines. Access 360 collects patient, provider and payer coverage
    data in conjunction with appropriate patient opt-ins to administer the
    limited reimbursement services offered by the program.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. For each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. Our commitment to improving the lives of patients goes
    beyond our innovative medicines. We place significant value on
    collaboration and partnerships, including work done by non-profits,
    patient advocates, medical professionals, and researchers. To that end,
    we provide support for eligible programs through corporate
    contributions, research support, fellowships, and medical education
    grants. We also support conferences and initiatives for healthcare
    professionals and scientists.

        AstraZeneca believes in providing information to the public about
    our company, our medicines and about how we do business. In 2008, we
    began publishing biannual reports of our contributions to nonprofit
    organizations. We use contributions as our umbrella term for financial
    support to nonprofit organizations contributing to the public good
    (e.g., donations, sponsorships, and partnerships).

        The below data reflects the total value of contributions made by
    AstraZeneca to nonprofit organizations in the U.S. in the years 2014-
    2018. A full list of contributions, including the recipient
    organization, associated program name, and amount of each contribution,
    can be found here: https://www.astrazeneca-us.com/sustainability/
    Corporate-transparency/grants-and-contributions-disclosure.html.

              2018: $18.3 million

              2017: $5.5 million

              2016: $10.9 million

              2015: $19.8 million

              2014: $15.5 million

        In addition, in 1993, AstraZeneca founded the AstraZeneca
    HealthCare Foundation, a 501(c)(3) entity. The AstraZeneca HealthCare
    Foundation aims to promote public awareness surrounding healthcare
    issues, further public education and medical knowledge, and support
    charitable and qualified exempt organizations whose work aligns with
    the Foundation's charitable goals.

        In furtherance of AstraZeneca's commitment to improving health, in
    2010 the AstraZeneca HealthCare Foundation launched the Connections for
    Cardiovascular HealthSM (CCH) program. With the mission of
    improving cardiovascular health in the U.S., CCH awards grants to U.S.-
    based nonprofit organizations whose work supports CCH's mission. Since
    its launch, CCH has awarded nearly $23 million to 52 organizations
    working to prevent cardiovascular disease.

        The below data reflects the approximate total value of grants made
    by CCH per year between 2014 and 2018. A full list of grants, including
    the recipient organization, associated program name, and amount of each
    contribution, can be found here: https://www.astrazeneca-us.com/
    sustainability/healthcare-foundation/connections-for-cardiovascular-
    health.html#past-grant-awardees--0.

              2018: $1.2 million

              2017: $993,880

              2016: $1.8 million

              2015: $1.9 million

              2014: $2.6 million

        AstraZeneca also awards medical education grants and scientific
    sponsorships. These grants are offered to support independent medical
    education, scientific sponsorships, and fellowship or healthcare
    professionalin-training. Grants are offered for conduct of programs,
    are awarded on the basis of individual applications through our medical
    education grants process, and are not conditioned on services. This
    process and all grant decisions are managed independently within our
    Medical Affairs group and have no connection to our sales and marketing
    departments.

        The below data reflects the approximate total value of medical
    education grants made by AstraZeneca per year, since 2014. A full list
    of medical education grants offered to non-profit organizations,
    including the recipient organization, associated program name, date,
    and amount of each contribution, can be found in Appendix A.

              2018: $28.9 million

              2017: $17.5 million

              2016: $11.6 million

              2015: $24.9 million

              2014: $14.8 million

        Question. Pay-for-delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the Preserve Access to Affordable
    Generics and Biosimilars Act, which would help put an end to these
    deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Answer. AstraZeneca has confidence in patents that protect our
    medicines and, where appropriate, we file lawsuits to protect our
    intellectual property.

        AstraZeneca does not enter into ``pay-off agreements,'' if those
    are understood to include settlements that pay generic competitors to
    delay entry into the market. AstraZeneca engages in patent settlements
    but we do not believe these resolutions contribute to increased prices.
    In the absence of a settlement, a generic would not necessarily prevail
    in the patent litigation and therefore would not be able to enter the
    market. Indeed, AstraZeneca has entered into many early-entry patent
    settlements that allow generic manufacturers to license innovator
    patents and thereby permit generic competition before expiration of
    AstraZeneca's patent rights.

        Settlement agreements that permit entry of generic drugs before
    expiration of relevant patent rights do not stifle competition but
    instead permit early entry by resolving patent disputes that would
    otherwise prevent generic alternatives to branded medication.

        All of AstraZeneca's patent settlements fully comply with the law.
    These settlements provide increased clarity and stability to both
    parties, allowing innovators like AstraZeneca to continue investing
    substantially in new medicines for patients and frequently allowing
    generic competitors to enter the market before expiration of
    AstraZeneca's patent rights.

        Question. Has your company ever entered into these kinds of
    settlements with a generic company?

        Answer. AstraZeneca does not enter into settlements that pay
    generic competitors to delay entry into the market.

        Question. Do you support the pay for delay bill?

        Answer. While AstraZeneca supports efforts to curb patent
    settlement abuses, we have concerns about the Preserve Access to
    Affordable Generics and Biosimilars Act in its current form. For
    example, the proposed legislation would be retroactive to 2013 and
    would unfairly subject to potential scrutiny lawful settlements entered
    into based on the then existing legal construct. As a general matter,
    AstraZeneca believes that patent settlement agreements are pro-
    competitive because they can permit entry of generic drugs before
    expiration of relevant patent rights.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Answer. AstraZeneca offers portfolio discount arrangements to
    improve patient access and affordability across multiple medicines,
    thus ensuring the right medicine can be prescribed for the right
    patient. Portfolio discounting allows manufacturers and plans another
    mechanism to negotiate for formulary access for the patient, in
    addition to single-medicine discounts and rebates. Irrespective of the
    approach to discounting, AstraZeneca also ensures discounts are
    appropriately reported in government price reporting metrics (e.g.,
    Best Price, Average Manufacturer Price, and Average Sales Price).

        Question. Does your company view these practices as anticompetitive
    or harmful to patients' access to quality, lower cost medicine?

        Answer. AstraZeneca does not view these practices as
    anticompetitive or harmful to patients' access. In fact, AstraZeneca
    offers portfolio discount arrangements to improve patient access and
    affordability.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. AstraZeneca believes that evolving the current system of
    paying for and delivering drug therapies to one in which patients more
    directly benefit from the discounts and rebates that AstraZeneca
    provides is an important step towards improving affordability and
    supporting innovation. This can best be accomplished by eliminating
    rebates in Medicare Part D and the commercial sector, which would
    create competition between manufacturers on net price instead of rebate
    amounts, thereby helping to eliminate rebate ``traps'' and ``walls.''

        AstraZeneca also believes that patient cost-sharing should be more
    aligned to a medicine's net price, and that eliminating rebates and
    moving to a point-of-sale discount model should help accomplish this
    goal. Additionally, it is important to note that lowering list prices
    in the U.S. without addressing broader challenges, including benefit
    design, will not improve affordability for many patients. While
    eliminating rebates is an important step, benefit designs must also be
    evaluated.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        Answer. AstraZeneca does not directly consider regulatory or
    compliance costs when setting the list price of a drug. AstraZeneca's
    approach to pricing across all medicines is driven by a number of
    factors, including clinical value, patient access and affordability,
    patient population, government and payer coverage requirements, RandD
    expenditures, manufacturing costs, and competitive dynamics.
    AstraZeneca is mindful of healthcare costs and is continuously
    exploring innovative opportunities and solutions to deliver medicines
    while considering cost and value. In setting drug prices, AstraZeneca
    takes into account both the budget impact to payers (including Medicare
    and pharmacy benefit managers (PBMs)) as well as patient out-of-pocket
    costs to maintain patient access to needed medication. AstraZeneca has
    also been a leading innovator in developing alternate payment
    structures for its medicines. In particular, AstraZeneca has emphasized
    value-based agreements, which, broadly speaking, seek to link access,
    reimbursement or price, to a demonstrated clinical benefit or outcome.

        Question. When setting the list price of a drug, does your company
    consider the risk of liability or litigation? If so, how specifically
    do those factors affect the list price of a drug? Please provide at
    least one specific example, if applicable, from your current product
    portfolio.

        Answer. AstraZeneca does not consider the risk of liability or
    litigation when setting the list price for a particular drug.

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see value-based arrangements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        Answer. We believe medicines are part of the solution to
    controlling health-care costs. They not only improve patient outcomes
    and increase quality of life, but also reduce downstream costs. Value-
    based agreements allow us to reimburse the health-care system if our
    medicines do not deliver as intended. This solution demonstrates our
    willingness to stand behind the value of our medicines.

        AstraZeneca is working closely with payers and health systems to
    explore innovative solutions to improve access and affordability that
    demonstrate the value our medicines bring to patients and the health-
    care system. Our value-based agreements aim to manage the totality of
    treatment costs and keep people healthy and out of the hospital. For
    several years, AstraZeneca has been exploring these types of solutions
    through value-based agreements where we are willing to work with
    health-care stakeholders to tie payment to patient outcomes.

        To date, we have entered into approximately 40 value-based
    agreements across our therapeutic areas with a variety of payers,
    making AstraZeneca a leader in the field of value-based agreements.

        As an example, and as noted in the written testimony submitted to
    the Senate Committee on Finance, AstraZeneca agreed with Express
    Scripts that for IRESSA, an oral treatment for certain types of lung
    cancer, we will fully reimburse Express Scripts for discontinued use
    before the third fill, including if discontinuation occurs because
    patients did not respond to treatment.

        Question. How can VBAs help lower what patients pay out-of-pocket?

        Answer. While most of these agreements have been focused on
    securing patient access to our medicines and delivering better patient
    outcomes, where payers are willing, we are also looking to more
    directly address patient out-of-pocket affordability through these
    innovative arrangements.

        Our ambition is that these agreements will evolve to enable
    reimbursement back to a payer to be shared with the patient when
    medicines do not perform as expected.

        As an example where a value-based agreement directly reduced out-
    of-pocket costs for patients, we recently announced the initiation of a
    value-based agreement for University of Pittsburgh Medical Center
    (UPMC) Medicare patients who are prescribed BRILINTA. This value-based
    contract, which was effective as of January 1, 2019, is groundbreaking
    in two ways. First, the contract lowers the out-of-pocket costs for a
    UPMC Medicare Part D patient to approximately $10 for a 30-day supply.
    Second, what UPMC pays for BRILINTA will vary based on patient
    outcomes, tying the cost of the medicine to its real-world clinical
    performance.

        We are currently exploring another value-based agreement in
    Medicare Part D. In addition to having a significant outcomes-based
    component, this arrangement would reduce patient out-of-pocket costs.
    This type of agreement allows patients to access their medicines at a
    lower out-of-pocket cost and payers to control their overall healthcare
    costs through paying for outcomes.

        Question. Can Congress do more to allow for and encourage the use
    of VBAs?

        Answer. We believe that there are steps the government can take to
    address challenges and help encourage the timely adoption of value-
    based agreements, including in public sector programs like Medicare.

        For example, at this time, the current Anti-Kickback Safe Harbor
    (AKS) regulations do not expressly address value-based agreements.
    Accordingly, manufacturers must seek to structure value-based
    agreements to meet the requirements of existing safe harbors from the
    AKS, such as the discount safe harbor and personal services safe
    harbor, that were created for purposes other than value-based
    agreements. Although we believe that value-based agreements can
    strongly benefit patients and the health-care system overall, the lack
    of clarity in application of the safe harbors to value-based agreements
    creates regulatory uncertainty that discourages broader implementation
    of value-based agreements in public-sector programs.

        In addition to the risk of AKS liability, value-based agreements
    present other regulatory challenges that manufacturers must navigate.
    For example, manufacturers must manage complex government price
    reporting calculations that may not account for price fluctuations over
    time that may be associated with a value-based agreement.

        In a future system, the default approach should be that pricing and
    reimbursement for drug therapies are tied to patient outcomes and the
    value the particular therapy provides. As such, it is imperative that
    manufacturers and payers--including Medicare plans--engage in value-
    based agreements similar to the IRESSA and BRILINTA examples referenced
    previously.

        Policies to encourage these arrangements and to reduce or eliminate
    existing challenges will be essential to their long-term success. To
    that end, AstraZeneca appreciates the support of Senators Warner and
    Cassidy for value-based agreements, as demonstrated by their requests
    for input on the Patient Affordability Value and Efficiency (PAVE) Act.
    This draft legislation would promote the development of value-based
    agreements by offering increased flexibility for manufacturers to enter
    into such arrangements, including with Medicare Part D plans by
    addressing AKS and government pricing concerns.

        This legislation is particularly important given the
    administration's proposal to eliminate PBM rebates under the discount
    safe harbor. Currently, many value-based agreements are structured
    using a rebate agreement, under which the terms of a discount are based
    on clinical or cost outcomes measures. Therefore, the elimination of
    discount safe harbor protection for rebates without an exception for
    value-based agreements could inadvertently reduce incentives for value-
    based agreements, which we do not believe is the administration's
    intent. We have therefore recommended to HHS that value-based
    agreements are exempt from the proposed changes to the discount safe
    harbor and we encourage members of Congress to support this exemption.

        Through the partnership of payers and policymakers, we look forward
    to a future where implementation of value-based agreements across
    public and private payers is widespread.

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad. Pharmacy benefit managers
    and plans have argued that rebates are used to lower premiums across
    the board and that it is the best way to seek a price concession on
    otherwise expensive drugs. Your industry argues that these payers are
    insisting on higher rebates that can only be achieved by raising list
    prices. But patients often lose under this system, with out of pocket
    costs being tied to list price. Insulin patients appear to be routinely
    impacted by this perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        Answer. Assuming the HHS rebate rule is finalized largely as
    proposed, AstraZeneca intends to comply with its requirements and use
    point-of-sale discounts. Our goal is to maintain net prices broadly in
    line with today, recognizing our ability to do so may be dependent on
    external factors and market response such as how plans evolve their
    benefit design and the total degree of transparency under the new
    model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector, and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.

        Question. What assurance can you provide that you would in fact
    lower your prices?

        Answer. Assuming the HHS rebate rule is finalized largely as
    proposed, AstraZeneca intends to comply with its requirements and use
    point-of-sale discounts. Our goal is to maintain net prices broadly in
    line with today, recognizing our ability to do so may be dependent on
    external factors and market response such as how plans evolve their
    benefit design and the total degree of transparency under the new
    model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.

        Question. What actions should be taken to ensure that patients are
    actually seeing the benefits of lower out-of-pocket costs?

        Answer. In the absence of rebates, the market incentives for the
    differential between list and net price should be reduced because
    manufacturers will be competing on the basis of net price instead of
    rebate amounts. Because Part D patient cost-sharing is currently based
    on list price and not net price, this change may also result in lower
    cost-sharing for patients. Additionally, it is important to note that
    lowering list prices in the U.S. without addressing broader challenges,
    including benefit design, will not improve affordability for many
    patients. While eliminating rebates is an important step, benefit
    designs must also be evaluated.

        AstraZeneca also supports monthly and annual out-of-pocket caps in
    Medicare Part D to further ensure that patients see the benefits of
    lower out-of-pocket costs.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        Answer. For our Part B products, price increases are modest and
    generally in line with inflation. We are supportive of competition,
    including policies that support more widespread use of biosimilars.

                                     ______

                    Questions Submitted by Hon. Steve Daines
        Question. As an advocate for improving Montanans' access to low-
    cost medications, I've been a champion of the Creating and Restoring
    Equal Access to Equivalent Samples (CREATES) Act, which would combat
    anticompetitive practices used by some brand-name pharmaceutical
    companies to block or delay competing generic drugs from entering the
    market. During the hearing when I asked if your company had ever
    withheld samples from generic manufacturers, you answered emphatically
    no. Yet, according to the Food and Drug Administration (FDA), generic
    drug makers have made inquiries with the agency claiming they were
    unable to access samples provided by Pfizer and AstraZeneca that are
    needed to conduct studies to produce low-cost generic drugs.

        Do you agree that denying generic drug manufacturers access to
    samples keeps drug costs high for patients due to lack of competition?

        Answer. AstraZeneca is supportive of allowing generic manufacturers
    to have access to samples.

        Question. Has your company refused to sell samples or placed any
    barriers in the way of generic drug makers acquiring samples?

        Answer. AstraZeneca is not aware of instances where the company has
    refused to sell samples or has otherwise blocked access to samples by
    generic manufacturers.

        Question. Are you aware of any outstanding requests for samples?

        Answer. AstraZeneca is not aware of any unanswered, delayed, or
    outstanding requests for samples of our medicines by generic
    manufacturers.

        It is our understanding that one of our medicines, BRILINTA, was
    included on the Reference Listed Drug Access Inquiries List (RLD List)
    based on a single inquiry received by the FDA. However, BRILINTA has
    always been available via normal commercial distribution channels
    (i.e., wholesalers) and has never had a restricted distribution
    program.

        Unfortunately, the RLD List does not identify the company that
    reportedly requested information (or samples) from AstraZeneca, the
    date the information was requested, or any other information that would
    allow AstraZeneca to better understand or further investigate the
    circumstances of this inquiry. On its website, the FDA does advise that
    it has ``not independently investigated or confirmed the access
    limitations described in the inquiries received.'' Given this
    limitation, the listing of an inquiry on the RLD List does not mean
    that the FDA has in fact determined that access to samples by generic
    manufacturers was limited or withheld for the medicines identified.
    Indeed, based on our internal review, we have not identified any
    circumstances that substantiate the inquiry received by the FDA
    relating to BRILINTA.

        Question. How does your company work to prevent abuses in the
    sample system?

        Answer. AstraZeneca is supportive of allowing generic manufacturers
    to have access to samples and is not aware of instances that would be
    considered abuse of the samples system.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices. With the increased
    scrutiny of the industry and of the drug supply chain as a whole in the
    United States, have any of your companies re-evaluated your business
    strategy in foreign countries?

        Answer. We continuously evaluate our business approaches in all
    markets and adjust our strategies accordingly based on many factors,
    including the overall environment.

        Question. If not, then why?

        Answer. See response above.

        Question. If a proposal, like IPI, were implemented, would it force
    your companies to potentially ``walk away from the negotiating table
    when other countries demand low prices subsidized by America's
    seniors,'' as HHS Senior Advisor for Drug Pricing Reform John O'Brien
    has said?

        Answer. If the IPI model were put into effect as proposed, where an
    identified average international price would be derived from 16
    countries, this would impact our ability to sell our medicines in some
    of the identified markets.

        The IPI model was issued as an Advanced Notice of Proposed
    Rulemaking (ANPRM). Important details such as the medicines that would
    be included in the model, the final list of nations included as
    reference countries, and the timing of reimbursement changes are still
    unknown. We look forward to engaging with policymakers on this
    proposal.

        Question. What are some of your ideas on how we can ensure
    Americans aren't shouldering the full cost of pharmaceuticals?

        Answer. We agree that out-of-pocket costs are unsustainable in the
    U.S., but the answer is not to move to a system found in other
    countries or to link pricing in the U.S. to the International Pricing
    Index.

        It is critical to recognize that while price controls are the
    default in many other countries, these price controls result in reduced
    access to important medicines. In the 16 countries referenced in the
    International Pricing Index model proposal, only 55 percent of new
    cancer medicines are available, compared to 96 percent in the U.S. In
    those countries, it also takes more than a year longer for the
    medicines to become available and this can have significant impacts on
    patients. For example, in 2018, the Food and Drug Administration (FDA)
    and the European Medicines Agency (EMA) approved a new indication for
    LYNPARZA for ovarian cancer. However, the U.K.'s National Institute for
    Health and Care Excellence (NICE) has not recommended that the U.K.'s
    National Health System (NHS) reimburse for LYNPARZA in this indication,
    resulting in limited access for patients in the U.K.

        Instead of international reference pricing, we should focus on
    market-based solutions. We believe that there are several steps that
    lawmakers can take to ensure that drug prices are affordable for
    Americans, while ensuring that innovation in the biopharmaceutical
    sector can continue to flourish in the U.S. Our suggestions fall in
    five main categories, described in more detail below:

              Rebate Reform: The current pharmacy benefit manager (PBM)
            rebate system does not fully benefit patients and has resulted
            in a lack of transparency across the supply chain. We support
            the current proposed rule to eliminate rebates in Medicare Part
            D and Medicaid managed care. We also support efforts to
            eliminate rebates in the commercial sector as well, which will
            likely require legislation. We therefore recommend that
            Congress explore legislation that would eliminate rebates in
            the commercial market.

              Value-Based Agreements: As described in detail in our
            written testimony to the Senate Committee on Finance hearing,
            we are also working closely with payers and health systems to
            explore innovative solutions to improve access and
            affordability that demonstrate the value our medicines bring to
            patients and the health-care system. For several years,
            AstraZeneca has been exploring these types of solutions through
            value-based agreements where we are willing to work with
            health-care stakeholders to tie payment to patient outcomes. To
            date, we have entered into approximately 40 value-based
            agreements across our therapeutic areas with a variety of
            payers, making AstraZeneca a leader in the field of value-based
            agreements.

               We believe that there are steps the government can take to
            address certain regulatory challenges to the broader
            implementation of value-based agreements and help encourage the
            timely adoption of value-based agreements, including in public-
            sector programs like Medicare. To that end, AstraZeneca
            appreciates the support of Senators Warner and Cassidy for
            value-based agreements, as demonstrated by their requests for
            input on the Patient Affordability Value and Efficiency (PAVE)
            Act. This draft legislation would promote the development of
            value-based agreements by offering increased flexibility for
            manufacturers to enter into such arrangements, including with
            Medicare Part D plans.

              Biosimilars: We also encourage Congress to consider policies
            to encourage greater use of biosimilars in the U.S. We believe
            that competition is a key component to reducing costs, and that
            is why we support expanded use of biosimilars in the U.S. As a
            global company, we operate in countries, particularly those in
            the European Union, where biosimilar competition is
            particularly robust. We support a similarly vigorous
            biosimilars market in the U.S.

               We therefore appreciate the efforts of the FDA to increase
            the availability of biosimilars in the U.S., including the
            FDA's development of a Biosimilars Action Plan. We support
            efforts to streamline and improve the efficiency of the
            biosimilars approval pathway for the benefit of patients. Such
            efforts could include increased transparency into the patents
            applicable to biologic medicines.

               We also support cost-sharing and reimbursement policies that
            facilitate the uptake of biosimilars. Such policies include
            Medicare reimbursement rates that ensure that biosimilars can
            compete on equal footing with innovator medicines, and
            reductions to cost-sharing amounts for biosimilars.

              Out-of-Pocket Caps for Medicare Patients: In the commercial
            market, it is common for patients to have a cap on total out-
            of-pocket amounts. However, such a construct does not exist in
            the Medicare program. Because of the way the Part D benefit is
            designed, for example, cost-sharing can be particularly high in
            the first months of the plan year and/or in the first months of
            therapy. A recent study found that rates of prescription
            abandonment and delayed initiation of oral cancer therapies
            increase as cost-sharing amounts rise. Such a result reflects
            the need for a restructuring of the current benefit design,
            which could be accomplished by establishing a monthly or annual
            out-of-pocket cap. This would give patients greater certainty
            in the total amount of out-of-pocket costs they could face.

              Transparency: We support greater transparency across the
            biopharmaceutical supply chain, which includes greater
            transparency into drug pricing. To that end, we generally
            support the policies included in the current versions of the
            SPIKE and C-THRU Acts. There are a variety of State-level drug
            pricing transparency laws and regulations. We believe that
            having a consistent, Federal standard for drug pricing
            transparency requirements, like those included in the SPIKE
            Act, should pre-empt state transparency laws to reduce
            confusion and compliance burden.

               We also support transparency efforts to ensure that patients
            and prescribers have meaningful information on out-of-pocket
            costs at the point of prescribing, so that they can make
            informed decisions about the most appropriate and affordable
            therapy.
                  foreign countries' pricing and reimbursement
        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year. ``When foreign governments extort unreasonably low
    prices from U.S. drug makers, Americans have to pay more to subsidize
    the enormous cost of research and development. . . . It's unfair and
    it's ridiculous, and it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing edical advances?

        Answer. We agree that many foreign countries' pricing and
    reimbursement systems do not adequately recognize innovation in the
    biopharmaceutical sector. In many other countries, the government
    utilizes price controls for drug therapies, and in many cases these
    price controls result in reduced or delayed access to therapy for
    patients in those countries. The U.S. benefits from an open-market
    system that supports competition and innovation and accordingly
    Americans place high value on both choice and access to the latest
    medicines. For patients in the U.S., it is not a question of when an
    important treatment will be available, but rather how they will access
    that medicine. It is in this context that AstraZeneca continues to
    engage with other stakeholders regarding possible solutions and
    specific actions that can be taken to address pricing concerns, which
    we describe in greater detail in our written testimony. These
    approaches must balance the need to improve access and affordability
    while fostering innovation. Pricing controls as well as access and
    reimbursement practices in other countries are a challenge.

        Question. How do foreign countries' pricing and reimbursement
    systems affect our prescription drug costs?

        Answer. We do not take into account foreign market pricing in
    setting U.S. prices.

        Question. Are foreign governments taking note of the concerns being
    raised by the Trump administration and have they responded in any way?

        Answer. While these matters have been widely reported on globally,
    we do not have insights into actions being taken by other health
    authorities directly in response to the Trump administration's efforts
    in this area.

        Question. Has there been any noticeable change in any of our trade
    agreements since these concerns have been raised by the Trump
    administration?

        Answer. AstraZeneca and the biopharmaceutical industry have
    consistently advocated for trade agreements that support strong
    intellectual property rights and protect market access. We believe our
    trade partners should be fair and transparent so that patients around
    the world can benefit from U.S. innovation.
                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various States
    have been exploring whether to exclude certain drugs from its Medicaid
    program. For example, the State of Massachusetts recently asked CMS for
    permission to create a closed formulary where the State Medicaid
    program would pick at least one drug per therapeutic class. CMS denied
    their waiver request citing violation of Federal law, but this proposal
    does bring up important questions on how to contain drug prices in
    State Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to State Medicaid programs,
    do you think it [would] lower drugs costs while ensuring access to
    patients?

        Answer. Under the current construct in Medicaid, manufacturers
    provide mandatory rebates and in turn, States are required to cover all
    of the manufacturer's drugs. This ensures that Medicaid patients have
    access to the full range of available therapies. We support increased
    flexibility for State Medicaid agencies in managing their Medicaid
    programs, but only so long as there are robust protections that ensure
    that Medicaid patients can continue to access the medicines they need.
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        Answer. We do not believe that the Medicaid Best Price requirement
    encourages manufacturers to increase their initial list price. However,
    the requirement does impact decisions regarding the size of rebates and
    discounts offered in the commercial sector because setting a new Best
    Price can result in significantly increased Medicaid rebate and 340B
    liability. Additionally, manufacturers may be hesitant to offer very
    aggressive value-based agreements due to the risk of setting a new Best
    Price.

        Question. What, if any, changes would you suggest we make to the
    program?

        Answer. We recommend an exemption from Best Price for value-based
    agreements, which is a policy included in Senator Grassley's and
    Senator Warner's draft version of the PAVE Act.
                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        Answer. While most value-based agreements have been focused on
    securing patient access to our medicines and delivering better patient
    outcomes, where payers are willing, AstraZeneca is also looking to more
    directly address patient out-of-
    pocket affordability through these innovative arrangements.

        As an example, we recently announced the initiation of a value-
    based agreement for University of Pittsburgh Medical Center (UPMC)
    Medicare patients who are prescribed BRILINTA. This value-based
    contract, which was effective as of January 1, 2019, is groundbreaking
    in two ways. First, the contract lowers the out-of-pocket costs for a
    UPMC Medicare Part D patient to approximately $10 for a 30-day supply.
    Second, what UPMC pays for BRILINTA will vary based on patient
    outcomes, tying the cost of the medicine to its real-world clinical
    performance.

        We are currently exploring another value-based agreement in
    Medicare Part D. In addition to having a significant outcomes-based
    component, this arrangement would reduce patient out-of-pocket costs.
    This type of agreement allows patients to access their medicines at a
    lower out-of-pocket cost and payers to control their overall healthcare
    costs through paying for outcomes.

        Question. How will they lower overall health-care costs for our
    Federal programs?

        Answer. We believe medicines are part of the solution to
    controlling health-care costs. They not only improve patient outcomes
    and increase quality of life, but also reduce downstream costs. Value-
    based agreements have the potential to increase efficiencies in the
    health-care system, including government programs, by ensuring that
    payment is based on value rather than reimbursement based on volume.
    These agreements support patients receiving the most appropriate
    treatment, ensure appropriate patient behaviors and, most importantly,
    tie reimbursement to improved patient outcomes.

        In many cases value-based agreements encourage a focus on important
    patient behaviors such as adherence and persistence as well as improved
    emphasis on patient education to promote healthier lifestyles and
    choices. These agreements broaden payer focus to the total cost of care
    and quality outcomes. It is important that we look at all aspects
    related to the cost of care to find efficiencies that drive greater
    value in the health-care system. These opportunities exist in both the
    commercial and government sectors.

        We support value-based agreements because they allow us to
    reimburse the health-care system if our medicines do not deliver as
    intended. This solution demonstrates our willingness to stand behind
    the value of our medicines.

        Through the partnership of payers and policymakers, we look forward
    to a future where implementation of value-based agreements across
    public and private payers is widespread.

        Question. What have the preliminary results looked like so far?

        Answer. We are frequently asked if we have ever had to ``pay out''
    on a value-based agreement, and the answer is ``yes.'' For example, we
    have entered into an agreement for one of our oncology medicines with a
    large payer. We have reimbursed the payer for more than 20 percent of
    patients on that medicine. Of course, we also have examples where we
    have seen the medicine perform as well or better than our clinical
    data. This is good for patients and good for the payer and health
    system overall in that, by providing access to that medicine, they have
    seen improved patient outcomes.
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point of sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        Answer. Yes, the Trump administration's rebate proposal should make
    transactions more transparent because cost-sharing will reflect point-
    of-sale discounts and, therefore, net prices. We encourage the
    administration and Congress to closely assess the impact of such
    increased transparency on patients and the biopharmaceutical supply
    chain more broadly.

        Question. If so, would this transparency bring down drug costs--
    overall and for specialty drugs?

        Answer. In general, we believe that increased transparency due to
    point-of-sale discounts will in turn lead to greater competition and
    reduced costs overall. However, the impact of transparency on the
    prices of specific drugs will vary based on the competitive landscape
    for that medicine.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the pharmacy benefit manager. But there's
    another side of the equation that I'd like to ask about. How do
    wholesalers negotiate pricing with manufacturers?

        Answer. In general, wholesalers do not negotiate pricing with
    manufacturers. Wholesalers receive service fees from manufacturers for
    bona fide services they provide.

        Question. What impact does this have on drug costs?

        Answer. In general, wholesalers do not negotiate pricing with
    manufacturers.

        Question. What incentives or disincentives do they have to contain
    price increases?

        Answer. Wholesalers receive service fees from manufacturers for
    bona fide services they provide. Certain fees across the supply chain--
    including with wholesalers--are based on a percentage of the list
    price. We support efforts to ``de-link'' such fees from the list price
    across the supply chain, as this would align incentives across the
    supply chain to lower prices.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price. Like many Oregonians, I am
    skeptical drug manufacturers would voluntarily lower their prices.

        Therefore, would you support legislation that would (1) make
    similar changes the administration has put forward related to Part D
    and Medicaid managed care, (2) change the rebate system in a similar
    way to the proposal for the commercial market, and (3) require drug
    makers to lower the list price of their drugs equal to the amount of
    rebates provided today?

        Answer. Assuming the HHS rebate rule is finalized largely as
    proposed, AstraZeneca intends to comply with its requirements and use
    point-of-sale discounts. Our goal is to maintain net prices broadly in
    line with today, recognizing our ability to do so may be dependent on
    external factors and market response such as how plans evolve their
    benefit design and the total degree of transparency under the new
    model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        Answer. Please see Appendix B.

        Question. For each drug listed in response to question 1, please
    also provide a list of which quarters and years each drug hit the cap.

        Answer. Please see Appendix B.
                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. For example, an analysis by the U.S.
    Department of Health and Human Services Office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.

        Accordingly, please describe the following:

        Your company's current compliance plan and procedures used to
    ensure compliance with the requirements of the Medicaid Drug Rebate
    Program including internal audits or other checks you use to identify
    compliance vulnerabilities.

        Answer. All aspects of AstraZeneca's compliance with the
    requirements of the Medicaid Drug Rebate Program, including Statutory
    Pricing (average manufacturer price (AMP) and Best Price) and Medicaid
    Rebate payments, are covered by AstraZeneca's compliance framework.
    This compliance plan includes a robust review process, including
    Sarbanes-Oxley testing, self-auditing, and formal audits by internal
    and external audit.

        Question. Any past or ongoing issues of non-compliance.

        Answer. Since the implementation of AstraZeneca's compliance
    framework, we are not aware of any compliance issues that have been
    identified via this internal and external audit process.

        Question. Any corrective actions taken to address identified
    problems or issues of non-compliance with the MDRP and how such steps
    were communicated to the Centers for Medicare and Medicaid Services.

        Answer. As noted above, to date, no compliance issues have been
    identified via this internal and external audit process.

        Question. Any steps taken to improve compliance and ensure that all
    Medicaid drug rebates owed to the Federal Government and the States are
    paid in full.

        Answer. AstraZeneca has a comprehensive compliance framework that
    includes Sarbanes-Oxley testing, self-auditing, and formal audits by
    internal and external audit. Additionally, as it relates to Medicaid
    drug rebates owed to the Federal Government and States, AstraZeneca
    performs additional reviews of claims-level data, ensuring the
    completeness and accuracy of both the payments made by manufacturers as
    well as claims submitted to manufacturers. This process has identified
    duplicate pharmacy claims submitted to State Medicaid Agencies
    resulting in overpayment by both States and manufacturers. Clearly,
    these overpayments disadvantage both the States and manufacturers like
    AstraZeneca.
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus, or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus or other compensation was tied.

        Answer. The CEO's compensation as well as the compensation of other
    senior leaders is directly based on three areas of performance that are
    generally weighted equally: development and delivery of innovative
    science, our aggregate sales, and other important financial metrics.

        AstraZeneca understands that executive pay is a closely scrutinized
    issue. As part of our compensation decisions, we are mindful of the
    sensitivity of this issue as we determine how best to incentivize,
    reward and retain executives capable of leading a global pharmaceutical
    company in a highly competitive market.

        Question. Is your salary, bonus, or other compensation tied to
    either revenue or net income of the company as a whole? Has it ever
    been? If yes, please explain what assumptions about price increases are
    used when the compensation committee sets revenue or net income goals.
    Does the compensation committee provide any guidance to executives in
    regards to the amount of revenue that the company will generate from
    price increases versus volume growth?

        Answer. The CEO's compensation as well as the compensation of other
    senior leaders is directly based on three areas of performance that are
    generally weighted equally: development and delivery of innovative
    science, our aggregate sales, and other important financial metrics.
    AstraZeneca's Remuneration Committee does not provide any guidance on
    price increases.
            provision of rebates in exchange for formulary placement
        Question. In today's system, drug makers receive a limited time
    window to sell their drug without competition. After that period has
    expired, low-cost generics should become available. However, drug
    makers often prevent access to these cheaper generic drugs in Medicare.
    Researchers have found that 72 percent of Medicare Part D plans charged
    lower cost-sharing for a brand name drug compared to its generic
    equivalent. This means seniors were charged less out of pocket for
    brand name drugs compared to generics that are on average four times
    cheaper than the brand-named drug. This happens because drug makers pay
    a rebate to the Part D plans in order to give the more expensive drug
    better treatment than a generic. As a result, Medicare spending
    increases due to the current structure of the Part D benefit.

        Has your company ever paid a rebate to a Part D plan so that a
    brand name drug would get preferential treatment (i.e., lower cost-
    sharing or less utilization management) compared to a cheaper generic?

        Answer. In certain instances, AstraZeneca enters into arrangements
    under which a branded agent is discounted at or below the net cost of
    the generic(s) in the market, therefore benefiting the plan and the
    beneficiary. AstraZeneca typically enters into these types of
    arrangements for medicines already existing on formulary. These
    arrangements benefit patients by ensuring greater affordability for the
    branded medicine and by ensuring continuity of treatment if a patient
    has already been prescribed a branded medicine. These arrangements also
    support competition because they provide the opportunity for multiple
    competitors and medicine options to compete on price and other factors.
    We have had several such arrangements in Medicare Part D (see Appendix
    C).

        Question. If so, please provide:

        A list of the drugs for which your company has done this since
    January 1, 2014.

        Answer. A list providing this information is attached as Appendix
    C.

        Question. The number of Part D plans in which this type of rebate
    was given for each drug in each year.

        Answer. A list of the relevant Part D plans is included in Appendix
    C.
                                   net prices
        Question. During your testimony, you stated, ``The estimates for
    2018 show that across our medicines, our average rebate is nearly 50
    percent of our gross revenues in the U.S. Despite this, in recent
    years, in our primary cap portfolio, we have seen flat to declining net
    effective prices for most of our medicines.''

        Please describe how the company's year-over-year aggregate net
    price is calculated.

        Answer. The analysis discussed during the hearing on February 26,
    2019 was completed by brand; the change in Net Price was calculated at
    the brand level, and then weighted based on Net Sales for each brand as
    a percent of Total Net Product Sales for 2018.\2\
    ---------------------------------------------------------------------------
        \2\ Net Product Sales reflect the invoiced amount less movements in
    estimated accruals for rebates and chargebacks given to managed-care
    and other customers. Cash discounts for prompt payment are also
    deducted from sales. Average Net Price per Unit excludes product
    returns, and the figures were arrived at using the conventional Net
    Price calculation, that is, before deducting cost of goods sold,
    royalties, and variable selling expenses.

    ---------------------------------------------------------------------------
        Question. Please also specifically address the following questions:

        How many products are included in the calculation of the average
    net price change? What was the median net price change?

        Answer. The analysis discussed during the hearing on February 26,
    2019 included 26 brands that represent 98 percent of annual Net Product
    Sales in the United States for the period ending December 31, 2018.

        The Median Price Change (prior to weighting) was a Net Price
    decrease of 1 percent.

        Question. Is net price weighted? If so, how? For example, in
    determining the aggregate net price does the company assign different
    weights to different products based on volume or other factors? Are
    ``on patent'' and ``off patent'' drugs weighted identically? Are other
    statistical weights used or are all products treated equally?

        Answer. The analysis discussed during the hearing on February 26,
    2019 was completed by brand; the change in Net Price was calculated at
    the brand level, and then weighted based on Net Sales for each brand as
    a percent of Total Net Product Sales for 2018 irrespective of whether
    the medicines are on or off patent.

        Question. Does the figure that you provided during your testimony
    account for U.S. prices, international prices, or both? Generally
    speaking, when your company reports net price changes, does it
    differentiate between U.S. and international prices?

        Answer. The analysis discussed during the hearing on February 26,
    2019 referred to 26 brands that represent 98 percent of annual Net
    Product Sales in the United States for the period ending December 31,
    2018.

        Question. Please list the five drugs your company sold in the U.S.
    that had the greatest year-over-year net price increase in 2018, noting
    the increase for each drug by dollar figure and percentage. Please list
    the five drugs your company sold in the U.S. that had the lowest year-
    over-year net price increase (and/or the greatest decrease) in 2018,
    noting the increase (or decrease) for each drug by dollar figure and
    percentage.

        Answer. In 2018, we experienced a Weighted Average Net price
    decline in our hyper-competitive respiratory and diabetes therapeutic
    areas, with declines of 2.4 percent and 1.9 percent, respectively. Our
    Weighted Average Net prices in oncology remained flat. Brand-specific
    pricing information is competitively sensitive information.

        Question. For 2018, what was the average net price change in the
    U.S. market for (1) drugs with no competition, (2) drugs with only
    branded competition, and (3) drugs with generic competition?

        Answer. For 2018, the Weighted Average Net price change in the
    United States market for:

              Medicines with no competition was an increase of 0.6
            percent;

              Branded ``on patent'' medicines without generic equivalents
            was a decrease of 4.7 percent;

              ``Off patent'' medicines with generic equivalent competition
            was an increase of 4.6 percent.

        With respect to the last category of medicines described above, we
    note by way of context that once generic options enter the market, our
    market share rapidly erodes, as many PBMs, insurers, and government
    agencies to which AstraZeneca offers rebates and discounts replace our
    branded medicines on their formularies with these generic competitors.
    Accordingly, the mix of business for medicines with generic competition
    shifts towards programs whereby health plans/PBMs chose to list our
    branded medicines on their formularies given a lower net cost versus
    generics, and to individual patients who chose to pay for branded
    agents over generic agents, resulting in a higher average net effective
    price across all distribution channels.

        Question. You state that ``the estimates for 2018 show that across
    our medicines, our average rebate is nearly 50 percent of our gross
    revenues in the U.S.'' For each product, please disclose the gross
    revenue and the amount of rebates paid.

        Answer. The table below reflects our Product Sales in the U.S. for
    the period ending December 31, 2018, including the proportion of Gross
    Sales allocated to estimated amounts we expect to pay to third-party
    managed care organizations, hospitals, long-term care facilities, group
    purchasing organizations, and various Federal or State programs. The
    percentage of Gross Product Sales column reflects our effective rebate
    rate per channel, a combination of mix of business in that channel and
    related rebate rate.

    ------------------------------------------------------------------------
                                               USD (in         % of Gross
                                              millions)       Product Sales
    ------------------------------------------------------------------------
    Gross Product Sales                        $16,538,000
    ------------------------------------------------------------------------
    Chargebacks                               $(2,224,000)              -13%
    ------------------------------------------------------------------------
    Regulatory--Medicaid and State            $(1,304,000)               -8%
     programs
    ------------------------------------------------------------------------
    Contractual--Managed-care and             $(4,600,000)              -28%
     Medicare
    ------------------------------------------------------------------------
    Cash and other discounts                    $(286,000)               -2%
    ------------------------------------------------------------------------
    Customer returns                            $(119,000)               -1%
    ------------------------------------------------------------------------
    U.S. Branded Pharmaceutical Fee             $(140,000)               -1%
    ------------------------------------------------------------------------
    Other                                       $(989,000)               -6%
    ------------------------------------------------------------------------
    Net Product Sales                           $6,876,000
    ------------------------------------------------------------------------
    Brand-specific pricing information is competitively sensitive
      information.

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. During the hearing, when I asked whether your company
    engaged in tactics to delay generic production of your products, you
    answered ``no.'' However, AstraZeneca appears on the FDA's list of
    companies who have access complaints against them.

        Can you explain the discrepancy between your answer and the FDA
    list? The FDA list can be found here: https://www.fda.gov/Drugs/
    DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/
    ApprovalApplications/AbbreviatedNewDrug
    ApplicationANDAGenerics/ucm607738.htm.

        Answer. AstraZeneca appreciates the opportunity to address the
    question of one of our medicines (BRILINTA) appearing on the Reference
    Listed Drug Access Inquiries list (RLD List). We would first like to
    state that AstraZeneca supports allowing generic manufacturers access
    to samples. Withholding or otherwise blocking such access is
    inconsistent with that position. Our internal review has not identified
    any unanswered, delayed, or outstanding requests for samples of
    BRILINTA (ticagrelor) by any generic manufacturers.

        It is our understanding that BRILINTA was included on the RLD List
    based on a single inquiry received by the FDA. Unfortunately, the RLD
    List does not identify the company that reportedly requested
    information (or samples) from AstraZeneca, the date the information was
    requested, or any other information that would allow AstraZeneca to
    better understand or further investigate the circumstances of this
    inquiry. On its website, the FDA does advise that it has ``not
    independently investigated or confirmed the access limitations
    described in the inquiries received.'' Given this limitation, the
    listing of an inquiry on the RLD List does not mean that the FDA has in
    fact determined that access to samples by generic manufacturers was
    limited or withheld for the medicines identified. Indeed, based on our
    internal review, we have not identified any circumstances that
    substantiate the inquiry received by the FDA relating to BRILINTA.

        BRILINTA is and has always been available via normal commercial
    distribution channels (i.e., wholesalers) since its U.S. launch. It has
    never had a restricted distribution program.

        Finally, more than 15 generic manufacturers have applied for
    regulatory approval from the FDA for the manufacture of generic
    ticagrelor and some, like Watson/Teva, have received tentative
    approvals from the FDA. Because conducting bioequivalence studies with
    the branded medicine is an FDA preapproval requirement, it is clear
    that these generic manufacturers are not having difficulty accessing
    branded ticagrelor for their studies.

        In light of the context provided above, it is unclear why any
    generic manufacturer would be unable to obtain a sample of BRILINTA for
    their purposes or why an inquiry was lodged with the FDA related to
    this medicine.

        Question. When new products enter the market, do drug companies set
    high initial rebates and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. No, this is not AstraZeneca's general practice. We
    negotiate rebates and discounts with payers and pharmacy benefit
    managers (PBMs)--including in Medicare Part D--to help ensure that
    patients have the most robust access possible to our therapies. Without
    these discounts and rebates, many lifesaving medicines would not be
    placed on plan formularies and therefore would be largely unavailable
    to the patients who need them most.

        The current rebate system creates misaligned incentives. This
    results in a growing differential between list and net prices. We
    support reforms of this system that include the elimination of rebates
    in the commercial sector and in Medicare Part D, which will result in
    the reduction of the differential between list and net prices and which
    would allow manufacturers to ensure that the initial list price of a
    drug reflects its net value.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. We believe that eliminating rebates across Medicare Part D
    and commercial will generally result in lower initial list prices than
    in the absence of reform, although the impact on specific medicines
    will vary based on the competitive dynamics for that medicine. Reform
    only in Part D and not commercial is unlikely to impact initial list
    price setting practices, as the current structure does not allow for
    two separate list prices (i.e., one list price for Part D and a
    different list price for the commercial sector).

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D? In
    the health insurance plans that you offer your employees, do you ask
    your insurers to pass through the full manufacturer rebates to the
    beneficiaries?

        Answer. All of our medicines are rebated under the statutory
    requirements of Medicaid, Federal Supply Schedule, 340B, and the Part D
    coverage gap discount program. For our highly innovative, targeted
    therapies, we do not typically provide additional rebates other than
    through our value-based agreements, where such discounts are based on
    patient outcomes.

        In general, medicines with minimal rebates are the newest and most
    innovative on the market. Expanded use of value-based agreements is a
    key component to lowering costs and improving access to these medicines
    that are currently not in highly rebated therapeutic classes. Under
    such arrangements, manufacturers may contract to reimburse plans if the
    medicine does not work as expected, lowering risks for the payer. This
    also results in competition across manufacturers of medicines in these
    classes by facilitating competition across clinical results and
    outcomes.

        As we stated before the Senate Committee on Finance, AstraZeneca
    has put forward several proposals in addition to value-based agreements
    to address drug pricing:

              Moving away from the current rebate system, while continuing
            to work with payers and PBMs to ensure robust negotiations;

              Using a portion of discounts and rebates to create out-of-
            pocket caps for Medicare patients;

              Encouraging biosimilars and eliminating policy and
            commercial barriers to their greater use.

        AstraZeneca also supports increased transparency across the
    biopharmaceutical supply chain, including transparency with respect to
    drug pricing. To that end, we generally support the policies included
    in the current versions of the SPIKE and C-THRU Acts. There are a
    variety of state-level drug pricing transparency laws and regulations.
    We believe that having a consistent, federal standard for drug pricing
    transparency requirements, like those included in the SPIKE Act, should
    pre-empt state level laws to reduce confusion and compliance burden.

        We also support transparency efforts to ensure that patients and
    prescribers have meaningful information on out-of-pocket costs at the
    point of prescribing, so that they can make informed decisions about
    the most appropriate and affordable therapy.

        AstraZeneca wants to be a constructive partner in identifying
    solutions that continue to allow manufacturers to innovate while
    creating a more efficient and more affordable system.

        AstraZeneca provides generous health-care benefits to its
    employees. Today, we provide a point-of-sale discount on prescription
    medicines in the form of low out-of-pocket costs for our employees. We
    cap our employees' out-of-pocket costs on prescription medicines at $50
    per fill to ensure they do not forgo their prescriptions due to high
    out-of-pocket costs.

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand.

        What are your recommendations for increasing transparency in how
    your companies set the list prices for drugs, and for improving
    transparency in the supply chain for prescription drugs? Would you
    support Federal standards for transparency in setting the list prices
    for drugs?

        Answer. We do believe that greater transparency is needed for
    manufacturers as well as other entities in the supply chain. We
    therefore would generally support transparency requirements such as
    those included in the SPIKE and C-THRU Acts. Any transparency
    requirements should consider the need to protect competitively
    sensitive information to ensure robust competition in the market.

        There are a variety of State-level drug pricing transparency laws
    and regulations. We believe that having a consistent, Federal standard
    for drug pricing transparency requirements, like those included in the
    SPIKE Act, should pre-empt State-level laws to reduce confusion and
    compliance burden.

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently.

        How many of your drugs are included in value-based contracts and
    how many patients are benefiting from them? How do these value-based
    contracts work to lower drug prices for both patients and taxpayers?

        Answer. We believe medicines are part of the solution to
    controlling health-care costs. They not only improve patient outcomes
    and increase quality of life, but also reduce downstream costs. Value-
    based agreements allow us to reimburse the health-care system if our
    medicines do not deliver as intended. This solution demonstrates our
    willingness to stand behind the value of our medicines.

        AstraZeneca is working closely with payers and health systems to
    explore innovative solutions to improve access and affordability that
    demonstrate the value our medicines bring to patients and the health-
    care system. Our value-based agreements aim to manage the totality of
    treatment costs and keep people healthy and out of the hospital. For
    several years, AstraZeneca has been exploring these types of solutions
    through value-based agreements where we are willing to work with
    health-care stakeholders to tie payment to patient outcomes.

        To date, we have entered into approximately 40 value-based
    agreements for 15 medicines across our therapeutic areas with a variety
    of payers, making AstraZeneca a leader in the field of value-based
    agreements. Tens of thousands of patients have benefited from improved
    access as part of these agreements.

        As an example, and as noted in our written testimony submitted to
    the Senate Committee on Finance, AstraZeneca agreed with Express
    Scripts that for IRESSA, an oral treatment for certain types of lung
    cancer, we will fully reimburse Express Scripts for discontinued use
    before the third fill, including if discontinuation occurs because
    patients did not respond to treatment.

        While most of these agreements have been focused on securing
    patient access to our medicines and delivering better patient outcomes,
    where payers are willing, we are also looking to more directly address
    patient out-ofpocket affordability through these innovative
    arrangements.

        As an example, we recently announced the initiation of a value-
    based agreement for University of Pittsburgh Medical Center (UPMC)
    Medicare patients who are prescribed BRILINTA. This value-based
    contract, which was effective as of January 1, 2019, is groundbreaking
    in two ways. First, the contract lowers the out-of-pocket costs for a
    UPMC Medicare Part D patient to approximately $10 for a 30-day supply.
    Second, what UPMC pays for BRILINTA will vary based on patient
    outcomes, tying the cost of the medicine to its real-world clinical
    performance.

        We are currently exploring another value-based agreement in
    Medicare Part D. In addition to having a significant outcomes-based
    component, this arrangement would reduce patient out-of-pocket costs.
    This type of agreement allows patients to access their medicines at a
    lower out-of-pocket cost and payers to control their overall health-
    care costs through paying for outcomes.

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack.

        Are any of your companies providing medical necessity paperwork to
    doctors in order to get your drugs covered by Medicare?

        Answer. AstraZeneca policies prohibit completing medical necessity
    paperwork for doctors or their staff as described in your inquiry.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers.

        What is delaying the uptake of biosimilar drugs in the United
    States? What policies do you recommend to increase the development of
    biosimilar drugs?

        Answer. AstraZeneca believes that competition is a key component to
    reducing costs, and that is why we support the expanded use of
    biosimilars in the U.S. As a global company, we operate in countries,
    particularly those in the European Union, where biosimilar competition
    is particularly robust. We support a similarly vigorous biosimilars
    market in the U.S.

        There are several challenges to biosimilar uptake in the U.S.,
    including contracting and rebating dynamics and difficulty in obtaining
    interchangeability status. We therefore appreciate the efforts of the
    FDA to increase the availability of biosimilars in the U.S., including
    the FDA's development of a Biosimilars Action Plan. We support efforts
    to streamline and improve the efficiency of the biosimilars approval
    pathway for the benefit of patients. Such efforts could include
    increased transparency into the patents applicable to biologic
    medicines.

        We also support reimbursement policies that facilitate the uptake
    of biosimilars. Such policies include Medicare reimbursement rates that
    ensure that biosimilars can compete on equal footing with innovator
    medicines, and reductions to cost-sharing amounts for biosimilars. We
    also believe the elimination of rebates will help biosimilars compete
    with innovator medicines.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach. Researchers
    say that this type of imagery, combined with viewing hours of drug
    commercials each month, leads consumers to underestimate the risks
    associated with medications. For the past decade, studies have shown
    that aggressive direct-to-consumer advertising is associated with
    rising drug prices and an increase in inappropriate drug prescriptions.

        Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. Our advertising complies with regulatory requirements
    governing direct-toconsumer (DTC) advertising and AstraZeneca believes
    that DTC advertising is important to raising brand and disease
    awareness, fostering patient education, and enhancing the dialogue
    between patients and their physicians. Unfortunately, these positive
    impacts of health-care communication efforts are often left out of the
    DTC debate.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organization for Economic Cooperation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price. One of
    the most well-known examples is Mylan's increase of the price of EpiPen
    from less than $100 in 2007 to more than $600 in 2016. Another example,
    is the ever-increasing price of insulin. Sanofi increased the price of
    a vial of Lantus from $88.20 in 2007 to $307.20 in 2017. And those are
    just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. As an initial matter, it is important to note the
    distinction between list and net prices. Over the past several years,
    discounts and rebates for our therapies have increased overall, both in
    the commercial sector and Part D. In recent years, in our primary care
    portfolio, which includes the majority of our therapies, we have seen
    flat to declining net effective prices to AstraZeneca for most of our
    medicines. Flat to declining net prices is a trend across the industry.

        However, the current system makes list price decreases challenging.

        Therefore, to accomplish meaningful change in terms of lowering
    list price, the system must be restructured to eliminate rebates.
    Assuming the HHS rebate rule is finalized largely as proposed,
    AstraZeneca intends to comply with its requirements and use point-of-
    sale discounts. Our goal is to maintain net prices broadly in line with
    today, recognizing our ability to do so may be dependent on external
    factors and market response such as how plans evolve their benefit
    design and the total degree of transparency under the new model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector, and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market. These ``pay-for-delay'' patent
    settlements benefit both brand-name pharmaceutical companies by helping
    them avoid costly patent litigation and general manufacturers by
    rewarding them a hefty sum to delay entering the market with a cheaper
    drug alternative. However, these deals do not benefit consumers.
    According to an FTC study, these anticompetitive deals cost consumers
    and taxpayers $3.5 billion in higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Answer. AstraZeneca does not enter into settlements that pay
    generic competitors to delay entry into the market. In the absence of a
    settlement, a generic would not necessarily prevail in the patent
    litigation and therefore would not be able to enter the market. Indeed,
    AstraZeneca has entered into many early-entry patent settlements that
    permit generic competitors to enter the market before expiration of
    AstraZeneca's patent rights by allowing generic manufacturers to
    license innovator patents.

        All of AstraZeneca's patent settlements fully comply with the law.
    These settlements provide increased clarity and stability to both
    parties, allowing innovators like AstraZeneca to continue investing
    substantially in new medicines for patients and frequently allowing
    generic competitors to enter the market before expiration of
    AstraZeneca's patent rights.

        Question. Why would a pharmaceutical company enter into a pay-for-
    delay agreement?

        Answer. AstraZeneca does not enter into agreements that pay generic
    competitors to delay entry into the market.

        Question. Do you think these agreements stifle competition and
    prevent generic alternatives to your branded medications?

        Answer. AstraZeneca does not enter into agreements that pay generic
    competitors to delay entry into the market. However, AstraZeneca has
    entered into many early-entry patent settlements that permit generic
    competitors to enter the market before expiration of AstraZeneca's
    patent rights by allowing generic manufacturers to license innovator
    patents. These do not stifle competition but instead permit early entry
    by resolving patent disputes that would otherwise prevent generic
    alternatives to branded medication.
                              value-based pricing
        Question. One idea I wanted to get your thoughts on today, is the
    idea of value-based pricing. This is an idea where a company could link
    the single price it charges for a given drug to an assessment of how
    well it works. Some value-based pricing arrangements could allow
    insurers and patients to receive rebates from drug manufacturers if a
    drug failed to work (outcome-based pricing). Another version would
    involve ``indication-based pricing'' in which drug companies charge
    different prices for the same drug when it is used to treat different
    conditions.

        Dr. Soriot, we have heard that AstraZeneca has been participating
    in a value-based program in collaboration with the University of
    Pittsburgh Medical Center.

        Could you talk more about your research in value-based pricing and
    how you believe this could be possible solution to some of the high
    drug prices?

        Answer. We believe medicines are part of the solution to
    controlling health-care costs. They not only improve patient outcomes
    and increase quality of life, but also reduce downstream costs. Value-
    based agreements allow us to reimburse the health-care system if our
    medicines do not deliver as intended. This solution demonstrates our
    willingness to stand behind the value of our medicines.

        AstraZeneca is working closely with payers and health systems to
    explore innovative solutions to improve access and affordability that
    demonstrate the value our medicines bring to patients and the health-
    care system. Our value-based agreements aim to manage the totality of
    treatment costs and keep people healthy and out of the hospital. For
    several years, AstraZeneca has been exploring these types of solutions
    through value-based agreements where we are willing to work with
    health-care stakeholders to tie payment to patient outcomes.

        To date, we have entered into approximately 40 value-based
    agreements across our therapeutic areas with a variety of payers.

        Our research in value-based agreements has been focused on
    addressing the comprehensive value of a medicine in terms of medical
    cost offsets and the economic impact of achieving certain health
    benefits with a medicine in a specific population. Our experience in
    this area consists of health economics and outcomes research (HEOR) and
    real-world evidence (RWE) studies which correlate improved outcomes and
    overall better health to a direct, positive economic impact, realized
    by both the payer and the patient. We use HEOR and RWE data to
    establish the metrics of the value-based agreement. Another important
    part of our value-based agreement research is how we measure the impact
    of a value-based agreement, so we can learn what works and what does
    not work for future iterations of value-based agreements.

        In addition, by aligning payments for medicines more directly with
    their value in improving health outcomes and/or reducing the need for
    other healthcare services (such as hospitalizations), value-based
    arrangements make pharmaceutical manufacturers accountable for the
    results our medicines achieve and can help improve patients' health and
    maximize the benefits of healthcare spending. Over time, proliferation
    of value-based agreements can shift utilization toward medicines with
    greater clinical value and greater ability to reduce hospitalizations
    and other costly services, resulting in better health outcomes and
    lower overall healthcare spending.

        As manufacturers develop more complex, personalized, and promising
    treatments--such as gene therapies, cell therapies, or immuno-
    therapies--it will be increasingly important for health plans to enter
    into value-based agreements so that they and our healthcare system may
    recognize the full value of those treatments and make them available to
    patients at affordable out-of-pocket amounts. Value-based agreements
    serve an important role in linking the price of a medicine to
    beneficiaries' demonstrated real world outcomes using that medicine.

        While most of these agreements have been focused on securing
    patient access to our medicines, some have also helped payers identify
    which patient types are most likely to benefit from our medicines and
    deliver improved patient outcomes. Partnering to drive this type of
    clarity can reduce overall drug spend in meaningful ways. Where payers
    are willing, we are also looking to more directly address patient out-
    of-pocket affordability through these innovative arrangements.

        As you mention, we recently announced the initiation of a value-
    based agreement for University of Pittsburgh Medical Center (UPMC)
    Medicare patients who are prescribed BRILINTA. This value-based
    contract, which was effective as of January 1, 2019, is groundbreaking
    in two ways. First, the contract lowers the out-of-pocket costs for a
    UPMC Medicare Part D patient to approximately $10 for a 30-day supply.
    Second, what UPMC pays for BRILINTA will vary based on patient
    outcomes, tying the cost of the medicine to its real-world clinical
    performance.

        Through the partnership of payers and policymakers, we look forward
    to a future where implementation of value-based agreements across
    public and private payers is widespread. Value-based agreements are one
    proactive solution; they are not the only solution.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) Office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections. The rule is
    predicted to increase net drug costs in its early years. The CMS
    actuaries estimate it would cost $196 billion over 10 years. Despite
    this high price tag, the beneficiary benefits are limited. The proposed
    rule notes that under the CMS Actuary's analysis, the majority of
    beneficiaries would see an increase in their total out-of-pocket
    payments and premium costs; reductions in total cost sharing will
    exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. Assuming the HHS rebate rule is finalized largely as
    proposed, AstraZeneca intends to comply with its requirements and use
    point-of-sale discounts. Our goal is to maintain net prices broadly in
    line with today, recognizing our ability to do so may be dependent on
    external factors and market response such as how plans evolve their
    benefit design and the total degree of transparency under the new
    model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector, and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spent nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9 percent of all medical marketing, in 1997 to $9.6
    billion, or 32 percent of total spending, in 2016.

        Can you please provide what your ratio of spending on sales and
    marketing to research and development is today?

        Answer. In 2018, we spent $5.9 billion on RandD and $6.1 billion on
    Sales and Marketing, globally. Our Sales and Marketing figures include
    all costs incurred in selling, marketing, promoting, and distributing
    our products.
                                 price-gouging
        Question. Sanofi, as I understand it, has made a pledge to the
    public to limit its price increases to the national health expenditures
    growth projection.

        Would your company commit to a cap on annual price increases as
    part of your PhRMA membership criteria?

        Answer. Our decisions around pricing would always need to remain
    independent of PhRMA membership criteria.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. As we stated at the Senate Committee on Finance hearing,
    AstraZeneca has put forward a number of proposals to address drug
    pricing, including:

              Moving away from the current rebate system, while continuing
            to work with payers and PBMs to ensure robust negotiations; and

              Encouraging biosimilars and eliminating policy and
            commercial barriers to their greater use.

               As described below, we also support efforts to increase
            transparency in the biopharmaceutical supply chain and drug
            pricing specifically.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates do
    not rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. Yes, AstraZeneca agrees that greater transparency is
    needed. We therefore generally support the policies included in the
    current versions of the SPIKE and C-THRU Acts.

        There are a variety of State-level drug pricing transparency laws
    and regulations. We believe that having a consistent, federal standard
    for drug pricing transparency requirements, like those included in the
    SPIKE Act, should pre-empt state level laws to reduce confusion and
    compliance burden.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health-care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        Answer. AstraZeneca prescription drug benefits are managed by
    Express Scripts.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, how do you utilize the
    rebates your PBM negotiates to lower health-care costs or drug costs
    for your employee plans and what does your company do with that
    savings? Specifically, do the savings go toward lowing premiums?

        Answer. AstraZeneca provides generous healthcare benefits to its
    employees. Today, we provide a point-of-sale discount on prescription
    medicines in the form of low out-of-pocket costs for our employees. We
    cap our employees' out-of-pocket costs on prescription medicines at $50
    per fill to ensure they do not forgo their prescriptions due to high
    out-ofpocket costs.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, does your PBM offer
    point-of-sale rebates to your employees?

        Answer. While AstraZeneca does not currently offer point-of-sale
    rebates to employees, we are exploring opportunities to evolve our
    benefits in the future.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. The current rebate construct is the key challenge in
    reducing list prices and we would support legislation that would
    eliminate rebates in Part D and the commercial sector. Assuming the HHS
    rebate rule is finalized largely as proposed, AstraZeneca intends to
    comply with its requirements and use point-of-sale discounts. Our goal
    is to maintain net prices broadly in line with today, recognizing our
    ability to do so may be dependent on external factors and market
    response such as how plans evolve their benefit design and the total
    degree of transparency under the new model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector, and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)? How many of your company's products are
    based, at least in part, on NIH research, and how many are the result
    of research funded solely by your company?

        Answer. We collaborate with the National Institutes of Health and
    the National Cancer Institute, and these partnerships can lead to
    important advances for patients. However, biopharmaceutical companies
    conduct the vast majority of R&D needed to bring new medicines to
    patients and they bear the associated costs and risks.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer. Last year alone, we invested nearly $6 billion in R&D,
    which represents 28 percent of our total product sales, well above the
    industry average.

        Our Sales and Marketing figures include all costs incurred in
    selling, marketing, promoting, and distributing our products.

    ------------------------------------------------------------------------
                  Year                 R&D Investment   Sales and Marketing
    ------------------------------------------------------------------------
    2018                                  $5.9 billion          $6.1 billion
    ------------------------------------------------------------------------
    2017                                  $5.8 billion          $5.6 billion
    ------------------------------------------------------------------------
    2016                                  $5.9 billion          $5.8 billion
    ------------------------------------------------------------------------
    2015                                  $6.0 billion          $6.6 billion
    ------------------------------------------------------------------------
    2014                                  $5.6 billion          $7.1 billion
    ------------------------------------------------------------------------

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        Answer. Assuming the HHS rebate rule is finalized largely as
    proposed, AstraZeneca intends to comply with its requirements and use
    pointof-sale discounts. Our goal is to maintain net prices broadly in
    line with today, recognizing our ability to do so may be dependent on
    external factors and market response such as how plans evolve their
    benefit design and the total degree of transparency under the new
    model.

        AstraZeneca would plan to reduce list prices, pending reforms
    across all payers, including in the commercial sector in addition to
    Part D, as the current construct does not allow for two separate list
    prices (i.e., one list price for Part D and a different list price for
    the commercial sector). Therefore, we also support efforts to eliminate
    rebates in the commercial sector, and recommend that Congress explore
    such legislation. While eliminating rebates is an important step,
    benefit designs must also be evaluated.

        Question. How will this proposal affect how your company sets the
    list prices for new drug products?

        Answer. We believe that eliminating rebates across Medicare Part D
    and commercial will generally result in lower initial list prices than
    in the absence of reform, although the impact on specific medicines
    will vary based on the competitive dynamics for that medicine. Reform
    only in Part D and not commercial is unlikely to impact initial list
    price setting practices, as the current structure does not allow for
    two separate list prices (i.e., one list price for Part D and a
    different list price for the commercial sector).

        Question. If the proposal is finalized and not extended to the
    private market, will your company make any list price reductions? If
    so, how large would the reductions be relative to the size of the
    rebates your company is currently providing?

        Answer. AstraZeneca would plan to reduce list prices, pending
    reforms across all payers, including in the commercial sector in
    addition to Part D, as the current construct does not allow for two
    separate list prices (i.e., one list price for Part D and a different
    list price for the commercial sector). Therefore, we also support
    efforts to eliminate rebates in the commercial sector, and recommend
    that Congress explore such legislation. While eliminating rebates is an
    important step, benefit designs must also be evaluated.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\3\ This requirement
    created an unintended loophole. Rather than use the price of the
    authorized generic, drug companies can sell its authorized generic to a
    corporate subsidiary at an artificially lower price, and use that lower
    price to bring down the AMP, which in turn lowers the rebate
    obligation.
    ---------------------------------------------------------------------------
        \3\ MACPAC, ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wp-content/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        Does your company engage in this practice? Has your company ever
    ---------------------------------------------------------------------------
    engaged in this practice in the past?

        Answer. No. In limited circumstances, AstraZeneca has made
    authorized generics available, but does so through a third-party
    distributor, not an AstraZeneca subsidiary.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? For those drugs, is
    your list price equal to your net price?

        Answer. All of our medicines are rebated under the statutory
    requirements of Medicaid, Federal Supply Schedule, 340B, and the Part D
    coverage gap discount program. For our highly innovative, targeted
    therapies, we do not typically provide additional rebates other than
    through our value-based agreements, where such discounts are based on
    patient outcomes. Therefore, due to statutory rebates and other fees
    and discounts, the net price is lower than list price for all
    medicines.

        Question. Do you invest more in R&D than you generate in U.S. sales
    revenue? Please include specific figures.

        Answer. In 2018, AstraZeneca's U.S. revenue was $6.88 billion. We
    invested $5.9 billion in R&D, globally.

        Question. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. In 2018, we spent $5.9 billion on R&D and $10 billion on
    Selling, General and Administrative (SG&A) costs globally, which is
    inclusive of Sales and Marketing costs of $6.1 billion.

        Selling, General and Administrative expenses are defined as fixed
    costs of selling products and services and costs of central services
    and administration, which are not included in inventory values.

        General and administrative costs include costs of central services
    and administration, such as: Human Resources, Finance, Facilities,
    Purchasing, Strategy and Business Development, Legal, Corporate
    Affairs, and other corporate expenses.

        Our Sales and Marketing figures include all costs incurred in
    selling, marketing, promoting, and distributing our products.

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. In 2018, we spent $5.9 billion on R&D and $6.1 billion on
    Sales and Marketing, globally.

        Our Sales and Marketing figures include all costs incurred in
    selling, marketing, promoting, and distributing our products.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. We consider many factors when making decisions regarding
    the advertising of our medicines, including the opportunity to raise
    brand and disease awareness, patient education, and the enhancement of
    the patient/physician dialogue.

        We believe that health-care communications efforts can have a
    positive impact on patient health. AstraZeneca made a decision several
    years ago to use our direct-to-consumer (DTC) advertisements to share
    another important message with patients: We were the first company to
    include messages about our affordability programs in all of our DTC TV
    advertisements, making clear to patients that if they cannot afford
    their medicines, AstraZeneca may be able to help. We continue this
    practice today, which we believe is reflective of AstraZeneca's
    commitment to patient access and affordability.

                                     ______

                                   Appendix A
    ------------------------------------------------------------------------
          Organization          Program Title        Date         Amount
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Chronic Total        01/07/2014       $5,000.00
     FOUNDATION               Occlusion and
                              Left Main Summit
                              2014: A Live
                              Demonstration
                              Course
    ------------------------------------------------------------------------
    TORRANCE MEMORIAL        Cardiology Update    01/08/2014       $2,500.00
     MEDICAL CENTER           2014:
                              Conventional
                              Wisdom and Beyond
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           Grand Rounds in      01/09/2014       $8,027.93
                              Cardiovascular
                              Diseases
    ------------------------------------------------------------------------
    UNIVERSITY OF CHICAGO    Sixth Annual         01/12/2014       $3,000.00
                              Morton Arnsdorf
                              Cardiovascular
                              Research Day at
                              the University of
                              Chicago
    ------------------------------------------------------------------------
    FLORIDA OSTEOPATHIC      15th Annual          01/15/2014       $5,000.00
     MEDICAL ASSOCIATION      Cardiovascular
     DISTRICT SOCIETY 2       and Medicine
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      25th Annual          01/16/2014       $5,000.00
     CARDIOLOGY--PUERTO       Meeting ACC
     RICO CHAPTER             Puerto Rico
                              Chapter
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Patient    01/23/2014      $25,000.00
     MANAGED CARE             Outcomes: Updated
     PHYSICIANS               Treatment
                              Strategies in the
                              Management of
                              Acute Coronary
                              Syndrome (ACS)
    ------------------------------------------------------------------------
    UNIVERSITY MEDICAL       6th Annual           01/23/2014       $5,000.00
     CENTER OF SOUTHERN       Cardiovascular
     NEVADA                   and Stroke
                              Symposium
    ------------------------------------------------------------------------
    SAINT JOSEPH'S           Antithrombotic       01/23/2014       $2,737.62
     HOSPITAL--ATLANTA        Protocol for
                              Acute Coronary
                              Sndrome
    ------------------------------------------------------------------------
    GORDON RESERACH          Gordon Research      01/26/2014       $1,700.00
     CONFRENCE                Seminar--``Lipopr
                              otein
                              Metabolism''
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Rheumatology Best    01/26/2014       $9,795.58
     EDUCATIONAL FOUNDATION   Practices 6th
                              Annual
                              Rheumatology
                              Highlights
                              Report--``Transla
                              ting an
                              International
                              Meeting into
                              Clinical
                              Practice''
    ------------------------------------------------------------------------
    KERN ASPEN LIPID         Evolving Concepts    01/26/2014       $7,000.00
     CONFERENCE               of HDL Function
                              in
                              Cardiometabolic
                              Diseases and
                              Beyond
    ------------------------------------------------------------------------
    ST. JOSEPH'S REGIONAL    Acute Coronary       01/27/2014       $2,225.00
     MEDICAL CENTER           Syndrome:
                              Evidence-Based
                              Management in the
                              Present Era
    ------------------------------------------------------------------------
    NATIONAL LIPID           Lipid Academy        01/28/2014      $20,000.00
     ASSOCIATION              Series of 2
    ------------------------------------------------------------------------
    NATIONAL LIPID           Masters in           01/28/2014      $20,000.00
     ASSOCIATION              Lipidology Series
                              of 2
    ------------------------------------------------------------------------
    REGENTS OF THE           Rheumatology Grand   01/29/2014       $5,000.00
     UNIVERSITY OF            Rounds
     CALIFORNIA
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          Overview of the      01/29/2014       $5,439.84
                              Duke Health
                              Systems Acute
                              Coronary
                              Syndromes
                              suggested
                              algorithm of care
    ------------------------------------------------------------------------
    PENNSYLVANIA ACADEMY OF  PAFP/F Smoking       01/29/2014      $13,666.00
     FAMILY PHYSICIANS        Cessation and
     FOUNDATION               Asthma Outcomes
                              CME
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Advances in the      01/30/2014      $30,000.00
     UNIVERSITY               Diagnosis and
                              Treatment of the
                              Rheumatic
                              Diseases
    ------------------------------------------------------------------------
    EMORY UNIVERSITY         Emory Symposium on   01/30/2014       $5,000.00
                              Coronary
                              Atherosclerosis
                              Prevention and
                              Education
                              (ESCAPE)
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Clinical Pearls      01/30/2014       $5,000.00
     ASSOCIATES FOR           for COPD
     CONTINUING EDUCATION
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Practical            01/30/2014      $25,000.00
     MANAGED CARE             Strategies to
     PHYSICIANS               Improve Patient
                              Outcomes in the
                              Prevention and
                              Treatment of COPD
    ------------------------------------------------------------------------
    ST. JOSEPH'S REGIONAL    COPD                 02/04/2014       $2,200.00
     MEDICAL CENTER
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 23rd Annual     02/04/2014      $16,130.00
     CLINICAL                 Scientific and
     ENDOCRINOLOGISTS         Clinical Congress
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Cardiovascular       02/04/2014       $5,000.00
     ASSOCIATES FOR           Pharmacology:
     CONTINUING EDUCATION     Latest Updates in
                              Caring for the
                              Cardiac Patient
    ------------------------------------------------------------------------
    MIDWEST CARDIOVASCULAR   Cardiology at the    02/04/2014       $5,000.00
     RESEARCH FOUNDATION      Bix
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACCs 63rd Annual     02/05/2014     $100,000.00
     CARDIOLOGY FOUNDATION    Scientific
                              Session (ACC.14)
                              Prevention
                              Learning Pathway
                              and Prevention
                              Pilot Program
    ------------------------------------------------------------------------
    LA BIOMED                Cardiology Grand     02/05/2014       $5,000.00
                              Rounds: Updates
                              in ACS
    ------------------------------------------------------------------------
    NEBRASKA ACADEMY OF      Ten Things You       02/05/2014       $5,500.00
     PHYSICIAN ASSISTANTS     Didn't Learn
                              About COPD in
                              Class (Even If
                              You Were Paying
                              Attention
    ------------------------------------------------------------------------
    MINNESOTA SOCIETY OF     MSHP Annual          02/05/2014       $2,533.00
     HEALTH-SYSTEM            Meeting 2014:
     PHARMACISTS              Evidenced-based
                              Updates in the
                              Management of
                              Dyslipidemia
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  20th Annual          02/05/2014      $15,000.00
     FOUNDATION               Interventional
                              Cardiology
                              Fellows Course
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Best of ACC.14:      02/05/2014      $50,000.00
     CARDIOLOGY FOUNDATION    Take Home
                              Messages for the
                              Clinicians
    ------------------------------------------------------------------------
    ENDOCRINE SOCIETY        ENDO 2014            02/06/2014      $40,000.00
                              Educational
                              Sessions
    ------------------------------------------------------------------------
    ALL NYC EMERGENCY        All NYC Emergency    02/06/2014       $5,000.00
     MEDICINE CONFERENCE,     Medicine
     INC.                     Conference; In
                              the Footsteps of
                              Giants
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Annual Scientific    02/09/2014      $10,000.00
     PHYSICIANS; PUERTO       Meeting
     RICO CHAPTER
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Optimizing PCI       02/09/2014       $5,000.00
     FOUNDATION               Outcomes: A
                              Vision for 2014
    ------------------------------------------------------------------------
    INTERNATIONAL            14th Annual          02/10/2014      $12,500.00
     ASSOCIATION FOR THE      Targeted
     STUDY OF LUNG CANCER     Threapies of Lung
                              Cancer Meeting
    ------------------------------------------------------------------------
    TENNESSEE ACADEMY OF     Breast and Ovarian   02/10/2014       $6,000.00
     PHYSICIAN ASSISTANTS     Cancer
    ------------------------------------------------------------------------
    PURDUE UNIVERSITY        A 2014 National      02/12/2014      $30,000.00
                              Educational
                              Initiative on
                              Therapeutics and
                              Rheumatology for
                              Rheumatology
                              State Societies
    ------------------------------------------------------------------------
    WEST PENN ALLEGHENY      Cardiovascular       02/17/2014      $10,000.00
     HEALTH SYSTEM, INC.      Medicine Update
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       12th International   02/18/2014      $25,000.00
     HOSPITAL CENTER          Congress on
                              Targeted
                              Anticancer
                              Therapies (TAT)
    ------------------------------------------------------------------------
    THE BIBIKHAN FOUNDATION  7th Annual           02/18/2014       $5,000.00
                              Cardiovascular
                              Update--``A
                              Practical
                              Tutortial''
    ------------------------------------------------------------------------
    SOCIETY OF GYNECOLOGIC   SGO 45th Annual      02/19/2014      $25,000.00
     ONCOLOGY                 Meeting on
                              Women's Cancer
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      02/19/2014       $5,000.00
     CONFERENCES              Conferences on
                              Cardiac
                              Regulatory
                              Mechanisms
    ------------------------------------------------------------------------
    BAYLOR UNIVERSITY        Emerging             02/20/2014      $17,460.00
     MEDICAL CENTER DBA A.    Therapeutic
     WEBB ROBERTS CENTER      Options for
                              Medullary Thyroid
                              Cancer and
                              Differentiated
                              Thyroid Cancer
    ------------------------------------------------------------------------
    ACADEMIA MEDICA DEL SUR- Cardiometabolic      02/20/2014      $20,000.00
     FONDO EDUCACION MEDICA   Health Congress
     CONTINUADA               2014
    ------------------------------------------------------------------------
    DUKE UNIVERSITY MEDICAL  13th Annual          02/25/2014       $5,498.41
     CENTER                   Southeastern
                              Fellows Research
                              Skills Retreat
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        19th Annual          02/25/2014       $5,000.00
     CHICAGO                  University of
                              Chicago Phase II
                              Consortium (UC
                              P2C) Symposium
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    60th Annual          02/25/2014      $25,000.00
     ON THROMBOSIS AND        Meeting of the
     HAEMOSTASIS              Scientific and
                              Standardization
                              Committee (SSC)
                              of the
                              International
                              Society on
                              Thrombosis and
                              Haemostasis
                              (ISTH)
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        Making Sense of      02/25/2014       $5,000.00
     CHICAGO                  the Sequence:
                              Genomics Primer
                              for Clinical
                              Cancer Genetic
                              Practitioners
    ------------------------------------------------------------------------
    WEST VIRGINIA ACADEMY    Dyslipidemia and     02/25/2014       $2,500.00
     OF FAMILY PHYSICIANS     Atherosclerosis--
                              Reducing the Risk
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      PediaLink            02/26/2014      $37,800.00
     PEDIATRICS               Influenza Course
                              Series
    ------------------------------------------------------------------------
    PREVENTIVE               20th Annual          02/26/2014      $15,000.00
     CARDIOVASCULAR NURSES    Symposium
     ASSOCIATION
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  2014 NAFC Annual     02/27/2014      $30,000.00
     FREE and CHARITABLE      Summit
     CLINICS
    ------------------------------------------------------------------------
    VANDERBILT UNIVERSITY    Cardiology 2014:     02/27/2014       $5,000.00
                              Advances in
                              Science and
                              Practice
    ------------------------------------------------------------------------
    THE BOARD OF REGENTS OF  Cardiovascular       02/27/2014       $5,000.00
     THE UNIVERSITY OF        Medicine and
     WISCONSIN SYSTEM         Prevention Update
                              for Primary Care
    ------------------------------------------------------------------------
    SOCIETY FOR VASCULAR     Society for          03/02/2014       $5,000.00
     MEDICINE                 Vascular Medicine
                              25th Anniversary
                              and Scientific
                              Sessions
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     94th Annual          03/04/2014      $10,000.00
     FOR THORACIC SURGERY     Meeting American
                              Association for
                              Thoracic Surgery
    ------------------------------------------------------------------------
    CHI ST. LUKE'S HEALTH    Cardiology Grand     03/05/2014       $3,857.58
                              Rounds
    ------------------------------------------------------------------------
    MIDWEST CARDIOVASCULAR   Cardiovascular       03/05/2014       $5,000.00
     RESEARCH FOUNDATION      Interventions and
                              Practice
                              Guidelines
    ------------------------------------------------------------------------
    UNIVERSITY OF ROCHESTER  27th Cardiology      03/05/2014       $4,805.00
                              Spring Update
                              2014
    ------------------------------------------------------------------------
    UNIVERSITY OF            Clinical             03/05/2014       $4,000.00
     WASHINGTON               Cardiology Pearls
                              for Primary Care
                              Providers
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Faces and Cases:     03/06/2014      $50,000.00
     PAIN MANAGEMENT          Assessing and
                              Managing People
                              With Complex
                              Chronic Pain
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Pediatric Asthma     03/06/2014       $5,000.00
     OF HARVARD COLLEGE       and Allergy
                              Updates for
                              Primary Care
                              Providers
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Boston Bacterial     03/06/2014       $2,500.00
     OF HARVARD COLLEGE       Meeting 2014
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  TCTMD 2014 Post      03/09/2014     $100,000.00
     FOUNDATION               Conference Web
                              Cast Series
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  DAPT Dilemmas: A     03/09/2014      $66,913.46
     FOUNDATION               Case-based
                              Roundtable
                              Tutorial
    ------------------------------------------------------------------------
    ASSOCIATION OF BLACK     40th Anniversary     03/11/2014      $20,000.00
     CARDIOLOGISTS            Annual Scientific
                              Sessions The
                              Ecology of
                              Cardiovascular
                              Disease in 2014:
                              Trends,
                              Challenges and
                              Targets for 2025
    ------------------------------------------------------------------------
    THE HOPE FOUNDATION      Spring 2014 SWOG     03/18/2014      $10,000.00
                              Group Meeting
    ------------------------------------------------------------------------
    AMERICAN LUNG            ALASD Asthma         03/18/2014       $2,500.00
     ASSOCIATION OF THE       Educator
     UPPER MIDWEST            Institute
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Getting to Goal:     03/19/2014       $5,950.00
     CONSULTANT PHARMACISTS   The Pharmacist's
     FL CHAPTER               Role in Managing
                              Dyslipidemia and
                              Atherosclerosis
    ------------------------------------------------------------------------
    THE RESEARCH FOUNDATION  Cal For Grants CGA   03/19/2014       $2,000.00
                              CV 1404--Time
                              Critical
                              Diagnosis (TCD)
                              Symposium
    ------------------------------------------------------------------------
    EMORY UNIVERSITY         Emory Practical      03/19/2014       $3,000.00
                              Intervention
                              Course (EPIC
                              2014)
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      03/20/2014       $5,000.00
     CONFERENCES              Conference and
                              Seminar on
                              Hemostasis
    ------------------------------------------------------------------------
    PENNSYLVANIA ALLERGY     2014 Annual          03/20/2014       $5,000.00
     AND ASTHMA ASSOCIATION   Meeting of the
                              Pennsylvania
                              Allergy and
                              Asthma
                              Association
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         Oncology Nursing     03/20/2014      $25,000.00
     SOCIETY                  Society 39th
                              Annual Congress
    ------------------------------------------------------------------------
    RICHMOND UNIVERSITY      Lipid Management     03/20/2014       $1,400.00
     MEDICAL CENTER           2014 Guidelines
                              and Beyond
    ------------------------------------------------------------------------
    JOHNS HOPKINS            5th Annual Johns     03/23/2014       $2,500.00
     UNIVERSITY               Hopkins
                              Cardiovascular
                              Research Retreat
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Fall 2014            03/23/2014       $5,000.00
     ALLERGY ASTHMA AND       Symposium of the
     IMMUNOLOGY               Los Angeles
                              Society of
                              Allergy, Asthma
                              and Clinical
                              Immunology
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     03/23/2014      $15,000.00
                              Working Group US
                              Chapter Meeting
    ------------------------------------------------------------------------
    THE SOCIETY FOR          2014 SCAI            03/23/2014      $15,000.00
     CARDIOVASCULAR           Transradial
     ANGIOGRAPHY AND          Interventional
     INTERVENTIONS            Program (TRIP)
                              Series
    ------------------------------------------------------------------------
    ASPEN LUNG CONFERENCE    Thomas L. Petty      03/24/2014       $5,000.00
                              Aspen Lung
                              Conference:
                              Rebuilding the
                              Injured Lung
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    ISHIB 2014 Annual    03/24/2014      $10,000.00
     ON HYPERTENSION IN       Conference-
     BLACKS INC.              Medical and
                              Social
                              Determinants of
                              Cardiometabolic
                              Health
    ------------------------------------------------------------------------
    ARKANSAS ACADEMY OF      67th Annual          03/24/2014       $3,000.00
     FAMILY PHYSICIANS        Scientific
                              Assembly of the
                              Arkansas Academy
                              of Family
                              Physicians
    ------------------------------------------------------------------------
    TRUSTEES OF THE          Current Advances     03/24/2014       $5,000.00
     UNIVERSITY OF            in Cardiovascular
     PENNSYLVANIA             Care 2014
    ------------------------------------------------------------------------
    ST. PETER'S HOSPITAL     Cardiology           03/25/2014       $3,000.00
                              Teaching Day
    ------------------------------------------------------------------------
    CHARLES R. DREW          18th Annual          03/26/2014      $25,000.00
     UNIVERSITY OF MEDICINE   Conference
     and SCIENCE
    ------------------------------------------------------------------------
    GORDON RESEARCH          2014 GRC on          03/27/2014       $2,500.00
     CONFERENCES              Heterocyclic
                              Compounds
    ------------------------------------------------------------------------
    THE ROCKEFELLER          Leptin and           03/30/2014      $25,000.00
     UNIVERSITY               Metabolic
                              Disease: A
                              Special Symposium
                              on the 20th
                              Anniversary of
                              the Discovery of
                              Leptin
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      CSAAI's A            03/30/2014       $5,000.00
     ALLERGY, ASTHMA AND      Midsummer Night's
     IMMUNOLOGY               Wheeze 2014
    ------------------------------------------------------------------------
    UNIVERSITY OF NEW        PeerView Live,       04/01/2014     $353,000.00
     MEXICO                   Using Evidence-
                              Based Treatment
                              to Optimize
                              Control of
                              Elevated Serum
                              Triglycerides
                              (150202699)
    ------------------------------------------------------------------------
    THOMAS JEFFERSON         Jefferson Critical   04/01/2014       $5,000.00
     UNIVERSITY               Care Symposium: A
                              Multidisciplinary
                              Review of Current
                              Evidence and
                              Controversies
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  35th Annual          04/01/2014       $3,000.00
     ENDOCRINE SURGEONS       Meeting of the
                              American
                              Association of
                              Endocrine
                              Surgeons
    ------------------------------------------------------------------------
    GORDON RESEARCH          2014 Bioorganic      04/02/2014       $1,000.00
     CONFERENCES              Chemistry Gordon
                              Research
                              Conference
    ------------------------------------------------------------------------
    THE NEW YORK             Seventh Annual       04/03/2014       $3,050.00
     CARDIOLOGICAL SOCIETY,   Cardiac Care
     INC.                     Associate
                              Symposium 2014
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         15th Annual          04/03/2014       $4,706.02
     EDUCATIONAL FOUNDATION   Intensive Review
                              of Cardiology
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    Cardiology Update    04/06/2014       $4,000.00
    ------------------------------------------------------------------------
    DIGNITY HEALTH ST.       16th Annual          04/06/2014       $6,000.00
     BERNARDINE MEDICAL       Cardiac Symposium
     CENTER
    ------------------------------------------------------------------------
    CONQUER CANCER           2014 Conquer         04/09/2014      $24,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Merit
     CLINICAL ONCOLOGY        Awards
    ------------------------------------------------------------------------
    MUNSTER MEDICAL          New Frontiers in     04/09/2014       $4,200.00
     RESEARCH FOUNDATION      Cardiovascular
     DBA COMMUNITY HOSPITAL   Disease 2014
    ------------------------------------------------------------------------
    GORDON RESEARCH          2014 Gordon          04/09/2014       $2,000.00
     CONFERENCES              Research
                              Conference:
                              Enzymes CoEnzymes
                              and Metabolic
                              Pathways
    ------------------------------------------------------------------------
    AMERICAN COLLEGE         2014 Mississippi/    04/09/2014       $5,000.00
     PHYSICIANS--MISSISSIPP   Louisiana ACP
     I CHAPTER                Educational and
                              Scientific
                              Meeting
    ------------------------------------------------------------------------
    ICHAN SCHOOL OF          Live Symposium of    04/10/2014      $10,000.00
     MEDICINE AT MOUNT        Complex Coronary,
     SINAI                    Valvular and
                              Vascular Cases
    ------------------------------------------------------------------------
    NATIONAL FOUNDATION FOR  Clinical             04/13/2014      $25,000.00
     INFECTIOUS DISEASES      Vaccinology
                              Course
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      The AAPA 2014        04/13/2014       $7,500.00
     PHYSICIAN ASSISTANTS     Annual
                              Conference--Cardi
                              ology Track
    ------------------------------------------------------------------------
    NEW JERSEY ACADEMY OF    Cardiovascular       04/13/2014       $5,000.00
     FAMILY PHYSICIANS        Controversies
                              JNC8 and
                              Cholesterol
                              Treatment
                              Guidelines (2014
                              Scientific
                              Assembly)
    ------------------------------------------------------------------------
    HUMBOLDT-DEL NORTE       Asthma Update        04/14/2014       $4,000.00
     COUNTY MEDICAL SOCIETY
    ------------------------------------------------------------------------
    DANNEMILLER, INC.        Contemporary         04/16/2014      $50,000.00
                              Perspectives in
                              COPD: A
                              Pulmonologist's
                              Guide to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    OKLAHOMA UNIVERSITY      17th Annual          04/16/2014       $3,000.00
     HEALTH SCIENCE CENTER--  Primary Care
     OUHSC                    Update
    ------------------------------------------------------------------------
    CONQUER CANCER           2014 Conquer         04/17/2014      $60,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Young
     CLINICAL ONCOLOGY        Investigator
                              Award (YIA)
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         6th Annual E-        04/17/2014       $9,352.86
     EDUCATIONAL FOUNDATION   Journal Club: The
                              Insights on
                              Biologics and New
                              Agents for
                              Rheumatic
                              Diseases
    ------------------------------------------------------------------------
    NATIONAL FOUNDATION FOR  17th Annual          04/21/2014      $15,000.00
     INFECTIOUS DISEASES      Conference on
                              Vaccine Research
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        2014 ECOG-ACRIN      04/21/2014       $5,000.00
     EDUCATION FOUNDATION     Spring Group
                              Meeting
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      Contemporary T2DM    04/21/2014     $229,200.00
     EDUCATION FOUNDATION     Management: Focus
                              on Safety and
                              Efficacy
    ------------------------------------------------------------------------
    THE CHEST FOUNDATION     The CHEST            04/21/2014      $35,000.00
                              Foundation
                              Diversity
                              Research/Women's
                              Respiratory
                              Health Awards
                              Program
    ------------------------------------------------------------------------
    MISSOURI ACADEMY OF      Hyperlipidemia       04/21/2014       $5,000.00
     PHYSICIAN ASSISTANTS
    ------------------------------------------------------------------------
    REGENTS OF THE           Lipidomics Impact    04/22/2014       $2,500.00
     UNIVERSITY OF            on Cell Biology,
     CALIFORNIA, SAN DIEGO    Inflammation and
                              Metabolic Disease
    ------------------------------------------------------------------------
    NATIONAL MINORITY        11th Annual          04/23/2014      $30,000.00
     QUALITY FORUM            National Summit
                              on Health
                              Disparities
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          2014 Carolinas       04/24/2014      $20,000.00
                              COPD Symposium
    ------------------------------------------------------------------------
    MICHIGAN STATE MEDICAL   Rheumatology         04/24/2014       $3,000.00
     SOCIETY FOUNDATION       Update
    ------------------------------------------------------------------------
    MAIN LINE HEALTH         Atherosclerosis:     04/24/2014       $5,000.00
                              Prevention of
                              Progression
    ------------------------------------------------------------------------
    CASE MANAGEMENT SOCIETY  CMSA 2014 Annual     04/27/2014      $15,000.00
     OF AMERICA               Conference and
                              Expo
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2014 Monthly    04/27/2014      $25,000.00
     CANCER NETWORK, INC.     Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    AMERICAN HEART           Arteriosclerosis,    04/27/2014      $20,000.00
     ASSOCIATION, INC.        Thrombosis, and
                              Vascular Biology
                              Scientific
                              Sessions 2014
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           25th Annual          04/27/2014       $5,000.00
                              Cardiovascular
                              Interventions
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Interventional       04/27/2014       $5,000.00
     CARDIOLOGY FOUNDATION    Cardiology Board
                              Preparatory
                              Educational
                              Package
    ------------------------------------------------------------------------
    TEXAS ONE VOICE: A       Designing            04/28/2014       $1,000.00
     COLLABORATIVE FOR        Healthcare in
     HEALTH AND HUMAN         Texas How the
     SERVICES                 Past and Present
                              will Guide the
                              Future
    ------------------------------------------------------------------------
    TRUSTEES OF THE          Cardiology Update    04/28/2014      $10,000.00
     UNIVERSITY OF            2014: A Patient
     PENNSYLVANIA             Management
                              Approach
    ------------------------------------------------------------------------
    CONQUER CANCER           2014 ASCO Annual     05/04/2014      $56,000.00
     FOUNDATION OF THE        Meeting Lung
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    FOUNDATION FOR CARE      Dyslipidemia and     05/06/2014      $25,000.00
     MANAGEMENT               New Cholesterol
                              Guidelines: What
                              the Primary Care
                              Provider Needs to
                              Know
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Update in Allergy,   05/06/2014      $10,000.00
     ALLERGY, ASTHMA AND      Asthma and
     IMMUNOLOGY               Immunology
    ------------------------------------------------------------------------
    FLORIDA ACADEMY OF       Update in the        05/06/2014       $5,000.00
     PHYSICIAN ASSISTANTS     Management of
                              Dyslipidemia
    ------------------------------------------------------------------------
    VASSAR BROTHERS MEDICAL  44th Annual          05/06/2014       $5,000.00
     CENTER                   Cardiology
                              Education Day
    ------------------------------------------------------------------------
    ZOE ROSE MEMORIAL        2014 Preemie         05/06/2014      $10,000.00
     FOUNDATION DBA PREEMIE   Parent Summit
     PARENT ALLIANCE
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 23rd Annual     05/07/2014      $25,000.00
     CLINICAL                 Scientific and
     ENDOCRINOLOGISTS         Clinical Congress
    ------------------------------------------------------------------------
    LOUISIANA SOCIETY OF     LSAAI 41st Annual    05/07/2014       $5,000.00
     ALLERGY, ASTHMA AND      Meeting
     IMMUNOLOGY
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAFP Assembly 60     05/07/2014      $13,000.00
     FAMILY PHYSICIANS        Minute Lecture
                              titled Chronic
                              Obstructive
                              Pulmonary
                              Disorder (COPD)
                              and Pulmonary
                              Function Testing
    ------------------------------------------------------------------------
    COLUMBUS COMMUNITY       2014 ASCO REVIEW     05/08/2014       $5,000.00
     CLINICAL ONCOLOGY
     PROGRAM
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Aspen Allergy        05/08/2014      $10,000.00
     ALLERGY, ASTHMA AND      Conference
     IMMUNOLOGY
    ------------------------------------------------------------------------
    AMERICAN DIABETES        29th Annual          05/11/2014      $20,000.00
     ASSOCIATION              Clinical
                              Conference on
                              Diabetes--Reducin
                              g Risks: Primary
                              and Secondary
    ------------------------------------------------------------------------
    REGENTS OF THE           20th Annual UCLA     05/11/2014       $5,000.00
     UNIVERSITY OF            Symposium
     CALIFORNIA               Pulmonary
                              Function and
                              Exercise Testing:
                              Practical
                              Approaches for
                              the Healthcare
                              Practitioner
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      The Changing         05/11/2014       $5,000.00
     ALLERGY, ASTHMA AND      Allergy Practice
     IMMUNOLOGY
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Caribbean Congress   05/12/2014       $5,000.00
     EMERGENCY PHYSICIANS,    on Emergency
     PUERTO RICO CHAPTER      Medicine
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         19th Annual          05/13/2014       $6,613.34
     EDUCATIONAL FOUNDATION   Diabetes Day:
                              Diabetes Therapy
    ------------------------------------------------------------------------
    THE REGENTS UNIVERSITY   UCLA Family          05/13/2014       $7,500.00
     OF CALIFORNIA            Medicine
                              Refresher Course
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         ASCO Review          05/13/2014       $4,000.00
     EDUCATIONAL FOUNDATION
    ------------------------------------------------------------------------
    SOCIEDAD PUERTORRIQUENA  Puerto Rican         05/14/2014      $10,000.00
     DE ENDOCRINOLOGIA Y      Endocrinology and
     DIABETOLOGIA             Diabetes Society
                              Scientific
                              Meeting
    ------------------------------------------------------------------------
    NATIONAL MEDICAL         Asthma as a Model    05/14/2014      $25,000.00
     ASSOCIATION              Chronic Illness
    ------------------------------------------------------------------------
    GORDON RESEARCH          2014 Lipoprotein     05/14/2014       $2,500.00
     CONFERENCES              Metabolism Gordon
                              Research
                              Conference
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         Pharmacology         05/14/2014       $5,000.00
     SOCIETY                  Update:Integratin
                              g Advances into
                              Practice
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  2014 National        05/14/2014       $5,000.00
     SERVICE COORDINATORS     Service
                              Coordinator
                              Conference
    ------------------------------------------------------------------------
    MAYO CLINIC ARIZONA      Cardiology Update    05/15/2014      $10,000.00
                              2014: The Heart
                              of the Matter
    ------------------------------------------------------------------------
    AMERICAN CHEMICAL        2014 ACS National    05/18/2014       $1,000.00
     SOCIETY--DIVISION OF     Medicinal
     MEDICINAL CHEMISTRY      Chemistry
                              Symposium
    ------------------------------------------------------------------------
    CHICAGO ASTHMA           Emergency            05/18/2014       $2,000.00
     CONSORTIUM               Management of
                              Asthma
    ------------------------------------------------------------------------
    SUFFOLK ACADEMY OF       31st Update in       05/19/2014       $3,000.00
     MEDICINE                 Allergy and
                              Immunology
                              Symposium
    ------------------------------------------------------------------------
    EMORY UNIVERSITY         Discussing Cases     05/19/2014      $20,000.00
                              with Diabetes
                              Experts
    ------------------------------------------------------------------------
    NATIONAL MEDICAL         Evidence-Based       05/19/2014      $23,405.00
     ASSOCIATION              Diagnosis and
                              Management of
                              Asthma and COPD:
                              Practical Tools
                              to Improve
                              Patient Care
    ------------------------------------------------------------------------
    NORTH SHORE LONG ISLAND  Post American        05/19/2014       $3,000.00
     JEWISH HEALTH SYSTEM     Society of
                              Clinical Oncology
                              Update 2014
    ------------------------------------------------------------------------
    LAHEY CLINIC HOSPITAL,   Cardiovascular       05/19/2014       $6,000.00
     INC.                     Disease: State of
                              the Art 2014
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2014                 05/19/2014       $5,000.00
     CARDIOLOGY FOUNDATION    Cardiovascular
                              Board Review for
                              Certification and
                              Recertification
                              Educational
                              Package
    ------------------------------------------------------------------------
    NEW JERSEY ACADEMY OF    The Current          05/21/2014       $2,500.00
     FAMILY PHYSICIANS        Standards Of Care
                              and Treatment of
                              Diabetes (2014
                              Scientific
                              Assembly)
    ------------------------------------------------------------------------
    CONQUER CANCER           2014 Conquer         05/21/2014     $250,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Career
     CLINICAL ONCOLOGY        Development Award
                              (CDA)
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  16th Annual Lynn     05/21/2014      $10,000.00
                              Sage Breast
                              Cancer Symposium
    ------------------------------------------------------------------------
    PENNSYLVANIA SOCIETY OF  Lipid Management     05/21/2014       $5,000.00
     PHYSICIAN ASSISTANTS     The Skinny on the
                              Fat
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          1st Annual Duke      05/29/2014      $10,000.00
                              Preventive
                              Cardiology
                              Symposium
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2014 Alzheimer's     05/29/2014      $95,000.00
                              Association
                              International
                              Conference
    ------------------------------------------------------------------------
    TRUSTEES OF THE          2014 Updates in      05/29/2014       $5,000.00
     UNIVERSITY OF            Oncology: With
     PENNSYLVANIA             Proceedings from
                              International
                              Medical Meetings
    ------------------------------------------------------------------------
    SOCIETY FOR              Young Investigator   06/01/2014      $25,000.00
     NEUROSCIENCE             Award
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      The Role of the      06/03/2014     $149,025.00
     EDUCATION FOUNDATION     Kidney in Glucose
                              Homeostasis and
                              Diabetes
    ------------------------------------------------------------------------
    VIVA PHYSICIANS          VIVA 14: Vascular    06/03/2014      $20,000.00
                              InterVentional
                              Advances
    ------------------------------------------------------------------------
    SOCIETY OF TOXICOLOGIC   Translational        06/04/2014       $3,000.00
     PATHOLOGY                Pathology:
                              Relevance of
                              Toxicologic
                              Pathology to
                              Human Health
    ------------------------------------------------------------------------
    UHS PROFESSIONAL         Gout and             06/04/2014     $100,825.00
     EDUCATION PROGRAMS,      Hyperuricemia--Cl
     INC.                     inical Spectrum
                              and Management
                              Update
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAFP Assembly 60     06/04/2014      $10,000.00
     FAMILY PHYSICIANS        Minute Lecture
                              titled Acute
                              Coronary Syndrome
                              and Angina
                              (Fundamentals)
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAFP Assembly 60     06/04/2014      $10,000.00
     FAMILY PHYSICIANS        Minute Lecture
                              titled Acute
                              Coronary Syndrome
                              and Angina
                              (Advanced)
    ------------------------------------------------------------------------
    THE NEPHCURE FOUNDATION  10th International   06/04/2014       $5,000.00
                              Podocyte
                              Conference
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Mount Sinai          06/09/2014       $2,500.00
     MEDICINE AT MOUNT        Division of
     SINAI                    Occupational
                              Medicine seminar
                              series
    ------------------------------------------------------------------------
    SWEDISH MEDICAL CENTER   Cardiology Update    06/09/2014       $5,000.00
     FOUNDATION               for Primary Care
    ------------------------------------------------------------------------
    JOSLIN DIABETES CENTER   The Institute of     06/11/2014      $15,000.00
                              Lifestyle
                              Medicine 2014
                              Educational
                              Activities
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  ACS/STEMI: Focus     06/11/2014      $60,000.00
     FOUNDATION               on Acute Care
    ------------------------------------------------------------------------
    PENN STATE COLLEGE OF    20th Annual          06/18/2014       $7,000.00
     MEDICINE                 Pennsylvania
                              Immunization
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASPMN 24th           06/18/2014      $10,000.00
     PAIN MANAGEMENT          National
     NURSING                  Conference
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     APhA Pharmacy-       06/18/2014       $2,500.00
     ASSOCIATION              Based
                              Immunization
                              Delivery
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    Mentors in           06/22/2014      $50,000.00
                              Medicine
    ------------------------------------------------------------------------
    PONCE MEDICAL SCHOOL     Advances in          06/24/2014       $5,000.00
     FOUNDATION INC.          Dyslipidemia and
                              Atherosclerosis
                              Management
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Cardiovascular       06/25/2014      $15,000.00
     EMERGENCY PHYSICIANS     Disease Track at
                              ACEP 2014
                              Scientific
                              Assembly
    ------------------------------------------------------------------------
    THE BRIGHAM AND WOMEN'S  BWH Thyroid          06/26/2014       $3,000.00
     HOSPITAL INC.            Visiting
                              Professor and
                              Endocrine Grand
                              Rounds Speaker
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    Clinical Allergy     06/26/2014       $5,000.00
                              for the
                              Practicing
                              Physician
    ------------------------------------------------------------------------
    PREVENTIVE               Fall Programs        06/26/2014       $5,000.00
     CARDIOVASCULAR NURSES
     ASSOCIATION
    ------------------------------------------------------------------------
    GORDON RESEARCH          2014 Gordon          06/26/2014         $500.00
     CONFERENCES              Research Seminar
                              on Synaptic
                              Transmission
    ------------------------------------------------------------------------
    GREENWOOD LEFLORE        Call for Grants:     06/29/2014       $2,500.00
     HOSPITAL                 CGA Educating the
                              Delta on
                              Asthmatic
                              Patients
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      06/29/2014       $2,000.00
     CONFERENCE               Conference on
                              Multi-Drug Efflux
                              Systems
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      06/29/2014       $2,000.00
     CONFERENCES              Conference: DNA
                              Topoisomerases in
                              Biology and
                              Medicine
    ------------------------------------------------------------------------
    ALBANY COLLEGE OF        Heart to Heart:      06/30/2014      $14,000.00
     PHARMACY AND HEALTH      Updates on
     SCIENCES                 Cardiovascular
                              Disease and the
                              Management of
                              Cholesterol and
                              Hypertension
    ------------------------------------------------------------------------
    CANCER MOLECULAR         Molecular            06/30/2014       $5,000.00
     THERAPEUTICS RESEARCH    Therapeutics of
     ASSOCIATION              Cancer Conference
                              2014
    ------------------------------------------------------------------------
    VANDERBILT UNIVERSITY    Vanderbilt           07/08/2014       $3,000.00
                              University
                              Hematology
                              Oncology
                              Educational
                              Symposium
    ------------------------------------------------------------------------
    CHILDREN'S HOSPITAL      Translating Neural   07/08/2014       $3,000.00
     CORPORATION              Circuits and
                              Pathways into
                              Treatments
    ------------------------------------------------------------------------
    PENNSYLVANIA SOCIETY OF  Breast Cancer-       07/09/2014       $3,000.00
     PHYSICIAN ASSISTANTS     Fight Like a Girl
    ------------------------------------------------------------------------
    PROMEDICA ACADEMIC       After the            07/09/2014       $2,500.00
     HEALTH CENTER            Diagnosis:
     CORPORATION              Helping
                              Cardiopulmonary
                              Patients Succeed--
                              Approaches to
                              Stay Ahead of the
                              Curve
    ------------------------------------------------------------------------
    CONQUER CANCER           2014 Breast Cancer   07/09/2014      $10,000.00
     FOUNDATION OF THE        Symposium
     AMERICAN SOCIETY OF
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Hyperlipidemia and   07/09/2014       $5,000.00
     ASSOC. FOR CONTINUING    Hypertension in
     EDUCATION                2014: What's New
                              in Treatment
                              Guidelines
    ------------------------------------------------------------------------
    DIABLO SOCIETY OF        Cost-Effective       07/10/2014       $5,600.00
     HEALTH SYSTEM            Genotype-Guided
     PHARMACISTS              Antiplatelet
                              Therapy with
                              Ticagrelor
    ------------------------------------------------------------------------
    ALAMO CITY CANCER        12th Annual Breast   07/10/2014       $1,500.00
     COUNCIL                  Cancer Conference
                              Update
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      37TH Annual San      07/10/2014      $10,000.00
     HEALTH SCIENCE CENTER    Antonio Breast
     SAN ANTONIO SCHOOL OF    Cancer Symposium
     MEDICINE
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Best Practices in    07/15/2014      $25,000.00
     MANAGED CARE             the Prevention
     PHYSICIANS               and Management of
                              Chronic
                              Obstructive
                              Pulmonary Disease
                              (COPD)
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     Advances in Care     07/17/2014       $3,000.00
     CENTER                   for the New
                              Millennium: 20th
                              Anniversary BRCA
                              Gene Symposium
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Current Treatments   07/17/2014      $25,000.00
     MANAGED CARE             and Novel
     PHYSICIANS               Strategies in the
                              Management of
                              Acute Coronary
                              Syndrome (ACS)
    ------------------------------------------------------------------------
    MARSHA RIVKIN CENTER     10th Biennial        07/22/2014       $5,000.00
     FOR OVARIAN CANCER       Ovarian Cancer
     RESEARCH                 Research
                              Symposium
    ------------------------------------------------------------------------
    FLORIDA ASSOCIATION OF   Optimizing Oral      07/22/2014       $9,600.00
     CONSULTANT PHARMACISTS   Antiplatelet
                              Therapy in Acute
                              Coronary Syndrome
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Foundations for      07/22/2014      $10,000.00
     CARDIOLOGY FOUNDATION    Practice
                              Excellence: Core
                              Curriculum for
                              the
                              Cardiovascular
                              Clinician 2014
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      12th Annual World    07/23/2014     $100,000.00
     EDUCATION FOUNDATION     Congress on
                              Insulin
                              Resistance
                              Diabetes and
                              Cardiovascular
                              Disease--WCIRDC
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Program Title        07/23/2014       $3,000.00
     ENDOCRINE SURGEONS       Masters Course in
     FOUNDATION               Endocrine Surgery
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Acute Coronary       07/24/2014      $20,000.00
     FOUNDATION               Syndromes,
                              Pharmacotherapy
                              and Shock/
                              Hemodynamic
                              Support
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Town Hall and        07/24/2014      $20,000.00
     FOUNDATION FDA           Clinical Trial
                              Design and
                              Interpretation
    ------------------------------------------------------------------------
    MINNESOTA PHARMACISTS    MPhA Annual          07/24/2014       $2,150.00
     ASSOCIATION              Meeting: MTM in
                              Cardiology Clinic
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      6th Annual           07/29/2014       $5,000.00
     PHYSICIAN ASSISTANTS     Allergy, Asthma
     IN ALLERGY, ASTHMA AND   and ENT CME
     IMMUNOLOGY               Conference
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Severe Asthma        07/29/2014      $22,000.00
     ALLERGY, ASTHMA AND      Workshop at the
     IMMUNOLOGY               2014 ACAAI Annual
                              Scientific
                              Meeting
    ------------------------------------------------------------------------
    INTERNATIONAL            16th World           07/29/2014      $30,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      The Affordable       07/29/2014      $22,000.00
     ALLERGY, ASTHMA AND      Care Act and
     IMMUNOLOGY               Asthma Control
    ------------------------------------------------------------------------
    DANA-FARBER CANCER       Dana-Farber Cancer   07/31/2014       $2,400.00
     INSTITUTE                Institute's 10th
                              Annual
                              Postdoctoral and
                              Graduate Student
                              Retreat
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION     2014 NAHQ 39th       07/31/2014      $15,000.00
     FOR HEALTHCARE QUALITY   Annual
                              Educational
                              Conference
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          2014 Top Ten         07/31/2014      $10,000.00
     MEDICINE AT MOUNT        Advances in
     SINAI                    Clinical
                              Cardiology
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      COPD/Asthma Track    07/31/2014      $25,800.00
     CHEST PHYSCIANS          at CHEST 2014
    ------------------------------------------------------------------------
    DREXEL UNIVERSITY        Hypertension         08/03/2014       $5,000.00
                              HighLights-ASH
                              2014
    ------------------------------------------------------------------------
    ASSOCIATION OF           No Gout About It:    08/03/2014       $9,500.00
     REPRODUCTIVE HEALTH      Targeted Provider
     PROFESSIONALS            Education and
                              Training to
                              Screen,
                              Diagnosis, and
                              Manage Gout among
                              Female Patients
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Tumor           08/03/2014      $10,000.00
     FOR CANCER RESEARCH      Immunology and
                              Immunotherapy: A
                              New Chapter
    ------------------------------------------------------------------------
    THE OHIO STATE           Sixth Annual         08/05/2014       $5,000.00
     UNIVERSITY               Contemporary
                              Multidisciplinary
                              Cardiovascular
                              Conference
    ------------------------------------------------------------------------
    WAYNE STATE UNIVERSITY   Update in            08/05/2014       $5,000.00
                              Rheumatology
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      COPD Interactive     08/06/2014      $20,000.00
     CHEST PHYSICIANS         Educational Game
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Updates in the       08/06/2014      $25,000.00
     MANAGED CARE             Treatment of
     PHYSICIANS, INC.         Hypertriglyceride
                              mia: A Closer
                              Look at the Role
                              of Omega-3 Fatty
                              Acids
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   19th Annual Allied   08/07/2014       $2,500.00
                              Health Regional
                              Conference
    ------------------------------------------------------------------------
    WESTERN SOCIETY OF       WSAAI 53rd Annual    08/07/2014      $15,000.00
     ALLERGY, ASTHMA AND      Scientific
     IMMUNOLOGY               Session
    ------------------------------------------------------------------------
    DELAWARE ACADEMY OF      Acute Coronary       08/07/2014       $3,500.00
     PHYSICIAN ASSISTANTS     Syndromes: Acute
                              Myocardial
                              Infarction and
                              Unstable Angina
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     Addressing Racial    08/10/2014      $25,000.00
     ASSOCIATION              and Ethnic
                              Healthcare
                              Disparities in
                              Diabetes
    ------------------------------------------------------------------------
    THOMAS JEFFERSON         Current Issues in    08/10/2014      $10,000.00
     UNIVERSITY               Coronary and
                              Structural Heart
                              Disease: A
                              Multidisciplinary
                              Approach
    ------------------------------------------------------------------------
    UNIVERSITY OF            University of        08/11/2014       $5,000.00
     WASHINGTON CME OFFICE    Washington Topics
                              in Allergy and
                              Immunology
                              Teaching Series
                              2014-2015
    ------------------------------------------------------------------------
    FOUNDATION OF THE        The Foundation of    08/11/2014      $50,000.00
     NATIONAL LIPID           the National
     ASSOCIATION              Lipid Association
                              Hunninghake FH
                              Abstract Award
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  NANN 30th Annual     08/13/2014      $10,000.00
     NEONATAL NURSES          Educational
                              Conference
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASTRO 56th Annual    08/17/2014       $3,000.00
     RADIATION ONCOLOGY       Meeting
     (ASTRO)
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      SGLT2 Inhibitor      08/17/2014     $170,000.00
     NEPHROLOGY               Therapy in
                              Patients with
                              Mild to Moderate
                              Diabetic Kidney
                              Disease
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Multidisciplinary    08/17/2014       $4,500.00
     OF HARVARD COLLEGE       Breast Rounds
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      Contemporary T2DM    08/17/2014     $376,125.00
     EDUCATION FOUNDATION     Management: Focus
                              on Safety and
                              Efficacy (Live
                              Program)
    ------------------------------------------------------------------------
    MISSISSIPPI HEALTHCARE   STEMI Protocols      08/17/2014       $1,464.83
     ALLIANCE
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Practical            08/19/2014     $144,399.00
     DIABETES EDUCATORS       Applications of
                              Pramlintide in
                              Type 1 Diabetes
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Novel Treatments     08/19/2014     $252,000.00
     HEALTH-SYSTEM            for the
     PHARMACISTS              Management of
                              Type 2 Diabetes:
                              Focus on SGLT2
                              Inhibitors
    ------------------------------------------------------------------------
    THE SOCIETY FOR          SCAI 2014            08/19/2014      $50,000.00
     CARDIOVASCULAR           Interventional
     ANGIOGRAPHY AND          Cardiology
     INTERVENTIONS            Fellows Courses
    ------------------------------------------------------------------------
    OLIGONUCLEOTIDE          10th Annual          08/19/2014      $10,000.00
     THERAPEUTICS SOCIETY     Meeting of the
                              Oligonucleotide
                              Therapeutics
                              Society
    ------------------------------------------------------------------------
    SOCIETY FOR THE          Advances in Cancer   08/19/2014      $75,000.00
     IMMUNOTHERAPY OF         Immunotherapy--Se
     CANCER                   ries of 5
                              Regional Programs
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      The Sixth Annual     08/19/2014       $7,500.00
     PHYSICIAN ASSISTANTS     Hospital Medicine
                              Boot Camp
    ------------------------------------------------------------------------
    UNIVERSITY OF            CAll for Grants      08/21/2014      $25,800.00
     CINCINNATI               Application (CGA)
                              CV14-1st Annual
                              Cincinnati
                              Collaborative
                              Cardiovascular
                              Consortium (C4):
                              Practical and
                              Contemporary
                              Cardiology 2014
    ------------------------------------------------------------------------
    WAYNE STATE UNIVERSITY   Pulmonary,           08/27/2014       $3,000.00
                              Critical Care and
                              Sleep Medicine
                              Update 2014
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    ISAM Textbook of     08/27/2014      $10,000.00
     FOR AEROSOLS IN          Aerosol Medicine
     MEDICINE
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Asthma and COPD      08/27/2014       $5,000.00
     ASSOCIATES FOR           2014
     CONTINUING EDUCATION
     (NPACE)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      CHEST 2014 Lung      08/27/2014      $24,150.00
     CHEST PHYSCIANS          Cancer Track
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  Medical Oncology     08/28/2014       $3,000.00
     MD ANDERSON CANCER       and Hematology
     CENTER                   2014:
                              Multidisciplinary
                              Approaches that
                              Improve
                              Coordination of
                              Care
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   37th Annual          08/28/2014       $5,000.00
                              Pulmonary and
                              Allergy Update
    ------------------------------------------------------------------------
    NOT-FOR-PROFIT HOSPITAL  Management and       08/28/2014       $2,400.00
     CORPORATION              Prevention of
                              Acute
                              Exacerbation of
                              COPD (AECOPD)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  New Jersey--AACE     08/31/2014       $5,000.00
     CLINICAL                 7th Annual
     ENDOCRINOLOGISTS         Meeting
    ------------------------------------------------------------------------
    WILLIAM BEAUMONT         Practical and        08/31/2014       $2,000.00
     HOSPITAL                 Progressive
                              Updates in
                              Primary Care
                              Medicine
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      47th Annual New      08/31/2014      $15,000.00
     CARDIOLOGY FOUNDATION    York
                              Cardiovascular
                              Symposium: Major
                              Topics in
                              Cardiology Today
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC Fellowships    09/02/2014      $43,000.00
     ASSOCIATION FOR THE
     STUDY OF LUNG CANCER
    ------------------------------------------------------------------------
    RUTGERS, THE STATE       Update in            09/02/2014       $7,500.00
     UNIVERSITY OF NEW        Rheumatology 2014
     JERSEY
    ------------------------------------------------------------------------
    CHILDREN'S HEALTHCARE    Respiratory Update   09/02/2014       $3,000.00
     OF ATLANTA               2014
    ------------------------------------------------------------------------
    UNIVERSITY OF MARYLAND,  Patient-Focused      09/02/2014      $10,000.00
     BALTIMORE FOUNDATION     Drug Development
    ------------------------------------------------------------------------
    THE ANGIOGENESIS         World Congress on    09/02/2014       $5,000.00
     FOUNDATION               Angiogenesis
    ------------------------------------------------------------------------
    JOHNS HOPKINS            New Therapeutic      09/02/2014      $20,000.00
     UNIVERSITY               Insights/Advances
                              in Allergic
                              Diseases
    ------------------------------------------------------------------------
    GORDON RESEARCH          Mammalian DNA        09/02/2014       $5,000.00
     CONFERENCES              Repair Gordon
                              Research
                              Conference and
                              Seminar 2015
    ------------------------------------------------------------------------
    ILLINOIS ACADEMY OF      Health Care Reform   09/04/2014       $2,000.00
     FAMILY PHYSICIANS        and Care
                              Coordination
    ------------------------------------------------------------------------
    EXCELLENCE IN            Rheumatology         09/04/2014      $25,000.00
     RHEUMATOLOGY EDUCATION   Winter Clinical
                              Symposium 2015
    ------------------------------------------------------------------------
    SOCIETY OF INFECTIOUS    Society of           09/04/2014       $5,000.00
     DISEASES PHARMACISTS     Infectious
                              Diseases
                              Pharmacists
                              Research Grant
                              Program
    ------------------------------------------------------------------------
    CARDIOVASCULAR           CVIs 21st Annual     09/09/2014      $10,000.00
     INSTITUTE OF             Cardiology
     PHILADELPHIA             Update: Clinical
                              Management of
                              Heart Disease
                              2014
    ------------------------------------------------------------------------
    PROVIDENCE HOLY CROSS    Acute Coronary       09/09/2014       $1,900.00
     MEDICAL CENTER           Syndrome
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          14th Annual          09/14/2014      $10,000.00
                              Southeastern
                              Fellows Research
                              Skills and
                              Training Workshop
    ------------------------------------------------------------------------
    PHILLIPS GILMORE         Atlanta Lung         09/14/2014       $3,000.00
     ONCOLOGY                 Cancer Symposium
     COMMUNICATIONS, INC.     2014
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        2014 ECOG-ACRIN      09/14/2014       $5,000.00
     EDUCATION FOUNDATION     Fall Group
                              Meeting
    ------------------------------------------------------------------------
    THE NEW YORK ACADEMY OF  Pharmacologic        09/14/2014      $10,000.00
     SCIENCES                 Resolution of
                              Inflammation as a
                              Novel Therapeutic
                              Approach
    ------------------------------------------------------------------------
    MEDICAL COLLEGE OF       8th Annual           09/15/2014       $3,000.00
     WISCONSIN                Translational
                              Oncology Research
                              Symposium
    ------------------------------------------------------------------------
    FRIENDS OF CANCER        Friends of Cancer    09/15/2014     $100,000.00
     RESEARCH                 Research 2014
                              programs
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     09/15/2014      $15,000.00
                              Working Group
                              Global Chapter
                              Meting
    ------------------------------------------------------------------------
    ORLANDO HEALTH           Advancements in      09/15/2014       $3,000.00
                              the Early
                              Detection and
                              Treatment of
                              Breast and
                              Gynecologic
                              Malignancies
    ------------------------------------------------------------------------
    YALE UNIVERSITY          Severe Asthma        09/17/2014       $5,000.00
                              2014: A
                              Personalized
                              Approach To
                              Treatment
    ------------------------------------------------------------------------
    EAST TENNESSEE STATE     Asthma and Allergy   09/17/2014       $3,000.00
     UNIVERSITY RESEARCH      2014: What's New,
     FOUNDATION               What's Hot
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2014 ACG             09/17/2014      $25,000.00
     GASTROENTEROLOGY         Presidential
                              Poster Award
    ------------------------------------------------------------------------
    PARTNERS HEALTHCARE      2014 Personalized    09/17/2014      $15,000.00
     SYSTEM INC.              Medicine
                              Conference
    ------------------------------------------------------------------------
    PERSONALIZED MEDICINE    Turning the Tide     09/17/2014       $5,000.00
     COALITION                Against Cancer
                              2014 National
                              Conference
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     Rheumatology Grand   09/21/2014       $5,000.00
     CENTER                   Rounds 2014
    ------------------------------------------------------------------------
    AMERICAN THYROID         Early Riser          09/21/2014     $125,900.00
     ASSOCIATION              Symposium:
                              Medullary Thyroid
                              Cancer
    ------------------------------------------------------------------------
    SAFETY PHARMACOLOGY      14th Annual Safety   09/21/2014       $3,000.00
     SOCIETY                  Pharmacology
                              Society Annual
                              Meeting
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      19th Annual ASHP     09/23/2014      $10,000.00
     HEALTH-SYSTEM            Conference for
     PHARMACISTS              Leaders in Health-
                              System Pharmacy
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Scenes and           09/23/2014      $35,000.00
     CLINICAL                 Seminars on
     ENDOCRINOLOGISTS         Hypoglycemia
                              Management:
                              Multidisciplinary
                              Approaches to
                              Improving Safety
                              for Patients with
                              Diabetes
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2014 NCCN Congress   09/23/2014      $25,000.00
     CANCER NETWORK, INC.     Series: Utilizing
                              Guidelines to
                              Customize Patient
                              Care in Non-Small
                              Cell Lung Cancer
    ------------------------------------------------------------------------
    CITY OF HOPE NATIONAL    Multidisciplinary    09/25/2014       $3,000.00
     MEDICAL CENTER           Approaches to
                              Cancer Symposium
    ------------------------------------------------------------------------
    THE DEUEL CONFERENCE ON  The 2015 Deuel       09/30/2014      $15,000.00
     LIPIDS                   Conference on
                              Lipids
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2014 ACR/ARHP        09/30/2014      $50,000.00
     RHEUMATOLOGY             Annual Meeting
                              Gout Educational
                              Track
    ------------------------------------------------------------------------
    NORTH AMERICAN SOCIETY   NASPGHAN Research    09/30/2014       $4,000.00
     FOR PEDIATRIC            Skills Workshop
     GASTROENTEROLOGY,
     HEPATOLOGY AND
     NUTRITION
    ------------------------------------------------------------------------
    SOCIETY FOR THE          SITC Workshop on     10/03/2014     $100,000.00
     IMMUNOTHERAPY OF         Combination
     CANCER                   Immunotherapy:
                              Where Do We Go
                              From Here?
    ------------------------------------------------------------------------
    LETTERS and SCIENCES     PARP Inhibition      10/07/2014     $275,478.44
                              for BRCA 1/2
                              Mutation-
                              Associated
                              Cancers and
                              Triple Negative
                              BC Advances in
                              Risk Reduction
                              and Treatment
    ------------------------------------------------------------------------
    CHILDREN'S HOSPITAL      Taking on            10/07/2014       $5,000.00
     CORPORATION              Tomorrow: Global
                              Pediatric
                              Innovation Summit
                              and Awards 2014
    ------------------------------------------------------------------------
    ENZYME MECHANISMS        24th Enzyme          10/07/2014       $3,000.00
     CONFERENCE, INC.         Mechanisms
                              Conference
    ------------------------------------------------------------------------
    NAMI MARYLAND            2014 NAMI Maryland   10/07/2014       $5,000.00
                              Annual Education
                              Conference
    ------------------------------------------------------------------------
    GORDON RESEARCH          Inhibition in the    10/07/2014       $5,000.00
     CONFERENCES              CNS Gordon
                              Research
                              Conference and
                              Seminar
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Cardiometabolic      10/08/2014     $150,000.00
     CARDIOLOGY FOUNDATION    Clinical
                              Community on
                              CardioSource/
                              ACC.org
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION     Managing Pain in     10/09/2014      $25,000.00
     DIRECTORS OF NURSING     LTC Residents:
     ADMINISTRATION/LTC,      Addressing
     INC.                     Opioiod-Induced
                              Constipation
    ------------------------------------------------------------------------
    AMERICAN HEART           Heart Innovation     10/09/2014      $15,000.00
     ASSOCIATION              Forum
    ------------------------------------------------------------------------
    MEDICAL SOCIETY OF NEW   Medical Society of   10/09/2014       $2,500.00
     JERSEY                   New Jersey 2015
                              Physician
                              Advocacy
                              Conference
    ------------------------------------------------------------------------
    PEDIATRIC ENDOCRINE      PES Parent,          10/13/2014      $50,000.00
     SOCIETY                  Patient and
                              Physician WEB
                              Education Program
                              for Lipodystrophy
                              in Children,
                              Adolescents, and
                              Adults
    ------------------------------------------------------------------------
    TRUSTEES OF THE          7th Focus on Lung    10/13/2014       $3,000.00
     UNIVERSITY OF            Cancer Conference
     PENNSYLVANIA             and 4rd
                              CANPrevent Lung
                              Cancer
    ------------------------------------------------------------------------
    SOCIETY FOR              Merrill J. Egorin    10/13/2014      $10,000.00
     TRANSLATIONAL ONCOLOGY   Workshop in
                              Cancer
                              Therapeutics and
                              Drug Development
    ------------------------------------------------------------------------
    SOCIETY FOR              The Oncologist CME   10/13/2014      $10,000.00
     TRANSLATIONAL ONCOLOGY   Online Journal
                              Curriculum: Lung
                              Cancer
    ------------------------------------------------------------------------
    PERSONALIZED MEDICINE    Integrating          10/15/2014       $5,000.00
     COALITION                Personalized
                              Medicine into
                              Health Care:
                              Solutions Summit
                              2015
    ------------------------------------------------------------------------
    BIOMEDICAL SCIENCE       Hope Scholarship     10/16/2014       $7,500.00
     CAREERS PROGRAM          2015-2016
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Fact vs Fact: The    10/21/2014      $25,000.00
     CARDIOLOGY FOUNDATION    Cholesterol
                              Guidelines Debate
    ------------------------------------------------------------------------
    A. WEBB ROBERTS CENTER   The 41st Annual      10/22/2014       $5,000.00
     OF BAYLOR HEALTH CARE    Williamsburg
     SYSTEM, DALLAS           Conference on
                              Heart Disease
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  COPD: What NPs in    10/22/2014      $20,000.00
     NURSE PRACTITIONERS IN   Women's Health
     WOMEN'S HEALTH           Need to Know
    ------------------------------------------------------------------------
    SOCIETY FOR THE          SITC 29th Annual     10/22/2014      $10,000.00
     IMMUNOTHERAPY OF         Meeting
     CANCER
    ------------------------------------------------------------------------
    DAIBETES TECHNOLOGY      Diabetes             10/22/2014      $10,000.00
     SOCIETY                  Technology
                              Meeting 2014
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  2014-2015 AAPS       10/30/2014      $45,000.00
     PHARMACEUTICAL           Sustaining
     SCIENTISTS               Sponsorship
    ------------------------------------------------------------------------
    AMERICAN PSYCHIATRIC     APNA 28th Annual     10/30/2014       $5,000.00
     NURSES ASSOCIATION       Conference-
                              Building
                              Connections: PMH
                              Nursing
                              Perspectives
    ------------------------------------------------------------------------
    PEDIATRIC ENDOCRINE      PES Consensus        10/30/2014      $92,200.00
     SOCIETY                  statement on the
                              Management of
                              Lipodystrophy in
                              Children,
                              Adolescents, and
                              Adults
    ------------------------------------------------------------------------
    LETTERS AND SCIENCES     Ovarian Cancer--     10/30/2014     $287,365.00
                              Evolution and
                              Evidence of
                              Emerging
                              Strategies (ISSS)
    ------------------------------------------------------------------------
    THE CVA MEDICAL          Cardiovascular       11/02/2014       $5,000.00
     EDUCATION FOUNDATION     Update 2015
    ------------------------------------------------------------------------
    UNIVERSITY OF MICHIGAN   Vaccines: Past,      11/04/2014      $10,000.00
                              Present, and
                              Future
    ------------------------------------------------------------------------
    SOCIETY OF TOXICOLOGY    Society of           11/04/2014       $2,000.00
                              Toxicology Annual
                              Meeting
    ------------------------------------------------------------------------
    NATIONAL COMMISSION FOR  CCMEP                11/04/2014      $10,000.00
     THE CERTIFICATION OF     Certification
     CME PROFESSIONALS        Exam for
                              Healthcare CE
                              Professionals
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       Cardiovascular       11/05/2014      $50,000.00
     HOSPITAL CENTER          Research
                              Technologies CRT
                              2015
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Primary Care         11/05/2014      $50,000.00
     FOUNDATION               Practitioner
                              (PCP) Attitudes
                              and Practices:
                              Testing Type-2
                              Diabetic Patients
                              for Chronic
                              Kidney Disease
                              (CKD) Survey
    ------------------------------------------------------------------------
    AMERICAN DIABETES        Pathway To Stop      11/07/2014   $2,500,000.00
     ASSOCIATION              Diabetes
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     Optimizing the       11/10/2014      $11,250.00
     ASSOCIATION              Management of
                              Acute Coronary
                              Syndromes through
                              the Transitions
                              of Care
    ------------------------------------------------------------------------
    TEMPLE UNIVERSITY        43rd Annual          11/10/2014       $5,000.00
                              Philadelphia
                              Workshop on
                              Hemostasis,
                              Thrombosis and
                              Atherosclerosis
    ------------------------------------------------------------------------
    NOT-FOR-PROFIT HOSPITAL  Recognizing and      11/11/2014       $3,400.00
     CORPORATION              Treating Acute
                              Coronary Syndrome-
                              Current Guideline
                              Based Management
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Chronic Total        11/11/2014      $10,000.00
     FOUNDATION               Occlusion Summit
                              2015: A Live
                              Demonstration
                              Course
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC                11/12/2014      $16,000.00
     ASSOCIATION FOR THE      International
     STUDY OF LUNG CANCER     Mentorship
                              Program
    ------------------------------------------------------------------------
    INTERNATIONAL            15th Annual          11/12/2014      $25,000.00
     ASSOCIATION FOR THE      Targeted
     STUDY OF LUNG CANCER     Therapies of Lung
     (IASLC)                  Cancer meeting
    ------------------------------------------------------------------------
    AMERICAN HEART           Scientific           11/13/2014      $30,000.00
     ASSOCIATION, INC.        Sessions 2014
                              Acute Coronary
                              Syndrome Track
    ------------------------------------------------------------------------
    THE JOHNS HOPKINS        The Johns Hopkins    11/13/2014     $138,261.57
     UNIVERSITY               University
                              Allergy and
                              Clinical
                              Immunology
                              Fellowship
                              Program
    ------------------------------------------------------------------------
    REGENTS OF THE           The 2nd Annual       11/16/2014       $5,000.00
     UNIVERSITY OF            UCLA Diabetes
     CALIFORNIA               Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          11/17/2014      $50,000.00
     FOR CANCER RESEARCH      Meeting--2015
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      American Society     11/17/2014      $25,000.00
     HEMATOLOGY               of Hematolgoy
                              Scholar Awards
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      The American         11/17/2014      $25,000.00
     HEMATOLOGY               Society of
                              Hematology's
                              Bridge Award
                              Program
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      2015 AAAAI Annual    11/18/2014      $30,000.00
     ALLERGY, ASTHMA AND      Meeting Allied
     IMMUNOLOGY (AAAAI)       Health
                              Programming
    ------------------------------------------------------------------------
    AMERICAN PSYCHIATRIC     Psychiatric          11/21/2014      $60,400.00
     NURSES ASSOCIATION       Nursing E Series:
                              Bipolar Disorder
                              Across the
                              Lifespan
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  New Paradigms in     12/01/2014       $2,500.00
     CLINICAL                 the Practice of
     ENDOCRINOLOGISTS PR      Endocrinology
     CHAPTER
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Outcomes   12/01/2014      $25,000.00
     MANAGED CARE             through Evidence-
     PHYSICIANS               Based Diagnosis
                              and Management of
                              Chronic
                              Obstructive
                              Pulmonary Disease
                              (COPD)
    ------------------------------------------------------------------------
    THE GYNECOLOGIC          3rd Semi Annual      12/02/2014      $10,000.00
     ONCOLOGY GROUP           Meeting of NRG
                              ONCOLOGY
                              (Formerly GOG,
                              NSABP, RTOG)
    ------------------------------------------------------------------------
    FLORIDA ALLERGY, ASTHMA  Florida Allergy,     12/02/2014      $10,825.00
     AND IMMUNOLOGY SOCIETY   Asthma and
                              Immunology
                              Society 2015
                              Annual CME
                              Conference
    ------------------------------------------------------------------------
    INTERNATIONAL            16th World           12/02/2014     $200,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer--ISS
     (IASLC)                  Association fee
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Evidence-based       12/02/2014      $23,795.71
     SCHOOL NURSES, INC.      asthma care in
                              schools
    ------------------------------------------------------------------------
    THE METHODIST HOSPITAL   Cardiovascular       12/03/2014      $15,000.00
                              Fellows' Bootcamp
                              Laying the
                              Foundation
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 20th Annual     12/03/2014      $85,000.00
     CANCER NETWORK, INC.     Conference
                              General Session:
                              Advancing the
                              Standard of
                              Cancer CareTM
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Advances in the      12/03/2014     $100,000.00
     CANCER NETWORK, INC.     Treatment of
                              Ovarian and
                              Cervical Cancers:
                              Expert-
                              Facilitated Small
                              Group Discussions
                              of Challenging
                              Cases
    ------------------------------------------------------------------------
    THE MOUNT SINAI          Complex Coronary     12/03/2014      $10,000.00
     HOSPITAL                 Cases
    ------------------------------------------------------------------------
    JOHNS HOPKINS            The Johns Hopkins    12/03/2014     $150,000.00
     UNIVERSITY               University School
                              of Medicine
                              eDiabetes Review
                              Volume 2
    ------------------------------------------------------------------------
    ROME FOUNDATION          Rome IV: The         12/04/2014     $100,000.00
                              Functional
                              Gastrointestinal
                              Disorders
    ------------------------------------------------------------------------
    UNIVERSITY OF KENTUCKY   9th Platelet         12/04/2014      $10,000.00
     COLLEGE OF MEDICINE      Colloquium
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Conquer         12/04/2014      $30,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Merit
     CLINICAL ONCOLOGY        Awards
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Conquer         12/04/2014      $25,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO
     CLINICAL ONCOLOGY        International
                              Innovation Grant
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2015 Annual          12/04/2014      $10,000.00
     CANCER NETWORK NCCN      Nursing Program:
                              Advancing
                              Oncology Nursing
                              at the 20th NCCN
                              Annual Conference
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2015 NCCN Oncology   12/04/2014      $10,000.00
     CANCER NETWORK, INC.     Fellows Program:
                              New Horizons in
                              Quality Cancer
                              Care at the 20th
                              Annual Conference
    ------------------------------------------------------------------------
    STENO DIABETES CENTER A/ 28th European        12/04/2014      $20,000.00
     S                        Diabetic
                              Nephropathy Study
                              Group Annual
                              Meeting
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Improving Patient    12/04/2014     $110,000.00
     HEALTH-SYSTEM            Outcomes:
     PHARMACISTS              Maximizing the
                              Role of the GLP-1
                              Based Therapies
                              in Our Patients
                              with Type 2
                              Diabetes
    ------------------------------------------------------------------------
    ENDOCRINE SOCIETY        ENDO 2015 Thyroid    12/04/2014      $55,000.00
                              Sessions
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      XVI Curso            12/07/2014      $10,000.00
     SOUTHWESTERN MEDICAL     Intensivo de
     CENTER                   Diabetes,
                              Endocrinologia y
                              Enfermedades
                              Metabolicas
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Advances in          12/07/2014      $10,000.00
     CLINICAL                 Medical and
     ENDOCRINOLOGISTS         Surgical
                              Management of
                              Thyroid Cancer
    ------------------------------------------------------------------------
    AMERICAN PAIN SOCIETY    2015 Fundamentals    12/07/2014      $35,000.00
                              of Pain
                              Management: An
                              Interdisciplinary
                              Primer
    ------------------------------------------------------------------------
    HEMATOLOGY/ONCOLOGY      2015 HOPA 11th       12/07/2014      $25,000.00
     PHARMACY ASSOCIATION     Annual Conference
    ------------------------------------------------------------------------
    LUMEN FOUNDATION         Lumen Global 2015    12/08/2014      $75,000.00
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Mentoring Program    12/08/2014      $10,000.00
     NEONATAL NURSES          Toolkit for
                              Novice Nurse
                              Practitioners
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Conquer         12/08/2014     $250,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Career
     CLINICAL ONOCLOGY        Development Award
                              (CDA)
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Conquer         12/08/2014      $10,500.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO
     CLINICAL ONCOLOGY        International
                              Development and
                              Education Award
                              (IDEA)
    ------------------------------------------------------------------------
    THE ENDOCRINE SOCIETY    Applying the         12/08/2014     $525,980.00
                              Evidence for GLP-
                              1 Receptor
                              Agonists in Type
                              2 Diabetes:
                              Practice
                              Perspectives
    ------------------------------------------------------------------------
    FORCE--FACING OUR RISK   Joining FORCEs       12/08/2014      $50,000.00
     OF CANCER EMPOWERED      Against
                              Hereditary Cancer
                              Conference
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Lipid Management     12/08/2014      $50,000.00
     CARDIOLOGY FOUNDATION    Today: Unanswered
                              Questions and
                              Unquestioned
                              Answers--Live
                              Clinical Focus
                              Session at ACC.15
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     Access to Care:      12/09/2014      $11,250.00
     ASSOCIATION              Addressing Health
                              Literacy in
                              Diabetes
    ------------------------------------------------------------------------
    THE ENDOCRINE SOCIETY    Diabetes Diagnosis   12/09/2014      $50,000.00
                              and Management
                              2015
    ------------------------------------------------------------------------
    ENDOCRINE SOCIETY        Endocrine Fellows    12/09/2014      $70,000.00
                              Conference: Type
                              1 Diabetes Care
                              and Management
    ------------------------------------------------------------------------
    CLINICAL AND PATIENT     Clinical Issues in   12/09/2014     $368,966.00
     EDUCATORS ASSOCIATION    Type 2 Diabetes:
                              Discussions and
                              Debates Around
                              GLP-1 Receptor
                              Agonists
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACCs 64th Annual     12/09/2014     $100,000.00
     CARDIOLOGY FOUNDATION    Scientific
                              Session--ACC.15
                              Acute Coronary
                              Syndromes
                              Clinical Learning
                              Pathway
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Conquer         12/10/2014      $60,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      Young
     CLINICAL ONCOLOGY        Investigator
                              Award
    ------------------------------------------------------------------------
    ENDOCRINE SOCIETY        Diabetes Masters     12/10/2014     $235,867.00
                              Series 2015 :
                              Solving the
                              Puzzle: Putting
                              the Pieces
                              Together to
                              Provide Quality
                              T2DM Care
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 ASCO Annual     12/10/2014     $112,000.00
     FOUNDATION OF THE        Meeting Lung
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    INSTITUTE FOR MEDICAL    Who s on First?      12/10/2014     $316,029.80
     AND NURSING EDUCATION    What s on Second?
                              Identifying a
                              Line-up of Newer
                              Agents to
                              Individualize
                              Care for Your
                              Patient with T2DM
    ------------------------------------------------------------------------
    PENNSYLVANIA STATE       Controlling Severe   12/11/2014     $236,659.94
     UNIVERSITY               Asthma Today and
                              Tomorrow
    ------------------------------------------------------------------------
    CHILDREN'S HOSPITAL      2015 Weinstein       12/11/2014       $5,000.00
     CORPORATION              Cardiovascular
                              Development
                              Conference
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2015-2016 Monthly    12/11/2014      $35,000.00
     CANCER NETWORK, INC      Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    ENDOCRINE SOCIETY        ENDO 2015 Diabetes   12/14/2014      $30,000.00
                              Sessions
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Case Challenges in   12/14/2014     $181,705.00
     CLINICAL                 T2D: Applying the
     ENDOCRINOLOGISTS         AACE Algorithm to
                              Practice
    ------------------------------------------------------------------------
    THE CHEST FOUNDATION     The CHEST            12/15/2014     $180,000.00
                              Foundation COPD
                              Research Grant
                              Program
    ------------------------------------------------------------------------
    JOSLIN DIABETES CENTER,  SGLT-2 Inhibitors    12/15/2014     $321,885.00
     INC.                     in Type 2
                              Diabetes:
                              Incorporating New
                              Approaches Into
                              Practice Through
                              an
                              Interdisciplinary
                              Exploration
    ------------------------------------------------------------------------
    AMERICAN OSTEOPATHIC     The Path to Better   12/15/2014     $263,394.54
     ASSOCIATION              T2DM Outcomes, A
                              Coordinated
                              Approach to
                              Patient-centered
                              Care
    ------------------------------------------------------------------------
    UNIVERSITY OF            Optimizing           12/21/2014      $62,825.00
     CINCINNATI               Outcomes in Type
                              2 Diabetes:
                              Integrating
                              Longer Acting GLP-
                              1 Receptor
                              Agonists
    ------------------------------------------------------------------------
    RICHMOND UNIVERSITY      Treatment-           12/22/2014       $1,100.00
     MEDICAL CENTER           Refractory Gout
    ------------------------------------------------------------------------
    DUKE UNIVERSITY SCHOOL   Regional Systems     01/04/2015   $3,500,000.00
     OF MEDICINE              Accelerator:
                              Implementation of
                              The American
                              Heart
                              Associations
                              Mission: Lifeline-
                              AMI Discharge and
                              Follow Up
                              Demonstration
                              Project
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      You Say Do, I Say    01/06/2015     $150,000.00
     CARDIOLOGY FOUNDATION    Don t:
                              Controversial
                              Debates in ACS--
                              Live Clinical
                              Focus Session at
                              ACC.15
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACC.15 Prevention    01/07/2015      $75,000.00
     CARDIOLOGY FOUNDATION    Learning Pathway
    ------------------------------------------------------------------------
    AMERICAN HEART           American Heart       01/08/2015   $2,000,000.00
     ASSOCIATION, INC.        Association
                              Cardiovascular
                              Genome Phenome
                              Study (CV-GPS)
    ------------------------------------------------------------------------
    AMERICAN HEART           American Heart       01/11/2015   $6,000,000.00
     ASSOCIATION, INC.        Association s
                              Guideline
                              Transformation
                              and Optimization
                              (GTO) Program
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Post Conference      01/14/2015     $100,000.00
     FOUNDATION               CME Webcast
                              Series 2015
    ------------------------------------------------------------------------
    GASTROINTESTINAL AND     The 2015 US GI and   01/14/2015      $35,000.00
     LIVER ASSOCIATION OF     Liver Association
     THE AMERICAS (GALA)      of the Americas
                              (GALA) Conference
                              Series
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACCs 64th Annual     01/14/2015      $25,000.00
     CARDIOLOGY FOUNDATION    Scientific
                              Session (ACC.15)
                              TCT@ACC-i2
                              Learning Pathway
    ------------------------------------------------------------------------
    GORDON RESEARCH          2015 Gordon          01/14/2015       $5,000.00
     CONFERENCES              Research
                              Conference on the
                              Molecular and
                              Cellular Biology
                              of Lipids
    ------------------------------------------------------------------------
    GEORGIA ASSOCIATION OF   Cardiology Track--   01/14/2015       $5,000.00
     PHYSICIAN ASSISTANTS     How PAs Can
                              Impact Patient
                              Outcomes Across
                              Cardiovascular
                              Diseases (Part of
                              GAPA 2015 Spring
                              Conference)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Endocrine            01/15/2015       $5,000.00
     CLINICAL                 University:
     ENDOCRINOLOGISTS         Disease
                              Management and
                              Technology Skills
                              for Fellows-in-
                              Training (Thyroid
                              Module)
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      16th Annual          01/15/2015       $3,000.00
     HEALTH SCIENCE CENTER    Practical
     SAN ANTONIO SCHOOL OF    Applications of
     MEDICINE                 New Agents in
                              Oncology
    ------------------------------------------------------------------------
    NATIONAL LIPID           National Lipid       01/15/2015      $15,000.00
     ASSOCIATION              Association 2015
                              Lipid Academy
    ------------------------------------------------------------------------
    NATIONAL LIPID           2015 Masters in      01/15/2015      $15,000.00
     ASSOCIATION              Lipidology
    ------------------------------------------------------------------------
    EMORY UNIVERSITY         Atlanta Clinical     01/18/2015      $15,000.00
                              Cardiology Update
    ------------------------------------------------------------------------
    SOCIETY FOR              SCAI 2015            01/27/2015      $85,000.00
     CARDIOVASCULAR           Scientific
     ANGIOGRAPHY AND          Sessions
     INTERVENTIONS
    ------------------------------------------------------------------------
    ENDOCRINE SOCIETY        Thyroid Endocrine    01/28/2015      $10,000.00
                              Self-Assessment
                              Program 2015
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           Scripps 35th         01/29/2015       $5,000.00
                              Annual
                              Conference:
                              Clinical
                              Hematology and
                              Oncology 2015
    ------------------------------------------------------------------------
    NORTHEASTERN UNIVERSITY  Boston Symposium     01/29/2015       $2,500.00
                              on Organic and
                              Bioorganic
                              Chemistry (BSOBC)
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  ACS/STEMI: Focus     01/29/2015      $60,000.00
     FOUNDATION               on Acute Care at
                              SCAI 2015
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Exploring Optimal    01/29/2015      $25,000.00
     MANAGED CARE             Antiplatelet
     PHYSICIANS               Therapies in the
                              Management of
                              Acute Coronary
                              Syndrome (ACS)
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  21st Annual          01/29/2015      $25,000.00
     FOUNDATION               Interventional
                              Cardiology
                              Fellows Course
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     01/29/2015      $15,000.00
                              Working Group US
                              Chapter Meeting
    ------------------------------------------------------------------------
    IOWA PHYSICIAN           Update on Lipid      01/29/2015       $6,500.00
     ASSISTANT SOCIETY        Management
    ------------------------------------------------------------------------
    PREVENTIVE               Cardiovascular       02/01/2015      $25,000.00
     CARDIOVASCULAR NURSES    Risk Reduction:
     ASSOCIATION              Leading the Way
                              in Prevention
                              (21st Annual
                              Symposium)
    ------------------------------------------------------------------------
    PRIMARY CARE NETWORK,    Are Gout Goals       02/02/2015     $619,095.00
     INC.                     Achievable? The
                              Provider/ Patient
                              Alliance
    ------------------------------------------------------------------------
    PREVENTIVE               PCNA-Triglycerides   02/02/2015     $179,540.00
     CARDIOVASCULAR NURSES
     ASSOCIATION
    ------------------------------------------------------------------------
    NATIONAL LIPID           National Lipid       02/02/2015     $120,000.00
     ASSOCIATION              Association 2015
                              Scientific
                              Meeting Series
    ------------------------------------------------------------------------
    AMERICAN HEART           Chest Pain           02/02/2015      $15,000.00
     ASSOCIATION              Coordinator Boot
                              Camp
    ------------------------------------------------------------------------
    THE BOARD OF REGENTS OF  Cardiovascular       02/08/2015       $5,000.00
     THE UNIVERSITY OF        Medicine and
     WISCONSIN SYSTEM         Prevention Update
                              for Primary Care
    ------------------------------------------------------------------------
    UNIVERSITY OF KANSAS     6th Expert           02/09/2015       $5,000.00
     MEDICAL CENTER           Strategies in
                              Endoscopy,
                              Gastrointestinal
                              and Liver
                              Disorders
    ------------------------------------------------------------------------
    TRUSTEES OF THE          2nd Cardiovascular   02/11/2015       $5,000.00
     UNIVERSITY OF            Symposium
     PENNSYLVANIA/CME
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     APhA2015 Rise in     02/11/2015      $22,500.00
     ASSOCIATION              Oral Oncologic
                              Medications
                              Creates New
                              Challenges in
                              Adherence
    ------------------------------------------------------------------------
    EMORY UNIVERSITY         EPIC SEC Emory       02/11/2015      $25,000.00
                              Practical
                              Intervention
                              Course Southeast
                              Consortium
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Advances in the      02/11/2015     $232,693.00
     CANCER NETWORK           Treatment of
                              Ovarian and
                              Cervical Cancers:
                              Expert-
                              Facilitated Small
                              Group Discussions
                              of Challenging
                              Cases
    ------------------------------------------------------------------------
    REGENTS OF THE           Moores Cancer        02/12/2015       $3,000.00
     UNIVERSITY OF            Center 11th
     CALIFORNIA               Industry/Academia
                              Translational
                              Oncology
                              Symposium
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           The Future of        02/12/2015      $10,000.00
                              Genomic Medicine
                              VIII
    ------------------------------------------------------------------------
    DELAWARE ACADEMY OF      Hyperlipidemia       02/12/2015       $2,780.00
     PHYSICIAN ASSISTANTS
    ------------------------------------------------------------------------
    THE MASSACHUSETTS        29th Harvard         02/17/2015       $5,000.00
     GENERAL HOSPITAL         Critical Issues
                              in Tumor
                              Microenvironment:
                              Angiogenesis
                              Metastasis and
                              Immunology Course
    ------------------------------------------------------------------------
    KERN ASPEN LIPID         Emerging Therapies   02/17/2015      $10,000.00
     CONFERENCE               for
                              Cardiovascular
                              Diseases: A
                              Dialogue Between
                              Academic and
                              Pharmaceutical
                              Research
    ------------------------------------------------------------------------
    FLORIDA ASSOCIATION OF   Acute Coronary       02/17/2015       $8,325.00
     CONSULTANT PHARMACISTS   Syndrome;
                              Strategies to
                              Optimize
                              Transitions in
                              Care and Reduce
                              Readmissions
    ------------------------------------------------------------------------
    ST. JOSEPH'S REGIONAL    COPD                 02/18/2015       $1,900.00
     MEDICAL CENTER
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Issues with DAPT     02/18/2015      $50,000.00
     FOUNDATION               Series 2015
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       The Challenges of    02/19/2015       $5,000.00
     ASSOCIATES FOR           Asthma and COPD
     CONTINUING EDUCATION     in Primary Care
     (NPACE)
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  The 8th Annual       02/19/2015       $2,500.00
                              Womens
                              Cardiovascular
                              Health Symposium
    ------------------------------------------------------------------------
    AMERICAN HEART           Atlanta Mission:     02/19/2015       $2,500.00
     ASSOCIATION              Lifeline Meeting
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  How to Talk to       02/22/2015     $231,590.00
     NURSE PRACTITIONERS      Your Patients
                              about Opioid-
                              induced
                              Constipation: A
                              Dialogue about
                              New Advances
    ------------------------------------------------------------------------
    AMERICAN THYROID         American Thyroid     02/22/2015      $25,000.00
     ASSOCIATION              Association
                              Satellite
                              Symposium: ATA
                              Guidelines on
                              Medullary Thyroid
                              Cancer and
                              Pediatric Thyroid
                              Cancer
                              Highlights,
                              Controversies a
    ------------------------------------------------------------------------
    THOMAS JEFFERSON         3rd Annual           02/22/2015       $3,000.00
     UNIVERSITY               Jefferson Lung
                              Cancer Symposium
                              2015
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      What's New in        02/22/2015      $95,085.00
     CHEST PHYSICIANS         Asthma/COPD
                              Syndrome
    ------------------------------------------------------------------------
    WEST PENN ALLEGHENY      Cardiovascular       02/22/2015      $10,000.00
     HEALTH SYSTEM            Medicine Update
                              2015
    ------------------------------------------------------------------------
    AMERICAN DIABETES        62nd Annual          02/23/2015      $10,000.00
     ASSOCIATION              Advanced
                              Postgraduate
                              Course 2015
    ------------------------------------------------------------------------
    SOCIETY OF GYNECOLOGIC   SGO Annual Meeting   02/23/2015      $50,000.00
     ONCOLOGY                 on Women's Cancer
    ------------------------------------------------------------------------
    BAYLOR UNIVERSITY        The 18th Annual      02/23/2015       $3,000.00
     MEDICAL CENTER DBA A.    Tyler Breast
     WEBB ROBERTS CENTER      Cancer Conferecne
                              2015
    ------------------------------------------------------------------------
    PENNSYLVANIA ACADEMY OF  PAFP/F Live and      02/23/2015       $5,000.00
     FAMILY PHYSICIANS        Enduring CME
     FOUNDATION               Primary and
                              Secondary
                              Prevention of
                              ASCVD
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         Oncology Nursing     02/23/2015      $25,000.00
     SOCIETY                  Society 40th
                              Annual Congress
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  2015-2016 AAPS       02/23/2015      $50,000.00
     PHARMACEUTICAL           Sustaining
     SCIENTISTS               Sponsorship
    ------------------------------------------------------------------------
    ASPEN LUNG CONFERENCE    Thomas L. Petty      02/24/2015      $15,000.00
                              Aspen Lung
                              Conference:Asthma
                              2015: Mechanisms
                              to Personalized
                              Medicine
    ------------------------------------------------------------------------
    ST. FRANCIS HOSPITAL--   Intravascular        02/26/2015       $7,000.00
     U.S. CATHOLIC            Coronary Imaging
     CONFERENCE               and Physiology
                              2015: A Clinical
                              Workshop
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  NAPNAP Conference    02/26/2015       $7,500.00
     PEDIATRIC NURSE          Sponsorship
     PRACTITIONERS
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     95th Annual          02/26/2015      $10,000.00
     FOR THORACIC SURGERY     Meeting American
                              Association for
                              Thoracic Surgery
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Session Support:     02/26/2015      $20,000.00
     FOUNDATION INC.          CKD MANAGEMENT
                              ALONG THE
                              CONTINUUM: FROM
                              PREDIALYSIS TO
                              POLICY
    ------------------------------------------------------------------------
    CITY OF HOPE NATIONAL    15th Annual          03/01/2015       $5,000.00
     MEDICAL CENTER           Rachmiel Levine
                              Diabetes and
                              Obesity Symposium
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2015             03/01/2015      $25,000.00
     SOCIETY                  International
                              Conference,
                              Fellows Track
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN THORACIC        2015 International   03/01/2015      $10,000.00
     SOCIETY ATS              Conference--Selec
                              ted Topics in
                              Asthma
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   Improving the        03/01/2015      $10,000.00
                              Quality of Care
                              for Patients with
                              Asthma
    ------------------------------------------------------------------------
    ST. JOSEPH'S REGIONAL    Year in Review in    03/01/2015       $3,700.00
     MEDICAL CENTER           Acute Coronary
                              Syndromes
    ------------------------------------------------------------------------
    THE BOARD OF REGENTS OF  COPD9USA             03/02/2015      $40,000.00
     THE UNIVERSITY OF
     NEBRASKA DBA THE
     UNIVERSITY OF NEBRASKA
     MEDICAL CENTER
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2015             03/02/2015      $72,919.82
     SOCIETY                  International
                              Conference--Selec
                              ted Topics in
                              COPD
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   Best Practices in    03/02/2015      $72,161.00
                              Managing Patients
                              with COPD:
                              Emerging
                              Therapies and
                              Patient Education
                              Strategies
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  DAPT Dilemmas: A     03/02/2015      $69,100.00
     FOUNDATION               Case-Based
                              Roundtable
                              Tutorial
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2015 Alzheimers      03/02/2015      $50,000.00
                              Association
                              Research
                              Roundtable
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 ASCO Annual     03/02/2015      $56,000.00
     FOUNDATION OF THE        Meeting
     AMERICAN SOCIETY OF      Gynecologic
     CLINICAL ONCOLOGY        Cancer Track:
                              Scientific and
                              Educational
                              Program
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAPA Conference      03/02/2015       $5,000.00
     PHYSICIAN ASSISTANTS     2015--CardiologyT
                              rack
    ------------------------------------------------------------------------
    PREVENTIVE               The Post-ACS         03/04/2015     $100,000.00
     CARDIOVASCULAR NURSES    Patient:
     ASSOCIATION              Adherence to
                              Critical
                              Therapies in the
                              Short- and Long-
                              Term
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  2015 Charitable      03/04/2015      $30,000.00
     FREE AND CHARITABLE      Health Care
     CLINICS                  Education and
                              Training
                              Symposium
    ------------------------------------------------------------------------
    GORDON RESEARCH          High Throughput      03/04/2015       $2,500.00
     CONFERENCES              Chemistry and
                              Chemical Biology
    ------------------------------------------------------------------------
    NEW YORK ACADEMY OF      Non-Motor            03/04/2015       $2,000.00
     SCIENCES                 Symptoms:
                              Unraveling the
                              ``Invisible''
                              Face of Parkinson
                              s Disease
    ------------------------------------------------------------------------
    SOCIETY FOR PHYSICIAN    SPAP's 9th Annual    03/08/2015       $1,500.00
     ASSISTANTS IN            Conference
     PEDIATRICS
    ------------------------------------------------------------------------
    JDRF INTERNATIONAL       TypeOneNation        03/08/2015       $4,500.00
                              Research Summit
    ------------------------------------------------------------------------
    GORDON RESEARCH          Solving Knowledge    03/08/2015       $3,000.00
     CONFERENCE               Gaps in Drug
                              Metabolism and
                              Pharmacokinetic
                              Prediction,
                              Improving
                              Translational
                              Medicine
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Clinical Pearls in   03/09/2015       $2,500.00
     ASSOCIATES FOR           Managing Diabetes
     CONTINUING EDUCATION     in 2015
     (NPACE)
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Cardiovascular       03/09/2015      $11,500.00
     OF HARVARD COLLEGE       Medicine 2015:
                              Updates for the
                              Practitioner
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Diabetes Sessions    03/10/2015      $25,000.00
     CLINICAL                 at Endocrine
     ENDOCRINOLOGISTS         University:
                              Disease
                              Management and
                              Technology Skills
                              for Endocrinology
                              Fellows in
                              Training
    ------------------------------------------------------------------------
    NEBRASKA ACADEMY OF      Gout 2015            03/10/2015       $1,500.00
     PHYSICIAN ASSISTANTS
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2015 Oncology   03/10/2015      $20,000.00
     CANCER NETWORK, INC.     Case Manager and
                              Medical Director
                              Program
    ------------------------------------------------------------------------
    GORDON RESEARCH          Preclinical Form     03/11/2015         $500.00
     CONFERENCES              and Formulation
                              for Drug
                              Discovery GRC/GRS
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          03/12/2015      $25,000.00
     FOR CANCER RESEARCH      Meeting--2015
    ------------------------------------------------------------------------
    THE HOPE FOUNDATION      2015 SWOG Group      03/12/2015       $5,000.00
                              Meetings
    ------------------------------------------------------------------------
    AMERICAN HEAD AND NECK   American Head and    03/12/2015      $10,000.00
     SOCIETY                  Neck Society 2015
                              Annual Meeting
    ------------------------------------------------------------------------
    BOSTON CHILDREN'S        Pediatric Asthma     03/16/2015       $3,000.00
     HOSPITAL                 and Allergy
                              Updates for
                              Primary Care
                              Providers
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Managing Asthma      03/16/2015       $1,500.00
     ASSOCIATES FOR           and COPD in 2015
     CONTINUING EDUCATION
     (NPACE)
    ------------------------------------------------------------------------
    HEALTHCARE ALLIANCE FOR  Essentials in        03/16/2015       $8,400.00
     MEDICAL EDUCATION        Primary Care
    ------------------------------------------------------------------------
    WEST VIRGINIA ACADEMY    Opioid Induced       03/17/2015       $3,000.00
     OF FAMILY PHYSICIANS     Constipation
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        2015 ECOG-ACRIN      03/18/2015       $5,000.00
     EDUCATION FOUNDATION,    Spring Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 ASCO Annual     03/18/2015      $84,000.00
     FOUNDATION OF THE        Meeting Breast
     AMERICAN SOCIETY OF      Cancer Track:
     CLINICAL ONCOLOGY        Scientific and
                              Educational
                              Program
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Diabetes is          03/19/2015      $15,000.00
     OSTEOPATHIC FAMILY       Primary
     PHYSICIANS               Addressing
                              Primary Care
                              Clinical Gaps in
                              Diabetes
                              Management by
                              Partnering With
                              Experts
    ------------------------------------------------------------------------
    MERCY HEALTH SYSTEM      Care Transitions     03/19/2015       $5,000.00
     SEPA                     Conference
    ------------------------------------------------------------------------
    THE MEDICAL UNIVERSITY   10th Annual          03/19/2015       $5,000.00
     OF SOUTH CAROLINA        Symposium
                              entitled the
                              Nephrology Update
                              for Primary Care
                              and Hospital
                              Medicine
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2015 Alzheimer's     03/23/2015      $95,000.00
                              Association
                              International
                              Conference
    ------------------------------------------------------------------------
    SOCIETY FOR              2015 Annual          03/23/2015      $25,000.00
     TRANSLATIONAL ONCOLOGY   Meeting
    ------------------------------------------------------------------------
    SWEDISH MEDICAL CENTER   Thyroid Cancer and   03/24/2015       $3,000.00
     FOUNDATION               Parathyroid
                              Disease--A
                              Practical
                              Approach
    ------------------------------------------------------------------------
    ASSOCIATION OF WOMEN'S   AWHONN Annual        03/24/2015       $7,500.00
     HEALTH, OBSTETRIC AND    Convention
     NEONATAL NURSES
     (AWHONN)
    ------------------------------------------------------------------------
    GORDON RESEARCH          2015 Proteins        03/24/2015       $3,000.00
     CONFERENCES              Gordon Conference
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 24th Annual     03/25/2015      $30,000.00
     CLINICAL                 Scientifc and
     ENDOCRINOLOGISTS         Clinical Congress
                              (Diabetes
                              portion)
    ------------------------------------------------------------------------
    THE ASSOCIATION FOR      AFTD's Annual        03/25/2015       $1,000.00
     FRONTOTEMPORAL           Education
     DEGENERATION (AFTD)      Conference
    ------------------------------------------------------------------------
    TRINITAS REGIONAL        Lung Cancer          03/25/2015       $1,750.00
     MEDICAL CENTER
    ------------------------------------------------------------------------
    INSTITUTE FOR PATIENT    2015 Premature       03/25/2015     $125,000.00
     ACCESS                   Infant Health
                              Summit
    ------------------------------------------------------------------------
    SOCIETY FOR              Young Investigator   03/25/2015      $25,000.00
     NEUROSCIENCE             Award
    ------------------------------------------------------------------------
    ST. DOMINIC--JACKSON     STOP STEMI and       03/25/2015      $25,000.00
     MEMORIAL HOSPITAL        STOP STROKE
                              program by
                              Pulsara
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     Anti-cancer Drug     03/26/2015      $10,000.00
     FOR CANCER RESEARCH      Action and Drug
                              Resistance:
    ------------------------------------------------------------------------
    YALE UNIVERSITY          2015 New England     03/26/2015       $3,000.00
                              Thyroid Club
                              Program
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 24th Annual     03/26/2015      $25,000.00
     CLINICAL                 Scientific and
     ENDOCRINOLOGISTS         Clinical Congress
                              (Thyroid
                              sessions)
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Cleveland Breast     03/26/2015       $5,000.00
     EDUCATIONAL FOUNDATION   Cancer 2015:
                              Collaborating For
                              A Cure
    ------------------------------------------------------------------------
    OKLAHOMA HEART RESEARCH  26th Annual Update   03/26/2015       $2,500.00
     AND EDUCATION            in Cardiology
     FOUNDATION
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     3rd Annual           03/29/2015       $5,000.00
     CENTER                   Experimental
                              Therapeutics in
                              Oncology: The
                              Road to
                              Personalized
                              Medicine
    ------------------------------------------------------------------------
    CASE MANAGEMENT SOCIETY  CMSA 2015            03/29/2015      $15,000.00
     OF AMERICA               Conference and
                              Expo
    ------------------------------------------------------------------------
    SOCIETY FOR              SCAI Complex         03/29/2015      $15,000.00
     CARDIOVASCULAR           Peripheral
     ANGIOGRAPHY AND          Vascular
     INTERVENTIONS            Interventions
     FOUNDATION               Course
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Bringing Science     03/29/2015      $50,000.00
     CARDIOLOGY FOUNDATION    to Clinical
                              Practice: Best of
                              ACC 2015
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Live Symposium of    03/29/2015      $10,000.00
     MEDICINE AT MOUNT        Complex Coronary
     SINAI                    Valvular and
                              Vascular Cases
    ------------------------------------------------------------------------
    ASOCIACION               Metabolic Syndrome   03/30/2015       $1,500.00
     PUERTORRIQUENA DE        Update:
     GRADUADOS DE             Challenges in
     UNIVERSIDADES            Preventive
     ESPANOLAS-APGUE          Medicine
    ------------------------------------------------------------------------
    UNIVERSITY OF            Breast Symposium     03/30/2015       $3,250.00
     PITTSBURGH               2015: Updates in
                              the Management of
                              Breast Cancer/
                              Breast Disease
    ------------------------------------------------------------------------
    JOHNS HOPKINS            6th Annual Johns     03/30/2015       $2,500.00
     UNIVERSITY               Hopkins
                              Cardiovascular
                              Research Retreat
    ------------------------------------------------------------------------
    SOCIETY FOR VASCULAR     Society for          03/30/2015       $5,000.00
     MEDICINE                 Vascular Medicine
                              26th Annual
                              Scientific
                              Sessions
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       Updates in COPD      03/30/2015       $3,200.00
     ASSOCIATES FOR           2015
     CONTINUING EDUCATION
     (NPACE)
    ------------------------------------------------------------------------
    THE CHRIST HOSPITAL      The FETCH            03/31/2015       $5,000.00
                              Conference
    ------------------------------------------------------------------------
    THE CHEST FOUNDATION     The CHEST            03/31/2015      $30,000.00
                              Foundation Lung
                              Cancer Clinical
                              Research Grant
                              Program
    ------------------------------------------------------------------------
    NEW YORK MEDICAL         Systemic Treatment   03/31/2015       $2,500.00
     COLLEGE                  of Lung Cancer
    ------------------------------------------------------------------------
    THE CENTER OF            8th Annual           03/31/2015       $5,000.00
     EXCELLENCE IN            Cardiovascular
     EDUCATION                Update- A
                              Practical
                              Tutorial
    ------------------------------------------------------------------------
    ST. JOSEPH'S HOSPITAL    4th Annual Arizona   04/01/2015      $15,000.00
     AND MEDICAL CENTER       Diabetes Series:
                              Focus on
                              Treatment
                              Advances, Patient-
                              Centered Care,
                              Obesity and Other
                              Comorbidities
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  Annual Meeting of    04/01/2015       $5,000.00
     MD ANDERSON CANCER       the Felix
     CENTER                   Rutledge Society
    ------------------------------------------------------------------------
    GOUT AND URIC ACID       Gout and Uric Acid   04/01/2015      $70,000.00
     EDUCATION SOCIETY        Education Society
                              Roundtable:
                              Elevating the
                              Severity of Gout
                              and Improving
                              Access to Public
                              Education and
                              Treatment
    ------------------------------------------------------------------------
    VIVA PHYSICIANS          VIVA 15: Vascular    04/01/2015      $20,000.00
                              InterVentional
                              Advances
    ------------------------------------------------------------------------
    UNIVERSITY OF            University of        04/02/2015      $20,000.00
     WASHINGTON               Washington
                              Allergy and
                              Immunology
                              Fellowship
    ------------------------------------------------------------------------
    WASHINGTON ACADEMY OF    26th Annual          04/06/2015       $1,500.00
     PHYSICIAN ASSISTANTS     Recertification
                              Review Course and
                              Spring Conference
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Advances in Lung     04/07/2015       $5,000.00
     EDUCATIONAL FOUNDATION   Cancer: A
                              Multidisciplinary
                              Approach
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   Molecular,           04/08/2015      $10,000.00
     SOCIETIES FOR            Structural and
     EXPERIMENTAL BIOLOGY     Clinical Aspects
                              of VK and VK-
                              Dependent
                              Proteins
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   FASEB conference     04/08/2015       $5,000.00
     SOCIETIES FOR            on Genetic
     EXPERIMENTAL BIOLOGY     Recombination and
                              Genome
                              Rearrangements
    ------------------------------------------------------------------------
    SCRIPPS WHITTIER         Emerging             04/09/2015      $30,000.00
     DIABETES INSTITUTE       Therapeutic
                              Trends to
                              Optimize Diabetes
                              Care
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2015                 04/09/2015       $5,000.00
     CARDIOLOGY FOUNDATION    Interventional
                              Cardiology Board
                              Preparatory
                              Course
    ------------------------------------------------------------------------
    AMERICAN FEDERATION FOR  2015 Eastern         04/12/2015       $2,500.00
     MEDICAL RESEARCH         Regional Meeting
                              of the American
                              Federation for
                              Medical Research
    ------------------------------------------------------------------------
    PONCE MEDICAL SCHOOL     Overcoming           04/12/2015      $10,000.00
     FOUNDATION INC.          Obstacles to
                              Reduce Acute
                              Coronary Syndrome
    ------------------------------------------------------------------------
    SOUTH CAROLINA ASTHMA    Midlands Regional    04/12/2015       $3,000.00
     ALLIANCE                 Asthma Conference
    ------------------------------------------------------------------------
    PHARMACY QUALITY         Measuring What       04/13/2015      $12,500.00
     ALLIANCE (PQA, INC.)     Matters:
                              Improving Care
                              and Driving the
                              Next Generation
                              of Performance
                              Measures
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      The Comprehensive    04/13/2015     $283,155.00
     EDUCATION FOUNDATION     Management of DM--
                              Focus on SGLT2
                              Inhibitors and
                              Combination
                              Therapy--Emerging
                              Concepts of Renal
                              Effects
    ------------------------------------------------------------------------
    ASTHMA AND ALLERGY       Wheezin', Sneezin'   04/14/2015       $5,000.00
     FOUNDATION OF AMERICA,   and Itchin' in
     ALASKA CHAPTER           Alaska
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Individualizing      04/14/2015      $25,000.00
     MANAGED CARE             Treatment
     PHYSICIANS, INC.         Strategies to
                              Improve Patient
                              Outcomes in the
                              Management of
                              Type 2 Diabetes
                              (T2DM)
    ------------------------------------------------------------------------
    MIDMICHIGAN MEDICAL      Valley Diabetes      04/15/2015       $2,500.00
     CENTER--MIDLAND          Symposium
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       Opioid Induced       04/15/2015     $117,200.00
     UNIVERSITY DBA BOSTON    Constipation: A
     UNIVERSITY SCHOOL OF     Neglected
     MEDICINE                 Complication
    ------------------------------------------------------------------------
    PARTNERS HEALTHCARE      World Medical        04/15/2015      $50,000.00
     SYSTEM                   Innovation Forum
    ------------------------------------------------------------------------
    MASSACHUSETTS INSTITUTE  CANCER COMPLEXITY:   04/15/2015       $5,000.00
     OF TECHNOLOGY            Heterogeneity in
                              Tumor Progression
                              and Drug Response
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASN Kidney Week--    04/16/2015      $55,000.00
     NEPHROLOGY               CKD Learning
                              Pathway Support
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION     Leading Care         04/19/2015      $15,000.00
     FOR HEALTHCARE QUALITY   Transitions:
                              Improving Quality
                              in Safety Across
                              the Healthcare
                              Continuum
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   12th FASEB Summer    04/19/2015       $7,000.00
     SOCIETIES FOR            Research
     EXPERIMENTAL BIOLOGY     Conference on
                              ``Proteases in
                              Hemostasis and
                              Vascular
                              Biology''
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASPMN 25th           04/20/2015      $20,000.00
     PAIN MANAGEMENT          National
     NURSING                  Conference
    ------------------------------------------------------------------------
    REGENTS OF THE           5th International    04/20/2015       $3,000.00
     UNIVERSITY OF            Symposium on Lung-
     CALIFORNIA               Sparing Therapies
                              for Malignant
                              Pleural
                              Mesothelioma
    ------------------------------------------------------------------------
    GORDON RESEARCH          2015 Medicinal       04/20/2015       $3,000.00
     CONFERENCES              Chemistry Gordon
                              Research
                              Conference
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2015             04/21/2015      $50,000.00
     SOCIETY                  International
                              Conference--Selec
                              ted Topics in
                              Lung Cancer
    ------------------------------------------------------------------------
    OKLAHOMA UNIVERSITY      18th Annual          04/21/2015       $1,500.00
     HEALTH SCIENCES CENTER   Primary Care
                              Update 2015
                              Asthma
    ------------------------------------------------------------------------
    OKLAHOMA UNIVERSITY      18th Annual          04/21/2015       $1,500.00
     HEALTH SCIENCE CENTER    Primary Care
     COLLEGE OF MEDICINE      Update 2015-
                              Ovarian Cancer
    ------------------------------------------------------------------------
    REGENTS OF THE           LIPID MAPS           04/21/2015       $7,500.00
     UNIVERSITY OF            Meeting:
     CALIFORNIA               Lipidomics Impact
                              on Cancer,
                              Metabolic and
                              Inflammatory
                              Diseases
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Knights of the       04/21/2015      $50,000.00
     FOUNDATION               Roundtable 2015:
                              Challenging AMI
                              Therapies
    ------------------------------------------------------------------------
    HOUSTON METHODIST        Cardiovascular       04/21/2015      $15,000.00
     HOSPITAL                 Fellows' Bootcamp-
                              Laying the
                              Foundation
    ------------------------------------------------------------------------
    UNIVERSITY OF            Seventh Annual       04/22/2015       $3,250.00
     PITTSBURGH               Multidisciplinary
                              Thyroid Cancer
                              Symposium:
                              Integrating the
                              New ATA
                              Guidelines into
                              Clinical Practice
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  36th Annual          04/22/2015       $3,000.00
     ENDOCRINE SURGEONS       Meeting of the
                              American
                              Association of
                              Endocrine
                              Surgeons
    ------------------------------------------------------------------------
    DUKE UNIVERSITY HEALTH   Closing the Gap on   04/22/2015      $20,000.00
     SYSTEM                   Medication
                              Management,
                              Discharge
                              Preparedness and
                              Readmissions
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         ASCO Review          04/23/2015       $3,000.00
     EDUCATIONAL FOUNDATION
    ------------------------------------------------------------------------
    SWEDISH MEDICAL CENTER   Annual Oncology      04/23/2015       $3,000.00
     FOUNDATION               Symposium:
                              Personalized
                              Medicine--Genetic
                              Testing, Targeted
                              Molecular Therapy
                              and WHole Patient
                              Care
    ------------------------------------------------------------------------
    OKLAHOMA UNIVERSITY      18th Annual          04/23/2015       $1,500.00
     HEALTH SCIENCE CENTER    Primary Care
     COLLEGE OF MEDICINE      Update: COPD
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    Update on            04/23/2015       $4,000.00
                              Gynecologic
                              Cancer
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    Cardiology Update    04/23/2015       $4,000.00
     SCHOOL OF MEDICINE,
     ST. LOUIS
    ------------------------------------------------------------------------
    NEW YORK ACADEMY OF      Emerging             04/27/2015       $5,000.00
     SCIENCES                 Approaches to
                              Cancer
                              Immunotherapy
    ------------------------------------------------------------------------
    LYMPHOMA RESEARCH        Lymphoma Research    04/27/2015      $15,000.00
     FOUNDATION               Foundation Immune
                              Checkpoint
                              Inhibitor
                              Workshop
    ------------------------------------------------------------------------
    YALE UNIVERSITY          Yale Cancer Center   04/28/2015       $5,000.00
                              Oncology Series--
                              2015
    ------------------------------------------------------------------------
    MOUNT CARMEL HEALTH      2015 ASCO REVIEW     04/28/2015       $3,000.00
     SYSTEM
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      Breast Cancer        04/28/2015       $3,000.00
     DEPARTMENT OF SURGERY    Management 2015
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  4th Annual Chicago   04/28/2015       $6,000.00
                              Cardiovascular
                              Update
    ------------------------------------------------------------------------
    DIGNITY HEALTH ST.       17th Annual          04/29/2015       $6,000.00
     BERNARDINE MEDICAL       Cardiac
     CENTER                   Symposium:
                              Advances in
                              Cardiovascular
                              Disease 2015
    ------------------------------------------------------------------------
    GORDON RESEARCH          2015 Gordon          04/29/2015       $2,500.00
     CONFERENCES              Conference on
                              Heterocyclic
                              Compounds
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    Regulatory and       04/29/2015       $2,500.00
     FOR COMPUTATIONAL        Systems Genomics,
     BIOLOGY INC.             with DREAM
                              Challenges
                              Conference
    ------------------------------------------------------------------------
    YALE UNIVERSITY          Yale ASCO Review     04/30/2015       $3,000.00
                              2015
    ------------------------------------------------------------------------
    UNIVERSITY OF VERMONT    OBESITY AND          04/30/2015       $5,000.00
     AND STATE AGRICULTURAL   METABOLISM: An
     COLLEGE                  Emerging Frontier
                              in Lung Health
                              and Disease
    ------------------------------------------------------------------------
    SWEDISH MEDICAL CENTER   The Transradial      04/30/2015       $5,000.00
     FOUNDATION               Approach: A Case-
                              based and Hands-
                              on Training
                              Course
    ------------------------------------------------------------------------
    MONTEFIORE MEDICAL       Achieving Balance:   05/03/2015     $161,500.00
     CENTER                   Practical
                              Management
                              Strategies for
                              Opioid-Induced
                              Constipation
    ------------------------------------------------------------------------
    CALIFORNIA SOCIETY OF    CSAAI 23rd Annual    05/05/2015       $3,000.00
     ALLERGY, ASTHMA, AND     Educational
     IMMUNOLOGY               Meeting
    ------------------------------------------------------------------------
    TRUSTEES OF THE          Advanced Thyroid     05/06/2015       $5,000.00
     UNIVERSITY OF            Master Class
     PENNSYLVANIA
    ------------------------------------------------------------------------
    CANCER MOLECULAR         Molecular            05/06/2015       $5,000.00
     THERAPEUTICS RESEARCH    Therapeutics of
     ASSOCIATION              Cancer
                              Conference, 2015
    ------------------------------------------------------------------------
    NORTH SHORE LONG ISLAND  Post American        05/07/2015       $3,000.00
     JEWISH HEALTH SYSTEM     Society of
     INC.                     Clinical Oncology
                              2015
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Update in Allergy,   05/12/2015       $5,000.00
     ALLERGY, ASTHMA AND      Asthma and
     IMMUNOLOGY               Immunology
    ------------------------------------------------------------------------
    ALBERT EINSTEIN          Complex              05/14/2015       $5,000.00
     HEALTHCARE NETWORK       Angioplasty
                              Symposium
                              Exchange
                              Philadelphia
    ------------------------------------------------------------------------
    SOCIETY FOR              The Oncologist CME   05/17/2015      $10,000.00
     TRANSLATIONAL ONCOLOGY   Online Journal
                              Curriculum:
                              Breast Cancer
    ------------------------------------------------------------------------
    ANENBERG CENTER FOR      PosterPerspectives   05/18/2015      $25,000.00
     HEALTH SCIENCES AT       : Research
     EISENHOWER               Developments in
                              NSCLC / 2015 ASCO
    ------------------------------------------------------------------------
    WESTERN ASSOCIATION      Hitting the          05/18/2015      $12,500.00
     GYNECOLOGIOC             targets in
     ONCOLOGISTS              Gynecologic
                              Cancer
    ------------------------------------------------------------------------
    AMERICAN THYROID         ATA Early Riser      05/19/2015     $129,500.00
     ASSOCIATION              Symposium: New
                              Modalities to
                              Treat Medullary
                              Thyroid Cancer
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Issues with DAPT:    05/19/2015      $25,000.00
     FOUNDATION               A Case-based
                              Roundtable with
                              the Experts
    ------------------------------------------------------------------------
    LAHEY CLINIC HOSPITAL,   Cardiovascular       05/19/2015       $6,000.00
     INC.                     Disease State of
                              the Art 2015
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACC Cardiovascular   05/19/2015       $5,000.00
     CARDIOLOGY FOUNDATION    Board Review for
                              Certification and
                              Recertification
    ------------------------------------------------------------------------
    CANCER RESEARCH          Immunotherapy for    05/19/2015      $75,000.00
     INSTITUTE                the Oncology
                              Nurse
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      05/20/2015       $5,000.00
     CONFERENCES              Conference;
                              Hormone dependent
                              cancer
    ------------------------------------------------------------------------
    NORTHEASTERN UNIVERSITY  Boston Symposium     05/21/2015       $3,500.00
                              on Organic and
                              Bioorganic
                              Chemistry (BSOBC)
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Anemia,              05/21/2015     $190,000.00
     NEPHROLOGY               Erythropoeisis,
                              and the
                              Nephrologist
    ------------------------------------------------------------------------
    CANCER RESEARCH          2015 International   05/24/2015      $50,000.00
     INSTITUTE                Cancer
                              Immunotherapy
                              Conference
    ------------------------------------------------------------------------
    ZOE ROSE MEMORIAL        2015 Preemie         05/24/2015      $10,000.00
     FOUNDATION               Parent Summit
    ------------------------------------------------------------------------
    THE GOG FOUNDATION INC   4th Semi Annual      05/26/2015      $20,000.00
                              Meeting of NRG
                              Oncology
                              (formerly GOG,
                              NSABP, RTOG)
    ------------------------------------------------------------------------
    CLINICAL CARE OPTIONS    Immunotherapy for    05/26/2015      $25,000.00
                              Cancer Track: CCO
                              Independent
                              Conference
                              Highlights of the
                              2015 ASCO Annual
                              Meeting
    ------------------------------------------------------------------------
    ACADEMIA MEDICA DEL SUR  Non-Small Cell       05/26/2015       $3,000.00
                              Lung Cancer:
                              Current Therapy
                              and Promising New
                              Regimens
    ------------------------------------------------------------------------
    AMERICAN                 ANMS 10th            05/26/2015       $6,400.00
     NEUROGASTROENTEROLOGY    Postgraduate
     AND MOTILITY SOCIETY     Course in
                              Gastroenterology
                              and
                              Neurogastroentero
                              logy in Clinical
                              Practice
    ------------------------------------------------------------------------
    CEO ROUNDTABLE ON        Prostate Cancer      05/27/2015      $30,000.00
     CANCER, INC.             DREAM Challenge
                              Winning Teams
                              Educational Grant
    ------------------------------------------------------------------------
    C-CHANGE                 Big Data in Cancer   05/27/2015      $25,000.00
                              Care
    ------------------------------------------------------------------------
    THE GOG FOUNDATION       Rational             05/27/2015      $10,000.00
                              Combination
                              Targeted
                              Therapies for
                              Gynecologic
                              Cancers
    ------------------------------------------------------------------------
    TRUSTEES OF COLUMBIA     Lung Cancer 2015:    05/27/2015       $3,000.00
     UNIVERSITY IN THE CITY   New Discoveries,
     OF NEW YORK              New Directions
    ------------------------------------------------------------------------
    NOT-FOR-PROFIT HOSPITAL  Lung Cancer          05/27/2015       $1,900.00
     CORPORATION              Screening in 2015
    ------------------------------------------------------------------------
    OLIGONUCLEOTIDE          11th Annual          05/31/2015       $7,500.00
     THERAPEUTICS SOCIETY     Meeting of the
                              Oligonucleotide
                              Therapeutics
                              Society
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Best of ASCO    05/31/2015      $15,000.00
     FOUNDATION OF THE        Meetings
     AMERICAN SOCIETY OF
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Improving Outcomes   06/02/2015     $101,800.00
     DIABETES EDUCATORS       for Women With
                              Type 2 Diabetes
                              Individualizing
                              Evidence-Based
                              Care
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Chronic Kidney       06/02/2015      $75,000.00
     FOUNDATION               Disease and the
                              Primary Care
                              Practitioner:
    ------------------------------------------------------------------------
    UNIVERSITY OF MARYLAND   17th Annual          06/02/2015      $15,000.00
     BALTIMORE FOUNDATION,    International
     INC.                     Meeting of the
                              Institute of
                              Human Virology
    ------------------------------------------------------------------------
    TRUSTEES OF THE          2015 Updates in      06/03/2015       $5,000.00
     UNIVERSITY OF            Oncology: With
     PENNSYLVANIA             Proceedings from
                              International
                              Medical Meetings
    ------------------------------------------------------------------------
    MELANOMA RESEARCH        Melanoma Research    06/03/2015     $112,280.00
     FOUNDATION               Foundation CURE
                              OM Junior
                              Fellowship
    ------------------------------------------------------------------------
    AMERICAN OSTEOPATHIC     Optimizing Anti-     06/04/2015     $357,790.00
     ASSOCIATION              platelet Therapy
                              and Secondary
                              Prevention
                              Strategies in
                              Acute Coronary
                              Syndromes The
                              Role of the
                              Primary Care
                              Practice
                              (150203494)
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    Workshop on          06/09/2015      $30,000.00
     FOR STEM CELL RESERACH   Clinical
                              Translation
    ------------------------------------------------------------------------
    NURSE PRACTITIONER       The Latest in        06/10/2015       $5,000.00
     ASSOCIATES FOR           Asthma and COPD
     CONTINUING EDUCATION
     (NPACE)
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     IMPACT Care          06/10/2015      $74,987.00
     ASSOCIATION FOUNDATION   Transformation
                              Institute
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     Advances in Breast   06/11/2015      $10,000.00
     FOR CANCER RESEARCH      Cancer Research
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     Advances in          06/11/2015      $10,000.00
     FOR CANCER RESEARCH      Ovarian Cancer
                              Research
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Symposium--Asthma,   06/11/2015      $50,000.00
     ALLERGY, ASTHMA AND      COPD and Asthma-
     IMMUNOLOGY               COPD Overlap
                              Syndrome (ACOS)
    ------------------------------------------------------------------------
    CASE MANAGEMENT SOCIETY  Improving            06/11/2015       $6,265.00
     OF AMERICA               Medication
                              Adherence in the
                              COPD Patient
                              through Greater
                              Patient
                              Engagement
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  California Chapter   06/16/2015      $20,000.00
     CLINICAL                 of the American
     ENDOCRINOLOGISTS         Association of
                              Clinical
                              Endocrinologists
                              Presents: Hot
                              Topics in
                              Diabetes and
                              Endocrinology for
                              Primary Care
    ------------------------------------------------------------------------
    FLORIDA ACADEMY OF       Update on COPD and   06/16/2015       $4,300.00
     PHYSICIAN ASSISTANTS     Asthma Management
     INC.
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      2015 AAFP FMX        06/16/2015      $13,000.00
     FAMILY PHYSICIANS        Assembly 60
                              Minute Lecture
                              titled Acute
                              Coronary Syndrome
                              and Angina
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACEP Pediatric       06/17/2015       $2,500.00
     EMERGENCY PHYSICAINS     Emergency
                              Medicine Special
                              Interest Section
                              Annual Meeting
    ------------------------------------------------------------------------
    FOUNDATION FOR           FGO Genetics         06/18/2015      $35,000.00
     GYNECOLOGIC ONCOLOGY     Summit
    ------------------------------------------------------------------------
    FRIENDS OF CANCER        2015 Friends of      06/22/2015     $100,000.00
     RESEARCH                 Cancer Research
                              Programs
    ------------------------------------------------------------------------
    DIVISION OF MEDICINAL    Division of          06/23/2015       $2,500.00
     CHEMISTRY                Medicinal
                              Chemistry Program
                              American Chemical
                              Society 250th
                              National Meeting
    ------------------------------------------------------------------------
    RECTOR AND VISITORS OF   Vasculata 2015       06/24/2015      $10,000.00
     THE UNIVERSITY OF
     VIRGINIA
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Preventing           06/24/2015      $48,000.00
     CHEST PHYSICIANS         Exacerbations of
                              COPD
    ------------------------------------------------------------------------
    ASSOCIATION OF ASTHMA    The Asthma Team:     06/24/2015       $5,000.00
     EDUCATORS                Making Wishes
                              Come True
    ------------------------------------------------------------------------
    THE MASSACHUSETTS        30th Annual          06/24/2015       $5,000.00
     GENERAL HOSPITAL         Critical Issues
                              In Tumor
                              Microenvironment:
                              Angiogenesis,
                              Metastasis and
                              Immunology
    ------------------------------------------------------------------------
    NATIONAL MEDICAL         The National         06/24/2015       $3,000.00
     ASSOCIATION              Medical
                              Association
                              Asthma Update:
                              Evidence-Based
                              Diagnosis and
                              management of
                              Asthma--Practical
                              Tools to Improve
                              Patient Care
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Reducing             06/25/2015      $12,500.00
     MANAGED CARE             Exacerbations in
     PHYSICIANS               the Treatment and
                              Management of
                              Chronic
                              Obstructive
                              Pulmonary Disease
                              (COPD)
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         Pharmacology         06/30/2015      $15,000.00
     SOCIETY                  Updates in
                              Oncology Practice
                              Conference
    ------------------------------------------------------------------------
    UC BERKELEY FOUNDATION   IGI CRISPR           06/30/2015      $10,000.00
                              Workshop: Routes
                              to Designer
                              Biology
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      13th Annual World    07/01/2015     $100,000.00
     EDUCATION FOUNDATION     Congress on
                              Insulin
                              Resistance
                              Diabetes and
                              Cardiovascular
                              Disease--WCIRDC
    ------------------------------------------------------------------------
    PARTNERS HEALTHCARE      2015 Personalized    07/02/2015      $25,000.00
     PERSONALIZED MEDICINE    Medicine
                              Conference
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Patient    07/02/2015      $25,000.00
     MANAGED CARE             Outcomes with
     PHYSICIANS, INC.         Novel Treatments
                              in the Management
                              of
                              Hypertriglyceride
                              mia
    ------------------------------------------------------------------------
    NEW YORK CITY SOCIETY    Practical            07/07/2015       $9,500.00
     OF HEALTH- SYSTEM        considerations
     PHARMACISTS              for using novel
                              oral antiplatelet
                              agents in
                              patients with
                              acute coronary
                              syndromes
    ------------------------------------------------------------------------
    INTERNATIONAL            EGFR Diagnostic      07/09/2015     $201,000.00
     ASSOCIATION FOR THE      Expert Consensus
     STUDY OF LUNG CANCER     meeting
    ------------------------------------------------------------------------
    UB FOUNDATION            Recent Advances in   07/09/2015       $2,500.00
     ACTIVITIES, INC.         the
                              pathophysiology
                              and management of
                              type 2 diabetes
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     APhA's Pharmacist    07/14/2015      $25,000.00
     ASSOCIATION              and Patient
                              Centered Diabetes
                              Care Certificate
                              Training Program
                              National
                              Offerings
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-NCI-EORTC       07/14/2015      $25,000.00
     FOR CANCER RESEARCH      Molecular Targets
                              and Cancer
                              Therapeutics
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Mid-Atlantic         07/14/2015      $49,381.58
     UNIVERSITY SCHOOL OF     Nephrology Young
     MEDICINE                 Investigators'
                              Forum
    ------------------------------------------------------------------------
    SOUTH DAKOTA ACADEMY OF  COPD: diagnosis      07/14/2015       $3,500.00
     PHYSICIAN ASSISTANTS     and optimum
                              treatment
    ------------------------------------------------------------------------
    SOUTHERN SOCIETY FOR     15th Annual SSCI     07/15/2015      $43,940.49
     CLINICAL INVESTIGATION   Nephrology Young
                              Investigators'
                              Forum
    ------------------------------------------------------------------------
    YALE UNIVERSITY          2015 London          07/16/2015       $5,000.00
                              Cardiovascular
                              Device Innovation
                              Summit
    ------------------------------------------------------------------------
    REGENTS OF THE           Updates in           07/19/2015       $5,000.00
     UNIVERSITY OF            Rheumatology 2015
     CALIFORNIA
    ------------------------------------------------------------------------
    REGENTS OF THE           13th Annual          07/21/2015      $34,698.53
     UNIVERSITY OF            Nephrology Young
     CALIFORNIA               Investigator's
                              Forum
    ------------------------------------------------------------------------
    SOCIETY FOR              2015 SITC            07/22/2015      $50,000.00
     IMMUNOTHERAPY OF         International
     CANCER                   Symposium on
                              Cancer
                              Immunotherapy
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC 2015 Global     07/22/2015      $25,000.00
     IMMUNOTHERAPY OF         Regulatory Summit
     CANCER
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN/SCCA 2015       07/26/2015      $10,000.00
     CANCER NETWORK, INC.     Thoracic Oncology
                              Symposium
    ------------------------------------------------------------------------
    SOCIETY FOR              Named Postdoctoral   07/26/2015     $120,000.00
     IMMUNOTHERAPY OF         Cancer
     CANCER                   Immunotherapy in
                              NSCLC Clinical
                              Fellowship Award
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION     Gout: Bridging       07/26/2015     $163,946.00
     FOR CONTINUING           Knowledge Gaps in
     EDUCATION                Diagnosis and
                              Treatment
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2015 NCCN Immuno-    07/26/2015      $35,000.00
     CANCER NETWORK, INC.     Oncology Webinar
                              Series for
                              Pharmacists
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      EPC--Updates in      07/28/2015      $10,000.00
     ALLERGY, ASTHMA AND      Pulmonary
     IMMUNOLOGY               Disease: Current,
                              Relevant and
                              Interactive
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          11th Annual          07/29/2015      $50,000.00
     FOUNDATION               National Young
                              Investigator's
                              Forum
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Immuno-Oncology: A   07/29/2015      $30,000.00
     UNIVERSITY SCHOOL OF     Revolution in
     MEDICINE                 Cancer Treatment
    ------------------------------------------------------------------------
    GEORGIA CHAPTER OF THE   2015 Scientific      07/30/2015       $5,000.00
     AMERICAN COLLEGE OF      Meeting
     CARDIOLOGY
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Outcomes   08/02/2015      $25,000.00
     MANAGED CARE             with
     PHYSICIANS, INC.         Individualized
                              Treatment
                              Strategies in the
                              Management of
                              Advanced Non
                              Small-Cell Lung
                              Cancer (NSCLC)
    ------------------------------------------------------------------------
    HACKENSACK UNIVERSITY    Fifth Annual Heart   08/03/2015       $5,000.00
     MEDICAL CENTER           and Vascular
                              Symposium
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      Early Intervention   08/06/2015     $149,515.00
     EDUCATION FOUNDATION     in The Continuum
                              of Hyperglycemia--
                              The Role of
                              Initial
                              Combination
                              Therapy
    ------------------------------------------------------------------------
    SOCIETY FOR              Primer on Tumor      08/10/2015      $15,000.00
     IMMUNOTHERAPY OF         Immunology and
     CANCER                   Cancer
                              Immunotherapy
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN/SCCA 2015       08/11/2015      -$2,005.40
     CANCER NETWORK, INC.     Thoracic Oncology
                              Symposium
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Breast Cancer   08/11/2015      $10,000.00
     FOUNDATION OF THE        Symposium:
     AMERICAN SOCIETY OF      Enhancing
     CLINICAL ONCOLOGY        Clinical Care
                              through
                              Collaboration
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Management of        08/11/2015     $242,009.00
     FAMILY PHYSICIANS        Gout:
                              Individualizing
                              the Approach
    ------------------------------------------------------------------------
    BREATHE CALIFORNIA OF    Advancing the        08/16/2015       $3,000.00
     LOS ANGELES COUNTY       diagnosis and
                              management of
                              COPD with a focus
                              on COPD
                              exacerbations
    ------------------------------------------------------------------------
    GLOBAL ACADEMY FOR       8th Annual           08/17/2015      $35,000.00
     MEDICAL EDUCATION        Perspectives in
                              Rheumatic
                              Diseases
                              presented by
                              Rheumatology
                              News, Internal
                              Medicine News,
                              Family Practice
                              News
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  17th Annual Lynn     08/17/2015      $10,000.00
                              Sage Breast
                              Cancer Symposium
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Cardiovascular       08/17/2015      $10,000.00
     EMERGENCY PHYSICIANS     Disease Track at
                              ACEP 2015
                              Scientific
                              Assembly
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  NANN 31st Annual     08/19/2015      $10,000.00
     NEONATAL NURSES          Educational
                              Conference
    ------------------------------------------------------------------------
    UNIVERSITY OF            2nd Annual           08/19/2015      $25,000.00
     CINCINNATI               Cincinnati
                              Collaborative
                              Cardiovascular
                              Symposium (C4)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE/ACE             08/20/2015      $99,804.71
     CLINICAL                 Scientific and
     ENDOCRINOLOGISTS         Clinical Review
                              of DKA and the
                              Effects of SGLT2
                              Inhibitors
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      TAS: Allergy,        08/23/2015       $1,000.00
     ALLERGY, ASTHMA AND      Asthma and
     IMMUNOLOGY               Immunology
                              Conference
    ------------------------------------------------------------------------
    NAMI MARYLAND            NAMI Maryland 2015   08/25/2015       $5,000.00
                              Annual Education
                              Conference
    ------------------------------------------------------------------------
    CONNECTICUT PHARMACISTS  Insights, Pearls,    08/25/2015       $5,000.00
     ASSOCIATION              and Perspectives--
                              An Update in the
                              Management of
                              Chronic
                              Obstructive
                              Pulmonary Disease
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Plenary Session--    08/25/2015      $50,000.00
     ALLERGY, ASTHMA AND      Updates in Severe
     IMMUNOLOGY               Asthma
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     08/26/2015      $10,000.00
                              Working Group
                              Global Chapter
                              Meeting
    ------------------------------------------------------------------------
    PENN STATE UNIVERSITY    Skin, Bones,         08/26/2015       $5,000.00
                              Hearts and
                              Private Parts
    ------------------------------------------------------------------------
    AMERICAS HEALTH          Roundtable           08/27/2015      $37,462.15
     FOUNDATION               Discussion on
                              Decreasing the
                              Burden of
                              Influenza in
                              Latin America
    ------------------------------------------------------------------------
    DANA-FARBER CANCER       11th Annual          08/27/2015       $2,500.00
     INSTITUTE INC.           Postdoctoral and
                              Graduate Student
                              Retreat
    ------------------------------------------------------------------------
    IOWA PHYSICIAN           COPD Board Review    08/27/2015       $2,000.00
     ASSISTANT SOCIETY        Track
    ------------------------------------------------------------------------
    BAYLOR COLLEGE OF        Breast Cancer        08/30/2015       $3,000.00
     MEDICINE                 Research and
                              Education Program
    ------------------------------------------------------------------------
    BAYLOR COLLEGE OF        Metastatic Breast    08/30/2015       $3,500.00
     MEDICINE                 Cancer Conference
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Top Ten Advances     08/30/2015      $10,000.00
     MEDICINE AT MOUNT        in Clinical
     SINAI                    Cardiology
    ------------------------------------------------------------------------
    ASSOCIATION OF           In the Era of        09/01/2015     $125,000.00
     COMMUNITY CANCER         Value: The
     CENTERS                  Importance of
                              Patient
                              Navigation,
                              Psychosocial
                              Distress
                              Screening, and
                              Survivorship Care
                              Planning Programs
                              in the Community
                              C
    ------------------------------------------------------------------------
    PENNSYLVANIA STATE       Constipation:        09/02/2015     $142,387.00
     UNIVERSITY               Improving
                              Outcomes With
                              Individualized,
                              Evidence-based
                              Treatment
    ------------------------------------------------------------------------
    SIDNEY KIMMEL MEDICAL    2nd Annual Current   09/03/2015       $5,000.00
     COLLEGE AT THOMAS        Issues in
     JEFFERSON UNIVERSITY     Coronary and
                              Structural Heart
                              Disease: A
                              Multidisciplinary
                              Approach
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      48th Annual New      09/08/2015      $15,000.00
     CARDIOLOGY FOUNDATION    York
                              Cardiovascular
                              Symposium: Major
                              Topics in
                              Cardiology Today
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASTRO's 57th         09/09/2015      $10,000.00
     RADIATION ONCOLOGY       Annual Meeting
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   38th Annual          09/14/2015       $5,000.00
                              Pulmonary and
                              Allergy Update
    ------------------------------------------------------------------------
    ST. JOSEPH'S REGIONAL    Acute Myocardial     09/14/2015       $1,700.00
     MEDICAL CENTER           Infarction:
                              Guidelines,
                              Controversies and
                              Updates
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       Head and Neck        09/15/2015       $3,000.00
     UNIVERSITY               Cancer Symposium:
                              From Pathways to
                              Therapies
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      Cancer Genetics:     09/15/2015       $3,000.00
     SOUTHWESTERN MEDICAL     Going Beyond the
     CENTER                   Guidelines
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  38TH Annual San      09/15/2015      $25,000.00
     HEALTH SCIENCE CENTER    Antonio Breast
     AT SAN ANTONIO           Cancer Symposium
    ------------------------------------------------------------------------
    BAYLOR UNIVERSITY        The 42nd Annual      09/15/2015       $8,500.00
     MEDICAL CENTER           Williamsburg
                              Conference on
                              Heart Disease
    ------------------------------------------------------------------------
    UNIVERSITY OF            Comprehensive        09/15/2015       $3,500.00
     WASHINGTON               Hematology and
                              Oncology Review
    ------------------------------------------------------------------------
    NATIONAL COMMITTEE FOR   NCQA Quality Talks   09/15/2015      $25,000.00
     QUALITY ASSURANCE        and 25th
                              Anniversary
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Acute Myocardial     09/15/2015       $1,400.00
     MEDICINE AT MOUNT        Infarction:
     SINAI                    Guidelines,
                              Controversies and
                              Updates
    ------------------------------------------------------------------------
    CONQUER CANCER           2015 Breast Cancer   09/16/2015      $25,000.00
     FOUNDATION OF THE        Symposium
     AMERICAN SOCIETY OF      Proceedings
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    UT HEALTH SCIENCE        38th Annual San      09/16/2015      $35,000.00
     CENTER SAN ANTONIO       Antonio Breast
                              Cancer Symposium--
                              Basic Science
                              Forum/Poster
                              Discussion
                              Session
    ------------------------------------------------------------------------
    AULTMAN HOSPITAL         Aultman Hospital's   09/17/2015       $2,500.00
                              15th Annual
                              Cancer Conference
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Recognizing          09/20/2015     $209,619.96
     EMERGENCY PHYSICIANS     Diabetic
                              Emergencies: Will
                              You Be Ready?
    ------------------------------------------------------------------------
    INTERNATIONAL            Best of the World    09/21/2015      $10,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
    ------------------------------------------------------------------------
    CONQUER CANCER           CancerLinQ: Real-    09/21/2015     $400,000.00
     FOUNDATION OF THE        time Learning
     AMERICAN SOCIETY OF      Intelligence
     CLINICAL ONCOLOGY        Network for
                              Quality
    ------------------------------------------------------------------------
    LUNG CANCER INITIATIVE   Advanced             09/22/2015       $3,000.00
     OF NC                    Laboratory
                              Testing Across
                              Cancer Types:
                              Everything you
                              need to know
    ------------------------------------------------------------------------
    CAROLINAS HEALTHCARE     27th Annual Fall     09/22/2015       $3,000.00
     SYSTEM                   Foliage Cancer
                              Conference
                              ``Update on Lung
                              Cancer''
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           TRANSFORMING         09/23/2015       $2,000.00
                              MEDICINE:
                              Evidence-Driven
                              mHealth
    ------------------------------------------------------------------------
    WESTERN SOCIETY OF       WSAAI 54th Annual    09/23/2015      $10,000.00
     ALLERGY, ASTHMA AND      Scientific
     IMMUNOLOGY               Session
    ------------------------------------------------------------------------
    CONQUER CANCER           2016 Conquer         09/23/2015     $120,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Young
     CLINICAL ONCOLOGY        Investigator
                              Award (YIA)
    ------------------------------------------------------------------------
    ASSOCIATION OF AMERICAN  2015 AACI/CCAF       09/28/2015      $10,000.00
     CANCER INSTITUTES        Annual Meeting
    ------------------------------------------------------------------------
    CONQUER CANCER           2016 Conquer         09/29/2015      $40,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Merit
     CLINICAL ONCOLOGY        Awards
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  2016 NAHN            09/29/2015      $10,000.00
     HISPANIC NURSES          Leadership
                              Meeting
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      2015 AAFP FMX        09/30/2015       $5,000.00
     FAMILY PHYSICIANS        Assembly 60
                              Minute Lecture
                              titled Chronic
                              Obstructive
                              Pulmonary Disease
                              (COPD) and
                              Pulmonary
                              Function Testing
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  2nd Annual Case-     09/30/2015       $5,000.00
                              Based Coronary
                              and Structural
                              Heart
                              Intervention
                              Update
    ------------------------------------------------------------------------
    TRUSTEES OF THE          44th Annual          10/04/2015       $5,000.00
     UNIVERSITY OF            Philadelphia
     PENNSYLVANIA             Workshop on
                              Hemostasis,
                              Thrombosis and
                              Artherosclerosis
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        ECOG-ACRIN Fall      10/05/2015       $5,000.00
     EDUCATION FOUNDATION,    2015 Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    PHARMACY QUALITY         Getting to the       10/05/2015       $3,500.00
     ALLIANCE (PQA, INC)      Core: Building
                              and Implementing
                              Core Measures
    ------------------------------------------------------------------------
    BAYLOR UNIVERSITY        Immune Checkpoint    10/07/2015       $5,000.00
     MEDICAL CENTER           Inhibitors in the
                              Treatment of
                              Selected Tumor
                              Types: A New
                              Prospective
    ------------------------------------------------------------------------
    CEDARS SINAI MEDICAL     4th Annual New       10/07/2015       $5,000.00
     CENTER                   Therapeutics in
                              Oncology: The
                              Road to
                              Personalized
                              Medicine
    ------------------------------------------------------------------------
    PENN STATE UNIVERSITY    Skin, Bones,         10/07/2015       $5,000.00
                              Hearts and
                              Private Parts
                              (two conferences)
    ------------------------------------------------------------------------
    INDIANA UNIVERSITY       Performance          10/07/2015       $5,000.00
                              Improvement with
                              Point of Care
                              Clinical Decision
                              Making App in non-
                              ST segment
                              elevation
                              myocardial
                              infarction
                              (NSTEMI) patients
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       Update In            10/08/2015      $15,000.00
     HOSPITAL CENTER          Rheumatology
                              2015: New
                              Diagnostic Tests
                              and Treatments
                              for Clinical
                              Practice
    ------------------------------------------------------------------------
    NEW YORK STATE           New York State       10/08/2015       $2,500.00
     OSTEOPATHIC MEDICAL      Osteopathic
     SOCIETY                  Medical Students
                              Health Policy
                              Initiative
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  2015 Oncologic       10/11/2015       $5,000.00
     MD ANDERSON CANCER       Emergency
     CENTER                   Medicine
                              Conference
    ------------------------------------------------------------------------
    AMERICAN PANCREATIC      46th Annual          10/11/2015      $10,000.00
     ASSOCIATION              Meeting of the
                              American
                              Pancreatic
                              Association
    ------------------------------------------------------------------------
    WAYNE STATE UNIVERSITY   2nd Annual Update    10/15/2015       $3,000.00
     SCHOOL OF MEDICINE       in Rheumatology
    ------------------------------------------------------------------------
    WAYNE STATE UNIVERSITY   State of the Art     10/15/2015       $3,000.00
                              Management of
                              Lung Cancer
                              Symposium
    ------------------------------------------------------------------------
    MEDICAL UNIVERSITY OF    2nd Annual           10/18/2015      $10,000.00
     SOUTH CAROLINA           Comprehensive
                              Stroke and
                              Cerebrovascular
                              Update
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2015                 10/19/2015      $25,000.00
     RHEUMATOLOGY             Musculoskeletal
                              Ultrasound Course
                              for
                              Rheumatologists
    ------------------------------------------------------------------------
    LOUISIANA STATE          LSUHSC               10/20/2015       $3,500.00
     UNIVERSITY HEALTH        Cardiovascular
     SCIENCES CENTER IN NEW   Centers Joint
     ORLEANS                  Retreat
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Achieving            10/20/2015     $389,000.00
     DIABETES EDUCATORS       Partnerships and
                              Improving
                              Outcomes in Your
                              Diabetes Patients
    ------------------------------------------------------------------------
    THE ENDOCRINE SOCIETY    The Truth of the     10/21/2015     $284,438.73
                              Matter: An
                              Evidence-Based
                              Review of the
                              Newer
                              Antihyperglycemic
                              Agents for T2DM:
                              a hot seat
                              Program
    ------------------------------------------------------------------------
    GORDON RESEARCH          2016 Basal Ganglia   10/21/2015       $2,500.00
     CONFERENCES              Gordon Research
                              Conference:
                              Emerging Views of
                              Cellular and
                              Circuit Diversity
                              Within the Basal
                              Ganglia
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       Lung Cancer 2015:    10/22/2015       $3,000.00
     HOSPITAL CENTER          A Shifting
                              Management
                              Paradigm with
    ------------------------------------------------------------------------
    NATIONAL QUALITY FORUM   NQF Measure          10/22/2015     $100,000.00
                              Incubator
    ------------------------------------------------------------------------
    GORDON RESEARCH          2016 Gordon          10/26/2015       $2,500.00
     CONFERENCES              Research
                              Conference on
                              Heterocyclic
                              Compounds
    ------------------------------------------------------------------------
    AMERICAN HEART           Scientific           10/26/2015      $30,000.00
     ASSOCIATION, INC.        Sessions 2015
                              Dedicated Track
                              on Acute Coronary
                              Syndrome: Current
                              and Emerging
                              Interventions and
                              Future Directions
    ------------------------------------------------------------------------
    INOVA HEALTH CARE        Inova Heart and      11/03/2015      $15,000.00
     SERVICES                 Vascular
                              Institute 2016
                              Interventional
                              Cardiology
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  17th Annual          11/04/2015      $20,000.00
     CLINICAL                 Intensive Course
     ENDOCRINOLOGISTS         on Diabetes,
                              Endocrinology,
                              and Metabolic
                              Diseases
    ------------------------------------------------------------------------
    WORLDWIDE INITIATIVE     Novel Therapies in   11/05/2015      $77,050.00
     FOR DIABETES EDUCATION   Type 2 Diabetes
                              Mellitus
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE/ACE             11/05/2015      $79,500.00
     CLINICAL                 Comprehensive
     ENDOCRINOLOGISTS         Diabetes
                              Algorithm 2015
                              Mobile App
    ------------------------------------------------------------------------
    GORDON RESEARCH          GRC Mutagenesis      11/05/2015       $3,500.00
     CONFERENCE               meeting 2016
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         InPractice           11/09/2015      $49,000.00
     SOCIETY                  Oncology Nursing
    ------------------------------------------------------------------------
    PARTNERS HEALTHCARE      World Medical        11/22/2015      $50,000.00
     SYSTEM INC.              Innovation Forum
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-IASLC Joint     11/22/2015      $25,000.00
     FOR CANCER RESEARCH      Conference on the
                              Molecular Origins
                              of Lung Cancer
    ------------------------------------------------------------------------
    PREVENTIVE               Cardiovascular       11/22/2015      $10,000.00
     CARDIOVASCULAR NURSES    Risk Reduction:
     ASSOCIATION              Leading the Way
                              in Prevention
                              (22nd Annual
                              Symposium)
    ------------------------------------------------------------------------
    NATIONAL LIPID           National Lipid       11/22/2015      $15,000.00
     ASSOCIATION              Association 2016
                              Lipid Academy
                              Course Series
    ------------------------------------------------------------------------
    NATIONAL LIPID           National Lipid       11/22/2015      $15,000.00
     ASSOCIATION              Association 2016
                              Masters in
                              Lipidology Course
                              Series
    ------------------------------------------------------------------------
    THE DEUEL CONFERENCE ON  The 2016 Deuel       11/24/2015      $20,000.00
     LIPIDS                   Conference on
                              Lipids
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     APhA2016             11/25/2015      $11,500.00
     ASSOCIATION              Respiratory
                              Update:
                              Guidelines, Novel
                              Inhalers and More
    ------------------------------------------------------------------------
    REGENTS OF THE           2016 World           12/01/2015      $10,000.00
     UNIVERSITY OF            Congress on
     CALIFORNIA               Continuing
                              Professional
                              Development:
                              Advancing
                              Learning and Care
                              in the Health
                              Professions
    ------------------------------------------------------------------------
    NASPGHAN FOUNDATION      Appropriate Use of   12/01/2015     $185,000.00
                              Proton Pump
                              Inhibitors in the
                              Treatment of
                              Pediatric
                              Patients with
                              GERD
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       A COPD Quality       12/01/2015     $139,644.64
     UNIVERSITY               Improvement
                              Consortium
    ------------------------------------------------------------------------
    FOUNDATION FOR           Evolution and        12/03/2015     $200,000.00
     GYNECOLOGIC ONCOLOGY     Revolution of
                              PARP Targeting in
                              Gynecologic
                              Malignancies
    ------------------------------------------------------------------------
    AMERICAN FEDERATION FOR  2016 Western         12/03/2015       $5,000.00
     MEDICAL RESEARCH         Regional Meeting
    ------------------------------------------------------------------------
    UNIVERSITY OF            University of        12/06/2015      $19,942.22
     WASHINGTON               Washington
                              Allergy and
                              Immunology
                              Fellowship
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2016 Congress   12/09/2015      $25,000.00
     CANCER NETWORK, INC.     Series: Breast
                              Cancer
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     2016                 12/10/2015      $10,000.00
     RADIATION ONCOLOGY       Multidisciplinary
                              Head and Neck
                              Cancer Symposium
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 21st Annual     12/10/2015      $75,000.00
     CANCER NETWORK, INC.     Conference
                              General Session:
                              Advancing the
                              Standard of
                              Cancer CareTM
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          12/10/2015     $125,000.00
     FOR CANCER RESEARCH      Meeting--2016
    ------------------------------------------------------------------------
    AMERICAN FEDERATION FOR  2016 Southern        12/10/2015       $5,000.00
     MEDICAL RESEARCH         Regional Meeting
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2016 Nursing    12/13/2015      $25,000.00
     CANCER NETWORK, INC.     Program:
                              Advancing
                              Oncology Nursing
                              at the NCCN 21st
                              Annual Conference
    ------------------------------------------------------------------------
    INTERNATIONAL            16th Targeted        12/13/2015      $82,500.00
     ASSOCIATION FOR THE      Therapy meeting
     STUDY OF LUNG CANCER     on Lung Cancer
    ------------------------------------------------------------------------
    AMERICAN                 Opioid-Induced       12/13/2015     $192,601.00
     GASTROENTEROLOGICAL      Constipation:
     ASSOCIATION              Recognition and
                              Optimal
                              Management
    ------------------------------------------------------------------------
    KANAWHA COUNTY           Mobile Integrated    12/14/2015      $50,000.00
     EMERGENCY AMBULANCE      Health Program:
     AUTHORITY                Emphasis on
                              Community
                              Paramedicine
    ------------------------------------------------------------------------
    INTERNATIONAL            PDL1 Atlas           12/14/2015     $120,000.00
     ASSOCIATION FOR THE
     STUDY OF LUNG CANCER
    ------------------------------------------------------------------------
    CONQUER CANCER           2016 Conquer         12/15/2015     $500,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of the American
     CLINICAL ONCOLOGY        Society of
                              Clinical Oncology
                              Mission Endowment
    ------------------------------------------------------------------------
    CATAMOUNT MEDICAL        PatientGPS :         12/16/2015      $74,841.86
     EDUCATION, LLC           Clinical Paths in
                              the Management of
                              Patients with
                              COPD
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     APhA 2016 Hot        12/16/2015      $20,000.00
     ASSOCIATION              Topics in
                              Dyslipidemia
    ------------------------------------------------------------------------
    THE SCRIPPS RESEARCH     27th Annual          12/16/2015       $1,500.00
     INSTITUTE                Frontiers in
                              Chemistry
                              Symposium at The
                              Scripps Research
                              Institute
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Behind the           12/17/2015      $10,000.00
     CANCER NETWORK, INC.     Guidelines:
                              Insights into the
                              Standard of Care
                              in Oncology 2016
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2016 Oncology   12/17/2015      $25,000.00
     CANCER NETWORK, INC.     Fellows Program:
                              New Horizons in
                              Quality Cancer
                              Care at the NCCN
                              21st Annual
                              Conference
    ------------------------------------------------------------------------
    NATIONAL LIPID           National Lipid       12/17/2015      $30,000.00
     ASSOCIATION              Association 2016
                              Scientific
                              Meeting Series
    ------------------------------------------------------------------------
    PEDIATRIC INFECTIOUS     Pediatric            12/20/2015      $55,000.00
     DISEASES SOCIETY         Infectious
     EDUCATION AND RESEARCH   Diseases Society
     FOUNDATION (PIDSERF)     Fellowship Awards
                              Program
    ------------------------------------------------------------------------
    THE VANDERBILT           Cardiology 2016:     12/20/2015       $5,000.00
     UNIVERSITY               Advances in
                              Science and
                              Practice
    ------------------------------------------------------------------------
    FOUNDATION FOR           Quality              12/22/2015      $20,000.00
     CONTINUING EDUCATION     Improvement
     IN THE HEALTH            Education (QIE)
     PROFESSIONS              Initiative
                              National Training
                              and Education
    ------------------------------------------------------------------------
    MARYLAND SOCIETY FOR     Update on Gout and   01/04/2016       $1,625.00
     THE RHEUMATIC DISEASES   Pseudogout
    ------------------------------------------------------------------------
    THE GOG FOUNDATION       5th Semi Annual      01/05/2016      $20,000.00
                              Meeting of NRG
                              Oncology
                              (formerly GOG,
                              NSABP,RTOG)
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     The James R.         01/05/2016       $5,000.00
     CENTER                   Klinenberg, MD
                              Symposium on
                              Rheumatic
                              Diseases: Hot
                              Topics in
                              Rheumatology
    ------------------------------------------------------------------------
    LUNGEVITY FOUNDATION     LUNGevity            01/06/2016      $25,000.00
                              Foundation
                              Scientific and
                              Clinical Research
                              Roundtable
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Chronic Total        01/07/2016      $10,000.00
     FOUNDATION               Occlusion Summit
                              2016
    ------------------------------------------------------------------------
    LUMEN FOUNDATION         Lumen Global 2016    01/10/2016      $35,000.00
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  St. Francis          01/10/2016       $5,000.00
     FOUNDATION               Imaging Course
                              2016
    ------------------------------------------------------------------------
    AMERICAN HEART           Epidemiology and     01/12/2016      $10,000.00
     ASSOCIATION, INC.        Prevention--Lifes
                              tyle and
                              Cardiometabolic
                              Health 2016
                              Scientific
                              Sessions
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Beyond               01/14/2016      $22,696.65
     EDUCATIONAL FOUNDATION   Revascularization
                              for CLI-The Role
                              of
                              Pharmacotherapy
                              Satellite
                              Symposium
    ------------------------------------------------------------------------
    CARDIOVASCULAR           CVIs 4th Annual      01/14/2016       $2,500.00
     INSTITUTE OF             Interventional
     PHILADELPHIA             Cardiovascular
                              Medicine: The
                              Crossroads of
                              Interventional
                              and Clinical
                              Cardiology
    ------------------------------------------------------------------------
    UNIVERSITY OF TENNESSEE  Testing to Target    01/19/2016     $288,885.00
     COLLEGE OF PHARMACY      in Non-Small Cell
                              Lung Cancer:
                              Managed Care
                              Perspectives
    ------------------------------------------------------------------------
    SOCIETY FOR VASCULAR     Society for          01/20/2016      $20,000.00
     MEDICINE                 Vascular Medicine
                              27th Annual
                              Scientific
                              Sessions
    ------------------------------------------------------------------------
    OHIOHEALTH               1st Bi-Annual        01/20/2016       $2,500.00
                              OhioHealth Acute
                              Cardiovascular
                              Care Conference
    ------------------------------------------------------------------------
    SOCIETY FOR              Immunotherapy of     01/24/2016      $40,000.00
     IMMUNOTHERAPY OF         Cancer for the
     CANCER                   Workshop on
                              Biomarkers
    ------------------------------------------------------------------------
    NORTHEAST GEORGIA        8th Annual           01/25/2016       $2,500.00
     MEDICAL CENTER INC.      Northeast Georgia
                              Regional STEMI
                              Summit
    ------------------------------------------------------------------------
    CALIFORNIA THORACIC      COPD: A TEAM         01/26/2016       $5,000.00
     SOCIETY                  APPROACH
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Issues with DAPT:    01/28/2016      $50,000.00
     FOUNDATION               A case-based
                              guide to optimal
                              antiplatelet
                              therapies
    ------------------------------------------------------------------------
    GASTROINTESTINAL AND     The 2016 US GI and   01/28/2016      $16,000.00
     LIVER ASSOCIATION OF     Liver Association
     THE AMERICAS INC.        of the Americas
                              (GALA) Conference
                              Series
    ------------------------------------------------------------------------
    GORDON RESEARCH          2016 Lipoprotein     01/28/2016       $5,000.00
     CONFERENCES              Metabolism Gordon
                              Research
                              Conference and
                              Gordon Research
                              Seminar
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAPM 32nd Annual     01/31/2016      $25,000.00
     PAIN MEDICINE            Meeting 2016
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          DCRI Evidence to     02/01/2016      $10,000.00
                              Practice Series:
                              Interventional
                              Cardiology
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACCs 65th Annual     02/01/2016      $50,000.00
     CARDIOLOGY FOUNDATION    Scientific
                              Session (ACC.16)
                              Acute Coronary
                              Syndromes
                              Clinical Learning
                              Pathway
    ------------------------------------------------------------------------
    REGENTS OF THE           LIPID MAPS           02/01/2016       $5,000.00
     UNIVERSITY OF            Meeting:
     CALIFORNIA               Lipidomics Impact
                              on Metabolic,
                              Cancer,
                              Cardiovascular
                              and Inflammatory
                              Diseases
    ------------------------------------------------------------------------
    SCOTTSDALE HEALTHCARE    2016 Scottsdale      02/02/2016       $2,500.00
     FOUNDATION               Interventional
                              Forum (SIF 2016)
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     02/02/2016      $15,000.00
                              Working Group
                              U.S. Chapter
                              Meeting
    ------------------------------------------------------------------------
    EMORY UNIVERSITY         EPIC SEC Emory       02/03/2016      $20,000.00
                              Practical
                              Intervention
                              Course--Southeast
                              Consortium
    ------------------------------------------------------------------------
    THE ENDOCRINE SOCIETY    DMS 2016:            02/07/2016     $235,318.22
                              Initiating the
                              Conversation:
                              Sharing
                              Perspectives on
                              Advances in T2DM
                              Treatment to
                              Improve Patient-
                              Centered Care
    ------------------------------------------------------------------------
    CONQUER CANCER           2016 ASCO Annual     02/07/2016      $56,000.00
     FOUNDATION OF THE        Meeting Lung
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    SOCIETY FOR              SCAI 2016            02/14/2016      $25,000.00
     CARDIOVASCULAR           Scientific
     ANGIOGRAPHY AND          Sessions
     INTERVENTIONS
     FOUNDATION
    ------------------------------------------------------------------------
    SOCIETY OF HOSPITAL      Hospital Medicine    02/14/2016      $15,000.00
     MEDICINE                 2016
    ------------------------------------------------------------------------
    AMERICAN HEAD AND NECK   American Head and    02/17/2016      $50,000.00
     SOCIETY                  Neck Society 9th
                              International
                              Conference on
                              Head and Neck
                              Cancer
    ------------------------------------------------------------------------
    GLOBAL EDUCATION GROUP   Clinical Issues in   02/18/2016     $411,613.00
                              Type 2 Diabetes:
                              Consensus and
                              Controversies
                              Around
                              Intensifying
                              Noninsulin
                              Therapy.
    ------------------------------------------------------------------------
    NYU POST-GRADUATE        Seminar in           03/01/2016       $5,000.00
     MEDICAL SCHOOL           Advanced
                              Rheumatology
    ------------------------------------------------------------------------
    NEW MEXICO THORACIC      44th Annual New      03/01/2016       $5,000.00
     SOCIETY                  Mexico Lung
                              Disease
                              Symposium--50
                              Shades of Blue
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       14th International   03/01/2016      $10,000.00
     HOSPITAL CENTER          Congress on
                              Targeted
                              Anticancer
                              Therapies
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   FASEB Conference     03/01/2016       $6,000.00
     SOCIETIES FOR            on Genome
     EXPERIMENTAL BIOLOGY     Engineering
                              Cutting-Edge
                              Research and
                              Application
    ------------------------------------------------------------------------
    DIVISION OF MEDICINAL    Division of          03/01/2016       $2,500.00
     CHEMISTRY                Medicinal
                              Chemistry Program
                              251st ACS
                              National Meeting
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Personalizing        03/01/2016      $35,000.00
     MANAGED CARE             Therapy for
     PHYSICIANS, INC.         Improved Patient
                              Outcomes in the
                              Management of
                              Advanced Non
                              Small-Cell Lung
                              Cancer (NSCLC)
    ------------------------------------------------------------------------
    THE AMERICAN THORACIC    ATS 2016             03/01/2016      $20,000.00
     SOCIETY                  International
                              Conference--Selec
                              ted Topics in
                              Lung Cancer
    ------------------------------------------------------------------------
    THE ASSOCIATION FOR      Building an          03/01/2016       $2,500.00
     FRONOTOTEMPORAL          Infrastructure to
     DEGENERATION             Support FTLD
                              Therapeutic
                              Development
    ------------------------------------------------------------------------
    WASHINGTON ACADEMY OF    27th Annual          03/01/2016       $1,750.00
     PHYSICIAN ASSISTANTS     Recertification
                              Review Course and
                              Spring Conference
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         41st Annual          03/01/2016      $35,000.00
     SOCIETY                  Oncology Nursing
                              Society Congress
                              and Pharmacology
                              Highlights
                              regional program
    ------------------------------------------------------------------------
    GORDON RESEARCH          Chemical             03/01/2016       $2,500.00
     CONFERENCES              Approaches for
                              Unraveling
                              Biology
    ------------------------------------------------------------------------
    GORDON RESEARCH          Medicinal            03/01/2016       $3,000.00
     CONFERENCE               Chemistry Gordon
                              Research
                              Conference
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  2016 Charitable      03/01/2016      $30,000.00
     FREE AND CHARITABLE      Health Care
     CLINICS                  Symposium
    ------------------------------------------------------------------------
    THE HOPE FOUNDATION      2016 SWOG Group      03/01/2016      $10,000.00
                              Meetings
    ------------------------------------------------------------------------
    HEMATOLOGY/ONCOLOGY      2016 Hematology/     03/01/2016      $25,000.00
     PHARMACY ASSOCIATION     Oncology PHarmacy
                              Association
    ------------------------------------------------------------------------
    MEDICAL LEARNING         New Developments     03/03/2016      $65,763.00
     INSTITUTE INC.           in the Treatment
                              of COPD: Updates
                              From San
                              Francisco
                              (150203884)
    ------------------------------------------------------------------------
    AMERICAN                 11th Postgraduate    03/03/2016      $10,000.00
     NEUROGASTROENTEROLOGY    Course on GI
     AND MOTILITY SOCIETY     Motility and
                              Neurogastroentero
                              logy in Clinical
                              Practice
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAPA Conference      03/03/2016       $5,000.00
     PHYSICIAN ASSISTANT      2016--Allergy/
                              Immunology and
                              Pulmonology Track
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      03/07/2016       $3,000.00
     CONFERENCE               Conference on
                              Cyclic Nucleotide
                              Phosphodiesterase
                              s: Mechanisms of
                              PDE Nano-Domain
                              Control and
                              Impacts on
                              Disease
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2016             03/07/2016      $70,000.00
     SOCIETY                  International
                              Conference--Selec
                              ted Topics in
                              COPD
    ------------------------------------------------------------------------
    MASSACHUSETTS GENERAL    CoNNCT Workshop      03/07/2016       $2,000.00
     HOSPTIAL                 (Collaborative
                              Novel-Novel
                              Cancer Therapies)
    ------------------------------------------------------------------------
    COLLEGIUM                31st Symposium of    03/08/2016      $10,000.00
     INTERNATIONALE           the Collegium
     ALLERGOLOGICUM           Internationale
                              Allergologicum
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Outcomes   03/08/2016      $25,000.00
     MANAGED CARE             in the Management
     PHYSICIANS               and Treatment of
                              Asthma
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Identifying New      03/08/2016      $25,000.00
     MANAGED CARE             Strategies to
     PHYSICIANS               Optimize the
                              Management and
                              Treatment of COPD
    ------------------------------------------------------------------------
    NORTHEASTERN SECTION OF  NESACS Advances in   03/08/2016       $1,500.00
     THE AMERICAN CHEMICAL    Chemical Sciences
     SOCIETY, INC.            Symposium
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2016             03/08/2016      $30,000.00
     SOCIETY INC.             International
                              Conference--Selec
                              ted Topics in
                              Asthma
    ------------------------------------------------------------------------
    YALE UNIVERSITY          4th Annual Yale      03/08/2016      $15,000.00
                              COPD Symposium
    ------------------------------------------------------------------------
    FLORIDA ALLERGY, ASTHMA  Florida Allergy,     03/14/2016      $15,000.00
     AND IMMUNOLOGY SOCIETY   Asthma and
                              Immunology
                              Society 2016
                              Annual CME
                              Conference
    ------------------------------------------------------------------------
    UNIVERSITY OF            Keep your patients   03/14/2016      $25,000.00
     CONNECTICUT              ``moving''--An
                              Overview of
                              Treatment Options
                              for Constipation
    ------------------------------------------------------------------------
    UHS PROFESSIONAL         32nd Annual          03/14/2016      $10,000.00
     EDUCATIONAL PROGRAMS,    Congress of
     INC.                     Clinical
                              Rheumatology
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          CKD-Related Anemia   03/17/2016     $100,050.00
     FOUNDATION               and
                              Cardiovascular
                              Risk
    ------------------------------------------------------------------------
    UHS-PROFESSIONAL         1st Annual           03/23/2016       $5,000.00
     EDUCATION PROGRAMS       Advances in Pain
     INC.                     Care
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      03/23/2016       $1,000.00
     CONFERENCE               Conference on
                              Cyclic Nucleotide
                              Phosphodiesterase
                              s: Mechanisms of
                              PDE Nano-Domain
                              Control and
                              Impacts on
                              Disease
    ------------------------------------------------------------------------
    OUHSC COLLEGE OF         19th Annual          03/24/2016       $1,500.00
     MEDICINE OFFICE OF CPD   Primary Care
                              Update
    ------------------------------------------------------------------------
    TENNESSEE ACADEMY OF     Spring Fling 2016--  03/27/2016       $3,000.00
     PHYSICIAN ASSISTANTS     Asthma and COPD
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2016             03/28/2016      $10,000.00
     SOCIETY INC.             International
                              Conference--Fello
                              w Track Symposium
    ------------------------------------------------------------------------
    COLORADO ALLERGY AND     Biologics in the     03/29/2016       $3,000.00
     ASTHMA SOCIETY           Treatment of
                              Respiratory
                              Disease
    ------------------------------------------------------------------------
    BOARD OF REGENTS FOR     Updates in           03/29/2016      $10,000.00
     UNIVERSITY OF NEBRASKA   Rheumatology:
                              Gout and
                              Hyperuricemia
    ------------------------------------------------------------------------
    CANCER RESEARCH          2016 International   04/06/2016      $50,000.00
     INSTITUTE                Cancer
                              Immunotherapy
                              Conference
    ------------------------------------------------------------------------
    AMERICAN PAIN SOCIETY    2016 Pain Care for   04/07/2016      $10,000.00
                              Primary Care
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2016 Alzheimer's     04/10/2016      $50,000.00
                              Association
                              Research
                              Roundtable
    ------------------------------------------------------------------------
    CANCER MOLECULAR         Molecular            04/10/2016       $1,500.00
     THERAPEUTICS RESEARCH    Therapeutics of
     ASSOCIATION              Cancer Conference
                              2016
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AAPS Sustaining      04/10/2016      $50,000.00
     PHARMACEUTICAL           Sponsorship
     SCIENTISTS
    ------------------------------------------------------------------------
    DINORA INC.              Lupus 2016           04/10/2016      $25,000.00
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    American             04/10/2016       $3,000.00
     OF PHARMACOMETRICS       Conference on
                              Pharmacometrics
    ------------------------------------------------------------------------
    HOWARD                   11th Kenneth         04/11/2016       $3,375.00
     UNIVERSITYHOSPITAL       Austin Annual
                              Rheumatology
                              Symposium
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        2016 ECOG-ACRIN      04/11/2016       $5,000.00
     EDUCATION FOUNDATION     Spring Group
                              Meeting
    ------------------------------------------------------------------------
    AMERICAN HEART           Arteriosclerosis,    04/11/2016      $15,000.00
     ASSOCIATION, INC.        Thrombosis and
                              Vascular Biology
                              Peripheral
                              Vascular Disease
                              2016
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      AUA2016 Highlights   04/11/2016      $25,000.00
     ASSOCIATION EDUCATION    in Bladder Cancer
     and RESEARCH INC.
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          National Kidney      04/11/2016       $5,000.00
     FOUNDATION               Foundation s
                              Ninth Annual Mid-
                              Atlantic First
                              Year Renal
                              Fellows Symposium
    ------------------------------------------------------------------------
    THOMAS JEFFERSON         5th Annual           04/11/2016       $3,000.00
     UNIVERSITY               Palliative Care
                              Spring Symposium
    ------------------------------------------------------------------------
    COLUMBUS NCORP           2016 ASCO REVIEW     04/12/2016       $2,000.00
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2016 Alzheimer's     04/12/2016      $45,000.00
                              Association
                              International
                              Conference
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2016-2017 Monthly    04/12/2016      $49,008.06
     CANCER NETWORK           Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    Advances in Lung     04/13/2016       $3,000.00
                              Cancer
    ------------------------------------------------------------------------
    TRANSLATIONAL RESEARCH   TRIO-US and UCLA     04/14/2016       $3,000.00
     IN ONCOLOGY-US, INC.     Annual Research
                              Conference
    ------------------------------------------------------------------------
    YALE UNIVERSITY          Yale ASCO Review     04/17/2016       $2,000.00
                              2016
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC 31st Annual     04/17/2016     $300,000.00
     IMMUNOTHERAPY OF         Meeting
     CANCER
    ------------------------------------------------------------------------
    SOCIETY FOR              2016 Primer on       04/17/2016      $50,000.00
     IMMUNOTHERAPY OF         Tumor Immunology
     CANCER                   and Cancer
                              Immunotherapy
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC Fellowship/    04/18/2016      $43,000.00
     ASSOCIATION FOR THE      Young
     STUDY OF LUNG CANCER     Investigator
                              Award
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASTRO 2016 58th      04/18/2016      $10,000.00
     RADIATION ONCOLOGY       Annual Meeting
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  18th Annual Lynn     04/18/2016      $10,000.00
                              Sage Breast
                              Cancer Symposium
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      GAIN (EnGAiging an   04/19/2016     $500,000.00
     CHEST PHYSICIANS         Inter-
                              Disciplinary Team
                              for NSCLC
                              Diagnosis,
                              Personalized
                              Assessment, and
                              Treatment)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     11th Biennial        04/21/2016      $10,000.00
     FOR CANCER RESEARCH      Ovarian Cancer
                              Research
                              Symposium
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      14th Annual World    04/21/2016      $75,000.00
     EDUCATION FOUNDATION     Congress on
                              Insulin
                              Resistance
                              Diabetes and
                              Cardiovascular
                              Disease--WCIRDC
    ------------------------------------------------------------------------
    C-CHANGE                 Catalyzing Change    04/24/2016      $50,000.00
                              in Big Data and
                              Value in Cancer
                              Care
    ------------------------------------------------------------------------
    CONQUER CANCER           2016 ASCO Pre-       04/24/2016       $5,000.00
     FOUNDATION OF THE        Annual Meeting
     AMERICAN SOCIETY OF      Seminar: How to
     CLINICAL ONCOLOGY        Integrate Tumor
                              Immunotherapy
                              into Your
                              Clinical Practice
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Southern Salt,       04/24/2016       $3,000.00
     FOUNDATION INC.          Water, and Kidney
                              Club 57th Annual
                              Scientific
                              Meeting
    ------------------------------------------------------------------------
    CONQUER CANCER           2016 Best of ASCO    04/24/2016      $30,000.00
     FOUNDATION OF THE        Meetings
     AMERICAN SOCIETY OF
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASPMN 26th           04/24/2016      $15,000.00
     PAIN MANAGEMENT          National
     NURSING                  Conference
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      American Society     04/24/2016       $2,000.00
     HEALTH SCIENCE CENTER    of Clinical
     AT SAN ANTONIO SOM       Oncology (ASCO)
                              2016 Review
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         ASCO Review          04/25/2016       $2,000.00
     EDUCATIONAL FOUNDATION
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          15th Annual          04/27/2016      $10,000.00
                              Southeastern
                              Fellows Research
                              Skills and
                              Training Workshop
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     2nd Annual Acing     05/02/2016       $5,000.00
     CENTER                   the GI Board
                              Exam: The
                              Ultimate High-
                              Speed Review
                              Course
    ------------------------------------------------------------------------
    AUGUSTA UNIVERSITY       Harnessing the       05/03/2016     $220,000.00
     RESEARCH INSTITUTE,      Body's Immune
     INC.                     System to Treat
                              Cancer: the
                              Promise of
                              Immunotherapy
    ------------------------------------------------------------------------
    AMERICAN HEART           Scientific           05/03/2016      $35,000.00
     ASSOCIATION, INC.        Sessions 2016
                              Dedicated Track
                              on Acute Coronary
                              Syndromes
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    ISN Global Kidney    05/04/2016      $30,000.00
     OF NEPHROLOGY            Health Summit
    ------------------------------------------------------------------------
    NORTHEASTERN UNIVERSITY  Boston Symposium     05/04/2016       $2,500.00
                              on Organic and
                              Bioorganic
                              Chemistry (BSOBC)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     11th Biennial        05/04/2016      $15,000.00
     FOR CANCER RESEARCH      Ovarian Cancer
                              Research
                              Symposium,
    ------------------------------------------------------------------------
    WORLD ALLERGY            WAO International    05/09/2016      $30,000.00
     ORGANIZATION             Scientific
                              Conference 2016:
                              Travel Grants
    ------------------------------------------------------------------------
    THE GOG FOUNDATION       6th Semi Annual      05/10/2016       $5,000.00
                              Meeting of NRG
                              Oncology
                              (formerly GOG,
                              NSABP,RTOG)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Cardiovascular       05/10/2016       $5,000.00
     PHYSICIANS OF INDIAN     Seminar
     ORIGIN (AAPI)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Cardiovascular       05/12/2016      $20,000.00
     EMERGENCY PHYSICIANS     Disease Track at
                              ACEP 2016
                              Scientific
                              Assembly
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Expanding the        05/15/2016     $190,000.00
     NEPHROLOGY               Therapeutic
                              Armamentarium for
                              Treatment of
                              Anemia of Kidney
                              Disease
    ------------------------------------------------------------------------
    BLADDER CANCER ADVOCACY  2016 Bladder         05/15/2016      $25,000.00
     NETWORK                  Cancer Think Tank
    ------------------------------------------------------------------------
    PREVENTIVE               2016 PCNA Fall       05/16/2016       $5,000.00
     CARDIOVASCULAR NURSES    Learning Series:
     ASSOCIATION              Diabetes and CVD:
                              Managing Patients
                              with High-Risk
                              and Co-Morbid
                              Conditions
    ------------------------------------------------------------------------
    ASSOCIATION OF AMERICAN  2016 AACI/CCAF       05/18/2016      $10,000.00
     CANCER INSTITUTES        Annual Meeting
    ------------------------------------------------------------------------
    UNIVERSIDAD CENTRAL DEL  Role of the          05/19/2016       $2,000.00
     CARIBE, INC.             Multidisciplinary
                              Care Team in
                              Personalizing
                              Treatment for Non-
                              Small Cell Lung
                              Cancer:
                              Addressing Tissue
                              Acquisition,
                              Diagnosis, and
                              Perso
    ------------------------------------------------------------------------
    THE LEUKEMIA AND         2016 Waldenstrom's   05/24/2016       $3,000.00
     LYMPHOMA SOCIETY, INC.   Roadmap Symposium
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASH Scholar Award    05/25/2016      $50,000.00
     HEMATOLOGY
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Conference on   05/25/2016      $35,000.00
     FOR CANCER RESEARCH      Tumor Immunology
                              and Immunotherapy
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           13th Annual          05/26/2016       $2,000.00
                              Oncology Update
    ------------------------------------------------------------------------
    DANA FARBER CANCER       International        06/02/2016      $10,000.00
     INSTITUTE                Workshop on
                              Waldenstroms
                              macroglobulinemia
                              and symposia on
                              Multiple myeloma
                              (IWWM9)
    ------------------------------------------------------------------------
    FRIENDS OF CANCER        2016 Friends of      06/05/2016     $100,000.00
     RESEARCH                 Cancer Research
                              Programs
    ------------------------------------------------------------------------
    PARTNERS HEALTHCARE      Massachusetts        06/08/2016       $4,771.88
     SYSTEM, INC.             General Hospital
                              Multidisciplinary
                              Breast Rounds
    ------------------------------------------------------------------------
    VIVA PHYSICIANS, INC.    VIVA 16: Vascular    06/12/2016      $25,000.00
                              InterVentional
                              Advances
    ------------------------------------------------------------------------
    UNIVERSITY OF COLORADO   Sex Differences      06/16/2016      $35,000.00
     DENVER, CENTER FOR       Across the
     WOMEN'S HEALTH HEALTH    Lifespan: A Focus
     RESEARCH                 on Metabolism
    ------------------------------------------------------------------------
    THE BOARD OF REGENTS OF  Immunotherapy:       06/20/2016      $40,000.00
     THE UNIVERSITY OF        Transformation of
     NEBRASKA                 Therapies for
                              Blood Cancer a
                              satellite
                              symposium held in
                              conjunction with
                              the 2016 ASH
                              Annual Meeting
    ------------------------------------------------------------------------
    VIVA PHYSICIANS, INC.    The Blockbuster at   06/21/2016      $69,100.00
                              VIVA 16
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      COPD Learning        06/22/2016      $40,000.00
     CHEST PHYSICIANS         Track
    ------------------------------------------------------------------------
    ENDOCRINE FELLOWS        Third Annual         06/23/2016     $278,000.00
     FOUNDATION               Endocrine Fellows
                              Foundation
                              Research Meeting
    ------------------------------------------------------------------------
    AMERICAN CANCER SOCIETY  American Cancer      06/30/2016     $163,500.00
     INC.                     Society Post-
                              Doctoral Research
                              Fellowship
                              Program
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Breathing New Air    07/03/2016      $10,000.00
     OSTEOPATHIC              into the
     INTERNISTS, INC.         Treatment of COPD
                              and Asthma
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      39th Annual San      07/03/2016      $75,000.00
     HEALTH SCIENCE CENTER    Antonio Breast
     AT SAN ANTONIO SCHOOL    Cancer Symposium
     OF MEDICINE--OFFICE OF
     CME
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   Evaluation and       07/04/2016      $94,011.50
                              Treatment of
                              Severe Asthma:
                              The Role of
                              Biologic and
                              Directed
                              Therapies
    ------------------------------------------------------------------------
    NATIONAL MEDICAL         Chronic              07/04/2016     $150,000.00
     ASSOCIATION              Obstructive
                              Pulmonary Disease
                              Interdisciplinary
                              Diagnostic and
                              Treatment
                              Symposium
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      07/10/2016       $1,440.00
     CONFERENCE               Seminar in
                              Microbial Toxins
                              and Pathogenesis
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      34th Annual Aspen    07/13/2016       $5,200.00
     ALLERGY, ASTHMA AND      Allergy
     IMMUNOLOGY               Conference
    ------------------------------------------------------------------------
    GORDON RESEARCH          2016 Protein         07/13/2016       $5,000.00
     CONFERENCE               Processing
                              Trafficking and
                              Secretion
    ------------------------------------------------------------------------
    SOCIETY FOR              New Cancer           07/14/2016      $35,000.00
     IMMUNOTHERAPY OF         Immunotherapy
     CANCER                   Agents in
                              Development
    ------------------------------------------------------------------------
    AMINISTRATORS OF THE     16th Annual SSCI     07/14/2016      $49,939.06
     TULANE EDUCATIONAL       Nephrology Young
     FUND                     Investigators'
                              Forum
    ------------------------------------------------------------------------
    NEW YORK ACADEMY OF      Targeting            07/18/2016      $15,000.00
     SCIENCES                 Inflammation and
                              Podocytopathy in
                              Chronic Kidney
                              Disease
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC 2016 Workshop   07/19/2016     $150,000.00
     IMMUNOTHERAPY OF         on Challenges,
     CANCER                   Insights, and
                              Future Directions
                              for Mouse and
                              Humanized Models
                              in Cancer
                              Immunology and
                              Immunotherapy
    ------------------------------------------------------------------------
    MASSACHUSETTS GENERAL    31th Annual          07/21/2016      $10,000.00
     HOSPITAL                 Critical Issues
                              In Tumor
                              Microenvironment:
                              Angiogenesis,
                              Metastasis and
                              Immunology
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  Transcatheter        07/21/2016      $10,000.00
     FOUNDATION               Cardiovascular
                              Therapeutics
                              (TCT) 2016
    ------------------------------------------------------------------------
    PEPTIDE THERAPEUTICS     11th Annual          07/26/2016      $15,000.00
     FOUNDATION               Peptide
                              Therapeutics
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASN Kidney Week--    07/27/2016      $20,000.00
     NEPHROLOGY               CKD Learning
                              Pathway Support
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR DNA Repair:     07/31/2016      $25,000.00
     FOR CANCER RESEARCH      Tumor Development
                              and Therapeutic
                              Response
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2016 Congress   08/01/2016      $50,000.00
     CANCER NETWORK INC.      Series:
                              Immunotherapies
                              in Cancer
    ------------------------------------------------------------------------
    CEDARS SINAI MEDICAL     Pancreatic Cancer    08/03/2016       $3,000.00
     CENTER                   Conference
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2016 Congress   08/04/2016      $25,000.00
     CANCER NETWORK INC.      Series: Utilizing
                              Guidelines to
                              Customize Patient
                              Care in Non-Small
                              Cell Lung Cancer
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Managing Severe      08/04/2016      $12,500.00
     ALLERGY, ASTHMA AND      Asthma in Adults
     IMMUNOLOGY               and Children
                              Workshop
    ------------------------------------------------------------------------
    ILLINOIS ACADEMY OF      Tenth Annual         08/07/2016      $54,768.91
     FAMILY PHYSICIANS        Family Medicine
                              Chief Residents
                              2016 Summit:
                              Intensifying
                              Diabetes
                              Management
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Advanced Non-Small   08/10/2016     $100,000.00
     CANCER NETWORK, INC.     Cell Lung Cancer
                              Patient
                              Management
                              Simulator
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 2016 Balance    08/11/2016     $233,374.80
     CLINICAL                 of Evidence:
     ENDOCRINOLOGISTS         Considering the
                              Clinical Impact
                              of Newer
                              Antihyperglycemic
                              Agents for the
                              Treatment of Type
                              2 Diabetes
    ------------------------------------------------------------------------
    HOUSTON METHODIST        4th Annual Houston   08/11/2016       $3,000.00
     HOSPITAL                 Methodist Cancer
                              Symposium
    ------------------------------------------------------------------------
    THE AMERICAN             AASLD/EASL HBV       08/14/2016       $3,000.00
     ASSOCIATION FOR THE      Treatment
     STUDY OF LIVER           Endpoints
     DISEASES                 Workshop
    ------------------------------------------------------------------------
    ASTHMA AND ALLERGY       Wheezin', Sneezin'   08/15/2016       $5,000.00
     FOUNDATION OF AMERICA,   and Itchin' in
     ALASKA CHAPTER           Alaska
    ------------------------------------------------------------------------
    DANA-FARBER CANCER       Dana-Farber Cancer   08/15/2016       $2,500.00
     INSTITUTE INC.           Institute's 12 th
                              Annual
                              Postdoctoral and
                              Graduate Student
                              Retreat
    ------------------------------------------------------------------------
    GLOBAL VIRUS NETWORK     3rd Annual Short     08/16/2016       $5,000.00
     INC.                     Course for
                              emerging leaders
                              in Medical
                              Virology of the
                              Global Virus
                              Network
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Eastern Pulmonary    08/21/2016       $8,000.00
     ALLERGY, ASTHMA AND      Conference 2016
     IMMUNOLOGY
    ------------------------------------------------------------------------
    CURATORS OF THE          2017 Midwest         08/25/2016      $35,260.00
     UNIVERSITY OF MISSOURI   Nephrology
                              Fellows Research
                              Day
    ------------------------------------------------------------------------
    GORDON RESEARCH          Mammalian DNA        08/25/2016       $2,000.00
     CONFERENCES              Repair Gordon
                              Research
                              Conference and
                              Seminar
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   The 21st Annual      08/28/2016       $3,000.00
                              Regional Allied
                              Health
                              Conference:
                              Current
                              Perspectives in
                              Asthma, Allergy
                              and Pulmonary
                              Practice
    ------------------------------------------------------------------------
    LUNGEVITY FOUNDATION     LUNGevity            08/28/2016      $25,000.00
                              Foundation
                              Science and
                              Clinical Research
                              Roundtable, Part
                              II
    ------------------------------------------------------------------------
    REGENTS OF THE           14th Annual          08/29/2016      $49,509.01
     UNIVERSITY OF            Nephrology Young
     CALIFORNIA               Investigator's
                              Forum
    ------------------------------------------------------------------------
    UNIVERSITY OF MARYLAND   18th Annual          09/01/2016       $5,000.00
     BALTIMORE FOUNDATION,    International
     INC.                     Meeting of the
                              Institute of
                              Human Virology
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC 17th Wolrd     09/04/2016      $82,500.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer--
                              International
                              Mentorship Awards
    ------------------------------------------------------------------------
    USF HEALTH PROFESSIONS   Update in Allergy    09/07/2016       $3,000.00
     CONFERENCING             and Immunology
     CORPORATION              2016 Symposium
                              and
                              Rhinolarngoscopy
                              Hands-On Workshop
    ------------------------------------------------------------------------
    UNIVERSITY OF NEW        Update and Review    09/07/2016       $2,500.00
     MEXICO                   of Internal
                              Medicine
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    GI Motility and      09/08/2016       $1,500.00
     OF HARVARD COLLEGE       Functional GI
                              Disease: Evidence
                              vs. Consensus
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACT's 37th Annual    09/08/2016       $5,000.00
     TOXICOLOGY               Meeting
    ------------------------------------------------------------------------
    PERSONALIZED MEDICINE    12th Annual          09/11/2016       $5,000.00
     COALITION                Personalized
                              Medicine
                              Conference
    ------------------------------------------------------------------------
    UNIVERSITY OF SOUTHERN   1st Annual           09/13/2016       $5,000.00
     CALIFORNIA               Southern
                              California Kidney
                              Symposium:
                              ``Slowing the
                              Progression of
                              Kidney Disease:
                              From Bench to
                              Bedside''
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Optimizing           09/21/2016      $35,000.00
     MANAGED CARE             Outcomes in
     PHYSICIANS, INC.         Advanced Non-
                              Small Cell Lung
                              Cancer (NSCLC):
                              Integrating Novel
                              Personalized
                              Therapy into the
                              Treatment
                              Paradigm
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     2016 JADPRO Live     09/22/2016     $100,000.00
     HEALTH SCIENCES AT       at APSHO
     EISENHOWER
    ------------------------------------------------------------------------
    PARTNERS HEALTHCARE      Massachusetts        09/22/2016       $5,000.00
     SYSTEM, INC.             General Hospital
                              Multidisciplinary
                              Breast Rounds
                              2016-2017
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     09/22/2016       $7,800.00
                              Working Group
                              Global Chapter
                              Meeting
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Allergy Grand        09/25/2016       $2,846.55
     UNIVERSITY               Rounds
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     09/25/2016     $126,500.00
     FOR CANCER RESEARCH      Fellowship in
                              Ovarian Cancer
                              Research
    ------------------------------------------------------------------------
    PHARMACY QUALITY         PQA Leadership       09/25/2016       $5,000.00
     ALLIANCE (PQA, INC.)     Summit 2016 The
                              I's Have It!
                              Insights into
                              Innovations,
                              Integration and
                              Implementation
                              Strategies for
                              Medication Use
                              Measurement
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2017 Congress   09/27/2016      $25,000.00
     CANCER NETWORK INC.      Series : Breast
                              Cancer with
                              Updates from the
                              2016 San Antonio
                              Breast Cancer
                              Symposium
    ------------------------------------------------------------------------
    THE SCRIPPS RESEARCH     28th Annual          09/27/2016       $1,500.00
     INSTITUTE                Frontiers in
                              Chemistry
                              Symposium
    ------------------------------------------------------------------------
    THE GOG FOUNDATION INC.  7th Semi Annual      09/28/2016      $20,000.00
                              Meeting of NRG
                              Oncology
                              (formerly; GOG,
                              NSABP, RTOG)
    ------------------------------------------------------------------------
    INTERNATIONAL            Global CME program   09/28/2016      $25,000.00
     FEDERATION OF HEAD AND   of IFHNOS
     NECK ONCOLOGIC
     SOCIETIES
    ------------------------------------------------------------------------
    PARKER INSTITUTE FOR     PICI Cancer          09/28/2016      $30,000.00
     CANCER IMMUNOTHERAPY     Immunotherapy
                              Workshops
    ------------------------------------------------------------------------
    SOCIEDAD PUERTORRIQUE A  Endocrinology Now    10/02/2016       $5,000.00
     DE ENDOCRINOLOG A Y      and Then SPEDs
     DIABETOLOGIA             40th Anniversary
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      Cancer Genetics:     10/03/2016       $5,000.00
     SOUTHWESTERN MEDICAL     Finding Meaning
     CENTER                   in Tumor and
                              Germline Genomes
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          12th Annual          10/03/2016      $50,000.00
     FOUNDATION               National Young
                              Investigator's
                              Forum
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  The Fourth           10/05/2016       $5,000.00
     MD ANDERSON CANCER       International
     CENTER                   Conference on
                              Cancer and the
                              Heart
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Translational   10/05/2016      $25,000.00
     FOR CANCER RESEARCH      Control of
                              Cancer: A New
                              Frontier in
                              Cancer Biology
                              and Therapy
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      14th Annual World    10/05/2016      $25,000.00
     EDUCATION FOUNDATION     Congress on
                              Insulin
                              Resistance
                              Diabetes and
                              Cardiovascular
                              Disease (WCIRDC)
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     5th Annual New       10/06/2016       $5,000.00
     CENTER                   Therapeutics in
                              Oncology: The
                              Road to
                              Personalized
                              Medicine
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Behind the           10/06/2016      $25,000.00
     CANCER NETWORK INC.      Guidelines:
                              Insights into the
                              Standard of Care
                              in Oncology 2017
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Chronic Kidney       10/06/2016     $139,980.00
     FOUNDATION INC.          Disease and
                              Cardiovascular
                              Disease: Best
                              Practices to
                              Improve Outcomes
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        Fall 2016 ECOG-      10/09/2016       $5,000.00
     EDUCATION FOUNDATION,    ACRIN Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC 17th World     10/09/2016     $170,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 Conquer         10/10/2016      $40,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Merit
     CLINICAL ONCOLOGY        Awards
    ------------------------------------------------------------------------
    PARTERS HEALTHCARE       Massachusetts        10/10/2016       $5,000.00
     SYSTEM, INC.             General Hospital
                              Cancer Center
                              Grand Rounds
    ------------------------------------------------------------------------
    UNIVERSIDAD CENTRAL DEL  Redefining Cancer    10/11/2016       $5,000.00
     CARIBE, INC.             Treatment
                              Paradigms in Non-
                              Small Cell Lung
                              Cancer
    ------------------------------------------------------------------------
    RUSH UNIVERSITY MEDICAL  Expert Insights      10/18/2016       $5,000.00
     CENTER                   and Key Nursing
                              Considerations:
                              Treating and
                              Caring for
                              Patients with
                              Lung Cancer
    ------------------------------------------------------------------------
    GLOBAL EDUCATION GROUP   GOLD COPD:           10/18/2016      $75,000.00
                              Continuum of Care
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 22nd Annual     10/18/2016     $100,000.00
     CANCER NETWORK           Conference:
                              Improving the
                              Quality,
                              Effectiveness,
                              and Efficiency of
                              Cancer CareTM
    ------------------------------------------------------------------------
    SOCIETY FOR              2016 Chabner         10/19/2016      $10,000.00
     TRANSLATIONAL ONCOLOGY   Colloquium:
                              Answering the Big
                              Questions in
                              Cancer Research
    ------------------------------------------------------------------------
    HEMATOLOGY ONCOLOGY      2017 Hematology      10/26/2016      $27,500.00
     PHARMACY ASSOCITATION    Oncology Pharmacy
                              Association q
    ------------------------------------------------------------------------
    INTERNATIONAL            10th Biennial        10/27/2016      $10,000.00
     EOSINOPHIL SOCIETY,      Symposium
     INC.
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 ASCO-SITC       11/03/2016      $13,750.00
     FOUNDATION OF THE        Clinical Immuno-
     AMERICAN SOCIETY OF      Oncology
     CLINICAL ONCOLOGY        Symposium
                              Proceedings
    ------------------------------------------------------------------------
    MEDSTAR GEORGETOWN       LUNG CANCER 2016:    11/03/2016       $5,000.00
     UNIVERSITY HOSPITAL      Progress and
                              Future Directions
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  18th Annual          11/03/2016      $15,000.00
     CLINICAL                 Intensive Course
     ENDOCRINOLOGISTS INC.    on Diabetes,
                              Endocrinology,
                              and Metabolic
                              Diseases
    ------------------------------------------------------------------------
    GORDON RESEARCH          Mammalian DNA        11/03/2016       $3,000.00
     CONFERENCES              Repair Gordon
                              Research
                              Conference and
                              Seminar
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     11/08/2016      $73,238.00
     FOR CANCER RESEARCH      Fellowships in
                              Lung Cancer
                              Research
    ------------------------------------------------------------------------
    PENN STATE UNIVERSITY    Cases from the       11/08/2016      $30,000.00
                              Community:
                              Investigator
                              Perspectives on
                              Emerging Research
                              and Patients with
                              Advanced Prostate
                              Cancer: A 2017 GU
                              Cancers Symposium
                              ISS
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     Genomic              11/08/2016       $5,000.00
     MOLECULAR AND CELLULAR   Instability and
     BIOLOGY                  DNA Repair
    ------------------------------------------------------------------------
    RENAL PHYISICIANS        RPA 2017 Annual      11/10/2016      $25,000.00
     ASSOCIATION              Meeting
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     11/13/2016     $253,000.00
     FOR CANCER RESEARCH      Fellowships in
                              Immuno-oncology
                              Research
    ------------------------------------------------------------------------
    WINGATE UNIVERSITY       AmCare Pharmacy      11/21/2016         $500.00
     SCHOOL OF PHARMACY       Forum of North
                              Carolina
    ------------------------------------------------------------------------
    SOCIETY FOR NEURO-       21st Annual          11/28/2016      $26,000.00
     ONCOLOGY                 Meeting of the
                              Society for Neuro-
                              Oncology
    ------------------------------------------------------------------------
    LYMPHOMA RESEARCH        Lymphoma Research    12/01/2016     $105,000.00
     FOUNDATION               Foundation
                              Postdoctoral
                              Fellowship Grant
                              Program
    ------------------------------------------------------------------------
    UNIVERSITY OF NEBRASKA   PARP Inhibition in   12/01/2016      $45,000.00
     MEDICAL CENTER           Ovarian Cancer:
                              Integrating Basic
                              Science, Clinical
                              Data, and the
                              Patient Voice to
                              Enhance Care
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA        2017 Keystone        12/01/2016      $25,000.00
                              Symposia
                              Directors' Fund
    ------------------------------------------------------------------------
    BOSTON UNIVERSITY        Are You Asking the   12/04/2016     $149,275.00
     SCHOOL OF MEDICINE--     Question?
     OFFICE OF CME            Strategies for
                              Engaging the
                              Patient in the
                              Diagnosis and
                              Management of
                              Opioid-Induced
                              Constipation
    ------------------------------------------------------------------------
    GLOBAL EDUCATION GROUP   Comprehensive Pain   12/04/2016     $324,107.00
                              Management in
                              Palliative Care:
                              Relieving the
                              Burden of Opioid-
                              Induced
                              Constipation
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 Conquer         12/04/2016     $500,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of the American
     CLINICAL ONCOLOGY        Society of
                              Clinical Oncology
                              Mission Endowment
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          12/04/2016     $150,000.00
     FOR CANCER RESEARCH      Meeting- 2017
    ------------------------------------------------------------------------
    SOCIETY OF GYNECOLOGIC   Clinical             12/04/2016      $50,000.00
     ONCOLOGY                 Management of New
                              Biologics and
                              Immunotherapies
                              in Gynecologic
                              Oncology
    ------------------------------------------------------------------------
    SOCIETY OF GYNECOLOGIC   Genetic Counseling   12/04/2016     $210,575.00
     ONCOLOGY                 in Gynecologic
                              Oncology: What
                              Advanced
                              Practitioners
                              Need to Know
    ------------------------------------------------------------------------
    JOHNS HOPKINS DIVISION   Mid-Atlantic         12/04/2016      $50,000.00
     OF NEPHORLOGY            Nephrology Young
                              Investigators
                              Forum
    ------------------------------------------------------------------------
    INTERNATIONAL            EGFR Atlas           12/04/2016     $380,000.00
     ASSOCIATION FOR THE
     STUDY OF LUNG CANCER
    ------------------------------------------------------------------------
    INTERNATIONAL            2017 IASLC WCLC      12/04/2016     $150,000.00
     ASSOCIATION FOR THE      Association-
     STUDY OF LUNG CANCER     Satellite Fee
    ------------------------------------------------------------------------
    FRIENDS OF CANCER        2017 Friends of      12/04/2016     $100,000.00
     RESERACH                 Cancer Research
                              Programs
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  2017 Oncologic       12/06/2016       $5,000.00
     MD ANDERSON CANCER       Emergency
     CENTER                   Medicine
                              Conference
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 Genitourinary   12/08/2016      $50,000.00
     FOUNDATION OF THE        (GU) Cancers
     AMERICAN SOCIETY OF      Symposium:
     CLINICAL ONCOLOGY        Translating
                              Research to Value-
                              Based and Patient-
                              Centric Care
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2017 Alzheimer's     12/08/2016      $50,000.00
                              Association
                              Research
                              Roundtable
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2017 Alzheimer's     12/08/2016      $45,000.00
                              Association
                              International
                              Conference
    ------------------------------------------------------------------------
    CANCER RESEARCH          Cancer Research      12/11/2016      $50,000.00
     INSTITUTE                Institute's
                              Irvington
                              Postdoctoral
                              Fellowship
                              Program
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 ASCO-SITC       12/11/2016      $60,000.00
     FOUNDATION OF THE        Clinical Immuno-
     AMERICAN SOCIETY OF      Oncology
     CLINICAL ONCOLOGY        Symposium
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 11th Annual     12/12/2016      $15,000.00
     CANCER NETWORK, INC.     Congress:
                              Hematologic
                              MalignanciesTM
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    ISN World Congress   12/12/2016     $130,000.00
     OF NEPHROLOGY            of Nephrology
                              2017--WCN 2017
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 26th Annual     12/12/2016      $50,000.00
     CLINICAL                 Scientific &
     ENDOCRINOLOGISTS         Clinical
                              Congress--Diabete
                              s Session
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          National Kidney      12/12/2016       $5,000.00
     FOUNDATION INC.          Foundation s
                              Tenth Annual Mid-
                              Atlantic First
                              Year Renal
                              Fellows Symposium
    ------------------------------------------------------------------------
    THE ENDOCRINE SOCIETY    Diabetes Masters     12/13/2016      $50,000.00
                              Series 2017:
                              Negotiating the
                              Therapeutic
                              Terrain: Steps to
                              Identifying
                              Individualized
                              Treatment
                              Approaches for
                              Patients With
                              T2DM
    ------------------------------------------------------------------------
    REGENTS OF THE           Making the           12/14/2016      $50,000.00
     UNIVERSITY OF            Connection
     CALIFORNIA               between Patients
                              and Providers: A
                              Modern Approach
                              to the Treatment
                              of Type 1 and
                              Type 2 Diabetes
    ------------------------------------------------------------------------
    THE NEW YORK ACADEMY OF  Cancer               12/14/2016      $20,000.00
     SCIENCES                 Immunotherapy:
                              Frontiers in
                              Cancer
                              Immunotherapy and
                              Quantitative
                              Approaches in
                              Immuno-Oncology
    ------------------------------------------------------------------------
    REGENTS OF THE           44th Annual Family   12/19/2016       $2,792.00
     UNIVERSITY OF            Medicine
     CALIFORNIA LOS ANGELES   Reffresher
                              Course"
    ------------------------------------------------------------------------
    RUTGERS, THE STATE       Rutgers              12/19/2016      $61,728.00
     UNIVERSITY OF NEW        Pharmaceutical
     JERSEY                   Industry
                              Fellowship
                              Program
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 Conquer         12/21/2016     $192,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Young
     CLINICAL ONCOLOGY        Investigator
                              Award (YIA)
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2017 Oncology   12/21/2016      $35,000.00
     CANCER NETWORK, INC.     Fellows Program:
                              New Horizons in
                              Quality Cancer
                              Care at the NCCN
                              22nd Annual
                              Conference
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      1st Annual Heart     12/21/2016     $100,000.00
     EDUCATION FOUNDATION     in Diabetes
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC 17th World     12/21/2016      $92,500.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
    ------------------------------------------------------------------------
    PRIMARY CARE EDUCATION   11th Annual Chief    12/21/2016      $50,000.00
     CONSORTIUM               Residents Summit
                              on Intensifying
                              Diabetes
                              Management
    ------------------------------------------------------------------------
    AMERICAN NEPHROLOGY      ANNA 2017 National   12/21/2016      $20,000.00
     NURSES ASSOCIATION       Symposium
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  2017 Charitable      12/21/2016      $30,000.00
     FREE AND CHARITABLE      Health Care
     CLINICS                  Symposium
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASN Kidney Week      12/21/2016      $37,500.00
     NEPHROLOGY               Educational
                              Session Support
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASN Kidney Week      12/21/2016      $15,000.00
     NEPHROLOGY               Early Program
                              Support
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASN Select           12/21/2016      $20,000.00
     NEPHROLOGY               Streamed Session
                              Support
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      Emerging             12/27/2016     $100,000.00
     ASSOCIATION EDUCATION    Immunotherapeutic
     AND RESEARCH INC.        Agents for the
                              Treatment of
                              Bladder Cancer
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      2016 American        01/04/2017     $150,000.00
     HEMATOLOGY               Society of
                              Hematology Annual
                              Meeting
    ------------------------------------------------------------------------
    RUTGERS, THE STATE       Severe Asthma:       01/04/2017     $225,000.00
     UNIVERSITY OF NEW        Clinical
     JERSEY                   Phenotypes and
                              the Emerging Age
                              of Personalized
                              Therapy
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       A Better Life for    01/05/2017     $100,000.00
     UNIVERSITY               Your Severe
                              Asthma Patients:
                              Targeted
                              Therapies for
                              Fewer
                              Exacerbations
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   Personalized         01/06/2017     $345,500.00
                              Medicine in
                              Severe Asthma:
                              Applying Emerging
                              Data and
                              Treatments to
                              Everyday Clinical
                              Practice
    ------------------------------------------------------------------------
    PARKER INSTITUTE FOR     Streamlining         01/18/2017      $60,000.00
     CANCER IMMUNOTHERAPY     Toxicity
                              Management
                              Guidelines
    ------------------------------------------------------------------------
    FLORIDA ALLERGY, ASTHMA  FAAIS 2017 Annual    01/25/2017      $20,000.00
     AND IMMUNOLOGY SOCIETY   CME Conference
    ------------------------------------------------------------------------
    NYU POST-GRADUATE        Asthma, Airways      01/26/2017      $20,000.00
     MEDICAL SCHOOL           and Environment
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Preventing Acute     01/29/2017      $15,000.00
     MANAGED CARE             Exacerbations
     PHYSICIANS, INC.         though Novel
                              Insights in
                              Treatment
                              Strategies for
                              COPD
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   39th Annual          01/29/2017      $20,000.00
                              National Jewish
                              Health Pulmonary
                              and Allergy
                              Update
    ------------------------------------------------------------------------
    INTERNATIONAL            Best of World        01/29/2017      $20,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
    ------------------------------------------------------------------------
    YALE UNIVERSITY          Severe Asthma        02/01/2017      $16,300.00
                              2016: A
                              Personalized
                              Approach To
                              Treatment
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     2017                 02/01/2017      $50,000.00
     RADIATION ONCOLOGY       Multidisciplinary
                              Thoracic Cancers
                              Symposium
    ------------------------------------------------------------------------
    NATIONAL MEDICAL         Implementing the     02/01/2017      $75,000.00
     ASSOCCIATION             New GOLD
                              Guidelines:
                              Interdisciplinary
                              Management of
                              Chronic
                              Obstructive
                              Pulmonary Disease
                              as a Chronic
                              Disease
    ------------------------------------------------------------------------
    CARDIOVASCULAR           Cardiovascular       02/01/2017      $25,000.00
     INNOVATIONS FOUNDATION   Innovations 2017
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2017             02/01/2017      $70,000.00
     SOCIETY INC.             International
                              Conference--Selec
                              ted Topics in
                              COPD
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  23rd Annual          02/01/2017      $10,000.00
     FOUNDATION               Interventional
                              Cardiology
                              Fellows Course
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   13th Annual          02/01/2017     $283,830.79
                              Respiratory
                              Disease Young
                              Investigators
                              Forum
    ------------------------------------------------------------------------
    WASHINGTON HOSPITAL      Cardiovascular       02/02/2017      $30,000.00
     CENTER CORPORATION       Research
                              Technologies
    ------------------------------------------------------------------------
    CONNECTICUT PHARMACISTS  Breathe Easy: An     02/02/2017       $2,000.00
     ASSOCIATION              Overview of
                              Inhalers for the
                              Management of
                              Asthma and COPD
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAPA 2017--Allergy/  02/06/2017       $7,500.00
     PHYSICIAN ASSISTANTS,    Immunology and
     INC.                     Pulmonology
                              Tracks
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Immuno-Oncology      02/07/2017      $75,000.00
     CANCER NETWORK           Therapeutics for
                              Renal Cell
                              Carcinoma and
                              Bladder Cancer:
                              Integrating the
                              Latest
                              Developments Into
                              Clinical Practice
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          02/09/2017     $100,000.00
     FOR CANCER RESEARCH      Meeting--2017
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 Conquer         02/12/2017     $253,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Career
     CLINICAL ONCOLOGY        Development Award
    ------------------------------------------------------------------------
    NYU POST-GRADUATE        NYU Seminar in       02/13/2017      $10,000.00
     MEDICAL SCHOOL           Advanced
                              Rheumatology
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  Cardio Renal         02/14/2017       $2,500.00
     HEALTH SCIENCE CENTER    Connections--2nd
     AT SAN ANTONIO           Annual Cardio-
                              Renal Conference
                              2017
    ------------------------------------------------------------------------
    TRUSTEES OF THE          Translational        02/14/2017       $2,500.00
     UNIVERSITY OF            Research Cancer
     PENNSYLVANIA             Centers
                              Consortium
    ------------------------------------------------------------------------
    AMERICAN HEAD AND NECK   AHNS 2017 Annual     02/14/2017      $25,000.00
     SOCIETY                  Meeting
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      02/15/2017       $2,500.00
     CONFERENCES              Conference on
                              Drug Metabolism
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   COPD Now: Applying   02/15/2017     $199,618.33
                              New Guidelines
                              and Effective
                              Strategies in
                              Diagnosis,
                              Treatment and
                              Management to
                              Everyday Practice
    ------------------------------------------------------------------------
    HUMBOLDT-DEL NORTE       COPD                 02/15/2017       $2,100.00
     CONSORTIUM FOR CME
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 ASCO Annual     02/15/2017      $84,000.00
     FOUNDATION OF THE        Meeting Lung
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    GORDON RESEARCH          Model Systems,       02/15/2017       $5,000.00
     CONFERENCES              Emerging
                              Technologies and
                              Precision
                              Medicine in
                              Arrhythmia
                              Research and
                              Therapeutic
                              Development
    ------------------------------------------------------------------------
    ST. JOSEPH'S REGIONAL    Acute Coronary       02/15/2017       $4,200.00
     MEDICAL CENTER           Syndrome
    ------------------------------------------------------------------------
    AMERICAN CHEMICAL        Division of          02/16/2017       $3,000.00
     SOCIETY DIVISION OF      Medicinal
     MEDICINAL CHEMISTRY      Chemistry Program
                              253rd ACS
                              National Meeting
    ------------------------------------------------------------------------
    SOCIETY FOR              2017 Advances in     02/16/2017     $500,000.00
     IMMUNOTHERAPY OF         Cancer
     CANCER                   Immunotherapy
                              Series
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     02/16/2017       $5,000.00
                              Working Group US
                              Chapter Meeting
    ------------------------------------------------------------------------
    CALIFORNIA ACADEMY OF    Addressing the       02/16/2017       $3,000.00
     PHYSICIAN ASSISTANTS     Needs of the ACS
                              Patient
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  DAPT Dilemmas: A     02/19/2017      $10,000.00
     FOUNDATION               Case-based
                              Roundtable
                              Tutorial
    ------------------------------------------------------------------------
    INDIANA ACADEMY OF       Managing Severe      02/19/2017       $3,921.00
     FAMILY PHYSICIANS        Asthma in the
                              Family
                              Physician's
                              Office
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     The Emerging Role    02/19/2017     $188,600.00
     HEALTH SCIENCES AT       of Molecular
     EISENHOWER               Testing in an Era
                              of Precision
                              Medicine--NSCLC
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     The Emerging Role    02/19/2017     $188,600.00
     HEALTH SCIENCES AT       of Molecular
     EISENHOWER               Testing in an Era
                              of Precision
                              Medicine--Ovarian
                              Cancer
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           Scripps 37th         02/20/2017       $5,000.00
                              Annual
                              Conference:
                              Clinical
                              Hematology and
                              Oncology 2017
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      The Great K Debate   02/21/2017     $100,000.00
     CARDIOLOGY FOUNDATION    Continues:
                              Updates and
                              Controversies in
                              Heart Failure
                              Management
    ------------------------------------------------------------------------
    GORDON RESEARCH          2017 Gordon          02/22/2017       $2,500.00
     CONFERENCES              Conference on
                              Medicinal
                              Chemistry
    ------------------------------------------------------------------------
    INTERNATIONAL            17th Annual          02/22/2017      $33,000.00
     ASSOCIATION FOR THE      Targeted
     STUDY OF LUNG CANCER     Therapies of lung
                              Cancer Meeting
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AHNS Head and   02/22/2017      $25,000.00
     FOR CANCER RESEARCH      Neck Cancer
                              Conference:
    ------------------------------------------------------------------------
    ASTHMA AND ALLERGY       Wheezin', Sneezin'   02/22/2017       $5,000.00
     FOUNDATION OF AMERICA,   and Itchin' in
     ALASKA CHAPTER           Alaska
    ------------------------------------------------------------------------
    FASEB SCIENCE RESEARCH   FASEB Autoimmunity   02/22/2017       $5,000.00
     CONFERENCES
    ------------------------------------------------------------------------
    FEDERATION OF CLINICAL   Federation of        02/23/2017      $15,000.00
     IMMUNOLOGY SOCIETIES     Clinical
     INC.                     Immunology
                              Societies Annual
                              Meeting
    ------------------------------------------------------------------------
    THE BOARD OF REGENTS OF  Biennial             03/02/2017      $50,000.00
     THE UNIVERSITY OF        International
     NEBRASKA                 Workshop on
                              Chronic
                              Lymphocytic
                              Leukemia (XVII
                              iwCLL 2017)
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Change in            03/02/2017      $50,000.00
     FOUNDATION, INC.         Albuminuria and
                              GFR as End Points
                              for Clinical
                              Trials in Early
                              Stages of Chronic
                              Kidney Disease: A
                              Scientific
                              Workshop
                              Sponsored by the
                              National Kidney
                              Foundation,
                              European
                              Medicines Agency
                              and the US Food
                              and Drug
                              Administration
    ------------------------------------------------------------------------
    AMERICAN RESPIRATORY     56th RESPIRATORY     03/05/2017      $18,000.00
     CARE FOUNDATION          CARE Journal
                              Conference
                              Respiratory
                              Medications for
                              COPD and Adult
                              Asthma:
                              Pharmacologic
                              Actions to
                              Clinical
                              Applications
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACAAI member         03/05/2017      $40,000.00
     ALLERGY, ASTHMA AND      publication--Alle
     IMMUNOLOGY               rgyWatch
    ------------------------------------------------------------------------
    GORDON RESEARCH          The Enduring         03/05/2017       $2,500.00
     CONFERENCE               Potential of
                              Heterocycles as
                              Synthetic
                              Targets, Cellular
                              Probes, and Drug
                              Candidates
    ------------------------------------------------------------------------
    THE REGENTS OF THE       35th Carl M.         03/06/2017      $10,000.00
     UNIVERSITY OF            Pearson Memorial
     CALIFORNIA               Symposium
                              Frontiers of
                              Rheumatology
    ------------------------------------------------------------------------
    GORDON RESEARCH          Staphylococcal       03/06/2017       $5,000.00
     CONFERENCES--STAPHYLOC   Gordon Research
     OCCAL DISEASES           Conference
    ------------------------------------------------------------------------
    COLD SPRING HARBOR       Cell Death           03/07/2017       $2,500.00
     LABORATORY
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     Lupus: What's        03/08/2017     $334,625.00
     CENTER                   Next? Examining
                              Mechanisms,
                              Monitoring, and
                              Medication
                              Updates
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2017 Fellows     03/09/2017      $20,000.00
     SOCIETY                  Track Symposium
    ------------------------------------------------------------------------
    BOSTON UNIVERSITY        EFFECTIVE ASTHMA     03/11/2017     $100,000.00
     SCHOOL OF MEDICINE,      MANAGEMENT IN
     CME                      PRIMARY CARE:
                              Severity
                              Assessment,
                              Guidelines, and
                              New Therapy
                              Options
    ------------------------------------------------------------------------
    PENNSYLVANIA STATE       Innovations in       03/12/2017       $2,500.00
     UNIVERSITY               Allergy, Asthma
                              and Immunology
                              Management
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC SCLC           03/14/2017      $25,000.00
     ASSOCIATION FOR THE      workshop
     STUDY OF LUNG CANCER
     (IASLC)
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       A Better Life for    03/14/2017     $321,485.44
     UNIVERSITY               Your Severe
                              Asthma Patients:
                              Targeted
                              Therapies for
                              Fewer
                              Exacerbations
    ------------------------------------------------------------------------
    REGENTS OF THE           Clostpath 10         03/16/2017       $5,000.00
     UNIVERSITY OF MICHIGAN   Support
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Asthma Fellows       03/20/2017       $5,000.00
     CHEST PHYSICIANS         Conference
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Multidisciplinary    03/20/2017      $24,354.00
     CHEST PHYSICIANS         Management Of
                              Severe Asthma: It
                              Takes A Village
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Asthma Learning      03/21/2017      $79,573.00
     CHEST PHYSICIANS         Track--CHEST 2017
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      COPD Learning        03/22/2017      $73,765.00
     CHEST PHYSICIANS         Track
    ------------------------------------------------------------------------
    THOMAS JEFFERSON         10th Annual Young    03/26/2017      $11,000.00
     UNIVERSITY               Investigators
                              Forum
    ------------------------------------------------------------------------
    FLORIDA ACADEMY OF       Diagnoses and        03/27/2017       $8,000.00
     PHYSICIAN ASSISTANTS     treatment for
     INC.                     Acute coronary
                              syndrome
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC's Toxicity      03/27/2017      $50,000.00
     IMMUNOTHERAPY OF         Managment
     CANCER                   Workshop
    ------------------------------------------------------------------------
    HOUSTON METHODIST        Cardiology for the   03/27/2017       $8,000.00
     HOSPITAL                 Non-Cardiologist
    ------------------------------------------------------------------------
    WEST PENN ALLEGHENY      Cardiovascular       03/28/2017       $3,000.00
     HEALTH SYSTEM INC.       Medicine Update
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      28th Annual          03/29/2017       $5,000.00
     CARDIOLOGY PUERTO RICO   Meeting of the
     CHAPTER                  ACC Puerto Rico
                              Chapter
    ------------------------------------------------------------------------
    HOWARD UNIVERSITY        The Kenneth Austin   03/30/2017       $2,500.00
                              12th Annual
                              Rheumatology
                              Symposium at
                              Howard University
                              Hospital
    ------------------------------------------------------------------------
    AMERICAN RADIUM SOCIETY  99th Annual          04/02/2017      $10,000.00
                              Meeting of the
                              American Radium
                              Society
    ------------------------------------------------------------------------
    TENNESSEE ACADEMY OF     Spring Fling 2017:   04/03/2017       $2,000.00
     PHYSICIAN ASSISTANTS     Optimizing
                              Outcomes in
                              Patients with
                              Opioid Induced
                              Constipation
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Navigating a         04/04/2017      $35,000.00
     MANAGED CARE             Complex Treatment
     PHYSICIANS, INC.         Landscape in
                              Advanced Non-
                              Small Cell Lung
                              Cancer (NSCLC):
                              Individualizing
                              Therapy for
                              Improved Patient
                              Outcomes
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Improving the        04/06/2017     $149,000.00
     INSTITUTE INC.           Physical and
                              Mental Well-Being
                              of Patients With
                              COPD: Integrating
                              Pharmacotherapy
                              With Pulmonary
                              Rehabilitation
                              and Self-
                              Management
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  UPDATES ABOUND!      04/06/2017     $374,606.00
     CLINICAL                 Latest and
     ENDOCRINOLOGISTS INC.    Greatest in
                              Practical
                              Application of
                              Cardiovascular
                              Outcomes for
                              Diabetes Drugs
    ------------------------------------------------------------------------
    GLOBAL EDUCATION GROUP   Overcoming           04/06/2017     $289,267.50
                              Challenges in
                              Cancer Pain
                              Management:
                              Engaging With
                              Patients About
                              Opioid-Induced
                              Constipation
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AAPS Sustaining      04/09/2017      $50,000.00
     PHARMACEUTICAL           Sponsorship
     SCIENTISTS
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        14th International   04/10/2017      $10,000.00
     CHICAGO CENTER FOR       Ultmann Chicago
     CONTINUING MEDICAL       Lymphoma
     EDUCATION                Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Hematologic     04/10/2017      $25,000.00
     FOR CANCER RESEARCH      Malignancies:
    ------------------------------------------------------------------------
    THE HOPE FOUNDATION      2017 SWOG Group      04/11/2017      $10,000.00
                              Meetings
    ------------------------------------------------------------------------
    PREVENTIVE               2017 PCNA FAll       04/11/2017      $25,000.00
     CARDIOVASCULAR NURSES    Regional
     ASSOCIATION              Education
                              Programs:
                              Cardiometabolics:
                              Focus on New
                              Medications and
                              Risk Reduction
                              Benefits and
                              Protection
    ------------------------------------------------------------------------
    EMORY UNIVERSITY SCHOOL  Updates in the       04/12/2017       $5,000.00
     OF MEDICINE              Management of
                              Head and Neck
                              Cancer
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2017 Congress   04/16/2017      $50,000.00
     CANCER NETWORK INC.      Series : Lung
                              Cancer
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         42nd Annual ONS      04/16/2017      $50,000.00
     SOCIETY                  Congress and
                              Oncology Updates
                              Regional Meetings
    ------------------------------------------------------------------------
    SWEDISH MEDICAL CENTER   Annual Oncology      04/16/2017       $5,000.00
     FOUNDATION               Symposium:
                              Innovations in
                              Gynecologic
                              Cancer Care--
                              Prevention to
                              Survivorship
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Master Class for     04/18/2017      $10,000.00
     HEALTH SCIENCES AT       Oncologists--Brea
     EISENHOWER               st Cancer Track
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Master Class for     04/18/2017      $10,000.00
     HEALTH SCIENCES AT       Oncologist--Genit
     EISENHOWER               ourinary Cancers
                              Track
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Oral Oncolytics      04/18/2017      $50,000.00
     HEALTH SCIENCES AT       Adherence
     EISENHOWER               Resource Center:
                              An Educational
                              Platform for
                              Advanced
                              Practitioners in
                              Oncology
    ------------------------------------------------------------------------
    BLADDER CANCER ADVOCACY  2017 Bladder         04/18/2017      $35,000.00
     NETWORK                  Cancer Think Tank
    ------------------------------------------------------------------------
    SOCIETY FOR              SCAI 2017            04/23/2017      $50,000.00
     CARDIOVASCULAR           Scientific
     ANGIOGRAPHY AND          Sessions
     INTERVENTIONS
    ------------------------------------------------------------------------
    TRUSTEES OF THE          BRCA1, BRCA2 and     04/23/2017      $20,000.00
     UNIVERSITY OF            Beyond: An Update
     PENNSYLVANIA             on Hereditary
                              Cancer
    ------------------------------------------------------------------------
    CANCER MOLECULAR         Molecular            04/24/2017       $2,000.00
     THERAPEUTICS RESEARCH    Therapeutics of
     ASSOCIATION              Cancer Research
                              Conference 2017
    ------------------------------------------------------------------------
    YALE UNIVERSITY          2017 Lung SPORE      04/24/2017      $30,000.00
                              Workshop
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        ECOG-ACRIN Spring    04/24/2017       $5,000.00
     EDUCATION FOUNDATION,    2017 Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Hormone Receptor-    04/25/2017      $20,111.61
     EDUCATIONAL FOUNDATION   Positive Advanced
                              Breast Cancer:
                              Challenges and
                              New Treatment
                              Options
    ------------------------------------------------------------------------
    INTERNATIONAL THYROID    2017 ITOG Annual     04/25/2017       $5,000.00
     ONCOLOGY GROUP           Meeting
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      Breast Cancer        04/25/2017       $3,000.00
     DEPARTMENT OF SURGERY    Management 2017
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         2017 Cleveland       04/26/2017       $5,000.00
     EDUCATIONAL FOUNDATION   Breast Cancer
                              Summit:
                              Collaborating For
                              A Cure
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          16th Annual          04/27/2017      $10,000.00
                              Southeastern
                              Fellows Research
                              Skills and
                              Training Workshop
    ------------------------------------------------------------------------
    YALE UNIVERSITY          Yale ASCO Review     05/01/2017       $5,000.00
                              2017
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Acute Management     05/02/2017     $573,560.00
     INSTITUTE INC.           of Immune-Related
                              Adverse Events in
                              Cancer Patients
                              Receiving
                              Immunotherapies:
                              Essential
                              Guidance for
                              Emergency
                              Medicine
                              Specialists
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      EAC 2017 Update in   05/04/2017      $10,000.00
     ALLERGY, ASTHMA AND      Allergy, Asthma
     IMMUNOLOGY               and Immunology
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      The Real Deal:       05/07/2017     $162,855.00
     EDUCATION FOUNDATION     Translating
                              Cardiovascular
                              Outcomes Data
                              into Best
                              Practices in Type
                              2 Diabetes
                              Management
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     EACR-AACR-SIC        05/08/2017      $50,000.00
     FOR CANCER RESEARCH      Special
                              Conference 2017:
                              The Challenges of
                              Optimizing Immuno-
                               and Targeted
                              Therapies
    ------------------------------------------------------------------------
    CONQUER CANCER           2017 Best of ASCO    05/09/2017     $120,000.00
     FOUNDATION OF THE        Meetings
     AMERICAN SOCIETY OF
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    REGENTS OF THE           Making the           05/10/2017     $200,000.00
     UNIVERSITY OF            Connection
     CALIFORNIA               Between Patients
                              and Providers--A
                              Modern Approach
                              to the Treatment
                              of Type 1 and
                              Type 2 Diabetes
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      05/11/2017       $1,500.00
     CONFERENCE               Conference:
                              Hormone-Dependent
                              Cancer:
                              Functional
                              Insight and
                              Clinical
                              Application
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  29th Annual          05/14/2017      $25,000.00
     FOUNDATION               Transcatheter
                              Cardiovascular
                              Therapeutics
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  DAPT and Triple      05/14/2017      $10,000.00
     FOUNDATION               Therapy: A Case-
                              based Guide to
                              Optimal
                              Antiplatelet
                              Therapies
    ------------------------------------------------------------------------
    MINNESOTA PHARMACISTS    Treating Acute       05/15/2017       $3,500.00
     ASSOCIATION              Coronary Syndrome
                              (ACS)
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Live Symposium of    05/15/2017       $5,000.00
     MEDICINE AT MOUNT        Complex Coronary,
     SINAI                    Valvular and
                              Vascular Cases
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Acute Coronary       05/17/2017       $5,000.00
     CRITICAL CARE NURSES     Syndrome New
     SEPA CHAPTER             Guidelines and
                              Therapeutic
                              Options
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Integration of       05/18/2017      $50,000.00
     HEALTH SCIENCES AT       Immunotherapy
     EISENHOWER               into the
                              Treatment of
                              Solid Tumors and
                              Hematologic
                              Malignancies:
                              Considerations
                              for Advanced
                              Practitioners in
                              Oncology
    ------------------------------------------------------------------------
    ST. FRANCIS HOSPITAL     Contemporary         05/18/2017       $3,300.00
                              Dilemmas in Anti
                              Platelet Therapy
    ------------------------------------------------------------------------
    MEMORIAL SLOAN           2017 MSK Cardio-     05/18/2017       $5,000.00
     KETTERING CANCER         Oncology
     CENTER                   Symposium:
                              Cardiovascular
                              Health and
                              Disease During
                              and After Cancer
                              Therapy--A Case
                              Based Curriculum
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      05/18/2017       $8,000.00
     CONFERENCE               Seminar and
                              Conference on
                              Lung Development,
                              Injury and Repair
    ------------------------------------------------------------------------
    GORDON RESEARCH          Next Generation      05/18/2017       $2,000.00
     CONFERENCES              Computer-Aided
                              Medicine Design:
                              Going Beyond
                              Traditional
                              Targets,
                              Pathways,
                              Modalities,
                              Agents and
                              Techniques
    ------------------------------------------------------------------------
    REGENTS OF THE           13th Annual          05/19/2017       $5,000.00
     UNIVERSITY OF            Biomarkers in
     CALIFORNIA               Heart Failure and
                              Acute Coronary
                              Syndromes:
                              Diagnosis,
                              Treatment and
                              Devices Symposium
    ------------------------------------------------------------------------
    LUNGEVITY FOUNDATION     LUNGevity            05/22/2017      $40,000.00
                              Foundation
                              Science and
                              Clinical Research
                              Roundtable
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Breast Cancer: New   05/22/2017      $20,000.00
     OF HARVARD COLLEGE       Horizons, Current
                              Controversies
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2017-2018 Monthly    05/25/2017      $50,000.00
     CANCER NETWORK           Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    AMERICAN LUNG            LungForce Expo       05/28/2017       $1,000.00
     ASSOCIATION IN
     MISSOURI
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Cardiovascular       06/03/2017     $150,000.00
     CARDIOLOGY FOUNDATION    Risk in Diabetes
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASTRO 2017 59th      06/04/2017      $25,000.00
     RADIATION ONCOLOGY       Annual Meeting
    ------------------------------------------------------------------------
    THE GOG FOUNDATION,      8th Semi Annual      06/04/2017      $20,000.00
     INC.                     Meeting of NRG
                              Oncology
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAFP FMX 60-minute   06/04/2017      $33,000.00
     FAMILY PHYSICIANS        Interactive
                              Lecture and 60-
                              Minute Problem-
                              Based Learning
                              Workshop titled
                              Acute Coronary
                              Syndromes
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  6th Annual Chicago   06/04/2017      $10,000.00
                              Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    MERCY HOSPITAL           Catholic Health      06/04/2017       $5,000.00
     FOUNDATION               8th Annual
                              Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Lung Cancer          06/06/2017      $50,000.00
     CHEST PHYSICIANS         Learning Track
    ------------------------------------------------------------------------
    SOCIETY FOR              2017 Primer on       06/06/2017      $50,000.00
     IMMUNOTHERAPY OF         Tumor Immunology
     CANCER                   and Cancer
                              Immunotherapy
    ------------------------------------------------------------------------
    SOCIETY FOR              2017 Workshop on     06/07/2017     $150,000.00
     IMMUNOTHERAPY OF         Single Cell
     CANCER                   Techniques in
                              Immunology and
                              Cancer
                              Immunotherapy
    ------------------------------------------------------------------------
    SOCIETY FOR              2018 SITC-           06/07/2017     $120,000.00
     IMMUNOTHERAPY OF         AstraZeneca
     CANCER                   Postdoctoral
                              Cancer
                              Immunotherapy in
                              Combination
                              Therapies
                              Clinical
                              Fellowship Award
    ------------------------------------------------------------------------
    TRANSLATIONAL RESEARCH   TRIO-US AND UCLA     06/08/2017       $5,000.00
     IN ONCOLOGY-US, INC.     Annual Research
                              Conference
    ------------------------------------------------------------------------
    ACS DIVISION OF          Division of          06/08/2017       $2,000.00
     MEDICINAL CHEMISTRY      Medicinal
                              Chemistry Program
                              254th ACS
                              National Meeting
    ------------------------------------------------------------------------
    SAINT FRANCIS HOSPITAL   53rd Annual Robert   06/11/2017       $3,000.00
     AND MEDICAL CENTER       M. Jeresaty,
                              M.D.,
                              Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    NYU POST-GRADUATE        Women and Cancer:    06/12/2017       $5,000.00
     MEDICAL SCHOOL           From Screening to
                              Survivorship
    ------------------------------------------------------------------------
    PREVENTIVE               Antiplatelet         06/12/2017      $10,000.00
     CARDIOVASCULAR NURSES    Therapy Post-ACS:
     ASSOCIATION              Choosing the
                              Right Therapy for
                              the Right
                              Duration
    ------------------------------------------------------------------------
    PERSONALIZED MEDICINE    Turning the Tide     06/13/2017      $10,000.00
     COALITION                Against Cancer
                              Through Sustained
                              Medical
                              Innovation 2017
                              National
                              Conference
    ------------------------------------------------------------------------
    MEDICAL LEARNING         The Present and      06/13/2017     $177,230.00
     INSTITUTE                the Future of
                              Cancer
                              Immunotherapy
                              Biomarkers:
                              Assessing
                              Challenges,
                              Opportunities,
                              and Implications
                              for athologists
                              (150204581)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACEP17               06/13/2017      $15,000.00
     EMERGENCY PHYSICIANS     Cardiovascular
                              Track
    ------------------------------------------------------------------------
    BINAYTARA FOUNDATION     5th International    06/14/2017       $5,000.00
                              Conference on
                              Advances in
                              Hematology and
                              Oncology (ICAHO
                              2017)
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  19th Annual Lynn     06/14/2017      $15,000.00
                              Sage Breast
                              Cancer Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Special         06/14/2017      $35,000.00
     FOR CANCER RESEARCH      Conference on
                              Tumor Immunology
                              and Immunotherapy
    ------------------------------------------------------------------------
    COPD FOUNDATION INC.     COPD10USA            06/14/2017       $6,800.00
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          Duke Heart Center    06/15/2017       $5,000.00
                              General
                              Cardiology
                              Update--A Case-
                              Based Review
    ------------------------------------------------------------------------
    AMERICAN HEART           2017 TN M:L STEMI    06/19/2017      $10,000.00
     ASSOCIATION              Conference
    ------------------------------------------------------------------------
    THE TRANSVERSE MYELITIS  2017 Rare Neuro-     06/19/2017       $5,000.00
     ASSOCIATION              immune Disorders
                              Symposium
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC--Lung Cancer   06/19/2017   $1,605,600.00
     ASSOCIATION FOR THE      Education
     STUDY OF LUNG CANCER
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Acute Coronary       06/20/2017     $125,000.00
     INSTITUTE INC.           Syndrome: Getting
                              to the Heart of
                              the Matter for
                              Pharmacists
    ------------------------------------------------------------------------
    USF HEALTH PROFESSIONS   inPractice           06/21/2017      $30,000.00
     CONFERENCING             Oncology 2017-
     CORPORATION              2018: Breast and
                              Gynecologic
                              Cancers Tracks
    ------------------------------------------------------------------------
    USF HEALTH PROFESSIONS   inPractice           06/21/2017      $20,000.00
     CONFERENCING             Oncology 2017
     CORPORATION              2018: Lung Cancer
                              Track
    ------------------------------------------------------------------------
    GLOBAL EDUCATION GROUP,  The Role of          06/22/2017      $10,000.00
     LTD.                     Antiplatelet
                              Therapy in the
                              Short- and Long-
                              term Management
                              of Highrisk
                              Patients with ACS
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   FASEB Autoimmunity-  06/22/2017       $5,000.00
     SOCIETIES FOR             Additional
     EXPERIMENTAL BIOLOGY     Funding for Grant
                              #73697
    ------------------------------------------------------------------------
    THE LEUKEMIA AND         Precision and        06/27/2017      $25,000.00
     LYMPHOMA SOCIETY, INC.   emerging Medicine
                              for Hematological
                              Diseases
    ------------------------------------------------------------------------
    ASSOCIATION OF ASTHMA    Unraveling Current   06/27/2017      $10,000.00
     EDUCATORS                Asthma Challenges
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2017 Oncology   06/27/2017      $40,000.00
     CANCER NETWORK           Case Manager and
                              Medical Director
                              Program
    ------------------------------------------------------------------------
    COPD FOUNDATION          PRAXIS and the       06/27/2017     $120,000.00
                              COPD Readmissions
                              Institute
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          New Paradigms in     06/28/2017     $158,250.00
     FOUNDATION, INC.         the Treatment of
                              Hyperkalemia
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      9th Allergy,         06/28/2017       $5,000.00
     PHYSICIAN ASSISTANTS     Asthma and ENT
     IN ALLERGY, ASTHMA AND   CME
     IMMUNOLOGY
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2017 Congress   06/29/2017      $25,000.00
     CANCER NETWORK           Series :
                              Biomarkers 101 (4
                              Live Webinars and
                              4 Enduring
                              Webinars)
    ------------------------------------------------------------------------
    ASSOCIATION OF           Association of       06/29/2017      $10,000.00
     PHYSICIAN ASSISTANTS     Physician
     IN ONCOLOGY INC.         Assistants in
                              Oncology 20th
                              Annual Conference
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      TSAAI 2017 Annual    07/02/2017       $3,000.00
     ALLERGY, ASTHMA AND      Meeting
     IMMUNOLOGY
    ------------------------------------------------------------------------
    FLORIDA ACADEMY OF       Rashes, joints and   07/02/2017       $3,000.00
     PHYSICIAN ASSISTANTS     ANA: 2017 Lupus
                              update
    ------------------------------------------------------------------------
    WEILL CORNELL MEDICINE   Emerging             08/01/2017      $20,000.00
                              Immunological
                              Themes in
                              Oncology,
                              Metabolism and
                              Inflammation
    ------------------------------------------------------------------------
    THE DIATRIBE FOUNDATION  Glycemic Outcomes    08/01/2017      $25,000.00
                              Beyond A1c
                              Consensus
                              Conference
    ------------------------------------------------------------------------
    THE BOARD OF REGENTS OF  PARP Inhibitors:     08/02/2017      $90,000.00
     THE UNIVERSITY OF        Their Role in the
     NEBRASKA MEDICAL         Treatment of
     CENTER DBA UNMC CENTER   Ovarian Cancer
     FOR CONTINUING EDU
    ------------------------------------------------------------------------
    LUNGEVITY FOUNDATION     HCP Attitudes        08/03/2017      $91,800.00
                              toward Re-biopsy
                              of Lung Cancer
                              Patients Project
    ------------------------------------------------------------------------
    HEART FAILURE SOCIETY    Clinical Care        08/03/2017     $150,000.00
     OF AMERICA INC.          Crossroads:
                              Navigating the
                              Intersection of
                              Heart Failure and
                              Diabetes
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      35th Annual Aspen    08/03/2017      $10,000.00
     ALLERGY ASTHMA AND       Allergy
     IMMUNOLOGY               Conference
    ------------------------------------------------------------------------
    BIOCONDUCTOR FOUNDATION  Bioconductor         08/03/2017       $2,000.00
     OF NA INC.               Conference 2017
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Orienteering on      08/09/2017     $795,250.00
     INSTITUTE, INC.          the Complex
                              Treatment
                              Landscape for
                              EGFR-Mutant
                              NSCLC: Latest
                              Evidence to Guide
                              Clinical
                              Decisions in
                              Everyday
                              Community
                              Practice
    ------------------------------------------------------------------------
    THE ANGIOGENESIS         xME: Targeted        08/10/2017      $15,000.00
     FOUNDATION               Therapy,
                              Immunotherapy,
                              and the Chronic
                              Lymphocytic
                              Leukemia
                              Microenvironment
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 12th Annual     08/21/2017      $75,000.00
     CANCER NETWORK, INC.     Congress:
                              Hematologic
                              MalignanciesT
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     08/21/2017     $253,000.00
     FOR CANCER RESEARCH      Fellowships in
                              Hematology-
                              Oncology Research
                              (Lymphoma)
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Master      08/21/2017     $340,120.00
     INSTITUTE, INC.          Class and
                              Practicum Live at
                              IASLC 2017 CMSTO:
                              New Options and
                              Evolving
                              Strategies for
                              Hitting the
                              Target in EGFR-
                              Mutant NSCLC
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASH Meeting on       08/22/2017      $60,000.00
     HEMATOLOGY               Hematologic
                              Malignancies
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Addressing Unmet     08/22/2017     $270,630.00
     INSTITUTE, INC.          Needs in Lung
                              Cancer With
                              Rational
                              Immunotherapy-
                              Based Approaches:
                              Evidence and
                              Practicalities
                              (150204646)
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Integrating          08/22/2017     $304,174.00
     INSTITUTE, INC.          Immunotherapy
                              into a Multimodal
                              Treatment
                              Approach
                              (150204726)
    ------------------------------------------------------------------------
    ENDOCRINE FELLOWS        Fourth Annual        08/23/2017     $250,000.00
     FOUNDATION               Endocrine Fellows
                              Research Forum
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      59th ASH Annual      08/24/2017     $250,000.00
     HEMATOLOGY               Meeting
    ------------------------------------------------------------------------
    MAYO CLINIC ARIZONA      Acute and Chronic    08/31/2017       $5,000.00
                              Leukemias 2017
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      Innovations in the   08/31/2017       $1,500.00
     DEPARTMENT OF SURGERY    Management of
                              Lung Cancer:
                              Immunotherapy,
                              targeted
                              therapies and
                              minimally
                              invasive
                              techniques
    ------------------------------------------------------------------------
    ANNEBERG CENTER FOR      JADPRO Live at       08/31/2017      $25,000.00
     HEALTH SCIENCES AT       APSHO 2017:
     EISENHOWER               Managing Side
                              Effects of Cancer
                              Patients Treated
                              With
                              Immunotherapy
    ------------------------------------------------------------------------
    UNIVERSITY OF MARYLAND,  UPDATE: Thoracic     08/31/2017       $5,000.00
     SCHOOL OF MEDICINE       Oncology 2017
    ------------------------------------------------------------------------
    BAYLOR COLLEGE OF        Breast Cancer        09/03/2017       $3,000.00
     MEDICINE. BREAST         Research and
     CENTER                   Education Program
    ------------------------------------------------------------------------
    SOCIETY FOR              Grant Writing        09/03/2017      $10,000.00
     IMMUNOTHERAPY OF         Workshop
     CANCER
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      2017 Gigi Shaw       09/07/2017       $3,500.00
     COLLEGE OF PHYSICIANS    Arledge
     AND SURGEONS, DEPT. OF   Conference on
     SURGERY                  Pancreatic
                              Disease
    ------------------------------------------------------------------------
    LUPUS RESEARCH           Lupus Research       09/11/2017      $25,000.00
     ALLIANCE, INC.           Alliance 2017
                              Annual Scientific
                              Conference--Forum
                              for Discovery
    ------------------------------------------------------------------------
    DANA FARBER CANCER       Dana-Farber Cancer   09/13/2017       $2,500.00
     INSTITUTE                Institute's 13th
                              Annual
                              Postdoctoral and
                              Graduate Student
                              Retreat
    ------------------------------------------------------------------------
    ASSOCIATION OF           The Evolving Role    09/13/2017      $20,000.00
     COMMUNITY CANCER         of the Oncology
     CENTERS                  Pharmacist in the
                              Management of Non-
                              small Cell Lung
                              Cancer
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Pharmacy Updates:    09/14/2017      $50,000.00
     CANCER NETWORK, INC.     A Webinar Series
    ------------------------------------------------------------------------
    CINCINNATI CHILDREN'S    4th CURED EGID       09/18/2017       $5,000.00
                              Research
                              Conference and
                              Patient Education
                              Program
    ------------------------------------------------------------------------
    JOHNS HOPKINS            OncologyConsults.c   09/19/2017      $10,000.00
     UNIVERSITY               om Integrating
                              Immunotherapy
                              into SCCHN Care:
                              Implications for
                              the
                              Multidisciplinary
                              Oncology Care
                              Team
    ------------------------------------------------------------------------
    PROSTATE CANCER          24th Annual          09/19/2017      $20,000.00
     FOUNDATION               Scientific
                              Retreat
    ------------------------------------------------------------------------
    AMERICAN PANCREATIC      48th Annual          09/19/2017      $25,000.00
     ASSOCIATION, INC.        Meeting of the
                              American
                              Pancreatic
                              Association
    ------------------------------------------------------------------------
    MAYO CLINIC ARIZONA      Mayo Clinic Cancer   09/20/2017       $5,000.00
                              Center Thoracic
                              Oncology Update
                              State of the Art
                              Evaluation and
                              Management of
                              Thoracic Cancers
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Behind the           09/24/2017      $25,000.00
     CANCER NETWORK           Guidelines:
     FOUNDATION (NCCN)        Insights into the
                              Standard of Care
                              in Oncology 2018
    ------------------------------------------------------------------------
    FOUNDATION FOR HEART     21st Annual Heart    09/25/2017      $10,000.00
     FAILURE INC.             Failure 2017-An
                              Update on Therapy
    ------------------------------------------------------------------------
    UNIVERSITY OF COLORADO/  Sex Differences      10/02/2017      $30,000.00
     CENTER FOR WOMEN'S       across the
     HEALTH RESEARCH          Lifespan: A Focus
                              on Metabolism
    ------------------------------------------------------------------------
    LYMPHOMA RESEARCH        Adherence and Oral   10/02/2017      $20,000.00
     FOUNDATION               Therapies in
                              Lymphoma and CLL
                              Workshop
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        ECOG-ACRIN 2017      10/02/2017      $15,000.00
     EDUCATION FOUNDATION,    Fall Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    SOCIETY FOR              SCAI 2017            10/02/2017      $35,000.00
     CARDIOVASCULAR           Interventional
     ANGIOGRAPHY AND          Cardiology
     INTERVENTIONS            Fellows Course
     FOUNDATION
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  Emerging Therapies   10/04/2017       $5,000.00
     MD ANDERSON CANCER       in Oncology From
     CENTER                   Phase I and
                              Beyond
    ------------------------------------------------------------------------
    INTERNATIONAL            Best of 18th World   10/05/2017      $20,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
                              (WCLC)
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      Assessing the        10/09/2017      $75,000.00
     ASSOCIATION              Educational Needs
                              of Urologic Care
                              Team in the area
                              of Bladder Cancer
                              and Immunotherapy
    ------------------------------------------------------------------------
    COLORADO ALLERGY AND     CAAS October 2017    10/09/2017       $3,343.10
     ASTHMA SOCIETY           ``State of the
                              Art Approaches to
                              Asthma Diagnosis
                              and Treatment''
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Top Ten Advances     10/12/2017       $5,000.00
     MEDICINE AT MOUNT        in Clinical
     SINAI                    Cardiology
    ------------------------------------------------------------------------
    THE MASSACHUSETTS        Boston               10/12/2017       $4,000.00
     GENERAL HOSPITAL         Angiogenesis
                              Meeting
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Anemia in Kidney     10/16/2017     $155,550.00
     NEPHROLOGY               Diseases: Beyond
                              the Usual
                              Suspects
    ------------------------------------------------------------------------
    REGENTS OF THE           Updates in           10/16/2017       $5,000.00
     UNIVERSITY OF            Rheumatology
     CALIFORNIA, UCSD         2017: Highlights
     OFFICE OF CME            from the ACR and
                              EULAR Meetings
    ------------------------------------------------------------------------
    FLORIDA ACADEMY OF       Acute Coronary       10/16/2017       $7,500.00
     PHYSICIAN ASSISTANTS     Syndrome
    ------------------------------------------------------------------------
    NEBRASKA ACADEMY OF      Acute Coronary       10/16/2017       $7,500.00
     PHYSICIAN ASSISTANTS     Syndrome: A
                              Review of
                              Diagnostic
                              Criteria, and
                              Treatment Options
    ------------------------------------------------------------------------
    PEPTIDE THERAPEUTICS     12th Annual          10/18/2017      $15,000.00
     FOUNDATION               Peptide
                              Therapeutics
                              Symposium
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     Cancer               10/18/2017      $15,000.00
     MOLECULAR AND CELLULAR   Immunotherapy:
     BIOLOGY                  Combinations
    ------------------------------------------------------------------------
    THE PENNSYLVANIA STATE   Beyond the           10/24/2017      $30,000.00
     UNIVERSITY               Guidelines:
                              Investigator
                              Perspectives on
                              Current Clinical
                              Issues and
                              Ongoing Research
                              in the Management
                              of Advanced
                              Prostate Cancer--
                              An ISS Held as a
                              Premium Ancillary
                              Educational Event
                              During the 2018
                              Genitourinary
                              Cancers Symposium
    ------------------------------------------------------------------------
    TRUSTEES OF TUFTS        2017 Tufts Cancer    10/26/2017       $2,500.00
     COLLEGE                  Symposium,
                              Transforming
                              Therapeutic
                              Outcomes:
                              Innovations in
                              Cancer Modeling
    ------------------------------------------------------------------------
    MEDSTAR GEORGETOWN       Lung Cancer 2017:    10/26/2017       $7,500.00
     MEDICAL CENTER INC.      Progress and
                              Future Directions
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      American College     10/29/2017       $5,000.00
     TOXICOLOGY               of Toxicology
                              38th Annual
                              Meeting,
                              Symposium 6:
                              Early Career
                              Professionals'
                              Forum: Current
                              Topics in
                              Toxicology
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC's connectED     11/01/2017     $500,000.00
     IMMUNOTHERAPY OF
     CANCER
    ------------------------------------------------------------------------
    THE BOARD OF TRUSTREES   Stanford Review of   11/06/2017       $5,000.00
     OF THE LELAND STANFORD   the 59th Annual
     JUNIOR UNIVERSITY        American Society
                              of Hematology
                              Meeting 2018
    ------------------------------------------------------------------------
    UNIVERSITY OF            Rheumatology         11/07/2017      $15,000.00
     CINCINNATI               Winter Clinical
                              Symposium 2018
                              (RWCS 2018)
    ------------------------------------------------------------------------
    UT HEALTH SAN ANTONIO    40TH Annual San      11/07/2017      $75,000.00
     (UTHSCSA)                Antonio Breast
                              Cancer Symposium
    ------------------------------------------------------------------------
    THE GOG FOUNDATION INC.  9th Semi Annual      11/08/2017      $20,000.00
                              Meeting of NRG
                              Oncology
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN AACR ASCO       11/08/2017     $710,115.00
     CANCER NETWORK, INC.     Stage III NSCLC
                              Practical
                              Application of
                              Immune Checkpoint
                              Inhibition After
                              Chemoradiotherapy
    ------------------------------------------------------------------------
    CANCER RESEARCH          CRI Irvington        11/08/2017      $50,000.00
     INSTITUTE                Postdoctoral
                              Fellowship
                              Program
    ------------------------------------------------------------------------
    MID-ATLANTIC SECTION OF  2017 Society for     11/09/2017      $10,000.00
     THE AMERICAN             Basic Urologic
     UROLOGICAL ASSOCIATION   Research (SBUR)
                              and European
                              Society for
                              Urological
                              Research (ESUR)
                              joint Fall
                              Symposium
    ------------------------------------------------------------------------
    WEST PENN ALLEGHENY      Twelfth Annual       11/09/2017       $8,000.00
     HEALTH SYSTEM DBA        Nemacolin
     ALLEGHENY GENERAL        International
     HOSPITAL                 Asthma Conference
                              An Interactive
                              Forum on Patient
                              Care, Therapy,
                              and Research
    ------------------------------------------------------------------------
    UNIVERSITY OF            Request for 2017     11/14/2017       $5,000.00
     CALIFORNIA BERKELEY      Funding for the
     FOUNDATION               Forum for
                              Collaborative
                              Research's
                              Program on HBV
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     2018                 11/14/2017      $35,000.00
     RADIATION ONCOLOGY       Multidisciplinary
     (ASTRO)                  Head and Neck
                              Cancer Symposium:
                              Expanding
                              Treatment
                              Horizons
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Hematology 2017:     11/15/2017      $75,000.00
     HEMATOLOGY               the ASH Education
                              Program
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  Leukemia Research    11/15/2017       $5,000.00
     MD ANDERSON CANCER       Meeting
     CENTER
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      2018 Highlights of   11/15/2017     $100,000.00
     HEMATOLOGY               ASHr in North
                              America
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 Conquer         11/16/2017      $40,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Merit
     CLINICAL ONCOLOGY        Awards
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO-SITC       11/21/2017      $60,000.00
     FOUNDATION OF THE        Clinical Immuno-
     AMERICAN SOCIETY OF      Oncology
     CLINICAL ONCOLOGY        Symposium
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      New York             11/21/2017       $5,000.00
     CARDIOLOGY FOUNDATION    Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Scientific           11/22/2017     $160,000.00
     FOUNDATION INC.          Workshop on
                              Change in
                              Albuminuria and
                              GFR as End Points
                              for Clinical
                              Trials in Early
                              Stages of Chronic
                              Kidney Disease
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView             11/27/2017      $50,000.00
     INSTITUTE, INC.          MasterClass--Prac
                              ticum Live at
                              ASCO GI The Quest
                              to Win Through
                              Science in
                              Pancreatic Cancer
                              From Sequencing
                              Current Options
                              to Testing Novel
                              Approaches
    ------------------------------------------------------------------------
    THE GUTHY JACKSON        ECTRIMS 2017 NMO     11/29/2017       $6,000.00
     CHARITABLE FOUNDATION    Symposium
    ------------------------------------------------------------------------
    AALAS FOUNDATION         Student and          11/30/2017       $5,000.00
                              Teacher Public
                              Educational
                              Outreach
    ------------------------------------------------------------------------
    GORDON RESEARCH          Biology of Acute     12/01/2017       $5,000.00
     CONFERENCE               Respiratory
                              Infection Gordon
                              Research
                              Conference
    ------------------------------------------------------------------------
    LEUKEMIA RESEARCH        Hollis Brownstein    12/03/2017     $100,000.00
     FOUNDATION               Research Grants
                              Program
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2017 ACR/ARHP        12/03/2017      $75,000.00
     RHEUMATOLOGY             Annual Meeting
                              Lupus Educational
                              Track
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   40th Annual          12/04/2017      $20,000.00
                              National Jewish
                              Health Pulmonary
                              and Allergy
                              Update
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     2018 Keystone        12/04/2017      $25,000.00
     MOLECULAR AND CELLULAR   Symposia
     BIOLOGY                  Directors' Fund
    ------------------------------------------------------------------------
    AMERICAN DIABETES        Diabetes is          12/04/2017      $40,568.50
     ASSOCIATION              Primary Digital
                              Program on
                              Cardiovascular
                              Risk
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2017 ACLAM Grants    12/04/2017       $4,000.00
     LABORATORY ANIMAL
     MEDICINE
    ------------------------------------------------------------------------
    SOUTHERN MEDICAL         Medical Dilemmas     12/05/2017       $2,500.00
     ASSOCIATION              in Patient Care
                              Conference
    ------------------------------------------------------------------------
    THE NORTH AMERICAN 3RS   Virtual Education    12/06/2017       $8,000.00
     COLLABORATIVE            Community Support
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 Conquer         12/10/2017     $500,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Mission
     CLINICAL ONCOLOGY        Endowment
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 Genitourinary   12/10/2017      $60,000.00
     FOUNDATION OF THE        (GU) Cancers
     AMERICAN SOCIETY OF      Symposium:
     CLINICAL ONCOLOGY        Translating
                              Evidence to
                              Multidisciplinary
                              Care
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 Conquer         12/10/2017     $256,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Young
     CLINICAL ONCOLOGY        Investigator
                              Award (YIA)
    ------------------------------------------------------------------------
    REGENTS OF THE           15th Annual          12/10/2017      $40,000.00
     UNIVERSITY OF            Nephrology Young
     CALIFORNIA               Investigators
                              Forum
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Mid Atlantic         12/10/2017      $50,000.00
     UNIVERSITY SCHOOL OF     Nephrology Young
     MEDICINE                 Investigators
                              Forum
    ------------------------------------------------------------------------
    ILLINOIS ACADEMY OF      The 12th Annual      12/11/2017      $54,771.32
     FAMILY PHYSICIANS        Chief Residents
                              Summit on
                              Intensifying
                              Diabetes
                              Management
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2018 ACR             12/11/2017      $50,000.00
     RHEUMATOLOGY             Rheumatology
                              Courses
    ------------------------------------------------------------------------
    JOHNS HOPKINS            FastForward          12/12/2017      $25,000.00
     UNIVERSITY               Corporate
                              Sponsorship
    ------------------------------------------------------------------------
    THE DEUEL CONFERENCE ON  The 2018 Deuel       12/13/2017       $5,000.00
     LIPIDS                   Conference on
                              Lipids
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   FASEB SRC            12/13/2017       $5,000.00
     SOCIETIES FOR            Immunoreceptors
     EXPERIMENTAL BIOLOGY     and Immunotrerapy
     (FASEB)
    ------------------------------------------------------------------------
    UNIVERSITY OF            Request for 2018     12/13/2017      $10,000.00
     CALIFORNIA BERKELEY      Funding for the
     FOUNDATION               Forum for
                              Collaborative
                              Research's
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Conference    12/14/2017       $5,000.00
     CONFERENCE               on Drug
                              Resistance 2018
    ------------------------------------------------------------------------
    ASSOCIATION FOR WOMEN    Innovation and       12/17/2017      $25,000.00
     IN SCIENCE               Inclusion: Women
                              at the Forefront
                              of STEM
    ------------------------------------------------------------------------
    VIRGINIA BIOTECHNOLOGY   MedImmune            12/17/2017      $25,000.00
     ASSOCIATION              Chairman's Circle
                              Membership
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   The Lung             12/20/2017       $5,000.00
     SOCIETIES FOR            Epithelium in
     EXPERIMENTAL BIOLOGY     Health and
     SRC                      Disease
    ------------------------------------------------------------------------
    ENGINEERING CONFERENCES  Cell Culture         12/21/2017      $10,000.00
     INTERNATIONAL            Engineering XVI
                              Conference
    ------------------------------------------------------------------------
    PENNYSLVANIA SOCIETY     2018 PSBR            12/24/2017       $2,000.00
     FOR BIOMEDICAL           Membership
     RESEARCH
    ------------------------------------------------------------------------
    NATIONAL ACADEMY OF      Roundtable in        12/24/2017       $4,000.00
     SCIENCES                 Science and
                              Welfare of
                              Laboratory Animal
                              Use
    ------------------------------------------------------------------------
    CONQUER CANCER           2018                 01/02/2018      $30,000.00
     FOUNDATION OF THE        Gastrointestinal
     AMERICAN SOCIETY OF      (GI) Cancers
     CLINICAL ONCOLOGY        Symposium:
                              Multidisciplinary
                              Care: Local
                              Practice, Global
                              Outcomes
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-IASLC Joint     01/02/2018      $25,000.00
     FOR CANCER RESEARCH      Conference on the
                              Molecular Origins
                              of Lung Cancer
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   14th Annual          01/02/2018     $299,608.49
                              Respiratory
                              Disease Young
                              Investigators'
                              Forum
    ------------------------------------------------------------------------
    THE CHEST FOUNDATION     CHEST Foundation     01/02/2018      $55,000.00
                              Research Award in
                              COPD
    ------------------------------------------------------------------------
    INTERNATIONAL            Implementation of    01/04/2018     $300,000.00
     ASSOCIATION FOR THE      diagnostic and
     STUDY OF LUNG CANCER     molecular
                              guidelines in low-
                              middle income
                              regions for
                              targeted
                              therapies in
                              NSCLC
    ------------------------------------------------------------------------
    UNIVERSITY OF NORTH      9th International    01/09/2018       $2,500.00
     CAROLINA AT CHAPEL       Symposia for the
     HILL                     CGRP Family
                              Peptides
                              Conference
    ------------------------------------------------------------------------
    UNIVERSITY OF            The Intersection     01/14/2018      $95,000.00
     CINCINNATI               Between COPD and
                              Cardiometabolic
                              Comorbidities
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          13th Annual          01/14/2018      $50,000.00
     FOUNDATION INC.          National Young
                              Investigator
                              Forum
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      WSAAI 2018: 56th     01/17/2018      $15,000.00
     ALLERGY, ASTHMA AND      Annual Scientific
     IMMUNOLOGY (ACAAI)       Session
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-SNMMI Joint     01/18/2018      $10,000.00
     FOR CANCER RESEARCH      Conference on
                              State-of-the-Art
                              Molecular Imaging
                              in Cancer Biology
                              and Therapy
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  2018 Oncologic       01/23/2018      $10,000.00
     MD ANDERSON CANCER       Emergency
     CENTER                   Medicine
                              Conference
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Exploring the        01/25/2018      $35,000.00
     MANAGED CARE             Challenges of
     PHYSICIANS               Severe Asthma:
                              Understanding
                              Appropriate
                              Treatment
                              Strategies for
                              Improved Patient
                              Outcomes
    ------------------------------------------------------------------------
    CANCER RESEARCH          Cancer               02/05/2018      $10,000.00
     INSTITUTE                Immunotherapy
                              Consortium
                              Workshop
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Advancing            02/11/2018     $200,000.00
     HEALTH SCIENCES AT       Knowledge to
     EISENHOWER               Practice
                              Optimizing Severe
                              Asthma Care in
                              the Age of
                              Biologics
    ------------------------------------------------------------------------
    PENNSYLVANIA STATE       PeerView Live at     02/12/2018     $104,507.00
     UNIVERSITY               the 2018 ASCO
                              Annual Meeting,
                              The Arrival of
                              Novel Agent
                              Classes in B-Cell
                              Non-Hodgkin
                              Lymphoma: A
                              Personal Guide to
                              Integrating New
                              Therapy into
                              Patient Care
                              (150204877)
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Clinical Advances    02/13/2018      $75,000.00
     HEALTH SCIENCES          and Case Studies
                              in Immune
                              Checkpoint
                              Inhibitors in
                              Oncology
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2018 Oncology   02/14/2018      $35,000.00
     CANCER NETWORK, INC.     Fellows Program:
                              New Horizons in
                              Quality Cancer
                              CareT at the NCCN
                              23rd Annual
                              Conference
    ------------------------------------------------------------------------
    INDY HEMATOLOGY          2018 Indy            02/14/2018      $10,000.00
     EDUCATION, INC.          Hematology Review
    ------------------------------------------------------------------------
    JOHNS HOPKINS            14th International   02/14/2018      $20,000.00
     UNIVERSITY               Symposium on
                              Sjogrens Syndrome
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           Scripps 38th         02/14/2018      $25,000.00
                              Annual Clinical
                              Hematology and
                              Oncology
                              Conference
    ------------------------------------------------------------------------
    THE CHEST FOUNDATION     CHEST Foundation     02/14/2018      $35,000.00
                              Research Award in
                              Severe Asthma
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Clinical             02/14/2018     $100,000.00
     HEALTH SCIENCES          Management of
                              Novel Therapies
                              for Hematological
                              Malignancies (5
                              Regional lectures
                              by APSHO/JADPRO)
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView inVision,   02/14/2018      $64,125.00
     INSTITUTE, INC.          ``Targeted
                              Treatment in
                              Severe Asthma:
                              Moving Toward
                              Precision
                              Medicine''
    ------------------------------------------------------------------------
    COLLEGIUM                32nd Symposium of    02/14/2018      $10,000.00
     INTERNATIONALE           the Collegium
     ALLERGOLOGICUM           Internationale
                              Allergologicum
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     Immuno-Oncology:     02/14/2018      $60,490.00
     CLINICAL PATHOLOGY       Scientific
                              Updates
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   COPD Basics: An      02/14/2018     $100,000.00
                              Integrated
                              Approach to Best
                              Practices in Five
                              Healthcare
                              Networks
    ------------------------------------------------------------------------
    MAYO CLINIC ARIZONA      Clinical             02/14/2018      $15,000.00
                              Multidisciplinary
                              Hematology and
                              Oncology: The
                              15th Annual
                              Review
    ------------------------------------------------------------------------
    INTERNATIONAL            18th Targeted        02/14/2018      $55,100.00
     ASSOCIATION FOR THE      Therapy meeting
     STUDY OF LUNG CACEER
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Master      02/14/2018     $299,330.00
     INSTITUTE, INC.          Class and
                              Practicum Live at
                              CHEST 2018, ``New
                              Avenues in Asthma
                              Management:
                              Finding the Right
                              Patients for
                              Targeted
                              Therapies''
                              (150205033)
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Chronic              02/15/2018     $232,979.00
     FOUNDATION INC.          Hyperkalemia
                              Management and
                              Outcomes in CKD
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  Alzheimer's          02/15/2018      $45,000.00
                              Association
                              International
                              Conference, AAIC
                              2018
    ------------------------------------------------------------------------
    ASTHMA AND ALLERGY       Wheezin', Sneezin'   02/16/2018      $10,000.00
     FOUNDATION OF AMERICA--  and Itchin' in
     ALASKA CHAPTER           Alaska
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  New Agents and       02/18/2018      $35,000.00
     MANAGED CARE             Emerging
     PHYSICIANS               Strategies in
                              Advanced Breast
                              Cancer: Patient-
                              Centric
                              Navigation in the
                              Age of
                              Personalized Care
    ------------------------------------------------------------------------
    THE PENNSYLVANIA STATE   PeerView inPlay,     02/18/2018     $145,730.00
     UNIVERSITY               ``The Role of the
                              Eosinophil in
                              COPD:
                              Implications for
                              Personalized Care
                              and Novel
                              Treatments''
                              (150205058)
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          3rd Annual Duke      02/19/2018       $2,500.00
                              Heart Center/DCRI
                              Fellows'
                              Presentation
                              Skills Course
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Novel Treatment      02/19/2018      $35,000.00
     MANAGED CARE             Strategies in the
     PHYSICIANS, INC.         Management of
                              Ovarian Cancer: A
                              Closer Look at
                              the Role of PARP
                              Inhibitors
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2018 Fellows     02/19/2018      $10,000.00
     SOCIETY INC.             Track Symposium
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       Cardiovascular       02/20/2018      $30,000.00
     HOSPITAL CENTER          Research
                              Technologies
                              (CRT) Annual
                              Meeting
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          The Southeastern     02/21/2018       $2,500.00
                              Fellows Research
                              Skills and
                              Training Workshop
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2018             02/21/2018      $30,000.00
     SOCIETY INC.             International
                              Conference--Selec
                              ted Sessions in
                              COPD
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           15th Annual          02/22/2018      $25,000.00
                              Fundamentals of
                              Diabetes
                              Management
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     FDA-AACR-ASTRO:      02/22/2018      $25,000.00
     FOR CANCER RESEARCH      Clinical
                              Development of
                              Drug-Radiotherapy
                              Combinations
                              Workshop
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     Advances in          02/25/2018      $25,000.00
     FOR CANCER RESEARCH      Malignant
                              Lymphoma (AACR/
                              ICML ``off year''
                              conference in US)
    ------------------------------------------------------------------------
    BLADDER CANCER ADVOCACY  2018 Bladder         02/25/2018      $35,000.00
     NETWORK                  Cancer Think Tank
    ------------------------------------------------------------------------
    GORDON RESEARCH          2018 Gordon          02/27/2018       $5,000.00
     CONFERENCE               Research Council
                              on New Antibiotic
                              Discovery and
                              Development
    ------------------------------------------------------------------------
    RUTGERS, THE STATE       Treat-to-Target      02/28/2018     $124,857.00
     UNIVERSITY OF NEW        and Targeted
     JERSEY                   Therapy: The
                              Evolving State of
                              Systemic Lupus
                              Erythematosus
                              Patient Care
    ------------------------------------------------------------------------
    AMERICAN DIABETES        Diabetes is          03/01/2018     $300,000.00
     ASSOCIATION              Primary Core
                              Programs
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          03/01/2018     $225,000.00
     FOR CANCER RESEARCH      Meeting--2018
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   A Severe Asthma      03/01/2018     $322,170.00
                              Roadmap for
                              Improved
                              Diagnosis and
                              Personalized
                              Treatment--A
                              Guided Workflow
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  California Chapter   03/01/2018      $10,000.00
     CLINICAL                 of the American
     ENDOCRINOLOGITS          Association of
                              Clinical
                              Endocrinologists
                              Presents Hot
                              Topics in
                              Diabetes and
                              Endocrinology for
                              Primary Care 2018
                              Series
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 23rd Annual     03/02/2018     $100,000.00
     CANCER NETWORK, INC.     Conference:
                              Improving the
                              Quality,
                              Effectiveness,
                              and Efficiency of
                              Cancer CareTM
    ------------------------------------------------------------------------
    EASTERN VIRGINIA         Turning the Tide     03/04/2018       $5,000.00
     MEDICAL SCHOOL           on Diabetes 2018
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        15th International   03/05/2018      $25,000.00
     CHICAGO                  Ultmann Chicago
                              Lymphoma
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Innovating           03/05/2018     $300,000.00
     CLINICAL                 Diabetes Care-Use
     ENDOCRINOLOGISTS         of Real-Time Data
                              to Transform
                              Clinical Practice
                              and Optimize
                              Patient Glucose
                              Management
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  24th Annual          03/05/2018      $10,000.00
     FOUNDATION               Interventional
                              Cardiology
                              Fellows Course
    ------------------------------------------------------------------------
    AMERICAN PHARMACISTS     APhA2018 Your        03/05/2018       $5,000.00
     ASSOC                    Annual Diabetes
                              Update
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  DAPT Dilemmas: A     03/05/2018      $20,000.00
     FOUNDATION               Case-Based
                              Roundtable at
                              Fellows 2018
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      Japanese             03/05/2018      $40,000.00
     ASSOCIATION              Urological
                              Association (JUA)
                              Meeting
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN Foundation      03/06/2018     $171,801.00
     CANCER NETWORK, INC.     Young
                              Investigator
                              Awards
    ------------------------------------------------------------------------
    PURDUE UNIVERSITY        Can You Do It        03/06/2018     $377,342.00
     OFFICE OF CONTINUING     Better?--A Unique
     PROFESSIONAL EDUCATION   Approach to
                              Enabling Improved
                              Asthma Management
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC Workshop on    03/06/2018      $25,000.00
     ASSOCIATION FOR THE      Neopadjuvant
     STUDY OF LUNG CANCER     Therapy in Lung
                              Cancer
    ------------------------------------------------------------------------
    UNT HEALTH SCIENCE       Filling the Gaps     03/07/2018       $4,750.00
     CENTER                   in Asthma Care--
                              Lessons Learned
                              from Asthma411
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Updates in           03/07/2018     $155,000.00
     HEALTH SCIENCES AT       Precision
     EISENHOWER               Medicine
                              Elevating the
                              Treatment of
                              Severe,
                              Eosinophilic
                              Asthma
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  27th Annual          03/07/2018      $63,052.00
     CLINICAL                 Scientific and
     ENDOCRINOLOGITS          Clinical
                              Congress--Diabete
                              s Sessions
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Support for NCCN     03/08/2018      $60,000.00
     CANCER NETWORK           Distribution of
                              the NCCN Clinical
                              Practice
                              Guidelines in
                              Oncology (NCCN
                              Guidelinesr) for
                              Management of
                              Immunotherapy-
                              Related
                              Toxicities Pocket
                              Guides
    ------------------------------------------------------------------------
    BOARD OF REGENTS OF THE  2018 Pan Pacific     03/11/2018     $125,000.00
     UNIVERSITY OF NEBRASKA   Lymphoma
                              Conference
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           Fifth Annual         03/11/2018       $5,000.00
                              Clinical Advances
                              in Heart Failure
                              and Arrhythmias
    ------------------------------------------------------------------------
    NORTHEAST GEORGIA        10th Annual          03/12/2018       $2,500.00
     MEDICAL CENTER           Northeast Georgia
                              STEMI Summit
    ------------------------------------------------------------------------
    HEMATOLOGY/ONCOLOGY      HOPA 14th Annual     03/12/2018      $30,000.00
     PHARMACY ASSOCIATION     Conference
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO Annual     03/12/2018      $20,000.00
     FOUNDATION OF THE        Meeting Breast
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO Annual     03/12/2018      $30,000.00
     FOUNDATION OF THE        Meeting
     AMERICAN SOCIETY OF      Genitourinary
     CLINICAL ONCOLOGY        Cancer Tracks
                              Bundle: Prostate
                              and Nonprostate
    ------------------------------------------------------------------------
    THE GUTHY JACKSON        The Guthy-Jackson    03/12/2018      $25,000.00
     CHARITABLE FOUNDATION    Industry Council
    ------------------------------------------------------------------------
    REGENTS OF THE           Making the           03/13/2018     $200,000.00
     UNIVERSITY OF            Connection
     CALIFORNIA               Between Patients
                              and Providers: A
                              Comprehensive
                              Overview of the
                              Modern Treatment
                              Strategies For
                              People With Type
                              1 and Type 2
                              Diabetes
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Cardiovascular       03/13/2018     $232,979.00
     FOUNDATION               Risk in Patients
                              with Chronic
                              Kidney Disease
                              (CKD): The Impact
                              of Anemia
    ------------------------------------------------------------------------
    ACADEMY OF MANAGED CARE  The Immuno-          03/13/2018      $35,000.00
     PHARMACY                 Oncology Pipeline
                              and the Managed
                              Care
                              Considerations
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC                03/13/2018      $25,000.00
     ASSOCIATION FOR THE      Immunotherapy
     STUDY OF LUNG CANCER     Meeting
    ------------------------------------------------------------------------
    ACS DIVISION OF          255th ACS National   03/13/2018       $5,000.00
     BIOCHEMICAL TECHNOLOGY   Meeting and
                              Exposition (BIOT
                              Division)
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     12th Biennial        03/14/2018      $15,000.00
     FOR CANCER RESEARCH      Ovarian Cancer
                              Research
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN HEART           Arteriosclerosis,    03/18/2018       $2,000.00
     ASSOCIATION              Thrombosis and
                              Vascular Biology
                              | Peripheral
                              Vascular Disease
                              2018Scientific
                              Sessions,
                              Vascular
                              Discovery: From
                              Genes to Medicine
    ------------------------------------------------------------------------
    RILITE FOUNDATION        Lupus 21st Century   03/18/2018      $25,000.00
                              2018 Conference
    ------------------------------------------------------------------------
    RHEUMATOLOGIC            4th International    03/19/2018      $10,000.00
     DERMATOLOGY SOCIETY      Conference on
     INC.                     Cutaneous Lupus
                              Erythematosus
    ------------------------------------------------------------------------
    HOWARD UNIVERSITY        13th Annual          03/19/2018       $2,500.00
                              Kenneth Austin
                              Rheumatology
                              Symposium
    ------------------------------------------------------------------------
    SOCIETY OF GYNECOLOGIC   SGO Lunch and        03/20/2018     $125,000.00
     ONCOLOGY                 Learn
                              Contemporary
                              Ovarian Cancer:
                              Keys to Therapies
                              and Integrated
                              Learning
    ------------------------------------------------------------------------
    LYMPHOMA RESEARCH        Mantle Cell          03/20/2018      $20,000.00
     FOUNDATION               Lymphoma
                              Scientific
                              Workshop
    ------------------------------------------------------------------------
    CANCER MOLECULAR         Molecular            03/21/2018       $5,000.00
     THERAPEUTICS RESEARCH    Therapeutics of
     ASSOCIATION              Cancer Research
                              Conference 2018
    ------------------------------------------------------------------------
    PREVENTIVE               PCNA's 24th Annual   03/22/2018      $10,000.00
     CARDIOVASCULAR NURSES    Symposium
     ASSOCIATION
    ------------------------------------------------------------------------
    ASPEN LUNG CONFERENCE    Thomas Petty Aspen   03/22/2018      $25,000.00
                              Lung Conference/
                              Translating
                              Resilience and
                              Pathogenesis to
                              Personalized
                              Therapy for COPD
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Master Class for     03/22/2018      $24,246.27
     HEALTH SCIENCES          Oncologists--Hema
                              tology Track
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Clinical Advances    03/25/2018      $15,000.00
     MANAGED CARE             in the Diagnosis,
     PHYSICIANS, INC.         Treatment and
                              Management of
                              COPD
    ------------------------------------------------------------------------
    FOUNDATION FOR SURGICAL  American Head and    03/25/2018      $15,000.00
     FELLOWSHIPS              Neck Society
                              Annual Meeting--
                              Evaluating Head
                              and Neck Cancer
                              Care Through
                              Evidence Based
                              Medicine
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          Duke Debates:        03/25/2018      $15,000.00
                              Controversies in
                              the Management of
                              Patients with
                              Hematologic
                              Malignancies
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          Mount Sinai          03/29/2018       $7,500.00
     MEDICINE AT MOUNT        Division of
     SINAI                    Occupational
                              Medicine Seminar
                              Series
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      04/01/2018       $2,500.00
     CONFERENCE               Conference:
                              Mutagenesis--Mech
                              anisms of
                              Intrinsic and
                              Induced Genome
                              Instability
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        Frontiers in         04/02/2018      $25,000.00
     CHICAGO                  Precision
                              Medicine for
                              Inherited
                              Cancers: From
                              Risk Assessment
                              to Targeted
                              Therapies
    ------------------------------------------------------------------------
    THE PENNSYLVANIA STATE   PeerView Live:       04/02/2018      $73,575.00
     UNIVERSITY               ``Unraveling the
                              Complex Treatment
                              Landscape for
                              Prostate Cancer:
                              Guidance for
                              Delivering
                              Evidence-Based,
                              Patient-Centered
                              Care''
                              (150204517)
    ------------------------------------------------------------------------
    GORDON RESEARCH          2018 Gordon          04/03/2018       $2,500.00
     CONFERENCES              Research
                              Conference on
                              Medicinal
                              Chemistry
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         2018 Cleveland       04/03/2018       $5,000.00
     EDUCATION FOUNDATION     Breast Cancer
                              Summit:
                              Collaborating for
                              a Cure
    ------------------------------------------------------------------------
    THE PENNSYLVANIA STATE   New Directions in    04/04/2018     $124,611.00
     UNIVERSITY               the Management of
                              Recurrent Ovarian
                              Cancer: Focus on
                              PARP Inhibitors
    ------------------------------------------------------------------------
    ASSOCIATION FOR          Advancing Patient    04/04/2018     $416,900.00
     MOLECULAR PATHOLOGY      Care in NSCLC:
                              Breaking Down
                              Barriers
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         2018 Diabetes Day    04/04/2018       $5,000.00
     EDUCATIONAL FOUNDATION   23rd Annual
                              Symposium New
                              Frontiers in
                              Diabetes
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Master      04/04/2018     $370,100.00
     INSTITUTE, INC.          Class and
                              Practicum Live at
                              ASH 2018:
                              ``Exploring the
                              Present and
                              Future of BTK
                              Inhibition in B-
                              cell
                              malignancies:
                              Expert Insights
                              on Practical
                              Implications for
                              Patient
                              Management''
                              (150205092)
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      AUA2018              04/04/2018     $150,000.00
     ASSOCIATION              Highlights:
                              Immunotherapy in
                              GU Cancer
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Master Class for     04/05/2018      $19,391.02
     HEALTH SCIENCES          Oncologists--Wome
                              n's Cancer Track
    ------------------------------------------------------------------------
    FRIENDS OF CANCER        Friends of Cancer    04/08/2018     $100,000.00
     RESEARCH 2018            Research Programs
    ------------------------------------------------------------------------
    THE HOPE FOUNDATION      2018 SWOG Group      04/08/2018      $10,000.00
                              Meetings
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO Annual     04/09/2018      $45,000.00
     FOUNDATION OF THE        Meeting
     AMERICAN SOCIETY OF      Gynecologic
     CLINICAL ONCOLOGY        Cancer Track
    ------------------------------------------------------------------------
    LAHEY CLINIC HOSPITAL,   Cardiovascular       04/09/2018       $5,000.00
     INC.                     Disease State of
                              the Art 2018
    ------------------------------------------------------------------------
    BOARD OF REGENTS FOR     Dissecting the       04/11/2018      $75,000.00
     UNIVERSITY OF NEBRASKA   Decision:
                              Documenting and
                              Discussing the
                              Clinical Practice
                              Patterns of
                              Hematologic
                              Oncology
                              Investigators in
                              the Management of
                              Chronic
                              Lymphocytic
                              Leukemia--An ISS
                              Held in
                              Conjunction with
                              the 2018 Pan
                              Pacific Lymphoma
                              Conference
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       CVD AND RENAL        04/11/2018     $109,420.00
     UNIVERSITY               DISEASE IN T2DM:
                              Pivotal Role of
                              Physician
                              Assistants in
                              Patient
                              Management
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 Conquer         04/12/2018     $253,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Career
     CLINICAL ONCOLOGY        Development Award
                              (CDA)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      CHEST 2018 Post      04/12/2018      $25,000.00
     CHEST PHYSICIANS         Graduate Program
                              on Difficult to
                              Treat Asthma
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        ECOG-ACRIN 2018      04/12/2018       $5,000.00
     EDUCATION FOUNDATION,    Spring Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    LUPUS FOUNDATION OF NEW  Lupus Medical and    04/15/2018       $5,000.00
     ENGLAND                  Educational
                              Symposim
    ------------------------------------------------------------------------
    HEART FAILURE SOCIETY    Future Leaders in    04/16/2018      $10,000.00
     OF AMERICA INC.          Heart Failure
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF CME  Applying the         04/17/2018     $313,595.00
     INC.                     Latest Evidence
                              to Improve Care
                              for Patients with
                              HR+/HER2-
                              Metastatic Breast
                              Cancer
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Practical            04/17/2018       $5,000.00
     OF HARVARD COLLEGE       Considerations
     ACTING THROUGH THE       and Rationale for
     DEPARTMENT OF GCE        Immunotherapy
                              2018
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  AACE 27th Annual     04/17/2018      $30,000.00
     CLINICAL                 Scientific &
     ENDOCRINOLOGITS          Clinical
                              Congress--Cardiov
                              ascular Track
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      2nd Annual Heart     04/18/2018      $50,000.00
     EDUCATION FOUNDATION     in Diabetes
    ------------------------------------------------------------------------
    SOCIETY FOR              SCAI 2018            04/18/2018      $40,000.00
     CARDIOVASCULAR           Scientific
     ANGIOGRAPHY AND          Sessions
     INTERVENTIONS            featuring
     FOUNDATION               Controversies in
                              Interventional
                              Pharmacology
    ------------------------------------------------------------------------
    AMERICAN HEART           STEMI Protocol       04/18/2018       $3,730.00
     ASSOCIATION              Stakeholder
                              Education
    ------------------------------------------------------------------------
    ALZHEIMER'S ASSOCIATION  2018 Research        04/19/2018      $50,000.00
                              Roundtable
    ------------------------------------------------------------------------
    PURDUE UNIVERSITY        Critical             04/23/2018     $575,210.00
                              Conversations on
                              Bruton's Tyrosine
                              Kinase Inhibitor
                              Development and
                              Use in B-Cell
                              Malignancies (CCO
                              GR Pgm)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Severe Asthma        04/23/2018      $60,000.00
     ALLERGY, ASTHMA AND      Shared Decision
     IMMUNOLOGY               Making Tool
                              Instructional
                              Video
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Symposium--A         04/23/2018      $80,375.00
     ALLERGY, ASTHMA AND      Personalized
     IMMUNOLOGY               Approach to
                              Managing Patients
                              with Uncontrolled
                              Asthma / Shifting
                              Paradigms in
                              Management of
                              Severe Asthma:
                              Pathogenesis,
                              Phenotypes and
                              Personalized
                              Medicine
    ------------------------------------------------------------------------
    MEDSTAR HEALTH, INC.     2018 MedStar         04/24/2018      $15,000.00
                              Health System
                              Prostate Cancer
                              Annual Meeting
    ------------------------------------------------------------------------
    UT HEALTH SAN ANTONIO    3rd Annual Cardio    04/24/2018       $5,000.00
                              Renal Connections
    ------------------------------------------------------------------------
    MEDSTAR HEALTH, INC.     Enhancing Health     04/24/2018      $10,000.00
                              System
                              Initiatives
                              Utilizing
                              Clinical Advances
                              to Optimize the
                              Diagnosis and
                              Treatment of
                              Prostate Cancer
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Best Practices in    04/25/2018      $35,000.00
     MANAGED CARE             the Management of
     PHYSICIANS, INC.         Advanced Non-
                              Small Cell Lung
                              Cancer (NSCLC):
                              Individualizing
                              Therapy for
                              Optimized Patient
                              Outcomes
    ------------------------------------------------------------------------
    TRUSTEES OF BOSTON       CVD AND RENAL        04/25/2018      $49,000.00
     UNIVERSITY               DISEASE IN T2DM:
                              Individualizing
                              Therapeutic
                              Options to Reduce
                              Comorbid Risk
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 Best of ASCO   04/25/2018     $120,000.00
     FOUNDATION OF THE        Meetings
     AMERICAN SOCIETY OF
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    AMERICAN CHEMICAL        Recovery of          04/26/2018      $10,000.00
     SOCIETY, DIVISION OF     Biological
     BIOCHEMICAL              Products XVIII
     TECHNOLOGY, RECOVERY     Conference
     OF BIOLOGICAL PRODUCTS
    ------------------------------------------------------------------------
    AMERICAN RADIUM SOCIETY  American Radium      04/26/2018      $10,000.00
                              Society 100th
                              Annual Meeting
    ------------------------------------------------------------------------
    VANDERBILT UNIVERSITY    Midwest Islet Club   04/26/2018       $2,500.00
                              Meeting
    ------------------------------------------------------------------------
    WEST PENN ALLEGHENY      2018                 04/29/2018       $5,000.00
     HEALTH SYSTEM, INC.      Cardiovascular
     DBA ALLEGHENY GENERAL    Medicine Update
     HOSPITAL                 Conference
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    Diabetes Update      04/30/2018       $5,000.00
     OF HARVARD COLLEGE       2018
     ACTING THROUGH THE
     DEPARTMENT OF GCE
    ------------------------------------------------------------------------
    ASPEN CANCER CONFERENCE  33rd Aspen Cancer    04/30/2018      $10,000.00
                              Conference
    ------------------------------------------------------------------------
    TRUSTEES OF THE          6th Annual           04/30/2018      $20,000.00
     UNIVERSITY OF            Scientific
     PENNSYLVANIA/PERELMAN    Symposium: BRCA1,
     SCHOOL OF MEDICINE AT    BRCA2 and Beyond:
     THE UNIVERSITY OF PA     An Update on
                              Hereditary Cancer
    ------------------------------------------------------------------------
    ASSOCIATION OF AMERICAN  2018 AACI/CCAF       05/01/2018      $15,000.00
     CANCER INSTITUTES        Annual Meeting
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         2018 ONS Annual      05/01/2018      $50,000.00
     SOCIETY                  Congress and two
                              Regional
                              Conferences
    ------------------------------------------------------------------------
    TRUSTEES OF THE          2018 New Advances    05/03/2018      $10,000.00
     UNIVERSITY OF            in Lung Cancer:
     PENNSYLVANIA/PERELMAN    Stretching the
     SCHOOL OF MEDICINE AT    Envelope
     THE UNIVERSITY OF PA
    ------------------------------------------------------------------------
    HEMATOLOGY ONCOLOGY      Immuno oncology      05/06/2018      $35,000.00
     PHARMACY ASSOCIATION     Educational
                              Modules for
                              Oncology
                              Pharmacists
    ------------------------------------------------------------------------
    CANCER RESEARCH           2018                05/06/2018      $50,000.00
     INSTITUTE                International
                              Cancer
                              Immunotherapy
                              Conference
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Pancreatic      05/06/2018      $25,000.00
     FOR CANCER RESEARCH      Cancer: Advances
                              in Science and
                              Clinical Care
    ------------------------------------------------------------------------
    ALLIANCE FOR CLINICAL    2018 Group           05/07/2018      $40,000.00
     TRIALS IN ONCOLOGY       Meetings
     FOUNDATION
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2018             05/07/2018      $40,000.00
     SOCIETY INC.             International
                              Conference--Selec
                              ted Sessions in
                              Lung Cancer
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      2018 ASH Meeting     05/08/2018      $50,000.00
     HEMATOLOGY               on Lymphoma
                              Biology
    ------------------------------------------------------------------------
    LUNGEVITY FOUNDATION     LUNGevity            05/08/2018      $50,000.00
                              Foundation
                              Scientific and
                              Clinical
                              Roundtable--
                              Streamlining
                              Clinical Trials
                              2018
    ------------------------------------------------------------------------
    HEMATOLOGY/ONCOLOGY      HOPA Early Career    05/08/2018      $60,000.00
     PHARMACY ASSOCIATION     Research Grant
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live at     05/09/2018     $323,020.00
     INSTITUTE, INC.          ASTRO 2018--The
                              Era of
                              Immunotherapy in
                              Stage III NSCLC
                              (150205115)
    ------------------------------------------------------------------------
    TRUSTEES OF THE          2018 Breast Cancer   05/09/2018       $5,000.00
     UNIVERSITY OF            Clinical Case
     PENNSYLVANIA/PERELMAN    Series: The Year
     SCHOOL OF MEDICINE AT    in Review
     THE UNIVERSITY OF PA
    ------------------------------------------------------------------------
    HEART FAILURE SOCIETY    2018 HFSA Board      05/09/2018      $15,000.00
     OF AMERICA INC.          Certification
                              Review Course in
                              Advanced Heart
                              Failure and
                              Transplant
                              Cardiology
    ------------------------------------------------------------------------
    SOCIETY FOR              Immuno-Oncology      05/10/2018      $25,000.00
     IMMUNOTHERAPY OF         Biomarkers State
     CANCER                   of the Art
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAPA 2018 Annual     05/10/2018      $10,000.00
     PHYSICIAN ASSISTANTS     Conference
    ------------------------------------------------------------------------
    HDL WORKSHOP             HDL Workshop 2018    05/10/2018       $5,000.00
    ------------------------------------------------------------------------
    LUPUS RESEARCH           Lupus Research       05/10/2018      $25,000.00
     ALLIANCE, INC.           Alliance 2018
                              Annual Scientific
                              Conference--Forum
                              for Discovery
    ------------------------------------------------------------------------
    BOARD OF REGENTS FOR     Dissecting the       05/13/2018     $200,000.00
     UNIVERSITY OF NEBRASKA   Decision:
                              Documenting and
                              Discussing the
                              Clinical Practice
                              Patterns of
                              Hematologic
                              Oncology
    ------------------------------------------------------------------------
    REGENTS OF THE           24th Annual San      05/13/2018      $10,000.00
     UNIVERSITY OF            Diego Heart
     CALIFORNIA               Failure Symposium
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Intensive Review     05/15/2018      $10,000.00
     EDUCATIONAL FOUNDATION   of Cardiology
    ------------------------------------------------------------------------
    GORDON RESEARCH          2018 Heterocyclic    05/15/2018       $2,000.00
     CONFERENCE               Gordon Research
                              Conference
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  30th Annual          05/16/2018      $40,000.00
     FOUNDATION               Transcatheter
                              Cardiovascular
                              Therapeutics
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      2018 Family          05/16/2018      $19,000.00
     FAMILY PHYSICIANS        Medicine
                              Experience
                              Interactive
                              Lecture titled
                              Acute Coronary
                              Syndrome
    ------------------------------------------------------------------------
    HUNTSVILLE HOSPITAL      RSS Breast Cancer    05/16/2018       $2,000.00
     FOUNDATION               Conference
    ------------------------------------------------------------------------
    SOCIETY OF               2018 WCIO            05/20/2018      $15,000.00
     INTERVENTIONAL
     ONCOLOGY (SIO)
    ------------------------------------------------------------------------
    UNIVERSITY OF            University of        05/20/2018      $24,300.00
     WASHINGTON SCHOOL OF     Washington Topics
     MEDICINE                 in Allergy and
                              Immunology
                              Teaching Series
    ------------------------------------------------------------------------
    THE GOG FOUNDATION       10th Semi Annual     05/21/2018      $20,000.00
                              Meeting of NRG
                              Oncology
                              (formerly NCI
                              cooperatives
                              groups, GOG,
                              NSABP, RTOG)
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  20th Annual Lynn     05/21/2018      $15,000.00
                              Sage Breast
                              Cancer Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     Molecular Biology    05/22/2018      $15,000.00
     FOR CANCER RESEARCH      in Clinical
                              Oncology Workshop
    ------------------------------------------------------------------------
    UNIVERSITY OF COLORADO   Precision Medicine   05/23/2018      $20,000.00
                              in Autoimmunity
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live at     05/23/2018     $313,240.00
     INSTITUTE, INC.          CAP18: Molecular
                              Testing for EGFR
                              Mutations in the
                              Context of a
                              Changing
                              Treatment
                              Landscape,
                              Evolving Testing
                              Options, and New
                              Guidelines
                              (150205165)
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  2018 Lung Cancer     05/23/2018      $15,000.00
     SOUTHWESTERN MEDICAL     SPORE Workshop
     CENTER
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACEP18, ACEP         05/23/2018      $20,000.00
     EMERGENCY PHYSICIANS     National
                              Scientific
                              Assembly--Cardiov
                              ascular Track
    ------------------------------------------------------------------------
    HOSPITAL QUALITY         Advances in the      05/23/2018     $222,127.50
     FOUNDATION, LLC          Management of
                              Acute and Chronic
                              Hyperkalemia: An
                              Update for
                              Emergency
                              Medicine,
                              Hospitalists and
                              Healthcare
                              Providers (MD, PA
                              and CRNP)
    ------------------------------------------------------------------------
    GORDON RESEARCH          2018 Cardiac         05/23/2018       $5,000.00
     CONFERENCE               Regulatory
                              Mechanisms Gordon
                              Research
                              Conference
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO Annual     05/24/2018      $30,000.00
     FOUNDATION OF THE        Meeting Head and
     AMERICAN SOCIETY OF      Neck Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO Pre-       05/24/2018      $10,000.00
     FOUNDATION OF THE        Annual Meeting
     AMERICAN SOCIETY OF      Seminar: New
     CLINICAL ONCOLOGY        Drugs in Oncology
    ------------------------------------------------------------------------
    FEDERATION OF CLINICAL   18th Annual          05/24/2018      $10,000.00
     IMMUNOLOGY SOCIETIES     Meeting of the
                              Federation of
                              Clinical
                              Immunology
                              Societies
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2018-2019 Monthly    05/24/2018      $75,000.00
     CANCER NETWORK           Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    WINTHROP UNIVERSITY      3rd Annual NYU       05/24/2018       $3,000.00
     HOSPITAL                 Winthrop Breast
                              Health Symposium
    ------------------------------------------------------------------------
    CONQUER CANCER           2018 ASCO Annual     05/27/2018      $25,000.00
     FOUNDATION OF THE        Meeting Lung
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    MISSOURI ACADEMY OF      Updates in           05/30/2018       $3,000.00
     PHYSICIANS ASSISTANTS    Treating Chronic
                              Obstructive
                              Pulmonary
                              Disorder
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Emergency Medicine   06/03/2018     $568,470.00
     INSTITUTE, INC.          and Immuno-
                              Oncology
                              Intersect:
                              Recognizing and
                              Managing Immune-
                              Related Adverse
                              Effects in the
                              Emergency
                              Department
                              (150205075)
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2018 Oncology   06/03/2018      $40,000.00
     CANCER NETWORK, INC.     Case Manager and
                              Medical Director
                              Program
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     ASTRO 2018 60th      06/03/2018      $50,000.00
     RADIATION ONCOLOGY       Annual Meeting
    ------------------------------------------------------------------------
    UNIVERSITY OF            2018 Pittsburgh      06/04/2018      $10,000.00
     PITTSBURGH               International
                              Lung Conference--
                              Pulmonary
                              Medicine: Basic
                              Biology and Novel
                              Therapies
    ------------------------------------------------------------------------
    AEGEAN CONFERENCES,      2nd International    06/05/2018       $5,000.00
     INC.                     Conference on
                              Tissue Repair,
                              Regeneration, and
                              Fibrosis
    ------------------------------------------------------------------------
    SYNAPTIV, INC.           Atlanta Lung         06/05/2018      $20,000.00
                              Cancer Symposium
                              2018
    ------------------------------------------------------------------------
    SOCIETY FOR              NSCLC Treatment in   06/05/2018      $38,885.00
     TRANSLATIONAL ONCOLOGY   the Era of
                              Precision
                              Medicine: Case-
                              Based Insights
                              from ASCO 2018
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Traveling Master     06/06/2018     $390,030.00
     INSTITUTE, INC.          Class for
                              Emergency
                              Medicine
                              Specialists:
                              Urgent Care of
                              Patients
                              Receiving Cancer
                              Immunotherapy:
                              Recognition and
                              Management of
                              Immune-Mediated
                              Adverse Reactions
                              in the ED
    ------------------------------------------------------------------------
    PRESIDENT AND FELLOWS    33rd Annual          06/06/2018      $15,000.00
     OF HARVARD COLLEGE       Critical Issues
                              In Tumor
                              Microenvironment:
                              Angiogenesis,
                              Metastasis and
                              Immunology
    ------------------------------------------------------------------------
    KERN ASPEN LIPID         Metabolic            06/06/2018      $10,000.00
     CONFERENCE               Regulation of
                              Immunity,
                              Cardiometabolic
                              Diseases and
                              Cancer: New
                              Theraepeutic
                              Approaches
    ------------------------------------------------------------------------
    SOCIETY OF TOXICOLOGIC   STP 37th Annual      06/06/2018       $3,000.00
     PATHOLOGY                Symposium:
                              KEEPING IT RENAL
    ------------------------------------------------------------------------
    WEILL CORNELL MEDICAL    2nd Annual           06/10/2018      $15,000.00
     COLLEGE                  International
                              Conference
                              Immunotherapy
                              Radiotherapy
                              Combinations
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2018 COPD Learning   06/10/2018       $5,000.00
     CHEST PHYSICIANS         Track
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2018                 06/10/2018      $27,000.00
     CHEST PHYSICIANS         Interdisciplinary
                              Program--Lung
                              Cancer: 2018
                              Update in Staging
                              and Management
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Breathing New Air    06/10/2018      $20,400.00
     OSTEOPATHIC INTERNISTS   into the
                              Treatment of COPD
                              and Asthma
    ------------------------------------------------------------------------
    THE RECTOR AND VISITORS  PREP2018 Symposium   06/10/2018       $5,000.00
     OF THE UNIVERSITY OF
     VIRGINIA
    ------------------------------------------------------------------------
    SOCIETY FOR NEURO-       3rd CNS Anticancer   06/11/2018      $15,000.00
     ONCOLOGY                 Drug Discovery
                              and Development
                              Conference
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     2018 JADPRO Live:    06/12/2018      $50,000.00
     HEALTH SCIENCES AT       The Annual APSHO
     EISENHOWER               Meeting--Sequenci
                              ng Therapies in
                              Indolent
                              Lymphomas
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACOI 2018 Annual     06/12/2018      $33,782.00
     OSTEOPATHIC INTERNISTS   Convention and
                              Scientific
                              Sessions:
                              Addressing Unmet
                              Needs in Type 2
    ------------------------------------------------------------------------
    UNIVERSITY OF            Moving Toward A      06/13/2018      $59,912.00
     CINCINNATI               New Standard of
                              Care: Checkpoint
                              Inhibitors in
                              Advanced
                              Urothelial Cancer
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  Reducing             06/13/2018     $178,188.13
     DIABETES EDUCATORS       Cardiovascular
                              Risk in T2DM with
                              SGLT2 Inhibitors
                              and GLP1-Receptor
                              Antagonists:
                              Translating
                              Evidence into
                              Patient Outcomes
    ------------------------------------------------------------------------
    SOCIETY FOR NEURO-       23rd Annual          06/13/2018      $75,000.00
     ONCOLOGY                 Scientific
                              Meeting of the
                              Society for Neuro-
                              Oncology
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2018 Lung Cancer     06/13/2018      $70,000.00
     CHEST PHYSICIANS         Learning Track
    ------------------------------------------------------------------------
    UNIVERSITY OF            Request for 2018     06/14/2018       $5,000.00
     CALIFORNIA BERKELEY      Funding for the
     FOUNDATION               Forum for
                              Collaborative
                              Research's
                              Program on HBV
    ------------------------------------------------------------------------
    JOHNS HOPKINS            OncologyConsults.c   06/15/2018      $89,885.00
     UNIVERSITY SCHOOL OF     om Improving
     MEDICINE                 Outcomes in Stage
                              III NSCLC The
                              Emerging Role of
                              Immunotherapy in
                              Curbing Disease
                              Progression
    ------------------------------------------------------------------------
    SOCIETY FOR              Advances in Cancer   06/17/2018     $500,000.00
     IMMUNOTHERAPY OF         ImmunotherapyT
     CANCER                   2018-19
                              Educational
                              Program Series
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      Medications' Class   06/19/2018     $100,000.00
     EDUCATION FOUNDATION     Effects in DM and
                              CVD--All you need
                              to know- and
                              never asked.
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live at     06/21/2018     $262,040.00
     INSTITUTE, INC.          ASCP 2018:
                              Navigating the
                              Complexities of
                              Molecular Testing
                              for EGFR
                              Mutations to
                              Guide Selection
                              of EGFR-Targeted
                              Therapy for
                              Patients With
                              Lung Cancer
                              (150205135)
    ------------------------------------------------------------------------
    NORTHWESTERN UNIVERSITY  Lurie Cancer         06/21/2018      $10,000.00
                              Center
                              Multidisciplinary
                              Head and Neck
                              Symposium
    ------------------------------------------------------------------------
    CHARLOTTE AHEC           30th Annual Fall     06/25/2018       $5,000.00
                              Foliage Cancer
                              Conference
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     Integrated           06/25/2018       $6,000.00
     MOLECULAR AND CELLULAR   Pathways of
     BIOLOGY                  Disease in NASH
                              and NAFLD
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASN Kidney Week      06/25/2018      $20,000.00
     NEPHROLOGY               Educational
                              Session Support
    ------------------------------------------------------------------------
    GORDON RESEARCH          DNA Topoisomerases   06/25/2018      $10,000.00
     CONFERENCE               in Biology and
                              Medicine
    ------------------------------------------------------------------------
    INDUSTRY NETWORKING      BioHealth Capital    06/25/2018      $10,000.00
     GROUP                    Region Workforce
                              Community
                              Engagement
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Unraveling the       07/01/2018      $33,782.00
     OSTEOPATHIC INTERNISTS   Effects of
                              Antihyperglycemic
                              Agents on
                              Cardiovascular
                              Risk
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live at     07/02/2018     $262,040.00
     INSTITUTE, INC.          ASCP 2018:
                              Advances and
                              Challenges in
                              Refining the Use
                              of Cancer
                              Immunotherapies
                              Through Biomarker
                              Testing
                              (150205136)
    ------------------------------------------------------------------------
    ENDOCRINE FELLOWS        Fifth Annual         07/02/2018     $250,000.00
     FOUNDATION               Research Forum
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC 2018 Workshop   07/02/2018     $100,000.00
     IMMUNOTHERAPY OF         on Nutrition,
     CANCER                   Metabolism and
                              the Microbiome in
                              Cancer Therapy
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      The Role of          07/02/2018     $167,500.00
     NEPHROLOGY               Hypoxia-Inducible
                              Factors and
                              Inflammation in
                              the Anemia of
                              Kidney Disease
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Managing             07/04/2018     $160,000.00
     PHYSICIAN ASSISTANTS     Cardiovascular
                              Risk Factors in
                              Patients with
                              Type 2 Diabetes:
                              Emerging Concepts
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASH Meeting on       07/04/2018      $60,000.00
     HEMATOLOGY               Hematologic
                              Malignancies
    ------------------------------------------------------------------------
    AMERICAN HEART           Scientific           07/05/2018      $20,000.00
     ASSOCIATION              Sessions 2018
                              Dedicated
                              Programming on
                              Acute Coronary
                              Syndrome
    ------------------------------------------------------------------------
    BREATHE CALIFORNIA OF    2018 BREATHE         07/08/2018       $3,000.00
     LOS ANGELES COUNTY       California of Los
                              Angeles County
                              10th Annual COPD
                              Conference
    ------------------------------------------------------------------------
    SOCIETY FOR INDUSTRIAL   SIMB Annual          07/08/2018       $3,000.00
     MICROBIOLOGY AND         Meeting
     BIOTECHNOLOGY
    ------------------------------------------------------------------------
    JOSLIN DIABETES CENTER,  2018 AANHPI          07/08/2018       $5,000.00
     INC.                     Diabetes
                              Coalition
                              Conference The
                              Future of
                              Population
                              Diabetes Research
                              and Advocacy:
                              Asian American
                              Native Hawaiian
                              Pacific Islanders
    ------------------------------------------------------------------------
    ACS DIVISION OF          Division of          07/09/2018       $2,500.00
     MEDICINAL CHEMISTRY      Medicinal
                              Chemistry Program
                              256th ACS
                              national meeting
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      07/10/2018      $10,000.00
     CONFERENCES, INC.        Conference Tissue
                              Niches and
                              Resident Stem
                              Cells in Adult
                              Epithelia
    ------------------------------------------------------------------------
    NORTH AMERICAN           Reducing             07/11/2018      $60,000.00
     THROMBOSIS FORUM         Cardiovascular
                              Risk in Patients
                              with Diabetes: A
                              Comprehensive Yet
                              Concise Patient
                              Focused Action
                              Plan
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      36th Annual Aspen    07/11/2018       $3,000.00
     ALLERGY ASTHMA AND       Allergy
     IMMUNOLOGY               Conference
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC 33rd Annual     07/16/2018     $400,000.00
     IMMUNOTHERAPY OF         Meeting
     CANCER
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC Cancer          07/16/2018      $67,500.00
     IMMUNOTHERAPY OF         Immunotherapy
     CANCER                   Sparkathon 2018--
                              Emerging Leaders
                              Igniting
                              Innovation
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Respiratory          07/16/2018      $35,000.00
     CHEST PHYSICIANS         Syncytial Virus
                              (RSV) Education
                              Program
    ------------------------------------------------------------------------
    BINAYTARA FOUNDATION     6th International    07/16/2018       $5,000.00
                              Conference on
                              Advances in
                              Hematology and
                              Oncology
    ------------------------------------------------------------------------
    SOCIETY FOR MUCOSAL      Mucosal Immunology   07/16/2018      $10,000.00
     IMMUNOLOGY               Course and
                              Symposium
    ------------------------------------------------------------------------
    BAYLOR COLLEGE OF        Breast Cancer        07/17/2018       $3,000.00
     MEDICINE                 Research and
                              Education program
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Conference on   07/17/2018      $25,000.00
     FOR CANCER RESEARCH      The Science of
                              Cancer Health
                              Disparities
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live at     07/18/2018     $164,230.00
     INSTITUTE, INC.          CAP18: The
                              Central Role of
                              Biomarker Testing
                              in Piecing
                              Together the
                              Immuno-Oncology
                              Puzzle in the Era
                              of Precision
                              Medicine
                              (150205123)
    ------------------------------------------------------------------------
    PENNSYLVANIA STATE       PeerView inClinic,   07/18/2018      $32,330.00
     UNIVERSITY               Building
                              Innovative
                              Treatment Options
                              for Patients with
                              B-cell
                              Malignancies:
                              Practical
                              Insights on
                              Clinical Evidence
                              and Integration
                              Strategies
                              150205182
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     2018 JADPRO Live:    07/19/2018      $50,000.00
     HEALTH SCIENCES AT       The Annual APSHO
     EISENHOWER               Meeting--Sequenci
                              ng of Treatments
                              for Patients with
                              Ovarian Cancer
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASH Scholar Awards   07/20/2018     $100,000.00
     HEMATOLOGY
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      60th ASH Annual      07/20/2018     $150,000.00
     HEMATOLOGY               Meeting
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Cancer Health   07/22/2018      $25,000.00
     FOR CANCER RESEARCH      Disparities Think
                              Tank
    ------------------------------------------------------------------------
    ASSOCIATION OF           Association of       07/23/2018      $10,000.00
     PHYSICIAN ASSISTANTS     Physician
     IN ONCOLOGY              Assistants in
                              Oncology 21st
                              Annual Conference
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     2018 JADPRO Live:    07/24/2018      $50,000.00
     HEALTH SCIENCES AT       The Annual APSHO
     EISENHOWER               Meeting--Manageme
                              nt of Side
                              Effects for
                              Patients with
                              Multi-Modality
                              Therapy in
                              Thoracic Oncology
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Kidney Health        07/24/2018      $30,000.00
     NEPHROLOGY               Initiative
    ------------------------------------------------------------------------
    GORDON RESEARCH          2018 Gordon          07/26/2018       $2,500.00
     CONFERENCES              Research
                              Conference and
                              Seminar on Cell
                              Death
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Fifth Annual         07/29/2018      $10,000.00
     UNIVERSITY SCHOOL OF     Metastatic Breast
     MEDICINE                 Cancer Conference
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Translational   07/31/2018      $25,000.00
     FOR CANCER RESEARCH      Cancer Research
                              for Basic
                              Scientists
                              Workshop
    ------------------------------------------------------------------------
    BOARD OF REGENTS FOR     Virtual              08/01/2018      $75,000.00
     UNIVERSITY OF NEBRASKA   Challenging Case
                              Clinic: B-Cell
                              Lymphomas
    ------------------------------------------------------------------------
    MASSACHUSETTS GENERAL    Gene Panel           08/01/2018     $100,000.00
     HOSPITAL                 Testing: Decision
                              Aid
    ------------------------------------------------------------------------
    LUNG CANCER ALLIANCE     Florida and          08/01/2018     $199,200.00
                              Georgia Lung
                              Cancer Screening
                              Demonstration
                              Project
    ------------------------------------------------------------------------
    YALE SCHOOL OF MEDICINE  Severe Asthma 2018   08/01/2018      $15,000.00
                              Advances in
                              Pathogenesis and
                              Treatment
    ------------------------------------------------------------------------
    UTAH CHAPTER OF THE      Rockies Chapter      08/02/2018       $3,000.00
     AMERICAN COLLEGE OF      Meeting
     CARDIOLOGY
    ------------------------------------------------------------------------
    SOCIETY FOR              Immune Escape:       08/02/2018      $25,000.00
     IMMUNOTHERAPY OF         Current
     CANCER                   Understanding of
                              Mechanisms and
                              Advances in
                              Therapeutics
                              Approaches
    ------------------------------------------------------------------------
    LUNG CANCER ALLIANCE     Florida and          08/02/2018     $147,972.00
                              Georgia Lung
                              Cancer Screening
                              Demonstration
                              Project
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   23rd Annual          08/02/2018       $5,000.00
                              Regional Allied
                              Health
                              Conference:
                              Current
                              Perspectives in
                              Asthma, Allergy,
                              and Pulmonary
                              Practice
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     FDA-AACR Workshop    08/02/2018      $25,000.00
     FOR CANCER RESEARCH      on Non-clinical
                              Models for Safety
                              Assessment of
                              Immunooncology
                              Products
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Novel Treatment      08/06/2018      $35,000.00
     MANAGED CARE             Advances and
     PHYSICIANS, INC.         Approaches in the
                              Management of
                              Advanced Breast
                              Cancer: Expert
                              Strategies for
                              Individualized
                              Treatment
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  New Frontiers in     08/06/2018      $45,000.00
     MANAGED CARE             the Management of
     PHYSICIANS, INC.         Ovarian Cancer:
                              Exploring the
                              Role of PARP
                              Inhibitors in the
                              Evolving
                              Treatment
                              Paradigm
    ------------------------------------------------------------------------
    SOCIETY FOR              2018 SITC Primer     08/07/2018      $50,000.00
     IMMUNOTHERAPY OF         on Tumor
     CANCER                   Immunology and
                              Cancer
                              ImmunotherapyT
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC 2018 Grant      08/07/2018      $10,000.00
     IMMUNOTHERAPY OF         Writing Workshop:
     CANCER                   Grant Writing:
                              From Start to
                              Finish, and Then
                              Starting Again
    ------------------------------------------------------------------------
    AMERICAS HEALTH          The Diagnosis and    08/07/2018      $85,240.00
     FOUNDATION               Treatment of
                              Hereditary Breast
                              and Ovarian
                              Cancer Syndrome
                              in Brazil
    ------------------------------------------------------------------------
    ADMINISTRATORS OF THE    18th Annual SSCI     08/10/2018      $55,000.00
     TULANE EDUCATION FUND    Nephrology Young
                              Investigators
                              Forum
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Joint Analyses of    08/10/2018     $105,895.00
     FOUNDATION               GFR slope and
                              Change in
                              Albuminuria by
                              AstraZeneca and
                              the CKDEPI
                              Collaboration
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     JADPRO Live 2018:    08/12/2018      $25,000.00
     HEALTH SCIENCES AT       New Drug Updates
     EISENHOWER
    ------------------------------------------------------------------------
    UNIVERSITY OF FLORIDA    Vascular Biology     08/12/2018       $7,500.00
                              Working Group
                              Global Chapter
                              Meeting
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Optimizing Small     08/12/2018      $50,000.00
     CANCER NETWORK, INC.     Molecule
                              Inhibitor Therapy
                              for Relapsed/
                              Refractory B-cell
                              Lymphomas
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Clinical   08/12/2018      $35,000.00
     MANAGED CARE             and Economic
     PHYSICIANS, INC.         Outcomes with
                              Emerging
                              Therapies in the
                              Management of
                              Chronic
                              Lymphocytic
                              Leukemia (CLL)
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Optimizing           08/13/2018      $35,000.00
     MANAGED CARE             Treatment
     PHYSICIANS, INC.         Strategies in the
                              Management of
                              Advanced Non-
                              Small Cell Lung
                              Cancer (NSCLC):
                              Individualized
                              Therapy for
                              Improved Patient
                              Outcomes
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 13th Annual     08/13/2018      $75,000.00
     CANCER NETWORK, INC.     Congress:
                              Hematologic
                              MalignanciesTM
    ------------------------------------------------------------------------
    AMERICAN PANCREATIC      49th Annual          08/13/2018      $25,000.00
     ASSOCIATION, INC.        Meeting of the
                              American
                              Pancreatic
                              Association
    ------------------------------------------------------------------------
    REGENTS OF THE           16th Annual          08/14/2018      $50,000.00
     UNIVERSITY OF            Nephrology Young
     CALIFORNIA               Investigators
                              Forum
    ------------------------------------------------------------------------
    PENNSYLVANIA STATE       PeerView             08/15/2018     $115,000.00
     UNIVERSITY COLLEGE OF    MasterClass:
     MEDICINE                 Innovative
                              Therapy in B-Cell
                              Malignancies: An
                              Expert Tumor
                              Board on Novel
                              Agent Classes in
                              CLL, FL, and MCL
                              (150205208)
    ------------------------------------------------------------------------
    ASSOCIATION OF           Series of AUTM       08/15/2018      $25,287.50
     UNIVERSITY TECHNOLOGY    2019 Annual
     MANAGERS INC.            Meetings
    ------------------------------------------------------------------------
    TRANSLATIONAL RESEARCH   TRIO-US & UCLA       08/16/2018       $5,000.00
     IN ONCOLOGY-US, INC.     Annual Research
                              Conference
    ------------------------------------------------------------------------
    DANA-FARBER CANCER       IWWM10--Internatio   08/17/2018     $100,000.00
     INSTITUTE                nal Workshop on
                              Waldenstroms
                              macroglobulinemia
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Integrating BTK      08/20/2018     $245,090.00
     INSTITUTE, INC.          Inhibitors into
                              the Management of
                              B cell
                              Malignancies: How
                              is Evidence
                              Driving Patient
                              Care
    ------------------------------------------------------------------------
    MEDICAL LEARNING         CRI-AACR ISS--       08/20/2018     $324,460.00
     INSTITUTE, INC.          Improving Patient
                              Outcomes With
                              Cancer
                              Immunotherapies
                              and Combinations
                              Throughout the
                              Continuum of Lung
                              Cancer
                              (150205201)
    ------------------------------------------------------------------------
    AMERICAN NEPHROLOGY      ANNA Fall Meeting    08/20/2018      $42,500.00
     NURSES ASSOCIATION       CE Symposium
     (ANNA)
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Risk and Treatment   08/20/2018     $125,000.00
     NEPHROLOGY               of Hyperkalemia
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     08/20/2018     $276,000.00
     FOR CANCER RESEARCH      Lymphoma Research
                              Fellowships
    ------------------------------------------------------------------------
    SOCIETY FOR              2019 SITC-           08/20/2018     $120,000.00
     IMMUNOTHERAPY OF         AstraZeneca
     CANCER                   Immunotherapy in
                              Lung Cancer
                              Clinical
                              Fellowship
    ------------------------------------------------------------------------
    GBMC HEALTHCARE          Advances in          08/21/2018       $2,000.00
                              Treatment and
                              Management of
                              Ovarian Cancer
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   PARP Inhibitors in   08/21/2018     $240,000.00
     CANCER NETWORK           Breast Cancer:
                              Expert
                              Perspectives on
                              Clinical
                              Application and
                              Genetic Testing
    ------------------------------------------------------------------------
    UT HEALTH SCIENCE        41st Annual San      08/21/2018      $75,000.00
     CENTER AT SAN ANTONIO    Antonio Breast
     SCHOOL OF MEDICINE       Cancer Symposium
     OFFICE OF CME
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live--The   08/22/2018     $269,660.00
     INSTITUTE, INC.          Evolving Role of
                              Immunotherapy as
                              a Component of
                              Multi-Modal
                              Therapy in
                              Earlier Stages of
                              Lung Cancer:
                              Rationale,
                              Current Evidence,
                              Key Trials, and
                              Implications for
                              Multidisciplinary
                              Care (150205392)
    ------------------------------------------------------------------------
    TEMPLE UNIVERSITY LUNG   Severe               08/26/2018      $65,000.00
     CENTER- OF THE           Uncontrolled
     COMMONWEALTH SYSTEM OF   Asthma:
     HIGHER EDUCATION         Definition,
                              Management, and
                              Advance Therapies
    ------------------------------------------------------------------------
    OHIO CHAPTER OF THE      28th Annual          08/26/2018       $4,500.00
     AMERICAN COLLEGE OF      Meeting of the
     CARDIOLOGY               Ohio Chapter of
                              the American
                              College of
                              Cardiology
    ------------------------------------------------------------------------
    PROSTATE CANCER          25th Annual          08/27/2018      $20,000.00
     FOUNDATION               Scientific
                              Retreat
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      Advancing the        08/27/2018      $25,000.00
     ASSOCIATION EDUCATION    Treatment of
     AND RESEARCH, INC.       Genitourinary
                              Cancer
    ------------------------------------------------------------------------
    THE ICAHN SCHOOL OF      The Lancet Women     08/30/2018      $50,000.00
     MEDICINE AT MOUNT        and
     SINAI                    Cardiovascular
                              Disease
                              Commission
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Behind the           08/30/2018      $25,000.00
     CANCER NETWORK           Guidelines:
                              Insights into the
                              Standard of Care
                              in Oncology 2019
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Behind the           08/30/2018      $25,000.00
     CANCER NETWORK           Guidelines:
                              Insights into the
                              Standard of Care
                              in Oncology 2019
    ------------------------------------------------------------------------
    THE BOARD OF TRUSTREES   Stanford Review of   09/05/2018       $5,000.00
     OF THE LELAND STANFORD   the 60th Annual
     JUNIOR UNIVERSITY ON     American Society
     BEHALF OF ITS SCHOOL     of Hematology
     OF MEDICINE              Meeting 2019
    ------------------------------------------------------------------------
    INTERNATIONAL CYTOKINE   6th Annual Meeting   09/11/2018      $20,000.00
     AND INTERFERON SOCIETY   of the
     INC.                     International
                              Cytokine and
                              Interferon
                              Society
    ------------------------------------------------------------------------
    CEDARS-SINAI             7th Annual New       09/11/2018      $10,000.00
                              Therapeutics in
                              Oncology: The
                              Road to
                              Personalized
                              Medicine
    ------------------------------------------------------------------------
    MERCY HEALTH FOUNDATION  2019 Tri-State ASH   09/11/2018       $5,000.00
                              Update
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          Duke Stanford CEC    09/18/2018      $20,000.00
                              Summit:
                              Scientific,
                              Regulatory and
                              Operational Best
                              Practices
    ------------------------------------------------------------------------
    KENTUCKY ACADEMY OF      Breast Cancer--      09/18/2018       $3,000.00
     PHYSICIAN ASSISTANTS     Diagnosis and
                              Patient Treatment
                              Options
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  13th Update on the   09/20/2018       $5,000.00
     MD ANDERSON CANCER       Management of
     CENTER                   Genitourinary
                              Malignancies
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2019 Congress   09/20/2018      $50,000.00
     CANCER NETWORK, INC.     SeriesTM: Breast
                              Cancer with
                              Updates from the
                              2018 San Antonio
                              Breast Cancer
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Hematology 2018:     09/21/2018     $100,000.00
     HEMATOLOGY               the ASH Education
                              Program Book
    ------------------------------------------------------------------------
    PENN STATE COLLEGE OF    Consensus or         09/23/2018      $75,000.00
     MEDICINE                 Controversy?
                              Clinical
                              Investigators
                              Provide
                              Perspectives on
                              the Current and
                              Future Management
                              of Patients with
                              Prostate Cancer--
                              An ISS Held as a
                              Premium Ancillary
                              Educational Event
                              During the 2019
                              Genitourinary
                              Cancers Symposium
    ------------------------------------------------------------------------
    HARTFORD HOSPITAL        34th Annual          09/23/2018       $5,000.00
                              Cardiovascular
                              Symposium
                              presented by
                              Hartford
                              HealthCare
    ------------------------------------------------------------------------
    JOHN HOPKINS UNIVERSITY  Novel Therapeutic    09/24/2018       $5,000.00
                              Approaches to
                              Allergic Diseases
    ------------------------------------------------------------------------
    INTERNATIONAL SOCIETY    Advances in          09/24/2018       $2,500.00
     FOR MAGNETIC RESONANCE   Multiscale Cancer
     IN MEDICINE              Detection: From
                              Micro to Macro
    ------------------------------------------------------------------------
    PARENTERAL DRUG          PDA Universe of      10/01/2018      $24,000.00
     ASSOCIATION (PDA)        Pre-filled
                              Syringes and
                              Injection Devices
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     2019 Keystone        10/01/2018      $25,000.00
     MOLECULAR AND CELLULAR   Symposia
     BIOLOGY                  Directors' Fund
    ------------------------------------------------------------------------
    MEMORIAL SLOAN           State-of-the-Art     10/01/2018       $5,000.00
     KETTERING CANCER         Gynecologic
     CENTER                   Surgery and
                              Ovarian Cancer
                              Management
                              Conference 2018
    ------------------------------------------------------------------------
    UNIVERSITY OF TEXAS      Official Best of     10/02/2018      $60,000.00
     HEALTH SCIENCE CENTER    San Antonio
     AT SAN ANTONIO           Breast Cancer
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     10/03/2018     $276,000.00
     FOR CANCER RESEARCH      Immuno-Oncology
                              Research
                              Fellowships
    ------------------------------------------------------------------------
    MEDCHI, THE MARYLAND     OPTIMAL DURATION      10/8/2018     $387,213.13
     STATE MEDICAL SOCIETY    OF ANTIPLATELET
                              THERAPY AFTER
                              PCI: The Case for
                              Longerterm Dual
                              Antiplatelet
                              Therapy in
                              Patients with
                              History of MI
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Symposium 4:         10/08/2018       $5,000.00
     TOXICOLOGY               Update on RNA
                              Therapies:
                              Challenges and
                              Opportunities,
                              American College
                              of Toxicology
                              39th Annual
                              Meeting
    ------------------------------------------------------------------------
    PEPTIDE THERAPEUTICS     13th Annual          10/08/2018      $15,000.00
     FOUNDATION               Peptide
                              Therapeutics
                              Symposium
    ------------------------------------------------------------------------
    UNIVERSITY OF NEBRASKA   7th International    10/09/2018       $5,000.00
     MEDICAL CENTER           Conference on
                              Gram-Positive
                              Pathogens
    ------------------------------------------------------------------------
    JOHNS HOPKINS            2019 Atlanta         10/09/2018      $10,000.00
     UNIVERSITY SCHOOL OF     Breast Cancer
     MEDICINE OFFICE OF       Symposium
     CONTINUING MEDICAL
     EDUCATION
    ------------------------------------------------------------------------
    LYMPHOMA RESEARCH        LRF Postdoctoral     10/10/2018     $105,000.00
     FOUNDATION               Fellowship
    ------------------------------------------------------------------------
    THE GOG FOUNDATION INC.  11th Semi Annual     10/10/2018      $20,000.00
                              Meeting of NRG
                              Oncology
                              (formerly GOG,
                              NSABP, RTOG)
                              cooperative
                              groups
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        Chicago Lung         10/10/2018      $10,000.00
     CHICAGO                  Cancer Updates
                              2018
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION OF  The Liver Meeting    10/11/2018      $15,000.00
     THE STUDY OF LIVER       2018 Park Benches
     DISEASES                 Support
    ------------------------------------------------------------------------
    NATIONAL ANIMAL          The Continued        10/14/2018       $2,000.00
     INTEREST ALLIANCE        Importance of
                              Animal Research
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     10/17/2018     $276,000.00
     FOR CANCER RESEARCH      Lung Cancer
                              Research
                              Fellowships
                              (Driver
                              Mutations)
    ------------------------------------------------------------------------
    THE COOPER HEALTH        Contemporary         10/22/2018       $2,500.00
     SYSTEM                   Practices in
                              Cardiology
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      2019 Highlights of   10/22/2018     $100,000.00
     HEMATOLOGY               ASH in North
                              America
    ------------------------------------------------------------------------
    EMORY UNIVERSITY SCHOOL  3rd National         10/24/2018       $5,000.00
     OF MEDICINE              Congress on the
                              Prevention of
                              Diabetes and Its
                              Complications
    ------------------------------------------------------------------------
    MEMORIAL SLOAN           2018 Annual Cancer   10/24/2018       $5,000.00
     KETTERING CANCER         Treatment-Related
     CENTER                   Adverse Events
                              Symposium
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        2018 ECOG-ACRIN      10/24/2018       $5,000.00
     EDUCATION FOUNDATION,    Fall Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Special         10/28/2018      $25,000.00
     FOR CANCER RESEARCH      Conference on
                              Tumor Immunology
                              and Immunotherapy
    ------------------------------------------------------------------------
    INTERNATIONAL            Best of 19th World   10/28/2018      $20,000.00
     ASSOCIATION FOR THE      Conference on
     STUDY OF LUNG CANCER     Lung Cancer
                              (WCLC)
    ------------------------------------------------------------------------
    WASHINGTON UNIVERSITY    45th Annual          10/29/2018       $3,000.00
                              Washington
                              University Kilo
                              Diabetes
                              Symposium
    ------------------------------------------------------------------------
    VIRGINIA BIOTECHNOLOGY   Medimmune            11/01/2018      $25,000.00
     ASSOCIATION              Chariman's Circle
                              Membership
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      16th Annual World    11/01/2018     $100,000.00
     EDUCATION FOUNDATION     congress on
                              Insulin
                              Resistance
                              Diabetes and
                              Cardiovascular
                              Disease (WCIRDC)
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live--ISS   11/01/2018     $286,060.00
     INSTITUTE, INC.          at the Thoracic
                              Cancers
                              Symposium, "The
                              Present and
                              Future of
                              Immunotherapy as
                              a Key Component
                              of the Treatment
                              Arsenal for
                              Locally Advanced
                              and Earlier
                              Stages of Lung
                              Cancer: State of
                              the Science,
                              Practicalities,
                              and Implications
                              for Mult
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      CHF, the Next        11/01/2018     $150,705.00
     EDUCATION FOUNDATION     Frontier in
                              Diabetes: Do
                              SGLT2 Inhibitors
                              Have a Role in
                              Management and
                              Prevention?
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   ASCO and NCCN 2019   11/01/2018      $60,000.00
     CANCER NETWORK, INC.     ISS CCO: PARP
                              Inhibitors in
                              Breast Cancer:
                              Expert
                              Perspectives on
                              Clinical
                              Application and
                              Genetic Testing
    ------------------------------------------------------------------------
    BOARD OF REGENTS OF THE  Grand Rounds         11/01/2018     $250,000.00
     UNIVERSITY OF NEBRASKA   series Bioascend:
                              2019 Ovarian
                              Community Grand
                              Rounds:
                              Incorporating
                              Recently Approved
                              Targeted Agents,
                              Emerging
                              Combinations, and
                              Genetic Testing
                              for the Optimal
                              Management of
                              Patients with
                              Ovarian Cancer
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Webinars: PARP       11/01/2018     $150,000.00
     MANAGED CARE             Inhibition and
     PHYSICIANS, INC.         its Evolving Use
                              in the Treatment
                              of Cancers: What
                              Managed Care
                              Needs to Know for
                              Improved Clinical
                              and Economic
                              Outcomes
    ------------------------------------------------------------------------
    JOHNS HOPKINS            FastForward Silver   11/05/2018      $25,000.00
     UNIVERSITY               Sponsorship
    ------------------------------------------------------------------------
    ASSOCIATION FOR WOMEN    Innovation and       11/05/2018      $25,000.00
     IN SCIENCE               Inclusion Summit
    ------------------------------------------------------------------------
    FOUNDATION FOR THE       2018 Biomarkers      11/05/2018      $10,000.00
     NATIONAL INSTITUTES OF   Consortium Cancer
     HEALTH                   Steering
                              Committee Annual
                              Scientific
                              Symposium
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Oncology--  11/06/2018     $324,340.00
     INSTITUTE, INC.          ISS at ASCO-SITC,
                              Seminars in
                              Immuno-Oncology,
                              ``III, II, I:
                              Addressing Unmet
                              Needs in Earlier
                              Stages of NSCLC
                              With
                              Immunotherapy''
                              (150205292)
    ------------------------------------------------------------------------
    MEDICAL LEARNING         ISS at 2019          11/06/2018     $286,060.00
     INSTITUTE, INC.          Multidisciplinary
                              Thoracic Cancers
                              Symposium-
                              Refining Current
                              Practice and
                              Exploring New
                              Frontiers in EGFR-
                              Mutant NSCLC
                              (150205322)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Comparative          11/06/2018       $2,000.00
     VETERINARY               Pathologists in
     PATHOLOGISTS             Translational
                              Medicine
                              reception at the
                              2018 ACVP/ASVCP
                              Concurrent Annual
                              Meeting
    ------------------------------------------------------------------------
    AMERICAN ASSOCATION OF   AAPS PharmSci 360    11/06/2018      $50,000.00
     PHARMACEUTICAL
     SCIENTISTS
    ------------------------------------------------------------------------
    MAYO CLINIC ARIZONA      Mayo Clinic Cancer   11/07/2018       $5,000.00
                              Center Thoracic
                              Oncology Update
                              State of the Art
                              Evaluation and
                              Management of
                              Thoracic Cancers
    ------------------------------------------------------------------------
    SOCIETY FOR              Case-based Forum:    11/07/2018      $20,000.00
     CARDIOVASCULAR           Individualizing
     ANGIOGRAPHY AND          Antithrombotic
     INTERVENTIONS            Therapies for PCI
     FOUNDATION               Patients
    ------------------------------------------------------------------------
    UT HEALTH SAN ANTONIO    2019 Practical       11/07/2018       $5,000.00
                              Application of
                              New Agents in
                              Oncology
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     2018 Best of ASTRO   11/07/2018      $10,000.00
     RADIATION ONCOLOGY
    ------------------------------------------------------------------------
    PERSONALIZED MEDICINE    14th Annual          11/11/2018      $25,000.00
     COALITION                Personalized
                              Medicine
                              Conference
    ------------------------------------------------------------------------
    ACLAM FOUNDATION         2018 ACLAM Grants    11/11/2018       $4,000.00
    ------------------------------------------------------------------------
    ICAHN SCHOOL OF          LIVE Conference:     11/11/2018       $5,000.00
     MEDICINE AT MOUNT        3rd International
     SINAI                    Prostate Cancer
                              and Urologic
                              Oncology
                              Symposium
    ------------------------------------------------------------------------
    AMERICAN SOCIETY FOR     2019                 11/11/2018      $50,000.00
     RADIATION ONCOLOGY       Multidisciplinary
                              Thoracic Cancers
                              Symposium
    ------------------------------------------------------------------------
    CENTER FOR MEDICAL       Core Outcomes in     11/11/2018      $75,000.00
     TECHNOLOGY POLICY        Non-Alcoholic
                              Steatohepatitis
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  Medical Oncology     11/11/2018      $10,000.00
     MD ANDERSON CANCER       and Hematology
     CENTER                   2019:
                              Multidisciplinary
                              Approaches that
                              Improve
                              Coordination of
                              Care
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2019 Nursing    11/11/2018      $30,000.00
     CANCER NETWORK, INC.     Program:
                              Advancing
                              Oncology NursingT
                              at the NCCN
                              Annual Conference
    ------------------------------------------------------------------------
    NORTH AMERICAN 3R'S      Virtual Education    11/11/2018       $4,000.00
     COLLABORATIVE            Community (VEC)
                              Support
    ------------------------------------------------------------------------
    COLLEGIUM                32nd Biennial        11/12/2018      $40,000.00
     INTERNATIONALE           Symposium of the
     ALLERGOLOGICUM           Collegium
                              Internationale
                              Allergologicum
    ------------------------------------------------------------------------
    PENN STATE COLLEGE OF    ISS at AACR BTK      11/12/2018     $370,330.00
     MEDICINE                 Inhibition as an
                              Anti-Cancer
                              Strategy:
                              Exploring a Model
                              for Modern
                              Targeted Therapy
                              in Hematologic
                              Malignancies and
                              Beyond
                              (150205409)
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Cleveland Clinic     11/12/2018       $5,000.00
     EDUCATIONAL FOUNDATION   Florida's 2nd
                              Annual San
                              Antonio Breast
                              Cancer Symposium
                              SABCS Official
                              Review Course
    ------------------------------------------------------------------------
    MAYO CLINIC              Mayo Clinic          11/12/2018      $15,000.00
     JACKSONVILLE             Advances in
                              Breast Cancer
                              Management 2019
    ------------------------------------------------------------------------
    LEUKEMIA RESEARCH        Hollis Brownstein    11/13/2018     $100,000.00
     FOUNDATION INC.          Research Grants
                              Program
    ------------------------------------------------------------------------
    MEDICAL LEARNING         ISS at ONS- Taking   11/13/2018     $317,050.00
     INSTITUTE, INC.          Aim at B-Cell
                              Malignancies with
                              BTK Inhibitors:
                              Hematology/
                              Oncology Nurse
                              Perspectives and
                              Insights on
                              Clinical Care
                              (150205361)
    ------------------------------------------------------------------------
    MEDSTAR HEALTH, INC.     Lung Cancer 2018:    11/15/2018       $5,000.00
                              Progress and
                              Future Directions
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Research             11/18/2018      $28,800.00
     FOUNDATION               initiative to
                              extend the
                              analytical work
                              related to
                              evaluation of
                              clinical
                              endpoints
                              suitable for
                              early phase
                              trials in CKD
                              using the CKD-
                              Epidemiology
                              Consortium (CKD-
                              EPI)
    ------------------------------------------------------------------------
    BOARD OF REGENTS OF THE  2019 Lymphoma        11/20/2018       $7,500.00
     UNIVERSITY OF NEBRASKA   Study Group
                              Hematology
                              Highlights A Post
                              ASH Review
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           39th Annual          11/20/2018      $25,000.00
                              Clinical
                              Hematology and
                              Oncology
                              Conference
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Pharmacists' Role    11/25/2018      $49,800.00
     CME, INC.                in the
                              Comprehensive
                              Care of Acute
                              Coronary Syndrome
    ------------------------------------------------------------------------
    PREVENTIVE               Connecting Heart     11/26/2018      $40,000.00
     CARDIOVASCULAR NURSES    Disease and
     ASSOCIATION              Diabetes-HCP Live
                              and On-Demand
                              Education
    ------------------------------------------------------------------------
    UHS PROFESSIONAL         Women's Health       11/26/2018       $5,000.00
     EDUCATION PROGRAMS       2019
     INC. (DBA VCU HEALTH
     CONTINUING MEDICAL
     EDUCATION)
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  25th Annual          11/26/2018      $15,000.00
     FOUNDATION               Interventional
                              Cardiology
                              Fellows Course
    ------------------------------------------------------------------------
    CEDARS-SINAI MEDICAL     13th Annual Women    11/28/2018       $5,000.00
     CENTER                   and Ischemic
                              Heart Disease
                              Symposium
    ------------------------------------------------------------------------
    SCRIPPS HEALTH           Dr. Richard Schatz   11/28/2018       $5,000.00
                              Interventional
                              Cardiology Summit
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     2019 DNA             11/29/2018      $10,000.00
     MOLECULAR AND CELLULAR   Replication and
     BIOLOGY                  Genome
                              Instability: From
                              Mechanism to
                              Disease A1
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  11th ANNUAL          11/29/2018      $50,000.00
     MD ANDERSON CANCER       HEMATOLOGIC
     CENTER                   MALIGNANCIES
                              DEMYSTIFIED: A
                              CRITICAL
                              APPRAISAL OF DATA
                              FROM 2018
    ------------------------------------------------------------------------
    MEDSTAR WASHINGTON       Cardiovascular       11/29/2018      $25,000.00
     HOSPITAL CENTER          Research
                              Technologies,
                              (CRT) 2019
    ------------------------------------------------------------------------
    CONQUER CANCER           2019 Conquer         12/02/2018      $40,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Merit
     CLINICAL ONCOLOGY        Awards
    ------------------------------------------------------------------------
    NORTHWELL HEALTH         New York City--      12/02/2018      $20,000.00
                              Debates in
                              Interventional
                              Cardiology
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      New York             12/02/2018      $10,000.00
     CARDIOLOGY FOUNDATION    Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    INTERNATIONAL            11th Biennial        12/02/2018      $25,000.00
     EOSINOPHIL SOCIETY,      Symposium
     INC.
    ------------------------------------------------------------------------
    JOHNS HOPKINS            Grand Rounds         12/03/2018     $150,000.00
     UNIVERSITY SCHOOL OF     series MCM:15
     MEDICINE                 visting faculty
                              series: Novel
                              Targeted Agents
                              in the Management
                              of Recurrent
                              Advanced Ovarian
                              Cancer
    ------------------------------------------------------------------------
    CONQUER CANCER           2019 Conquer         12/03/2018     $500,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Mission
     CLINICAL ONCOLOGY        Endowment
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     12/03/2018     $276,000.00
     FOR CANCER RESEARCH      Breast Cancer
                              Research
                              Fellowships
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR-AstraZeneca     12/03/2018     $276,000.00
     FOR CANCER RESEARCH      Ovarian Cancer
                              Research
                              Fellowships (DNA
                              Damage Response)
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      ASH Bridge Grant     12/03/2018     $150,000.00
     HEMATOLOGY               Program
    ------------------------------------------------------------------------
    GORDON RESEARCH          Gordon Research      12/03/2018       $4,000.00
     CONFERENCE               Conference:
                              Biotherapeutics
                              and Vaccines
                              Development
    ------------------------------------------------------------------------
    INDIANA UNIVERSITY       Breast Cancer Year   12/03/2018       $5,000.00
                              in Review
    ------------------------------------------------------------------------
    AMERICAN ASSOCIATION     AACR Annual          12/03/2018     $225,000.00
     FOR CANCER RESEARCH      Meeting 2019
    ------------------------------------------------------------------------
    TEXAS HEART INSTITUTE    9th Annual Women's   12/03/2018       $3,000.00
                              Heart and
                              Vascular
                              Symposium: A New
                              Era in
                              Prevention,
                              Diagnosis and
                              Treatment
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      2018 Managing        12/03/2018     $150,000.00
     CARDIOLOGY FOUNDATION    Cardiovascular
                              Risk in Diabetes
                              Roundtable
    ------------------------------------------------------------------------
    INTERNATIONAL            IASLC 19th           12/03/2018     $100,000.00
     ASSOCIATION FOR THE      Targeted
     STUDY OF LUNG CANCER     Therapies for
                              Lung Cancer
                              Meeting
    ------------------------------------------------------------------------
    NORTH CAROLINA THORACIC  North Carolina       12/04/2018      $14,500.00
     SOCIETY                  Thoracic Society
                              Annual Meeting
    ------------------------------------------------------------------------
    CONQUER CANCER           2019 Conquer         12/05/2018     $287,500.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Young
     CLINICAL ONCOLOGY        Investigator
                              Award (YIA)
    ------------------------------------------------------------------------
    CONQUER CANCER           2019 Conquer         12/05/2018     $230,000.00
     FOUNDATION OF THE        Cancer Foundation
     AMERICAN SOCIETY OF      of ASCO Career
     CLINICAL ONCOLOGY        Development Award
                              (CDA)
    ------------------------------------------------------------------------
    FRIENDS OF CANCER        2019 Friends of      12/05/2018     $200,000.00
     RESEARCH                 Cancer Research
                              Programs
    ------------------------------------------------------------------------
    COLEGIO DE MEDICOS       Innovations in       12/06/2018      $10,000.00
     CIRUJANOS DE PUERTO      Medicine 2018
     RICO
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC's Cancer        12/06/2018     $150,000.00
     IMMUNOTHERAPY OF         Immunotherapy
     CANCER                   Winter School
    ------------------------------------------------------------------------
    USF HEALTH PROFESSIONS   15th Annual          12/06/2018       $7,500.00
     CONFERENCING             Clinical
     CORPORATION              Breakthroughs and
                              Challenges in
                              Hematologic
                              Malignancies
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC's Cancer        12/09/2018     $100,000.00
     IMMUNOTHERAPY OF         Immunotherapy
     CANCER                   Guidelines
                              Project
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      Next Frontiers in    12/09/2018      $10,000.00
     ASSOCIATION              Urology 2019: a
                              Biennial AUA/JUA
                              Symposium
    ------------------------------------------------------------------------
    HOSPITAL QUALITY         Update on NSTEMI     12/10/2018     $185,000.00
     FOUNDATION               Management for
                              Hospitalists
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  DAPT Dilemmas: A     12/12/2018      $25,000.00
     FOUNDATION               Case-Based
                              Roundtable
                              Tutorial
    ------------------------------------------------------------------------
    ST. DOMINIC-JACKSON      Neuroscience         12/12/2018       $5,000.00
     MEMORIAL HOSPITAL        Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    HEART FAILURE SOCIETY    2019 Future          12/12/2018      $25,000.00
     OF AMERICA INC.          Leaders in Heart
                              Failure Symposium
    ------------------------------------------------------------------------
    CONQUER CANCER           2019                 12/13/2018      $40,000.00
     FOUNDATION OF THE        Gastrointestinal
     AMERICAN SOCIETY OF      (GI) Cancers
     CLINICAL ONCOLOGY        Symposium:
                              Multidisciplinary
                              Treatment,
                              Personalized
                              Care, Optimal
                              Outcomes
    ------------------------------------------------------------------------
    UNIVERSITY OF NEBRASKA   ONS 2019 ISS         12/13/2018     $150,000.00
     MEDICAL CENTER           Bioascend:
                              Patient and Nurse
                              Perspectives on
                              the Use of PARP
                              Inhibitors for
                              Ovarian Cancer:
                              Strategies for
                              Maximizing
                              Patient Outcomes
    ------------------------------------------------------------------------
    THE UNIVERSITY OF TEXAS  2019 Oncologic       12/13/2018      $20,000.00
     MD ANDERSON CANCER       Emergency
     CENTER                   Medicine
                              Conference
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          4th Annual Duke      12/13/2018       $3,000.00
                              Heart Center/DCRI
                              Fellows'
                              Presentation
                              Skills Course
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   Acute Kidney         12/16/2018       $5,000.00
     SOCIETIES FOR            Injury: from
     EXPERIMENTAL BIOLOGY     beside to bench
                              (and back again)
    ------------------------------------------------------------------------
    CONQUER CANCER           2019 ASCO-SITC       12/16/2018      $70,000.00
     FOUNDATION OF THE        Clinical Immuno-
     AMERICAN SOCIETY OF      Oncology
     CLINICAL ONCOLOGY        Symposium
    ------------------------------------------------------------------------
    PENNYSLVANIA SOCIETY     2018 Educational     12/16/2018       $2,000.00
     FOR BIOMEDICAL           Programming
     RESEARCH                 Support
    ------------------------------------------------------------------------
    AMERICAN DIABETES        Pathway to Stop      12/16/2018     $500,000.00
     ASSOCIATION              Diabetes
    ------------------------------------------------------------------------
    MEDICAL LEARNING         ISS at ASCO GI--     12/17/2018      $37,500.00
     INSTITUTE, INC.          Breaking the
                              Paradox:
                              Expanding Options
                              and New Questions
                              in HCC Management
                              (150205289)
    ------------------------------------------------------------------------
    C DAVIS AND S THOMPSON   Corporate            12/17/2018       $2,000.00
     DVM FOUNDATION           Membership
    ------------------------------------------------------------------------
    MIDWINTER CONFERENCE OF  58th Midwinter       12/18/2018       $5,000.00
     IMMUOLOGISTS             Conference of
                              Immunologists
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC General         12/19/2018       $3,000.00
     IMMUNOTHERAPY OF         Society
     CANCER
    ------------------------------------------------------------------------
    NATIONAL ACADEMY OF      Roundtable in        12/20/2018       $4,000.00
     SCIENCES                 Science and
                              Welfare of
                              Laboratory Animal
                              Use
    ------------------------------------------------------------------------
    MIT                      Koch Institute       12/23/2018       $5,000.00
                              2019 Immune
                              Engineering
                              Symposium
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          The Role of the      01/03/2019     $100,000.00
     FOUNDATION               Kidney and SGLT2
                              in Glucose
                              Homeostasis and
                              Kidney Disease: A
                              Scientific
                              Workshop
                              Sponsored by the
                              National Kidney
                              Foundation
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      AAAAI Foundation     01/03/2019     $150,000.00
     ALLERGY, ASTHMA AND      2019 Lectureship
     IMMUNOLOGY FOUNDATION,   Series
     INC.
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   15th Annual          01/03/2019     $299,856.00
                              Respiratory
                              Disease Young
                              Investigators'
                              Forum
    ------------------------------------------------------------------------
    MEDICAL LEARNING         ONS 2019 ISS         01/07/2019     $250,000.00
     INSTITUTE INC.           Peerview:,
                              ``Realizing the
                              Promise of PARP
                              Inhibitors in
                              Solid Tumor
                              Therapy Guiding
                              Oncology Nurses
                              on the Advances
                              and Challenges''
                              (150205359)
    ------------------------------------------------------------------------
    AMERICAN SOCIETY OF      Kidney Health        01/14/2019      $30,000.00
     NEPHROLOGY               Initiative
    ------------------------------------------------------------------------
    MELANOMA RESEARCH        Melanoma Research    01/14/2019      $10,000.00
     ALLIANCE                 Alliance 11th
                              Annual Scientific
                              Retreat
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      3rd Annual Heart     01/15/2019     $100,000.00
     EDUCATION FOUNDATION     in Diabetes (HiD)
    ------------------------------------------------------------------------
    COLD SPRING HARBOR       Integrated control   01/16/2019      $10,000.00
     LABORATORY               of feeding and
                              energy balance by
                              hypothalamic and
                              hindbrain
                              circuits
    ------------------------------------------------------------------------
    NEW YORK UNIVERSITY      XXIV Conference on   01/16/2019       $5,000.00
                              the Chemistry of
                              the Organic Solid
                              State
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   41st Annual          01/22/2019      $10,000.00
                              National Jewish
                              Health Pulmonary
                              and Allergy
                              Update
    ------------------------------------------------------------------------
    MEDICAL LEARNING         ISS at AATS 2019     01/22/2019     $302,760.00
     INSTITUTE INC.           Broadening
                              Horizons:The
                              Expanding Role of
                              Immunotherapy in
                              Locally Advanced
                              and Earlier
                              Stages of Lung
                              Cancer
                              (150205422)
    ------------------------------------------------------------------------
    MEDICAL LEARNING         CAP Chapter          01/24/2019     $414,050.00
     INSTITUTE, INC.          Meetings:
                              Molecular Testing
                              for EGFR
                              Mutations in the
                              Context of a
                              Changing
                              Treatment
                              Landscape,
                              Evolving Testing
                              Options, and New
                              Guidelines What
                              Do Pathologists
                              Need to Know and
                              Do? (150205307)
    ------------------------------------------------------------------------
    LUNGEVITY FOUNDATION     LUNGevity            02/03/2019      $10,000.00
                              Foundation
                              Nursing and Nurse
                              Navigator
                              Roundtable
    ------------------------------------------------------------------------
    REGENTS OF UC SAN DIEGO  2nd Annual Multi-    02/04/2019      $25,000.00
                              Disciplinary Head
                              and Neck Cancer
                              Conference-
                              Maximizing Speech
                              and Swallowing
                              Outcomes in
                              Patients
                              Undergoing
                              Radiation
                              Therapy: We're in
                              This Together
    ------------------------------------------------------------------------
    UNIVERSITY OF KANSAS     2018 San Antonio     02/06/2019       $5,000.00
     MEDICAL CENTER           Breast Cancer
                              Symposium Review
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Individualizing      02/06/2019      $22,500.00
     MANAGED CARE             Treatment in the
     PHYSICIANS, INC.         Management of
                              Advanced Breast
                              Cancer: How Novel
                              Therapies Are
                              Changing the
                              Treatment
                              Paradigm
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Integrating New      02/06/2019      $22,500.00
     MANAGED CARE             and Emerging
     PHYSICIANS, INC.         Targeted
                              Therapies into
                              the Treatment
                              Paradigm in
                              Ovarian Cancer:
                              Expert Strategies
                              for Improved
                              Patient Outcomes
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   Mitochondrial        02/07/2019      $10,000.00
     SOCIETIES FOR            Biogenesis and
     EXPERIMENTAL BIOLOGY     Dynamics in
                              Health and
                              Disease
    ------------------------------------------------------------------------
    NATIONAL JEWISH HEALTH   Impact of            02/07/2019      $64,925.00
                              Educational
                              Program on the
                              Career
                              Development of
                              Physician
                              Scientists;
                              Outcomes from 14
                              years of the
                              Annual
                              Respiratory
                              Disease Young
                              Investigators'
                              Forum--An Article
                              for Publication
    ------------------------------------------------------------------------
    NYU SCHOOL OF MEDICINE   Asthma Airways and   02/10/2019      $20,000.00
                              the Environment
    ------------------------------------------------------------------------
    MEDSTAR HEALTH           Mid-Atlantic         02/10/2019      $50,000.00
                              Nephrology Young
                              Investigators
                              Forum
    ------------------------------------------------------------------------
    SOCIETY OF GYNECOLOGIC   SGO 2019 Annual      02/10/2019      $62,500.00
     ONCOLOGY                 Meeting on
                              Women's Cancer
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      Heart Disease and    02/11/2019       $7,500.00
     DEPARTMENT OF SURGERY    Women
    ------------------------------------------------------------------------
    AMERICAN DIABETES        66th Advanced        02/11/2019      $40,000.00
     ASSOCIATION              Postgraduate
                              Course
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Hypoxia-Inducible    02/11/2019     $100,000.00
     FOUNDATION               Factor
                              Stabilization as
                              an Emerging
                              Therapy for CKD
                              Related Anemia A
                              Scientific
                              Workshop
                              Sponsored by the
                              National Kidney
                              Foundation
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2019-2020 Monthly    02/13/2019      $25,000.00
     CANCER NETWORK, INC.     Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   2019-2020 Monthly    02/13/2019      $25,000.00
     CANCER NETWORK, INC.     Oncology Tumor
                              Boards: A
                              Multidisciplinary
                              Approach to
                              Individualized
                              Patient Care
    ------------------------------------------------------------------------
    THE SOCIETY OF SURGICAL  SSO 2019 Annual      02/14/2019       $5,000.00
     ONCOLOGY                 Cancer Symposium
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         ONS Evidence-Based   02/17/2019     $293,500.00
     SOCIETY                  Practice
                              Improvement
                              Project:
                              Constipation
    ------------------------------------------------------------------------
    THE UNIVERSITY OF        16th Annual          02/17/2019      $50,000.00
     CHICAGO                  International
                              Ultmann Chicago
                              Lymphoma
                              Symposium
    ------------------------------------------------------------------------
    HOUSTON METHODIST        Heart of a Woman     02/17/2019       $3,000.00
     HOSPITAL
    ------------------------------------------------------------------------
    HEMATOLOGY/ONCOLOGY      HOPA 15th Annual     02/18/2019      $35,000.00
     PHARMACY ASSOCIATION     Conference
    ------------------------------------------------------------------------
    BAYLOR SCOTT AND WHITE   8th Annual           02/18/2019      $10,000.00
     HEALTH                   Symposium on
                              Current
                              Strategies in the
                              Treatment of
                              Multiple Myeloma,
                              Leukemia,
                              Hodgkin's
                              Lymphoma and B-
                              cell Non-
                              Hodgkin's
                              Lymphoma
    ------------------------------------------------------------------------
    USF HEALTH PROFESSIONS   CARDIOVASCULAR AND   02/18/2019     $247,330.00
     CONFERENCING             RENAL
     CORPORATION              COMPLICATIONS IN
                              T2DM: Roles of
                              Physician
                              Assistants and
                              Nurse
                              Practitioners in
                              Patient
                              Management
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  New Horizons in      02/18/2019      $35,000.00
     MANAGED CARE             the Treatment and
     PHYSICIANS, INC.         Management of B-
                              Cell Non-Hodgkin
                              Lymphoma: A
                              Closer Look at
                              the Role of
                              Emerging Targeted
                              Therapies
    ------------------------------------------------------------------------
    ONCOLOGY NURSING         ONS 44th Annual      02/18/2019      $50,000.00
     SOCIETY                  Congress and
                              Regional
                              Workshops
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView inVision:   02/19/2019     $122,250.00
     INSTITUTE INC.           ``New Frontiers
                              in Managing Heart
                              Failure: Are
                              SGLT2 Inhibitors
                              the Next Leap
                              Forward in
                              Optimizing
                              Patient Care?''
                              (150205455)
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2019 Annual     02/19/2019      $75,000.00
     CANCER NETWORK, INC.     Conference:
                              Improving the
                              Quality,
                              Effectiveness,
                              and Efficiency of
                              Cancer CareTM
    ------------------------------------------------------------------------
    ACS DIVISION OF          257th ACS National   02/19/2019       $2,000.00
     MEDICINAL CHEMISTRY      Meeting
    ------------------------------------------------------------------------
    ASSOCIATION FOR          TARC Targeting DNA   02/19/2019     $125,000.00
     MOLECULAR PATHOLOGY      Repair Pathways:
                              Current and
                              Future
                              Implications of
                              PARP Inhibitors
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      Pancreas Symposium   02/20/2019       $3,000.00
     DEPARTMENT OF SURGERY    2019: Current
                              Controversies in
                              Benign and
                              Malignant
                              Pancreatic
                              Disease
    ------------------------------------------------------------------------
    CONQUER CANCER           2019 ASCO Annual     02/20/2019      $30,000.00
     FOUNDATION OF THE        Meeting Breast
     AMERICAN SOCIETY OF      Cancer Track
     CLINICAL ONCOLOGY
    ------------------------------------------------------------------------
    ST. JOSEPH REGIONAL      Annual               02/21/2019       $1,000.00
     HEALTH NETWORK           Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Master Class for     02/21/2019      $25,000.00
     HEALTH SCIENCES AT       Oncologists 2019--
     EISENHOWER               Women's Cancer
                              Track
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     Master Class for     02/21/2019      $25,000.00
     HEALTH SCIENCES AT       Oncologists 2019--
     EISENHOWER               Hematologic
                              Malignancies
                              Track
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Achieving            02/24/2019       $1,500.00
     PHYSICIANS; PUERTO       Excellence in
     RICO CHAPTER             Patient Care
                              American College
                              of Physician
                              Annual Meeting
                              and Internal
                              Medicine Update
                              and Board Review
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Video in    02/25/2019      $95,975.00
     INSTITUTE INC.           Exchange
                              Navigating
                              Clinical
                              Challenges to
                              Maximize the
                              Benefits and
                              Minimize the
                              Risks of Cancer
                              Immunotherapies
                              (150204478)
    ------------------------------------------------------------------------
    COLUMBIA UNIVERSITY      Breast Cancer        02/26/2019       $2,000.00
     DEPARTMENT OF SURGERY    Management 2019
    ------------------------------------------------------------------------
    HOLY CROSS HOSPITAL      Updates in the       02/28/2019       $2,000.00
     INC.                     Treatment of
                              Common Cancers:
                              Lung,
                              Gastrointestinal,
                              GYN, and Breast
    ------------------------------------------------------------------------
    HOLY CROSS HOSPITAL      Updates in the       02/28/2019       $2,000.00
     INC.                     Treatment of
                              Common Cancers:
                              Lung,
                              Gastrointestinal,
                              GYN, and Breast
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Chronic              03/01/2019     $257,085.00
     FOUNDATION               Hyperkalemia
                              Management and
                              Outcomes in CKD
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Crucial              03/03/2019      $99,990.00
     CME, INC.                Conversations in
                              Nephrology: PHD
                              Inhibition as an
                              Emerging Approach
                              to Treating CKD
                              Anemia
    ------------------------------------------------------------------------
    UNIVERSITY OF ROCHESTER  20th Annual          03/03/2019       $6,500.00
                              Diabetes
                              Conference:
                              Current
                              Treatments for
                              Diabetes
                              Complications
    ------------------------------------------------------------------------
    CLEVELAND CLINIC         Advanced             03/03/2019      $10,000.00
     EDUCATIONAL FOUNDATION   Diagnostic
                              Bronchoscopy
                              Workshop
    ------------------------------------------------------------------------
    PREVENTIVE               Cardiovascular       03/03/2019      $50,000.00
     CARDIOVASCULAR NURSES    Risk Reduction:
     ASSOCIATION              25th
                              Cardiovascular
                              Nursing Symposium
                              Opening Session
    ------------------------------------------------------------------------
    PENN STATE COLLEGE OF    An Update on SGLT2   03/03/2019     $142,430.00
     MEDICINE                 Inhibition for
                              the Prevention
                              and Treatment of
                              Kidney Disease in
                              Patients with
                              Type 2 Diabetes
                              (150205286)
    ------------------------------------------------------------------------
    REGENTS OF THE           Making the           03/03/2019     $200,000.00
     UNIVERSITY OF            Connection: A
     CALIFORNIA, SAN DIEGO    Comprehensive
                              Strategy on the
                              Modern Management
                              of Type 1 and
                              Type 2 Diabetes
                              2019
    ------------------------------------------------------------------------
    ANNENBERG CENTER FOR     From Inquiry to      03/03/2019      $50,000.00
     HEALTH SCIENCES AT       Investigation to
     EISENHOWER               Insight (I3):
                              Clinical Clarity
                              in Non-Small Cell
                              Lung Cancer--The
                              2019 JADPRO Lung
                              Cancer Conference
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Advances in the      03/03/2019      $30,000.00
     MANAGED CARE             Management of
     PHYSICIANS, INC.         Acute Coronary
                              Syndrome (ACS):
                              Updated Guideline
                              Recommendations
                              for Dual
                              Antiplatelet
                              Therapy
    ------------------------------------------------------------------------
    EASTERN VIRGINIA         Turning the Tide     03/03/2019       $5,000.00
     MEDICAL SCHOOL           on Diabetes 2019
    ------------------------------------------------------------------------
    AMERICAN ACADEMY OF      Foundations of       03/04/2019     $200,000.00
     ALLERGY ASTHMA AND       Asthma Management
     IMMUNOLOGY
    ------------------------------------------------------------------------
    KEYSTONE SYMPOSIA ON     2019 Cancer          03/04/2019       $5,000.00
     MOLECULAR AND CELLULAR   Immunotherapy:
     BIOLOGY                  Mechanistic
                              Insights to
                              Improve Clinical
                              Benefit
    ------------------------------------------------------------------------
    METABOLIC ENDOCRINE      The Primary          03/04/2019     $154,110.00
     EDUCATION FOUNDATION     Prevention of CHF
                              and CKD in
                              Diabetes
                              Satellite
                              Symposium
    ------------------------------------------------------------------------
    THE CHEST FOUNDATION     2019 CHEST           03/04/2019      $35,000.00
                              Foundation
                              Research Award in
                              Severe Asthma
    ------------------------------------------------------------------------
    MEDICAL LEARNING         PeerView Live at     03/04/2019      $90,000.00
     INSTITUTE INC.           USCAP 2019,
                              Clinical Advances
                              in Cancer
                              Immunotherapies,
                              Biomarkers, and
                              Testing:
                              Implications for
                              Pathologists at
                              the Forefront of
                              the Emerging
                              Precision
                              Oncology Era
                              (150205529)
    ------------------------------------------------------------------------
    AMERICAN NEPHROLOGY      The CKD Patient      03/05/2019      $61,500.00
     NURSES ASSOCIATION       with
     (ANNA)                   Hyperkalemia:
                              Nephrology Nurses
                              Evidence Based
                              Care
    ------------------------------------------------------------------------
    NATIONAL ASSOCIATION OF  Improving Clinical   03/05/2019      $35,000.00
     MANAGED CARE             and Economic
     PHYSICIANS, INC.         Outcomes with
                              Personalized
                              Treatment in the
                              Management of
                              Advanced Non-
                              Small Cell Lung
                              Cancer (NSCLC)
    ------------------------------------------------------------------------
    DUKE UNIVERSITY          The Southeastern     03/06/2019       $2,500.00
                              Fellows Research
                              Skills and
                              Training Workshop
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   NCCN 2019 Oncology   03/06/2019      $10,000.00
     CANCER NETWORK, INC.     Fellows Program:
                              New Horizons in
                              Quality Cancer
                              CareT at the NCCN
                              Annual Conference
    ------------------------------------------------------------------------
    UNIVERSITY OF            Allergy Fellowship   03/06/2019      $40,000.00
     WASHINGTON SCHOOL OF
     MEDICINE
    ------------------------------------------------------------------------
    DREXEL MEDICINE          Updates In Women's   03/06/2019       $2,000.00
                              Health 2109
    ------------------------------------------------------------------------
    MEDICAL LEARNING         Addressing Unmet     03/06/2019     $122,250.00
     INSTITUTE INC.           Needs in Managing
                              Anemia in Chronic
                              Kidney Disease: A
                              Closer Look at
                              the Clinical
                              Potential of HIF-
                              PH Inhibitors
                              (150205556)
    ------------------------------------------------------------------------
    SIDNEY KIMMEL MEDICAL    7th Annual Lung      03/06/2019       $2,500.00
     COLLEGE AT THOMAS        Cancer Symposium
     JEFFERSON UNIVERSITY
    ------------------------------------------------------------------------
    MEDICAL LEARNING         ASCO 2019 peer       03/10/2019      $30,000.00
     INSTITUTE INC.           view Stories from
                              the Pancreatic
                              Cancer CaseBook:
                              Taking the Road
                              to Improved
                              Outcomes with
                              Modern
                              Therapeutic
                              Concepts and
                              Innovative
                              Treatments
                              (150205416)
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      GKCAS 2019 Annual    03/10/2019       $3,000.00
     ALLERGY, ASTHMA AND      Meeting
     IMMUNOLOGY
    ------------------------------------------------------------------------
    REGENTS OF THE           13th International   03/10/2019      $25,000.00
     UNIVERSITY OF            Congress on
     CALIFORNIA               Systemic Lupus
                              Erythematosus
                              (LUPUS 2019)
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Support for NCCN     03/11/2019      $60,000.00
     CANCER NETWORK, INC.     Distribution of
                              the NCCN Clinical
                              Practice
                              Guidelines in
                              Oncology (NCCN
                              Guidelinesr) for
                              Management of
                              Immunotherapy-
                              Related
                              Toxicities Pocket
                              Guides
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      Bladder Cancer in    03/11/2019      $15,000.00
     ASSOCIATION              Women:
                              Identifying
                              Research Needs to
                              Improve Diagnosis
                              and Treatment A
                              Johns Hopkins
                              Greenberg Bladder
                              Cancer Institute/
                              American
                              Urological
                              Association
                              Translational
                              Research
                              Collaboration
    ------------------------------------------------------------------------
    GORDON RESEARCH          2019 Multidrug       03/11/2019       $2,500.00
     CONFERENCES              Efflux Systems
                              Gordon Research
                              Conference
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          14th Annual Young    03/12/2019      $50,000.00
     FOUNDATION               Investigator's
                              Forum
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      Lung Cancer          03/12/2019      $25,000.00
     CHEST PHYSICIANS         Screening
                              Decision
                              Counselor and
                              Navigator
                              Training
    ------------------------------------------------------------------------
    SOCIETY OF               SIR Annual           03/13/2019      $12,500.00
     INTERVENTIONAL           Scientific
     RADIOLOGY                Meeting
    ------------------------------------------------------------------------
    ECOG RESEARCH AND        ECOG-ACRIN Spring    03/13/2019       $5,000.00
     EDUCATION FOUNDATION,    2019 Group
     INC.                     Meeting
    ------------------------------------------------------------------------
    MEDSTAR HEALTH, INC.     Kidney and Bladder   03/14/2019      $10,000.00
                              Cancers 2019
    ------------------------------------------------------------------------
    AMERICAN COLLEGE OF      ACC Annual           03/14/2019      $50,000.00
     CARDIOLOGY FOUNDATION    Scientific
                              Session
    ------------------------------------------------------------------------
    SAINT FRANCIS HOSPITAL   55th Annual Robert   03/14/2019       $5,000.00
     AND MEDICAL CENTER       M. Jeresaty, MD
                              Cardiovascular
                              Symposium
    ------------------------------------------------------------------------
    CARDIOVASCULAR RESEARCH  A New Beat:          03/14/2019      $25,000.00
     FOUNDATION               Improving
                              Cardiovascular
                              Care in Women and
                              Minorities
    ------------------------------------------------------------------------
    GORDON RESEARCH          Therapeutically      03/14/2019       $2,500.00
     CONFENCE                 Targeted Small
                              Molecules and
                              Enabling
                              Technologies in
                              Drug Discovery
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Support for NCCN     03/14/2019      $25,000.00
     CANCER NETWORK           Distribution of
                              the NCCN Clinical
                              Practice
                              Guidelines in
                              Oncology (NCCN
                              Guidelinesr) for
                              Breast Cancer
                              Pocket Guides
    ------------------------------------------------------------------------
    NORTHWELL HEALTH         1st Annual Heart     03/17/2019      $15,000.00
                              of Prevention
                              Symposium:
                              Updates on
                              Cardiovascular
                              Disease
                              Prevention With a
                              Focus on Women's
                              Heart Health
    ------------------------------------------------------------------------
    AMERICAN THORACIC        ATS 2019 Fellows     03/17/2019      $10,000.00
     SOCIETY INC.             Track Symposium
    ------------------------------------------------------------------------
    SOCIETY FOR              SITC's PD-L1         03/17/2019      $35,000.00
     IMMUNOTHERAPY OF         Resistance
     CANCER                   Definition
                              Project
    ------------------------------------------------------------------------
    CITY OF HOPE             8th Annual           03/17/2019      $10,000.00
                              Clinical Cancer
                              Genetics and
                              Genomics
                              Conference; From
                              Exceptionalism to
                              Exceptional Care:
                              Mainstreaming
                              Genomic Medicine
                              in Clinical
                              Practice
    ------------------------------------------------------------------------
    FEDERATION OF AMERICAN   2019 FASEB SRC on    03/18/2019       $5,000.00
     SOCIETIES FOR            Intracellular RNA
     EXPERIMENTAL BIOLOGY     localization and
                              local translation
    ------------------------------------------------------------------------
    FOUNDATION FOR HEART     23rd Annual Heart    03/18/2019      $10,000.00
     FAILURE EDUCATION,       Failure-An Update
     INC.                     on Therapy
    ------------------------------------------------------------------------
    PURDUE UNIVERSITY        Type 2 Diabetes      03/19/2019      $75,000.00
                              Mellitus and
                              Heart Failure:
                              Screening,
                              Diagnosis, and
                              Management
    ------------------------------------------------------------------------
    ASTHMA AND ALLERGY       ``Wheezin, Sneezin   03/19/2019      $10,000.00
     FOUNDATION OF AMERICA--  and Itchin in
     ALASKA CHAPTER           Alaska''
    ------------------------------------------------------------------------
    AMERICAN RADIUM SOCIETY  101st Annual         03/19/2019      $25,000.00
                              Meeting
    ------------------------------------------------------------------------
    NATIONAL KIDNEY          Anemia in Chronic    03/19/2019     $257,085.00
     FOUNDATION               Kidney Disease:
                              Arming Clinicians
                              with Meaningful
                              Solutions
    ------------------------------------------------------------------------
    AMERICAN UROLOGICAL      The Evolving Role    03/19/2019      $25,000.00
     ASSOCIATION EDUCATION    of the Urologist
     AND RESEARCH, INC.       in Advanced
                              Castration
                              Dependent
                              Prostate Cancer:
                              a Guidelines and
                              Case-based
                              Discussion
    ------------------------------------------------------------------------
    NATIONAL COMPREHENSIVE   Emerging Issues in   03/20/2019      $25,000.00
     CANCER NETWORK, INC.     Oncology--Ensurin
                              g Access to, and
                              Delivery of,
                              Innovative
                              Therapies and
                              Patient Centered
                              Care in Oncology
    ------------------------------------------------------------------------
    ACS DIVISION OF          257th ACS National   03/20/2019       $5,000.00
     BIOCHEMICAL TECHNOLOGY   Meeting and
                              Exposition (BIOT
                              Division)
    ------------------------------------------------------------------------
    Worksheet: Grants 2014 to Mar 20 2019

                                                                           Appendix B
    --------------------------------------------------------------------------------------------------------------------------------------------------------
       Product     Q114   Q214   Q314   Q414   Q115   Q215   Q315   Q415   Q116   Q216   Q316   Q416   Q117   Q217   Q317   Q417   Q118   Q218   Q318   Q418
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    FARXIGA                                                                                               X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    ONGLYZA                                       X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    KOMBIGLYZE                                                         X      X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    SYMBICORT                                                                 X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    PULMICORT                                                                                             X      X      X      X      X      X      X      X
     FLEXHALER
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NEXIUM OS         X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    NEXIUM XSULE      X      X      X      X      X      X      X      X      X      X      X      X      X      X             X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    CRESTOR           X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BYETTA                                        X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    BYDUREON                                                                                                                          X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    SYMLIN            X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    TUDORZA                                                                                                                           X      X      X      X
    --------------------------------------------------------------------------------------------------------------------------------------------------------
    X URA Capped at AMP

                                   Appendix C
    ------------------------------------------------------------------------
            Product                 MPD Plan             Effective Dates
    ------------------------------------------------------------------------
                            Abarca                           1/1/18-12/31/19
                           -------------------------------------------------
                            Envision                         1/1/18-12/31/18
                           -------------------------------------------------
    Byetta                  Express Scripts                  4/1/18-12/31/19
                           -------------------------------------------------
                            Health Delegates                 1/1/18-12/31/18
                           -------------------------------------------------
                            MedImpact                        1/1/19-12/31/19
                           -------------------------------------------------
                            SIS                              1/1/18-12/31/19
    ------------------------------------------------------------------------
                            Abarca                           1/1/16-12/31/16
                           -------------------------------------------------
                            Blue Shield of CA        7/1/15-12/31/16; 5/2/16-
                                                                    12/31/16
                           -------------------------------------------------
                            Emblem Health            1/1/15-12/31/15; 1/1/16-
                                                                    12/31/16
                           -------------------------------------------------
                            Envision                         1/1/17-12/31/17
                           -------------------------------------------------
                            Express Scripts                  5/2/16-12/31/19
                           -------------------------------------------------
                            Florida Health                   1/1/14-12/31/16
                           -------------------------------------------------
                            Health Alliance Medical          1/1/15-12/31/16
                             Plan
                           -------------------------------------------------
                            Health Partners Plans            1/1/15-12/31/16
                           -------------------------------------------------
                            Healthspring                     4/1/15-12/31/15
                           -------------------------------------------------
                            Highmark                         7/1/14-12/31/16
                           -------------------------------------------------
                            Humana                   1/1/15-12/31/16; 5/1/16-
                                                      7/30/16; 8/1/2016-P12/
                                                                       31/16
                           -------------------------------------------------
    Crestor                 IHA                              1/1/15-12/31/16
                           -------------------------------------------------
                            MedImpact                          1/1/15-5/1/16
                           -------------------------------------------------
                            Navitus                          1/1/15-12/31/16
                           -------------------------------------------------
                            OptumRx                          7/1/16-12/31/17
                           -------------------------------------------------
                            Perform Rx                      10/1/15-12/31/16
                           -------------------------------------------------
                            Pharm. Tech                      1/1/15-12/31/16
                           -------------------------------------------------
                            Prime Therapeutics               5/2/16-12/31/16
                           -------------------------------------------------
                            SelectHealth                     1/1/15-12/31/16
                           -------------------------------------------------
                            SilverScript                     7/1/14-12/31/16
                           -------------------------------------------------
                            SIS                              1/1/15-12/31/16
                           -------------------------------------------------
                            Ventegra                         1/1/15-12/31/16
                           -------------------------------------------------
                            WellCare                         1/1/15-12/31/16
    ------------------------------------------------------------------------
                            Envision                 1/1/17-12/31/17; 1/1/18-
                                                                    12/31/18
                           -------------------------------------------------
                            Express Scripts                  1/1/16-12/31/19
                           -------------------------------------------------
                            Harvard Pilgrim                  1/1/14-12/31/14
                           -------------------------------------------------
                            Health Alliance Medical          1/1/14-12/31/14
                             Plan
                           -------------------------------------------------
                            Healthspring                     4/1/15-12/31/15
                           -------------------------------------------------
                            Highmark                         7/1/14-12/31/16
                           -------------------------------------------------
    Nexium                  Humana                   1/1/14-12/31/14; 1/1/15-
                                                                    12/31/16
                           -------------------------------------------------
                            Navitus                  1/1/14-1/31/14; 1/1/15-
                                                                    12/31/16
                           -------------------------------------------------
                            Optum Rx                         1/1/14-12/31/18
                           -------------------------------------------------
                            Prime Therapeutics               1/1/14-12/31/14
                           -------------------------------------------------
                            Scott & White                    1/1/14-12/31/14
                           -------------------------------------------------
                            SilverScript                     7/1/14-12/31/16
                           -------------------------------------------------
                            WellCare                         1/1/15-12/31/16
    ------------------------------------------------------------------------
                            Abarca                           1/1/16-12/31/16
                           -------------------------------------------------
                            Blue Shield of CA                1/1/15-12/31/16
                           -------------------------------------------------
                            Emblem Health            1/1/15-12/31/15; 1/1/16-
                                                                    12/31/16
                           -------------------------------------------------
                            Envision                 1/1/17-12/31/17; 1/1/18-
                                                                    12/31/18
                           -------------------------------------------------
                            Health Partners Plans            1/1/15-12/31/16
                           -------------------------------------------------
                            Healthspring                     4/1/15-12/31/15
                           -------------------------------------------------
    Seroquel                Highmark                         7/1/14-12/31/16
                           -------------------------------------------------
                            Humana                           1/1/15-12/31/16
                           -------------------------------------------------
                            IHA                              1/1/15-12/31/16
                           -------------------------------------------------
                            Navitus                  1/1/15-12/31/16; 1/1/17-
                                                                    12/31/19
                           -------------------------------------------------
                            Perform Rx                      10/1/15-12/31/16
                           -------------------------------------------------
                            Pharm. Tech              1/1/15-12/31/16; 1/1/18-
                                                                    12/31/18
                           -------------------------------------------------
                            SelectHealth                     1/1/17-12/31/18
                           -------------------------------------------------
                            SIS                              1/1/15-12/31/16
    ------------------------------------------------------------------------
                            Health Alliance Medical          1/1/15-12/31/16
                             Plan
                           -------------------------------------------------
    Seroquel XR             SilverScript                     7/1/14-12/31/16
                           -------------------------------------------------
                            Ventegra                         1/1/15-12/31/16
                           -------------------------------------------------
                            WellCare                         1/1/15-12/31/16
    ------------------------------------------------------------------------

                         AstraZeneca Pharmaceuticals LP

                               1800 Concord Pike

                                 P.O. Box 15437

                            Wilmington DE 19850-5437

                                Tel 302-886-3000

                             www.astrazeneca-us.com

    March 7, 2019

    The Honorable Charles E. Grassley
    Chairman
    Committee on Finance
    U.S. Senate
    Washington, DC 20510

    The Honorable Ron Wyden
    Ranking Member
    Committee on Finance
    U.S. Senate
    Washington, DC 20510

    Dear Chairman Grassley and Ranking Member Wyden:

        AstraZeneca's CEO Pascal Soriot appeared before your Committee on
    February 26, 2019 and answered a question from Senator Cortez Masto
    regarding whether AstraZeneca offers authorized generic versions of any
    of its products. At that time, Mr. Soriot indicated that AstraZeneca
    does not offer any authorized generics, however, following the hearing,
    Mr. Soriot was informed by AstraZeneca staff that an authorized generic
    is currently available in the U.S. This letter is intended to correct
    the record regarding that inadvertent oversight.

        AstraZeneca does, in fact, currently have one authorized generic in
    the U.S. market, and it was launched more than 3 years after the first
    generic of that product was introduced. Authorized generics are not a
    primary area of focus for AstraZeneca and are introduced on a selective
    basis. In limited circumstances, AstraZeneca has made an authorized
    generic available through a third-party distributor. Because patient
    prescription access and coverage may vary with respect to branded
    versus generic medicines, AstraZeneca believes it is important to keep
    branded options available for patients who continue to rely on them.

        We appreciate your invitation to discuss important issues of
    patient access and affordability with the Committee and the opportunity
    to supplement Mr. Soriot's testimony. We look forward to working with
    you as a constructive partner in addressing challenges in our health-
    care system.

    Sincerely,

    Christie Bloomquist
    Vice President, Corporate Affairs, North America

                                     ______

       Prepared Statement of Jennifer Taubert, Executive Vice President,
         Worldwide Chairman, Janssen Pharmaceuticals, Johnson & Johnson
        Chairman Grassley, Ranking Member Wyden, and members of the
    committee, thank you for the opportunity to be here to discuss how we
    can ensure that Americans have affordable access to the best healthcare
    today and to the extraordinary medical breakthroughs of tomorrow.

        I am Jennifer Taubert, and I lead the Janssen Pharmaceutical
    Companies of Johnson & Johnson. At Janssen, we focus on discovering and
    developing transformational medicines that treat and cure some of the
    world's most challenging diseases, including blood cancers like
    multiple myeloma, chronic lymphocytic leukemia, and mantle cell
    lymphoma; prostate cancer; HIV; schizophrenia and other serious mental
    illnesses; cardiovascular diseases; rheumatoid arthritis; Crohn's
    Disease and other destructive gastrointestinal illnesses; and pulmonary
    hypertension, among others.

        Like many of you, I know what it's like when a loved one faces a
    serious disease. My own mother died of lung cancer in 1988, in her 40s.
    At the time, there was very little that could be done for my mom. I've
    committed my career to bringing families genuine, meaningful hope--hope
    for years of life, hope for the chance to be there for a daughter's
    wedding or the birth of a grandchild.
                            commitment to innovation
        Last year Janssen invested $8.4 billion globally in research and
    development,\1\ making Janssen one of the world's top research and
    development (``R&D'') investors in any industry, anywhere in the
    world.\2\ In fact, our investment in R&D last year was 86 percent more
    than we spent on sales and marketing. This substantial investment has
    enabled us to research and develop more than 100 medicine candidates
    last year; and, over the past 5 years, we have introduced six
    innovative products in the U.S.\3\ The nine Breakthrough Therapy
    Designations we have received from the Food and Drug Administration
    (``FDA'') reflect the significance of the advances we are pursuing in
    areas of profound unmet medical need.\4\
    ---------------------------------------------------------------------------
        \1\ Johnson & Johnson, FY18-Q4 Form 10-K for the Period Ending
    December 31, 2018 (filed February 20, 2019).
        \2\ PricewaterHouseCoopers. ``2018 Global Innovation 1000 Study.''
    https://www.strategyand.
    pwc.com/innovation1000.
        \3\ U.S. Food and Drug Administration Center for Drug Evaluation
    and Research. ``NDA and BLA Approval Reports--New Molecular Entity
    (NME) Drug and New Biologic Approvals.'' https://wayback.archive-
    it.org/7993/20170404174205/https://www.fda.gov/Drugs/Develop
    mentApprovalProcess/HowDrugsareDevelopedandApproved/
    DrugandBiologicApprovalReports/NDAandBLAApprovalReports/ucm373420.htm.
        \4\ U.S. Food and Drug Administration Center for Drug Evaluation
    and Research. ``CDER Breakthrough Therapy Designation Approvals.''
    https://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/
    HowDrugsareDevelopedandApproved/DrugandBiologicApproval
    Reports/NDAandBLAApprovalReports/UCM481542.pdf.

        Our investment changes lives. It has helped turn HIV from a death
    sentence into a manageable disease. Today, people with HIV can have a
    near-normal life expectancy.\5\ And we are working on a vaccine with
    the potential to eliminate HIV altogether. Our biologic therapies have
    transformed the lives of patients with Inflammatory Bowel Disease by
    dramatically improving their quality of life. Our therapies have
    reduced major bowel surgeries for patients with Crohn's Disease by 82
    percent and cut hospitalizations by 65 percent.\6\ In ulcerative
    colitis patients, our therapies have reduced the need for total
    colectomy by 41 percent.\7\ One of our earliest pharmaceutical
    innovations enabled people with serious mental illness to be treated at
    home and in their communities rather than in psychiatric institutions,
    and today our innovative first and only 4-time-a-year schizophrenia
    treatment is improving adherence and breaking the cycle of
    hospitalization so that people with schizophrenia can live their best
    lives.\8\ In the area of mental health, we are also investigating a new
    medicine for people suffering from treatment-resistant depression,
    which profoundly impacts these patients and their families and loved
    ones as well. Our first-in-class cancer medicines have helped patients
    with some of the most common and deadly types of cancer live longer, in
    some cases for many additional years.\9\, \10\ In multiple
    myeloma, one of our medicines has more than doubled the length of time
    patients live without return of their disease.\11\ We recently launched
    a new prostate cancer treatment that delays the spread of the disease
    by over an additional two years versus the prior standard of
    care.\12\, \13\
    ---------------------------------------------------------------------------
        \5\ Trickey, Adam, Margaret T. May, Jorg-Janne Vehreschild, Niels
    Obel, M. John Gill, Heidi M. Crane, Christoph Boesecke et al.
    ``Survival of HIV-positive patients starting antiretroviral therapy
    between 1996 and 2013: a collaborative analysis of cohort studies.''
    The Lancet HIV 4, no. 8 (2017): e349-e356. doi: 10.1016/S2352-
    3018(17)30066-8.
        \6\ Lichtenstein, Gary R., Songkai Yan, Mohan Bala, Marion Blank,
    and Bruce E. Sands. ``Infliximab maintenance treatment reduces
    hospitalizations, surgeries, and procedures in fistulizing Crohn's
    disease.'' Gastroenterology 128, no. 4 (2005): 862-869. doi: 10.1053/
    j.gastro.2005.01.048.
        \7\ Sandborn, William J., Paul Rutgeerts, Brian G. Feagan, Walter
    Reinisch, Allan Olson, Jewel Johanns, Jiandong Lu et al. ``Colectomy
    rate comparison after treatment of ulcerative colitis with placebo or
    infliximab.'' Gastroenterology 137, no. 4 (2009): 1250-1260.
    doi:10.1053/j.gastro.2009.06.061.
        \8\ INVEGA TRINZA U.S. Prescribing Information, January 2019.
    http://www.janssenlabels.
    com/package-insert/product-monograph/prescribing-information/
    INVEGA+TRINZA-pi.pdf.
        \9\ IMBRUVICA U.S. Prescribing Information, January 2019. https://
    www.imbruvica.com/docs/librariesprovider7/default-document-library/
    prescribing-information.pdf.
        \10\ ZYTIGA U.S. Prescribing Information, April 2019. http://
    www.janssenlabels.com/package-insert/product-monograph/prescribing-
    information/ZYTIGA-pi.pdf.
        \11\ Bahlis, Nizar, Meletios A. Dimopoulos, Darrell J. White, Lotfi
    Benboubker, Gordon Cook, Merav Leiba, P. Joy Ho et al. ``Three-Year
    Follow-up of the Phase 3 Pollux Study of Daratumumab Plus Lenalidomide
    and Dexamethasone (D-Rd) Versus Lenalidomide and Dexamethasone (Rd)
    Alone in Relapsed or Refractory Multiple Myeloma (RRMM).'' (2018):
    1996-1996. doi: 10.1182/blood-2018-99-112697.
        \12\ DARZALEX U.S. Prescribing Information, June 2018. http://
    www.janssenlabels.com/package-insert/product-monograph/prescribing-
    information/DARZALEX-pi.pdf.
        \13\ ERLEADA U.S. Prescribing Information, February 2018. http://
    www.janssenlabels.com/package-insert/product-monograph/prescribing-
    information/ERLEADA-pi.pdf.

        This progress against some of the world's most challenging diseases
    is heartening but hard-won. Continued advancement will require
    perseverance and dedication. For example, we remain very committed to
    continuing research exploring new approaches and investigational
    medicines to prevent Alzheimer's dementia, which starts many years
    before the full onset of disease. In fact, we have invested billions of
    dollars in this area, and despite some significant projects that were
    halted because of lack of efficacy or a newly identified imbalance in
    benefit-risk, we continue to invest with the goal of conquering this
    ---------------------------------------------------------------------------
    major public health challenge in our lifetimes.

        Defeating Alzheimer's would not only change the lives of millions
    of patients and their families, it would dramatically change the
    economic burden of the disease. According to one analysis, if a new
    treatment that delays the onset of Alzheimer's by just five years were
    approved by 2025, the U.S. would save an estimated $367 billion each
    year by 2050.\14\
    ---------------------------------------------------------------------------
        \14\ Alzheimer's Association. ``Changing the Trajectory of
    Alzheimer's Disease: How a Treatment by 2025 Saves Lives and Dollars.''
    May 2015. https://www.alz.org/media/Documents/changing-the-trajectory-
    r.pdf.

        In fact, across a wide range of conditions, prescription medicines
    play a key role in keeping people well and productive and preventing
    the need for costly procedures and hospitalizations. For example, since
    the introduction of antiretroviral therapies, we've seen up to a
    $402,000 lifetime cost savings for each HIV patient diagnosed at an
    early stage.\15\ Cardiovascular medicines have led to a 27 percent
    reduction in costs for hospitalizations and procedures.\16\ In fact,
    the U.S. health-care system could save $213 billion annually with the
    correct use of prescription medications.\17\, \18\
    ---------------------------------------------------------------------------
        \15\ Farnham, Paul G., Chaitra Gopalappa, Stephanie L. Sansom,
    Angela B. Hutchinson, John T. Brooks, Paul J. Weidle, Vincent C.
    Marconi, and David Rimland. ``Updates of Lifetime Costs of Care and
    Quality-of-Life Estimates for HIV-Infected Persons in the United
    States: Late Versus Early Diagnosis and Entry Into Care.'' Journal of
    Acquired Immune Deficiency Syndromes 64, no. 2 (2013): 183-189. doi:
    10.1097/QAI.0b013e3182973966.
        \16\ Gotto, Antonio M., Stephen J. Boccuzzi, John R. Cook, Charles
    M. Alexander, James B. Roehm, Gregg S. Meyer, Michael Clearfield,
    Stephen Weis, and Edwin Whitney. ``Effect of Lovastatin on
    Cardiovascular Resource Utilization and Costs in The Air Force/Texas
    Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS).'' The
    American Journal of Cardiology 86, no. 11 (2000): 1176-181.
    doi:10.1016/s0002-9149(00)01198-x.
        \17\ IMS Institute for Healthcare Informatics, ``Avoidable Costs in
    U.S. Healthcare'' (June 2013). http://offers.premierinc.com/rs/381-NBB-
    525/images/Avoidable_Costs_in%20_US_Healthcare-
    IHII_AvoidableCosts_2013%5B1%5D.pdf.
        \18\ Roebuck, M.C., J.N. Liberman, M. Gemmill-Toyama, and T.A.
    Brennan. ``Medication Adherence Leads to Lower Health Care Use and
    Costs Despite Increased Drug Spending.'' Health Affairs 30, no. 1
    (2011): 91-99. doi:10.1377/hlthaff.2009.1087.

        But medicines can't make a difference if patients who need them
    can't get them. We understand concerns about the cost of health care.
    Although prescription medicines represent only 14 percent of overall
    health-care spend--a figure that has remained relatively steady for the
    past decade and is projected to remain so into the future \19\--and 90
    percent of prescriptions are filled with generics,\20\ managing the
    cost of medicines, particularly what patients pay at the pharmacy
    counter, is important.
    ---------------------------------------------------------------------------
        \19\ Altarum Institute. ``A 10-Year Projection of the Prescription
    Drug Share of National Health Expenditures, Including Nonretail.''
    Report. August 2015. http://altarum.org/sites/default/files/uploaded-
    publication-files/Non-Retail%20Rx%20Forecast%20Data%20Brief%2010-14-14.
    pdf.
        \20\ IQVIA. ``2017 Medicine Use and Spending in the U.S. a Review
    of 2017 and Outlook to 2022.'' April 2018. https://www.iqvia.com/-/
    media/iqvia/pdfs/institute-reports/medicine-use-and-spending-in-the-us-
    a-review-of-2017-and-outlook-to-2022.pdf.
    ---------------------------------------------------------------------------
                            our approach to pricing
        At Janssen, we take a responsible approach to pricing that
    recognizes our dual responsibility to patients today and patients
    tomorrow. Patients today need access to our medicines. Patients
    tomorrow count on us to deliver cures and treatments for the most
    challenging, intractable diseases. When we set an initial price for our
    medicines, we balance:

              Value to patients, the health-care system, and society. We
            consider how the medicine will improve patient health and
            assess its potential to reduce other costs--surgeries, hospital
            stays, or long-term care, for example--and the improvement the
            medicine represents over the existing standard of care.

              Affordable access to medicines for people who need them. We
            want to ensure appropriate insurance coverage so that patients
            who are prescribed our medicines can get them.

              Ability to develop future groundbreaking cures and
            treatments. We have an obligation to ensure we have the
            resources necessary to invest in future R&D to address serious
            unmet medical needs.

        The list price of a medicine is a starting point that is ultimately
    reduced by the substantial discounts, rebates, and fees we provide to
    insurance companies, pharmacy benefit managers (``PBMs''), government
    programs, and others. We pay required discounts to government programs,
    and we negotiate with private payers so that they will cover our
    medicines and make them available to patients with lower out-of-pocket
    cost. In 2018, we provided approximately $21 billion in discounts and
    rebates on our medicines--an overall reduction from list price of 47
    percent. For some of our medicines, and for some of our customers, we
    pay discounts, rebates, and fees totaling well over 50 percent of our
    list price--so middlemen in the supply chain in those cases realize a
    majority of the revenue.

        All told, while our 2018 aggregate list price increase was 6.3
    percent,\21\ for the second year in a row discounts and rebates
    outweighed that increase, and aggregate net price--in other words, the
    real price--decreased by 6.8 percent.\22\
    ---------------------------------------------------------------------------
        \21\ Represents the year-over-year change in the average list
    price, or wholesale acquisition cost (``WAC'').
        \22\ Represents the year-over-year change in the average net price,
    which is WAC less rebates, discounts, and returns.

                       trends in pharmaceutical spending
        The fact is that across the industry net prices for branded
    medicines have increased well below the rate of medical inflation in
    recent years.\23\, \24\, \25\, \26\ In
    2017, the total expenditure on pharmaceuticals in the U.S. grew by only
    0.4 percent, compared to a 3.9 percent increase in overall health
    spending and a 4.6 percent increase in hospital spending.\27\
    ---------------------------------------------------------------------------
        \23\ IQVIA INSTITUTE for Human Data Science. ``The Global Use of
    Medicine in 2019 and Outlook to 2023.'' Report. January 2019. https://
    www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-global-use-of-
    medicine-in-2019-and-outlook-to-2023.pdf.
        \24\ U.S. Department of Labor. Bureau of Labor Statistics.
    ``Consumer Price Index--December 2016.'' News release, January 18,
    2017. https://www.bls.gov/news.release/archives/cpi_01182017.pdf.
        \25\ U.S. Department of Labor. Bureau of Labor Statistics.
    ``Consumer Price Index--December 2017.'' News release, January 12,
    2018. https://www.bls.gov/news.release/archives/cpi_01122018.pdf.
        \26\ U.S. Department of Labor. Bureau of Labor Statistics.
    ``Consumer Price Index--December 2018.'' News release, January 11,
    2019. https://www.bls.gov/news.release/pdf/cpi.pdf.
        \27\ U.S. Centers for Medicare and Medicaid Services. ``NHE Fact
    Sheet.'' December 6, 2017. https://www.cms.gov/research-statistics-
    data-and-systems/statistics-trends-and-reports/national
    healthexpenddata/nhe-fact-sheet.html.

        Unfortunately, these trends are not reflected in many patients'
    experiences at the doctor's office or pharmacy counter. In fact, total
    patient out-of-pocket spending on medicines grew by 54 percent from
    2006 to 2016.\28\
    ---------------------------------------------------------------------------
        \28\ Claxton, Gary, Larry Levitt, Matthew Rae, and Bradley Sawyer.
    ``Increases in Cost-sharing Payments Continue to Outpace Wage Growth.''
    Peterson-Kaiser Health System Tracker. June 15, 2018. https://
    www.healthsystemtracker.org/brief/increases-in-cost-sharing-payments-
    have-far-outpaced-wage-growth/.

        One reason patient out-of-pocket spending has grown is due to
    changes in how health insurance is designed and, specifically, how
    pharmaceutical benefits are managed. As one recent analysis shows,
    patients are required to pay 13 percent of overall pharmaceutical costs
    versus only 3 percent of hospital costs--even though medicine can help
    keep patients out of the hospital.\29\
    ---------------------------------------------------------------------------
        \29\ PhRMA. ``PhRMA Chart Packs: Biopharmaceuticals in
    Perspective.'' Report. 2018. https://www.phrma.org/report/chart-pack-
    biopharmaceuticals-in-perspective-summer-2018.

        The reality is that our health coverage system simply wasn't built
    in anticipation of medicines that treat diseases previously only
    treated with surgeries, hospitalizations and other complex
    interventions. Medicines today can extend and transform life for people
    facing very challenging, often relatively rare, diseases. It's critical
    that we work together to ensure that today's medicines are more
    accessible and affordable for patients while at the same time
    preserving the incredible ecosystem of medical innovation that has
    delivered so much and promises so much more.
                  solutions to address the challenges we face
        Above all, we need an American solution to this American challenge.
    We must maintain the hallmarks that make American health care
    remarkable: access to innovative therapies, personal choice, and
    doctors and patients making decisions based on what is right for each
    individual.

        At Janssen, we are committed to being part of the solution.

        We believe open dialogue and partnership is essential to addressing
    the challenges in our health-care system. That's why in 2016 we began
    issuing an annual Janssen U.S. Transparency Report, sharing information
    about how we invest our resources, price our medicines, and help people
    who need Janssen medicines get access to them. Just recently, we
    expanded our commitment to transparency, announcing plans to
    voluntarily include list price and potential patient out-of-pocket
    costs in our pharmaceutical direct-to-consumer TV advertising, starting
    with our most frequently prescribed medicine.

        These more recent steps build on a legacy of commitment to
    transparency at Janssen. For example, we believe that making clinical
    trial data available promotes the understanding of disease, expands the
    knowledge needed to develop new treatments, and generates new insights
    and more complete evidence that lead to better health-care decisions
    for patients. In a first-of-its-kind agreement with the Yale University
    School of Medicine, we share clinical trial data through the Yale Open
    Data Access (YODA) Project. Since 2014, YODA Project has served as an
    independent review panel, evaluating researchers' requests for access
    to participant-level trial data and research reports, which provide
    extensive details about the methods and results of a clinical trial.
    Researchers can use these clinical trial data in their own research to
    increase medical knowledge and improve public health.

        In the same spirit of open dialogue and partnership, we have
    consistently brought forward ideas and perspectives to both Congress
    and the administration, with the goal of building on what is working in
    our healthcare system while fixing what is not:
                            part d out-of-pocket cap
        While Medicare Part D is working for many seniors and has been
    effective in containing costs, we believe an out-of-pocket cap in
    Medicare Part D is a needed protection. Without a cap, Medicare
    beneficiaries face unlimited out-of-pocket expenses, and, as research
    shows, high out-of-pocket costs reduce patient adherence to prescribed
    treatments and make them more likely to abandon their prescriptions.
    Poor patient outcomes related to lack of adherence or abandonment of
    prescribed treatments can lead to an increase in overall health-care
    costs.

        Individual and group health insurance policies are already required
    to have out-of-pocket caps. We believe that Medicare, which serves some
    of the sickest and most vulnerable patients and is essential to the
    health of American seniors, should also have that protection. We have
    been working on policy approaches that would make it possible to
    implement an out-of-pocket cap in a fiscally responsible way without
    creating new costs or access barriers for patients. As Congress
    considers any changes to Part D, we look forward to discussing these
    ideas in more depth.
                             medicare part b reform
        We believe policy solutions in Medicare Part B should meet three
    objectives: (1) reduce cost and spending; (2) increase competition; and
    (3) remove incentives to prescribe higher cost therapies without
    causing significant disruption to physicians or patient care.

        As changes to Part B are contemplated, it is important to remember
    that Medicare currently benefits from aggressive negotiations in the
    commercial market through the Average Sales Price (ASP) mechanism. Any
    reform should therefore leverage the benefits of the existing system.

        In our response to the Health and Human Services advance notice of
    proposed rulemaking regarding Part B, we proposed an option that would
    allow Medicare to continue to achieve the negotiated cost savings of
    the free market, reduce Part B acquisition cost under the ASP-based
    model, and reimburse all stakeholders on a fee-based mechanism aligned
    with the services that they provide. Our proposal aims to eliminate
    incentives for selecting higher list price drugs while maintaining
    current Part B patient access to appropriate clinical care.
                                 rebate reform
        We support reforms to the rebate system that restructure incentives
    to ensure patients benefit from a competitive marketplace and see lower
    out-of-pocket costs. In 2017, the pharmaceutical industry paid $150
    billion in negotiated rebates and discounts.\30\ As we have noted, too
    often these rebates and discounts are not shared with patients, leaving
    the sickest patients paying higher out-of-pocket costs. We anticipate
    eliminating rebates could result in lower list prices, provided these
    rebates and discounts are not replaced with equally high fees or other
    payments demanded by middlemen. We also strongly advocate that
    beneficiary copays be based on net price.
    ---------------------------------------------------------------------------
        \30\ Adam J. Fein. ``The Gross-to-Net Bubble Topped $150 Billion in
    2017.'' Drug Channels (April 24, 2018) (citing IQVIA Institute for
    Human Data Science. ``Medicines Use and Spending in the U.S.: A Review
    of 2017 and Outlook to 2022.'' Report. April 2018. https://
    www.iqvia.com/institute/reports/medicine-use-and-spending-in-the-us-
    review-of-2017-outlook-to-2022.

        Altering the current rebate structure would be a major change to
    the entire pharmaceutical supply chain. It would need to be done
    thoughtfully and carefully to avoid disruption for patients. We look
    forward to commenting on the administration's proposed rule in this
    area.
                                value-based care
        Our current system rewards the quantity or volume of care
    delivered, regardless of the results of that care. Consequently,
    sometimes we spend money on treatments, diagnostic procedures, and
    surgeries that provide limited value or may not even be needed, driving
    up health-care costs without actually improving patient health.

        At Janssen, we're working with partners throughout the health-care
    system to encourage more results-based health-care approaches. While we
    have negotiated several value-based contracts, current policy often
    limits our ability to implement creative solutions. To address policy
    barriers, we support the following measures:

              Establish safe harbors in the Federal Anti-Kickback Statute
            that better enable manufacturers to partner with payors and
            share risk; and,

              Clarify Medicaid pricing treatment, including existing
            Medicaid best price requirements that inhibit companies from
            offering arrangements that may yield lower price in some
            circumstances.
                 promoting competition on a level playing field
        Biosimilars--near copies of biologic medicines--have the potential
    to increase competition and bring down costs, which is why Janssen has
    long supported a
    patient-focused, science-based regulatory framework for biosimilars.

        Some stakeholders have called for government to drive uptake by
    creating further incentives for biosimilars. But policies designed to
    increase share for biosimilar manufacturers would distort the
    competitive environment and risk limiting the savings biosimilars
    deliver to patients and taxpayers. We saw this risk realized most
    recently in the 340B Drug Discount Program, where policy designed to
    encourage the use of biosimilars had the unfortunate effect of
    increasing cost to patients, including low-income patients who can
    least afford it, and to taxpayers.\31\
    ---------------------------------------------------------------------------
        \31\ Center for Biosimilars. ``340B Changes: What Biosimilar
    Manufacturers Need to Know.'' Feb. 19, 2018. https://
    www.centerforbiosimilars.com/contributor/amanda-forys/2018/02/340b-
    changes-what-biosimilar-manufacturers-need-to-know.

        When it comes to making more biosimilars available for patients and
    their physicians, competition, not government intervention, is the best
    approach. And that approach is working. Not only is competition driving
    prices down for both innovator biologics and biosimilars, the
    biosimilars pipeline is strong. Competition on a level playing field
    will keep it that way.
                                  340b policy
        At Janssen, we recognize that the 340B Drug Discount Program plays
    an important role in the healthcare system, helping to ensure that low-
    income, needy patients have appropriate access to medicine. However,
    congressional oversight, proper implementation, and equitable
    application of the program are essential to ensuring the 340B program
    is helping those it was designed to help.

        Under the 340B Drug Discount Program, we are required to provide
    significant discounts on certain medicines purchased by 340B covered
    entities (comprised of specific categories of hospitals, clinics, and
    health centers that meet Federal eligibility requirements). Growth in
    the 340B program has been well documented, and Janssen has experienced
    significant growth in this highly discounted channel as well. Although
    the program was intended to benefit needy patients, the facilities
    themselves receive the discounts. There is no requirement that 340B
    covered hospitals pass along those discounts to patients. 340B covered
    hospitals can therefore access 340B pricing on outpatient drugs for all
    of their patients, including wealthy and well-insured patients.

        A more direct and accountable link between the provision of the
    discount and patient access is needed. We believe the benefits of the
    program should flow more directly and transparently to needy patients.
    We support efforts to strengthen the 340B program through greater
    transparency and increased clarity and accountability for all
    stakeholders. These goals can be achieved through the establishment of
    clear, reasonable and auditable rules including a clear definition of
    ``patient'' as well as hospital eligibility criteria.
                                   conclusion
        We are here today at a moment of incredible hope, on the verge of
    extraordinary progress that could change our lives and the lives of our
    children and grandchildren. We have the opportunity to get this right
    for Americans today and for future generations. At Janssen, we are
    committed to bringing that promise to life with transformational
    medical innovation.

                                     ______

             Questions Submitted for the Record to Jennifer Taubert
                   Questions Submitted by Hon. Chuck Grassley
         spending on advertising/marketing vs. research and development
        Question. The Department of Health and Human Services' proposed
    rule, ``Fraud and Abuse; Removal of Safe Harbor Protection for Rebates
    Involving Prescription Pharmaceuticals and Creation of New Safe Harbor
    Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees,'' envisions that drug manufacturers will offer up-front
    discounts rather than the back-end rebates that are now commonly
    provided. Some observers argue that a 1996 court case called into
    question whether manufacturers could offer up-front discounts,
    resulting in today's rebate-based system. I've heard differing opinions
    as to whether the issues related to the initial court case are still
    relevant. If the HHS proposed rule is finalized, can you assure the
    committee that your company will offer up-front discounts? If not, why?

        Please describe how you expect your company to respond to the HHS
    proposed rule to eliminate safe harbor protection for back-end rebates
    in Medicare Part D that is referenced above if it is finalized.
    Assuming you are confident that antitrust laws do not prevent your
    company from offering up-front discounts, specifically, do you envision
    that your company lowers the list price of a drug to the current after-
    rebate net price, offer discounts equal to the current rebate amount,
    or a combination of both?

        Answer. The 1996 antitrust law case cited, in our assessment,
    should not limit the ability to move from rebates to other types of
    discounts. Depending on whether elimination of rebates applies to the
    entire market or only to those related to Federal health plans and
    assuming rebates are not replaced by high fees or other costs that
    offset the amount saved, we expect to lower list prices or offer
    discounts for pass-through at the point of sale. In either case, we
    would need to renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.

        Question. To what extent are the back-end rebates your company
    currently offers contingent on the amount of market share realized for
    your drugs as a result of Part D plan formulary placement and other
    techniques?

        Answer. Janssen does not currently offer rebates contingent on the
    amount of market share for our drugs as a result of Medicare Part D
    formulary placement. In other words, Janssen's current Medicare Part D
    rebate agreements do not contain any market share performance
    requirement.

        Question. Please provide a breakdown of percentage of sales that go
    to each payer (including Medicare, Medicaid, private pay, other) and a
    similar percentage by volume of the total number of each drug compared
    to total volume. Please provide this data for the most recent year
    available.

        Answer. Potentially responsive information may not be maintained by
    the company in the ordinary course of business. As such, an answer to
    this question is not readily available.

        Question. Do your companies hire consultants or lobbyists to
    promote products at State Medicaid Pharmacy and Therapeutics
    Committees? To whom do you disclose advocacy activities surrounding
    State Medicaid programs, if at all?

        Answer. Janssen does not hire external lobbyists or consultants for
    the purpose of promoting products at State Medicaid Pharmacy and
    Therapeutics Committees. We have internal employees who register as
    lobbyists and provide information about Janssen products to State
    Medicaid Pharmacy and Therapeutics Committee personnel. We comply with
    varied State laws regarding advocacy, including disclosure
    requirements.

        Question. Please describe how the costs of patient assistance
    programs are accounted for within your company's financial statements.
    Please also describe the types of market information, such as
    prescribing and use patterns, that your company collects from different
    types of patient assistance programs and patient hub services.

        Answer. Our patient assistance programs include both commercial
    copay support programs and charitable donations, which include both
    financial contributions and pharmaceutical products.

        With respect to Janssen's copay card programs, the value of patient
    copayment support is recorded as a reduction in sales revenue. The
    administrative costs associated with implementing the copayment
    programs are captured in selling, marketing and administrative expenses
    on Johnson & Johnson's SEC Form 10K.

        With respect to the company's charitable free product programs,
    Janssen donates prescription products to the Johnson & Johnson Patient
    Assistance Foundation, Inc. (``JJPAF''), a 501(c)(3) organization with
    an independent board and decision-making. Janssen also makes financial
    contributions to JJPAF and other independent 501(c)(3) organizations.
    These product and financial donations are recorded as charitable
    deductions.

        With respect to our commercial patient assistance programs, we
    collect information that is needed to support administering the
    program, helping patients get access to the medically appropriate
    treatment they have selected, and identifying and addressing barriers
    to patient access.

        Question. Please provide a list of all contributions since January
    1, 2014, that your company has made to any tax-exempt organizations
    working on issues related to drugs within your product lines, including
    but not limited to patient groups, disease awareness groups, medical or
    professional societies, universities or hospitals, industry
    associations or leagues. For each contribution, please provide the name
    of the organization that received the donation, the date the donation
    was made, the amount of the donation, and a description of the purpose
    of the contribution (i.e., was the contribution for the general fund, a
    specific purpose to a specific program, or continuing medical
    education). Please also note whether the contribution was unrestricted
    or restricted; if it was restricted, please explain all restrictions.
    Finally, if your company maintains a foundation or other separate
    charitable arm, please provide the name of all such entities, and list
    all donations made from that entity or entities.

        Answer. Through our Janssen charitable giving, we're proud to make
    a difference for patients and for the communities where we live and
    work. Janssen provides charitable donations through an established
    application review and approval process designed to ensure that the
    recipient of any contribution (i) is a valid 501(c)(3) charitable
    organization; (ii) has an established, good reputation; and (iii) is
    not on a Federal exclusion list (if the non-profit is a provider or
    government contractor). In addition, the charitable contributions
    review process is designed to review requests for donations to make
    sure that they are not made for the purpose of inducing the use or
    recommending the use of any J&J product.

        Janssen releases a contributions transparency report
    (``Contributions Report'') that details all of the charitable donations
    from the company for the prior year. Please see the attached link for
    the most recently posted Contributions Report, https://www.janssen.com/
    us/transparency/educational-charitable-contribution-disclosures.

        With respect to the Contributions Report, please note:

              In keeping with our donor agreements and applicable
            regulatory guidance, financial donations made to independent
            charitable foundations that assist patients who are
            underinsured and in need of financial assistance with
            treatment-related expenses are disclosed in aggregate on the
            Janssen Contributions Report.

              Charitable contributions made by recently acquired company
            Actelion are not included in our report. In future years, these
            donations will be included in the Contributions Report.

              Donations in the amount of $270,000 have been made annually
            to support the mission of PhRMA Foundation. These donations
            were made on April 29, 2014; January 21, 2015; December 21,
            2015; September 11, 2017; June 1, 2018; and January 15, 2019.

        Contribution Reports for years 2014 through 2017 are attached.

        Most donation requests seek support for a specific program or
    initiative. If approved, the use of the contributed funds will be
    restricted to the purpose set forth in the application request. The
    Contribution Report details this purpose in the project title section.

        In addition, the company's standard donation agreement used for
    most contributions stipulates that funds should not be used to (i)
    educate, train or support meals, salary, travel, consulting fees or any
    other reimbursement to U.S.-licensed physicians; or (ii) fund services
    for which the organization receives government reimbursement under a
    fee-for-service model.

        Janssen makes financial contributions and prescription product
    donations to the Johnson & Johnson Patient Assistance Foundation, Inc.
    (``JJPAF''), a 501(c)(3) organization with an independent board and
    decision-making. The JJPAF provides free products directly to patients
    who meet certain income requirements and who do not have insurance
    coverage. In limited circumstances, JJPAF may work with other non-
    profit entities to distribute products to patients in need. JJPAF does
    not advise Janssen of the specific recipients of its donations.

        In 2018, Janssen donated approximately $1 billion in free product
    and financial support to the JJPAF, enabling it to provide medicines at
    no cost to approximately 76,000 patients.

        The Johnson & Johnson Foundation (``JJF'') is a private non-profit
    501(c)(3) organization, founded in 1953. Solely funded by the Johnson &
    Johnson Family of Companies, the Foundation is responsible for managing
    the Corporation's Global Community Impact (``GCI'') programs and
    activities across the globe. Donations made by this foundation are
    available publicly through the IRS Form 990 it submits each year.

        Question. Pay-for-delay agreements cost consumers and taxpayers
    billions in higher drug costs every year. The FTC has gone after drug
    companies that enter into these settlements where the brand pays the
    generic company to keep its lower cost alternative off the market. I'm
    the lead Republican sponsor of S. 64, the Preserve Access to Affordable
    Generics and Biosimilars Act, which would help put an end to these
    deals.

        Do you agree that these pay-off agreements keep drug costs high for
    patients because they delay competition?

        Has your company ever entered into these kinds of settlements with
    a generic company?

        Do you support the pay for delay bill?

        Answer. J&J has not entered into patent settlement agreements that
    require payment of money to a generic manufacturer. Since J&J has not
    entered into agreements of this type, we do not have direct experience
    with their competitive impacts. The current legal framework--FTC
    oversight and judicial review on a case-by-case basis--is intended to
    identify any patent settlement that is anti-competitive. It is
    important to note that not all settlement agreements would result in a
    delay in competition; for example, some agreements of this type might
    facilitate generic entry prior to patent expiry.

        Although we believe that the current legal framework is sufficient
    to ensure that patent settlements are not anti-competitive, we would
    not oppose pay-for-delay legislation, provided that such legislation
    clearly, and in a manner consistent with current case law, defines the
    specific features of settlement agreements within its scope, does not
    hinder the ability of parties to utilize settlement agreements to
    efficiently settle patent disputes, and allows for an assessment of the
    competitive impacts of individual settlement agreements on a case-by-
    case basis.
                               rebate traps/walls
        Question. I'm increasingly concerned about the effect of so-called
    ``rebate traps'' or ``rebate walls'' on patients' access to quality,
    lower cost medicine. I understand there is ongoing litigation
    challenging these practices as anti-competitive.

        Does your company engage in the bundling of rebates over multiple
    products? If so, why? And what benefit does the consumer gain from
    that?

        Answer. Like other companies with broad portfolios of medicines
    that are highly valued by payers, health-care providers, and patients,
    Janssen offers incremental value when customers make a broader range of
    our medicines available to patients. Similar programs are common in the
    pharmaceutical and other industries. These programs provide an
    incentive for the customer to utilize our products and can lower costs.
    Those savings may be passed through to patients.

        Question. Does your company view these practices as anticompetitive
    or harmful to patients' access to quality, lower cost medicine?

        Answer. Janssen's contract offerings encourage price competition
    among drug manufacturers and ultimately enhance patients' access to
    quality medicines at lower prices.

        Question. If a policy were adopted to eliminate rebates, or to
    require that rebate savings be passed on to the consumer, would that in
    and of itself solve the issue of rebate ``traps'' and ``walls''? And
    would consumers benefit from such a policy?

        Answer. We support reforms to the rebate system that restructure
    incentives to ensure patients benefit from a competitive marketplace
    and see lower out-of-pocket costs.

        It is important to note that in today's health-care marketplace,
    payers use their ability to influence utilization to extract rebates,
    thereby enhancing competition and lowering overall system costs.
    Unfortunately, these savings are not usually shared with patients.

        Similarly, if rebates are eliminated, we anticipate that payers
    will use their ability to influence utilization to extract discounts
    and fees from manufacturers.
                                  drug pricing
        Question. When setting the list price of a drug, does your company
    consider regulatory costs or compliance? If so, how specifically do
    those factors affect the list price of a drug? Please provide at least
    one specific example, if applicable, from your current product
    portfolio.

        When setting the list price of a drug, does your company consider
    the risk of liability or litigation? If so, how specifically do those
    factors affect the list price of a drug? Please provide at least one
    specific example, if applicable, from your current product portfolio.

        Answer. At Janssen, we take a responsible approach to pricing that
    recognizes our dual responsibility to patients today and patients
    tomorrow. Patients today need access to our medicines. Patients
    tomorrow count on us to deliver cures and treatments for the most
    challenging, intractable diseases. When we set an initial list price
    for our medicines, we balance:

              Value to patients, the health-care system, and society.
                  We consider how the medicine will improve
            patient health. We also assess the medicine's potential to
            reduce other costs--surgeries, hospital stays, or long-term
            care, for example--and the improvement the medicine represents
            over the existing standard of care.

              The importance of maintaining affordable access to medicines
            for people who need them.
                  We work with insurers, pharmacy benefits
            managers, governments, hospitals, physicians, and other
            providers of care so that patients who are prescribed our
            medicines can get access to them.

              The importance of preserving our ability to develop future
            groundbreaking cures and treatments.
                  We have an obligation to ensure that the sale
            of our medicines provides us with the resources to invest in
            R&D to address serious, unmet medical needs.

        In addition, the sale of our medicines must enable us to cover the
    costs of compliance with all laws and regulations.

        Regarding the requests for specific examples from our current
    product portfolio, the information requested is confidential and
    competitively sensitive. As such, potentially responsive information is
    not available for public disclosure.

                                     ______

                    Questions Submitted by Hon. Pat Roberts
        Question. What role do you see value-based arrangements (VBAs)
    playing in the effort to reduce prescription drug costs? What potential
    do these arrangements have to find the ``sweet spot'' between
    controlling costs to patients and encouraging innovation of new drugs?

        Answer. We believe a value-based health-care system has tremendous
    potential to improve patient health, increase access to care, and curb
    the growth in health-care spending. Our current health-care system
    rewards the quantity or volume of care delivered, regardless of the
    results of that care. Consequently, sometimes money is spent on
    treatments, diagnostic procedures, and interventions that provide
    limited value or may not even be needed, driving up healthcare costs
    without actually improving patient health.

        Shifting to a value-based system requires innovation in the way
    contracts between payers and manufacturers are structured. By creating
    common incentives to deliver value for patients, value-based
    agreements, including innovative approaches to contracting models, can
    provide better outcomes at lower costs. We have established several
    innovative, value-based contracts and continue to explore new
    opportunities. For example, we have contracts tied to measurable
    medical outcomes and contracts tied to offsets of other expenditures.

        Fundamentally we believe a value-based health system will drive
    down the amount of waste in our current health-care system, so the
    money spent actually makes a measurable difference in individual health
    and the health of our society overall. Efforts to achieve a more value-
    based system have encouraged all stakeholders to more clearly define
    and measure the value of health-care services offered, including
    medicines. In a health-care system that rewards value over volume, we
    believe incentives will be greater to bring to market new drugs that
    can reduce the need for other costly health-care intervention and
    ultimately produce better health outcomes and lower cost.

        Question. How can VBAs help lower what patients pay out-of-pocket?

        Answer. Innovative contracting models can align the incentives of
    all stakeholders, including pharmaceutical companies, health-care
    providers, and payers, to achieve better outcomes for patients at a
    lower overall cost of care to the health-care system, including Federal
    programs. In most cases, because the pharmaceutical company agrees to
    share some of the risk around the economics of the arrangement for a
    particular medicine, the health plan or PBM will provide better access
    to that medicine, which may entail placing the medicine on a lower
    formulary tier. Lower formulary tier placement results in lower out-of-
    pocket costs for patients. We know that rising patient copayments are a
    barrier to adherence and therefore to optimal outcomes. We believe that
    keeping out-of-pocket costs reasonable for patients is an important
    element of getting to better outcomes, and innovative contracts can
    support this goal.

        According to an analysis by PhRMA and Avalere Health, commercially
    insured patients in health plans with outcome-based contracts for
    diabetes, high cholesterol and HIV medicines between 2015 and 2017 had
    copays that were, on average, 28 percent lower for those medicines
    compared to patients in other plans.

        Question. Can Congress do more to allow for and encourage the use
    of VBAs?

        Answer. We are enthusiastic about the potential for expanding the
    use of innovative value-based agreements. Nevertheless, a number of
    technological and policy barriers can make these agreements challenging
    to implement. To address technological barriers, we advocate for
    modernizing our healthcare data system to make it easier to track
    patient outcomes. To address policy barriers, we support the following
    approaches: establishing safe harbors to better enable manufacturers to
    partner with payers and share risk; clarifying the treatment of value-
    based contracts in government price calculations, including in the
    complex Medicaid Best Price determination; and making comparative
    formulary and cost-sharing information readily available so patients
    have the information they need to make better decisions.

                                     ______

                    Questions Submitted by Hon. John Cornyn
        Question. We continue to hear that rebates negotiated off of the
    list price of a drug are both good and bad.

        Pharmacy benefit managers and plans have argued that rebates are
    used to lower premiums across the board and that it is the best way to
    seek a price concession on otherwise expensive drugs.

        Your industry argues that these payers are insisting on higher
    rebates that can only be achieved by raising list prices. But patients
    often lose under this system, with out of pocket costs being tied to
    list price. Insulin patients appear to be routinely impacted by this
    perversity in the system.

        Please explain to the committee how your company would reduce list
    prices if rebates were no longer a part of the equation?

        What assurance can you provide that you would in fact lower your
    prices?

        What actions should be taken to ensure that patients are actually
    seeing the benefits of lower out of pocket costs?

        Answer. Depending on whether elimination of rebates applies to the
    entire market or only to those related to Federal health plans and
    assuming rebates are not replaced by high fees or other costs that
    offset the amount saved, we expect to lower list prices or offer
    discounts for pass-through at the point of sale. In either case, we
    would need to renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.

        We support reforms to the rebate system that restructure incentives
    to ensure patients benefit from rebates and discounts that are
    provided.

        Question. If rebates are driving high list prices for drugs as drug
    manufacturers' claim, why do you think that Part B drugs, which have no
    PBM rebates, are also seeing significant price increases? Whose fault
    is that?

        Answer. Part B benefits from competitive commercial rebates and
    discounts, while maintaining access to medicines for our nation's
    seniors, through the Average Selling Price (``ASP''). ASP, which is the
    basis for Part B drug reimbursement, reflects all commercial discounts
    and rebates. Since both provider reimbursement and patient out-of-
    pocket costs for Part B drugs are based on ASP, changes in a product's
    ASP is a more relevant indicator of true cost to the Medicare system
    and beneficiaries.

                                     ______

                   Question Submitted by Hon. Michael B. Enzi
        Question. The Food and Drug Administration's drug review process is
    known to many as the ``gold standard'' for evaluating medical products.
    I've long thought that it is critical that we maintain public
    confidence in their ability to ensure that drugs are safe and
    effective. There is a perception among some, however, that biosimilars
    might not be as safe as their reference products. That perception can
    undermine patient and provider confidence. Do you believe that when FDA
    approves a biosimilar, providers can be confident that it is safe and
    effective?

        Answer. Biosimilars granted licensure by the FDA are by definition
    safe and effective and are highly similar to the reference biologic. We
    support the FDA's application of rigorous scientific standards and
    appropriate data requirements for the licensure of both biosimilars and
    interchangeable biosimilars, and we believe evidence and experience
    will drive patient and provider confidence in these products.

                                     ______

                     Questions Submitted by Hon. Todd Young
             re-evaluating business strategies in foreign countries
        Question. Since taking office, President Trump has made reducing
    drug prices one of his highest priorities--and has repeatedly spoken
    about his frustration with the U.S. subsidizing the costs of
    pharmaceuticals for the rest of the world. He has gone so far as to
    issue proposals, like the International Pricing Index (IPI) Model, in
    an attempt to bring down prescription drug prices.

        With the increased scrutiny of the industry and of the drug supply
    chain as a whole in the United States, have any of your companies re-
    evaluated your business strategy in foreign countries?

        If not, then why?

        If a proposal, like IPI, were implemented, would it force your
    companies to potentially ``walk away from the negotiating table when
    other countries demand low prices subsidized by America's seniors,'' as
    HHS Senior Advisor for Drug Pricing Reform John O'Brien has said?

        What are some of your ideas on how we can ensure Americans aren't
    shouldering the full cost of pharmaceuticals?

        Answer. We continuously evaluate our global business strategy and
    country-
    specific market access approaches in light of current conditions,
    including changing policies and circumstances.

        We support the use of trade tools to improve the policy environment
    for U.S. companies operating overseas and to enhance incentives for
    innovation. The U.S. government has already taken steps to advance this
    goal with some of our key trading partners. The U.S. Mexico Canada
    Agreement (``USMCA'') includes important provisions committing Canada
    and Mexico to recognize the value of pharmaceuticals either through the
    operation of competitive markets or through procedures that
    appropriately value pharmaceuticals. The agreement also contains
    procedural safeguards for U.S. companies. These include a requirement
    that Canada and Mexico provide opportunities for stakeholder comment on
    measures before they are finalized and also offer U.S. companies an
    opportunity to appeal administrative actions. These are critical tools
    that will help American companies obtain fair value for innovation
    outside the U.S.

        The U.S. government has announced its intention to negotiate trade
    agreements with Japan, the European Union, and the United Kingdom.
    These negotiations could address inadequacies in the systems of some
    our largest trading partners.

        The U.S. government can also effectively leverage existing trade
    agreements and tools like Organisation for Economic Cooperation
    accession negotiations to induce foreign governments to provide
    appropriate value for innovation and offer greater incentives for new
    treatments and cures.

                  foreign countries' pricing and reimbursement

        Question. President Trump and Secretary Azar have both repeatedly
    described their frustrations with ``foreign freeloading'' of U.S. drugs
    in the last year.

        ``When foreign governments extort unreasonably low prices from U.S.
    drug makers, Americans have to pay more to subsidize the enormous cost
    of research and development. . . . It's unfair and it's ridiculous, and
    it's not going to happen any longer.''

        Do you agree that because of foreign countries' pricing and
    reimbursement systems, U.S. patients and innovators are shouldering the
    burden for financing medical advances?

        Answer. According to a report by the U.S. Department of Commerce,
    international reference pricing and controls suppress worldwide private
    research and development by up to 16 percent annually, leading to fewer
    new medicines launched each year. Conversely, recent estimates
    demonstrate that removing price controls in other wealthy countries
    would increase the number of available new treatments by 9 percent by
    2030, equivalent to a range of 8 to 13 new therapeutics that year.

        Question. How do foreign countries' pricing and reimbursement
    systems affect our prescription drug costs?

        Answer. While there is no direct relationship between U.S. drug
    prices and foreign prices, according to a report by the U.S. Department
    of Commerce, existing foreign price controls suppress worldwide private
    research and development and decrease the number of new treatments and
    cures, to the detriment of U.S. patients.

        It is important to note that most cross-country pricing comparisons
    focus solely on the list prices of medicines and do not account for the
    significant discounts required for participation in U.S. public
    programs, such as Medicaid, the 340B Drug Discount Program, and the
    Federal Supply Schedule (for U.S. Department of Veterans Affairs and
    the Department of Defense), as well as the discounts and rebates
    negotiated by private payers. For this reason, most international
    comparisons are not ``apples to apples.'' In addition, in other
    countries, medicine prices are achieved through national regulation,
    which often restricts or delays access to innovative medicines and
    limits patient and physician choice.

        Question. Are foreign governments taking note of the concerns being
    raised by the Trump administration and have they responded in any way?

        Answer. We understand that some foreign government officials have
    noted the concerns raised by the Trump administration and appear to be
    seeking a better understanding of the proposed policy changes in the
    United States and the potential future impacts on their countries.

        Question. Has there been any noticeable change in any of our trade
    agreements since these concerns have been raised by the Trump
    administration?

        Answer. The U.S.-Mexico-Canada Agreement (``USMCA'') contains
    important provisions on intellectual property that establish a higher
    global IP standard than in previous agreements, particularly with
    respect to data protection for biologics. The agreement also contains
    important provisions committing Canada and Mexico to recognize the
    value of pharmaceuticals either through the operation of competitive
    markets or through procedures that appropriately value pharmaceuticals.
    The agreement includes procedural safeguards for U.S. companies. These
    include a requirement that Canada and Mexico provide opportunities for
    stakeholder comment on measures before they are finalized and also
    offer U.S. companies an opportunity to appeal administrative actions.
    These are critical tools that will help American companies obtain fair
    value for innovation. The U.S. government has announced its intention
    to negotiate trade agreements with Japan, the European Union, and the
    United Kingdom. These negotiations could address inadequacies in the
    systems of some our largest trading partners. The U.S. government can
    also effectively leverage existing trade agreements and tools like
    Organisation for Economic Co-operation accession negotiations to induce
    foreign governments to provide appropriate value for innovation and
    offer greater incentives for new treatments and cures.
                      medicaid closed formulary proposals
        Question. In an attempt to bring down drug costs, various states
    have been exploring whether to exclude certain drugs from its Medicaid
    program. For example, the state of Massachusetts' recently asked CMS
    for permission to create a closed formulary where the state Medicaid
    program would pick at least one drug per therapeutic class. CMS denied
    their waiver request citing violation of federal law, but this proposal
    does bring up important questions on how to contain drug prices in
    state Medicaid programs.

        If the principles of the Medicare Part D program--including the
    necessary patient protections--were applied to State Medicaid programs,
    do you think it would lower drug costs while ensuring access to
    patients?

        Answer. By legislative design, the Medicaid Program already
    receives the ``best'' price, in addition to substantial rebates
    associated with an inflation penalty and negotiated supplemental
    rebates. The rebate is never less than 23.1 percent, the required
    statutory minimum, and often requires manufacturers to sell their
    products (both older and newer) for as low as 1 cent per pill or unit.

        The Medicaid drug rebate statute represents a carefully crafted
    legislative approach developed by Congress and designed as a package to
    offer Medicaid beneficiaries comprehensive coverage and access to
    outpatient drugs at the lowest cost in the marketplace. We support the
    significant access protections required under the current Medicaid Drug
    Rebate Program that serve a uniquely vulnerable population. We also
    question whether reducing access to medically necessary medication for
    vulnerable Medicaid beneficiaries will yield true program savings. Any
    further restrictions in medication access is likely to increase the
    risk of higher costs elsewhere in the health-care continuum. Moreover,
    vulnerable Medicaid beneficiaries may be particularly challenged to
    navigate the administrative, technical, logistical and other challenges
    that inevitably arise when additional restrictions are placed on their
    access to care.
                            medicaid ``best price''
        Question. In the Trump administration's Blueprint, they suggested
    that because drug manufactures have to give Medicaid the ``best price''
    on drugs, there is no incentive to offer deeper discounts to other
    payers--both government and commercial--than what is already offered
    under the Medicaid Drug Rebate Program.

        Does the Medicaid ``best price'' requirement encourage
    manufacturers to increase initial prices?

        Answer. We take into account the Medicaid ``best price''
    requirement at all stages of the drug lifecycle, including launch. We
    consider best price when offering large discounts to commercial
    customers after a drug is launched and when designing value-based
    agreements.

        Question. What, if any, changes would you suggest we make to the
    program?

        Answer. We are supportive of ongoing efforts to promote a value-
    driven health-care system, including in Medicaid, and applaud recent
    efforts by both the administration and Congress that seek to address
    regulatory and legal uncertainty around value-based payment
    arrangements. We also support CMS's recent approvals of State proposals
    to advance specific Medicaid value-based arrangements with drug makers.
                            outcomes-based contracts
        Question. In almost all of your testimonies, you highlight your
    support of outcomes-based contracts and how we need to be shifting our
    system toward that approach.

        How will these contracts lower drug costs for patients in both the
    near term and long-term?

        How will they lower overall health-care costs for our Federal
    programs?

        What have the preliminary results looked like so far?

        Answer. Innovative contracting models can align the incentives of
    all stakeholders, including pharmaceutical companies, health-care
    providers, and payers, to achieve better outcomes for patients at a
    lower overall cost of care to the health-care system, including Federal
    programs.

        In most cases, because the pharmaceutical company agrees to share
    some of the risk around the economics of the arrangement for a
    particular medicine, the health plan or PBM will provide better access
    to that medicine, which often entails placing the medicine on a more
    preferable formulary tier. More preferable formulary tier placement
    results in lower out-of-pocket costs for patients. We know that rising
    patient copayments are a barrier to adherence and therefore to optimal
    outcomes. We believe that keeping out-of-pocket costs reasonable for
    patients is an important element of getting to better outcomes, and
    innovative contracts can support this goal.

        According to an analysis by PhRMA and Avalere Health, commercially
    insured patients in health plans with outcome-based contracts for
    diabetes, high cholesterol and HIV medicines between 2015 and 2017 had
    copays that were, on average, 28 percent lower for those medicines
    compared to patients in other plans.

        Innovative contracting models are still relatively new, and we look
    forward to the point at which we will have the long-term data necessary
    to evaluate the success of these programs with respect to health-care
    cost reduction. We are enthusiastic about the potential of innovative
    value-based contracting models to enable us to take full advantage of
    medicines' benefits, including their potential to reduce other health-
    care costs.
                           transparency/point of sale
        Question. In almost all of your testimonies, you express your
    support for the Trump administration's proposal to allow manufacturers
    to provide PBMs up-front discounts that are passed onto patients at the
    point of sale.

        Do you feel like this proposal will make the transactions within
    the drug supply chain more transparent?

        If so, would this transparency bring down drug costs--overall and
    for specialty drugs?

        Answer. We do believe that a point-of-sale discount model, wherein
    manufacturer discounts could be passed through to a patient at the
    point-of-sale, will make price reductions offered by the manufacturer
    more transparent because these discounts would be more directly
    reflected in patient out-of-pocket cost at the pharmacy. However, we do
    not believe that the proposal will improve transparency with respect to
    fees or mark-ups to the price of drugs added elsewhere in the supply
    chain.

        Depending on whether elimination of rebates applies to the entire
    market or only with respect to Federal health plans and assuming
    rebates are not replaced by high fees or other costs that offset the
    amount saved, we expect to lower list prices or offer discounts for
    pass-through at the point of sale.
             the relationship between wholesalers and manufacturers
        Question. When talking about the pharmaceutical supply chain, a lot
    of focus has been placed on the pharmacy benefit manager. But there's
    another side of the equation that I'd like to ask about: how do
    wholesalers negotiate pricing with manufacturers?

        Answer. Janssen sells to wholesalers and specialty distributors at
    list price, with discounts customarily offered for prompt payment.
    Janssen occasionally offers discounts to wholesalers for discrete
    periods of time on certain products. These are generally offered to
    contracted, authorized wholesalers market-wide. In addition, Janssen
    negotiates service agreements with wholesalers and specialty
    distributors for bona fide services relating to distribution of Janssen
    products.

        Question. What impact does this have on drug costs?

        Answer. We do not know the details of the wholesalers' arrangements
    with downstream stakeholders such as pharmacies, hospitals, providers,
    and other sites of care.

        Question. What incentives or disincentives do they have to contain
    price increases?

        Answer. We are not in a position to comment on wholesaler
    incentives or disincentives to contain price increases.

                                     ______

                     Questions Submitted by Hon. Ron Wyden
                              proposed rebate rule
        Question. As has been done in many other settings, drug
    manufacturers said during the hearing that one reason list prices for
    drugs are high is that pharmaceutical benefit managers (PBMs) demand
    larger and larger rebates in order for the drug to receive favorable
    placement on a formulary. You and your colleagues who testified during
    the hearing stated if the administration's proposal on changes to the
    anti-kickback safe harbor for pharmaceutical rebates took effect, your
    company would likely lower list price.

        Like many Oregonians, I am skeptical drug manufacturers would
    voluntarily lower their prices. Therefore, would you support
    legislation that would (1) make similar changes the administration has
    put forward related to Part D and Medicaid managed care, (2) change the
    rebate system in a similar way to the proposal for the commercial
    market, and (3) require drug makers to lower the list price of their
    drugs equal to the amount of rebates provided today?

        Answer. We support reforms to the rebate system that restructure
    incentives to ensure patients benefit from a competitive marketplace
    and see lower out-of-pocket costs.

        Depending on whether elimination of rebates applies to the entire
    market or only to those related to Federal health plans and assuming
    rebates are not replaced by high fees or other costs that offset the
    amount saved, we expect to lower list prices or offer discounts for
    pass-through at the point of sale. In either case, we would need to
    renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.
                          medicaid drug rebate program
        Question. The Medicaid Drug Rebate Program (MDRP) requires
    manufacturers to provide a basic rebate and an additional inflationary
    rebate for both brand and generic drugs. The inflationary rebate is an
    increasingly substantial part of total rebates due in large part to
    large increases in drug prices that exceed inflation. Under current
    law, this inflationary rebate is capped at 100 percent of Average
    Manufacturer Price (AMP). This is the case even when manufacturers
    continue to raise their prices well above inflation.

        Please provide a list of all of your pharmaceutical products that
    have reached the Medicaid AMP rebate cap in any of the 20 quarters from
    January 1, 2014 through December 31, 2018.

        For each drug listed in response to question 1, please also provide
    a list of which quarters and years each drug hit the cap.

        Answer. Janssen has numerous current products, and products that
    have since been sold to third parties, that have reached the Medicaid
    AMP rebate cap in at least one of the 20 quarters from 1Q 2014 through
    4Q 2018. The fact that these products reaching the 100 percent AMP cap
    is based on confidential metrics reported under the Medicaid Drug
    Rebate Program. The Medicaid AMP rebate cap is reached when AMP is less
    than or equal to the Unit Rebate Amount (URA). URA is calculated based
    on AMP and Best Price--which are confidential under the Medicaid Drug
    Rebate statute at 42 U.S.C. ' 1396r8(b)(3)(D). There are exceptions in
    the statute that permit the Secretary and State Medicaid agencies to
    disclose the information only in certain situations, including
    disclosure to CBO. Thus, if there was legislation proposing to amend
    the 100 percent AMP cap, CBO would be able to access the drugs and
    underlying data to estimate the cost/savings to the government of such
    a legislative change.

        The product-specific information requested is confidential and
    competitively sensitive. As such, potentially responsive information is
    not available for public disclosure.
                    medicaid drug rebate program compliance
        Question. I am concerned about recent reports and legal settlements
    surrounding drug manufacturers' failure to comply fully with the
    requirements of the MDRP. For example, an analysis by the U.S.
    Department of Health and Human Services Office of Inspector General
    found that between 2012 and 2016 taxpayers may have overpaid by as much
    as $1.3 billion for 10 potentially misclassified drugs. That is why I
    introduced the Right Rebate Act with Chairman Grassley to prevent drug
    manufacturers from manipulating Medicaid to increase their profits.
    However, I continued to be concerned about oversight and manufacturer
    compliance with the requirements of the Medicaid Drug Rebate Program.
    Accordingly, please describe the following:

        Your company's current compliance plan and procedures used to
    ensure compliance with the requirements of the Medicaid Drug Rebate
    Program including internal audits or other checks you use to identify
    compliance vulnerabilities.

        Any past or ongoing issues of non-compliance.

        Any corrective actions taken to address identified problems or
    issues of non-
    compliance with the MDRP and how such steps were communicated to the
    Centers for Medicare and Medicaid Services.

        Any steps taken to improve compliance and ensure that all Medicaid
    drug rebates owed to the Federal Government and the States are paid in
    full.

        Answer. We comply with the obligations we undertake when
    participating in U.S. Federal, State, or local government contracts and
    government pricing programs such as the Medicaid Drug Rebate Program.
    We have an established compliance framework along with organizational
    structure and accountabilities designed to assure compliance. Our
    framework includes testing and monitoring and an obligation to correct
    any identified discrepancies. As such, any discrepancies have been
    timely addressed and corrected.

        The other information requested is confidential. As such,
    potentially responsive information is not available for public
    disclosure.
                     bonus payments tied to specific drugs
        Question. I am concerned by the potential for employee financial
    incentives to encourage high launch prices and price increases for
    prescription drugs.

        Is your salary, bonus or other compensation tied to sales or
    revenue targets of a single product your company sells? Has it ever
    been? If yes, please state the product or products to which your
    salary, bonus or other compensation was tied.

        Answer. At no time during her employment with the Johnson & Johnson
    Family of Companies has Ms. Taubert's salary, bonus, or other
    compensation been tied to sales or revenue targets of a single product.

        Question. Is your salary, bonus, or other compensation tied to
    either revenue or net income of the company as a whole? Has it ever
    been? If yes, please explain what assumptions about price increases are
    used when the compensation committee sets revenue or net income goals.
    Does the compensation committee provide any guidance to executives in
    regards to the amount of revenue that the company will generate from
    price increases versus volume growth?

        Answer. We structure performance-based compensation to reward an
    appropriate balance of short-term and long-term financial and strategic
    business results, with an emphasis on managing the business for long-
    term results. Our compensation program's emphasis on long-term value
    reduces the possibility that our executives make excessively risky
    business decisions that could maximize short-term results at the
    expense of long-term value.

        Ms. Taubert's base salary is tied to performance, market data,
    responsibilities, time in position, internal equity, and experience.
    Ms. Taubert's bonus and long-term incentive compensation has been and
    is awarded based on her individual performance and the company's
    performance.

        The compensation committee does not provide guidance to executives
    regarding the amount of revenue that the company will generate from
    price increases versus volume growth.
            provision of rebates in exchange for formulary placement
        Question. In today's system, drug makers receive a limited time
    window to sell their drug without competition. After that period has
    expired, low-cost generics should become available. However, drug
    makers often prevent access to these cheaper generic drugs in Medicare.
    Researchers have found that 72 percent of Medicare Part D plans charged
    lower cost-sharing for a brand name drug compared to its generic
    equivalent. This means seniors were charged less out of pocket for
    brand name drugs compared to generics that are on average four times
    cheaper than the brand-named drug. This happens because drug makers pay
    a rebate to the Part D plans in order to give the more expensive drug
    better treatment than a generic. As a result, Medicare spending
    increases due to the current structure of the Part D benefit.

        Has your company ever paid a rebate to a Part D plan so that a
    brand name drug would get preferential treatment (i.e., lower cost-
    sharing or less utilization management) compared to a cheaper generic?

        If so, please provide: a list of the drugs for which your company
    has done this since January 1, 2014; and the number of Part D plans in
    which this type of rebate was given for each drug in each year.

        Answer. In negotiations with PBMs and payers, Janssen may offer
    multiple different rebate options. The PBM or payer has sole discretion
    over how formularies are structured. In some cases, a PBM or payer may
    establish a formulary that puts a branded drug in a preferential
    position.

        The information requested is confidential and competitively
    sensitive. As such, potentially responsive information is not available
    for public disclosure.
                                   net prices
        Question. Your testimony stated that ``while our 2018 aggregate
    list price increase was 6.3 percent, for the second year in a row
    discounts and rebates outweighed that increase, and aggregate net
    price--in other words, the real price--decreased by 6.8 percent.''
    According to your testimony, the net price ``represents the year-over-
    year change in the average net price, which is WAC less rebates,
    discounts, and returns.'' Please describe how the company's year-over-
    year aggregate net price is calculated. Please also specifically
    address the following questions:

        Answer. Average net price change represents the year-over-year
    change in the average net price, which is Wholesale Acquisition Cost
    less rebates, discounts, and returns.

        Question. How many products are included in the calculation of the
    average net price change? What was the median net price change?

        Answer. We believe weighted average net price change is the
    appropriate metric for evaluating list price changes across the
    portfolio. There are 99 products (brands) included in the average net
    price change calculation. The 2017-2018 weighted average net price
    change is -6.8 percent. The non-weighted average 2017-2018 net price
    change is -3.7 percent. The 2017-2018 median net price change is -1.9
    percent. It is important to note that non-weighted average or median
    net price change treats all medicines--whether used by many patients or
    by very few--equally, so those figures are not useful or valuable in
    understanding the actual change experienced.

        Question. Is net price weighted? If so, how? For example, in
    determining the aggregate net price does the company assign different
    weights to different products based on volume or other factors? Are
    ``on patent'' and ``off patent'' drugs weighted identically? Are other
    statistical weights used or are all products treated equally?

        Answer. Annual net price change versus prior year is calculated at
    the product level and weighted across the company's U.S. product
    portfolio using net trade sales. All products, both ``on patent'' and
    ``off patent,'' are included.

        Question. Does the figure that you provided during your testimony
    account for U.S. prices, international prices, or both? Generally
    speaking, when your company reports net price changes, does it
    differentiate between U.S. and international prices?

        Answer. The figure provided, -6.8 percent, accounts for 2018 net
    price change for our U.S. pharmaceutical business only. We disclose
    this figure in our annual Janssen U.S. Transparency Report.

        Question. Please list the five drugs your company sold in the U.S.
    that had the greatest year-over-year net price increase in 2018, noting
    the increase for each drug by dollar figure and percentage. Please list
    the five drugs your company sold in the U.S. that had the lowest year-
    over-year net price increase (and/or the greatest decrease) in 2018,
    noting the increase (or decrease) for each drug by dollar figure and
    percentage.

        Answer. The information requested is confidential and competitively
    sensitive. As such, potentially responsive information is not available
    for public disclosure.

        Question. For 2018, what was the average net price change in the
    U.S. market for (1) drugs with no competition, (2) drugs with only
    branded competition, and (3) drugs with generic competition?

        Answer. The information requested is confidential and competitively
    sensitive. As such, potentially responsive information is not available
    for public disclosure.

        Question. Your company noted in its annual financial filing with
    the Securities and Exchange Commission that ``Immunology was negatively
    impacted by lower sales of REMICADE' (infliximab) due to
    increased discounts/rebates and biosimilar competition,'' and ``Strong
    sales of long-acting injectables INVEGA TRINZA'/
    TREVICTA' (paliperidone palmitate) and INVEGA
    SUSTENNA'/XEPLION' were partially offset by
    cannibalization of RISPERDAL CONSTA' (risperidone) and
    generic competition for CONCERTA'/methylphenidate,'' and
    ``Lower sales of INVOKANA'/INVOKAMET'
    (canagliflozin) in the U.S. was primarily due to an increase in price
    discounts, higher rebates and market share decline driven by
    competitive pressure. Lower sales of XARELTO' (rivaroxaban)
    were driven by an increase in discounts and rebates, partially offset
    by an increase in market share.'' What were the year-over-year net
    price changes for each of these drugs?

        Answer. The information requested is confidential and competitively
    sensitive. As such, potentially responsive information is not available
    for public disclosure.

        Question. Please define the following terms that were used on page
    20 of your company's annual report for the year ending December 31,
    2018 regarding sales of various pharmaceutical products: strong uptake,
    market growth, and share gain. Please also define ``reduction in
    sales,'' as used in the sentence ``Biosimilar versions of
    REMICADE' have been introduced in certain markets outside
    the U.S., resulting in a reduction in sales of REMICADE' in
    those markets.''

        Answer. ``Strong uptake'' means that we are seeing significant
    utilization of a medicine that was recently introduced into the market
    or approved for a new indication.

        ``Market growth'' refers to increase in utilization of medicines
    overall for a particular disease state or in a particular class of
    medicines.

        ``Share gain'' means that within a class of medicines or
    therapeutic area, a particular medicine is being selected and utilized
    more than it had been previously and now represents a greater
    percentage of utilization within that class relative to competitor
    medicines.

        ``Reduction in sales'' in the sentence you reference means that
    revenues for REMICADE' are lower than they have been in
    previous years. Please note that our 2018 Annual Report goes on to
    state, ``In the U.S., a biosimilar version of REMICADE' was
    introduced in 2016, and additional competitors continue to enter the
    market. Continued infliximab biosimilar competition in the U.S. market
    will result in a further reduction in U.S. sales of
    REMICADE'.''

                                     ______

                  Questions Submitted by Hon. Robert Menendez
        Question. During the hearing, when I asked whether your company
    engaged in tactics to delay generic production of your products, you
    answered ``no.'' However, your Johnson & Johnson's Actelion appears on
    the FDA's list of companies who have access complaints against them.
    Can you explain the discrepancy between your answer and the FDA list?
    The FDA list can be found here: https://www.fda.gov/Drugs/
    DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/
    ApprovalApplications/AbbreviatedNewDrugApplicationANDAGenerics/
    ucm607738.htm.

        Answer. Johnson & Johnson acquired Actelion in June 2017. We share
    FDA's commitment to policies that promote access to generics when
    balanced with the protection of innovation and the safeguarding of
    patient safety. It is important to note that the FDA's website on
    Reference Listed Drug (``RLD'') Access Inquiries does not differentiate
    between inquiries and complaints, and does not clarify whether the RLD
    Sponsor made samples available after the FDA issued a Safety
    Determination Letter. Following the receipt of a Safety Determination
    Letter from the FDA, Actelion has actively entered into a supply
    agreement with every generic manufacturer who has requested testing
    samples of our products. This is true for each instance cited in the
    FDA's RLD Access Inquiry list. Actelion is also actively engaging with
    generic manufacturers to develop shared REMS programs that protect
    patient safety while enabling patient access to our medicines.

        Question. When new products enter the market, do drug companies set
    high initial rebates and then provide deep rebates in order to gain
    access to insurance plan's formularies?

        Answer. At Janssen, we take a responsible approach to pricing that
    recognizes our dual responsibility to patients today and patients
    tomorrow. Patients today need access to our medicines. Patients
    tomorrow count on us to deliver cures and treatments for the most
    challenging, intractable diseases. When we set an initial list price
    for our medicines, we balance:

              Value to patients, the health-care system, and society.
                  We consider how the medicine will improve
            patient health. We also assess the medicine's potential to
            reduce other costs--surgeries, hospital stays, or long-term
            care, for example--and the improvement the medicine represents
            over the existing standard of care.

              The importance of maintaining affordable access to medicines
            for people who need them.
                  We work with insurers, pharmacy benefits
            managers, governments, hospitals, physicians, and other
            providers of care so that patients who are prescribed our
            medicines can get access to them.

              The importance of preserving our ability to develop future
            groundbreaking cures and treatments.
                  We have an obligation to ensure that the sale
            of our medicines provides us with the resources to invest in
            R&D to address serious, unmet medical needs.

        We go through a lengthy process to gather the information necessary
    to assess the medicine according to these factors. We use this
    information to determine the value of our medicine compared to what is,
    or will be, available to treat the same condition--be it other
    medicines, surgery, or other forms of health care.

        Question. If CMS finalizes the rebate rule, do you anticipate
    future products entering the market with significantly lower initial
    list prices?

        Answer. Depending on whether elimination of rebates applies to the
    entire market or only to those related to Federal health plans and
    assuming rebates are not replaced by high fees or other costs that
    offset the amount saved, we expect to lower list prices or offer
    discounts for pass-through at the point of sale. In either case, we
    would need to renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.

                                     ______

                  Questions Submitted by Hon. Thomas R. Carper
        Question. What are your recommendations for lowering prices for the
    40 percent of drugs that do not offer rebates in Medicare Part D? In
    the health insurance plans that you offer your employees, do you ask
    your insurers to pass through the full manufacturer rebates to the
    beneficiaries?

        Answer. Drugs that offer lower rebates tend to be drugs that face
    less competition in the marketplace. Increased competition can lead to
    lower prices of branded and generic drugs. FDA Commissioner Scott
    Gottlieb prioritized faster approval of generic drugs. In 2018, FDA set
    a record by approving an estimated 971 generic drugs.

        Within today's health-care system, we do recover manufacturer
    rebates from our PBM. Any savings we receive are used to offset out-of-
    pocket costs for employees and total plan costs. In order to help
    ensure affordability for our employees, we limit out-of-pocket pharmacy
    costs through a monthly per prescription cap.

        Question. The systems for pricing and distributing drugs are opaque
    and difficult to understand. What are your recommendations for
    increasing transparency in how your companies set the list prices for
    drugs, and for improving transparency in the supply chain for
    prescription drugs? Would you support federal standards for
    transparency in setting the list prices for drugs?

        Answer. At Janssen, we issue an annual U.S. Transparency Report
    that explains what we take into account in setting list prices for our
    medicines. When we set an initial list price for our medicines, we
    balance:

              Value to patients, the health-care system, and society.
                  We consider how the medicine will improve
            patient health. We also assess the medicine's potential to
            reduce other costs-- surgeries, hospital stays, or long-term
            care, for example--and the improvement the medicine represents
            over the existing standard of care.

              The importance of maintaining affordable access to medicines
            for people who need them.
                  We work with insurers, pharmacy benefits
            managers, governments, hospitals, physicians, and other
            providers of care so that patients who are prescribed our
            medicines can get access to them.

              The importance of preserving our ability to develop future
            groundbreaking cures and treatments.
                  We have an obligation to ensure that the sale
            of our medicines provides us with the resources to invest in
            R&D to address serious, unmet medical needs.

        The list price we set is a publicly available figure that can be--
    and is-- compared to other options available. We believe that a point-
    of-sale discount model will make price reductions offered by the
    manufacturer more transparent because these discounts will be directly
    reflected in patient out-ofpocket cost at the pharmacy. However, we do
    not believe that the proposal will improve transparency with respect to
    fees or mark-ups to the price of drugs added elsewhere in the supply
    chain.

        Transparency that is meaningful and valuable to patients can help
    achieve what we all want: better health care, at more manageable cost,
    and, most importantly, longer, healthier lives for all.

        We believe an environment that encourages medical innovation and
    robust competition to deliver the best health outcomes is essential to
    achieving these goals. Our support for legislation that establishes a
    federal standard for transparency in setting the list price for drugs
    would depend on the extent to which the proposed standards maintained
    such an environment.

        Question. In nearly every sector of the health-care industry,
    Medicare, Medicaid, employers, and insurers are moving away from fee-
    for-service payments to reimbursements based on value and performance.
    Prescription drugs and medical devices were the glaring exceptions to
    this trend until recently. How many of your drugs are included in
    value-based contracts and how many patients are benefiting from them?
    How do these value-based contracts work to lower drug prices for both
    patients and taxpayers?

        Answer. We have established several innovative, value-based
    contracts with insurers and continue to explore new opportunities. For
    example, in immunology, we partnered with payers to create an agreement
    in which the price of a medicine for chronic immune conditions varies
    based on how well it works for patients. In oncology, we partnered with
    public and private payers on novel contracts for patients with prostate
    cancer and agreed in one contract to provide additional rebates to the
    insurer for plan members who meet eligibility criteria and whose
    treatment duration is shorter than a predetermined period of time. We
    also partnered with a leading payer on a contract under which we are
    paid more if data show our medicine that treats adults with type 2
    diabetes contributed to lowering other identified health-care costs,
    such as the use of additional medicines.

        Question. Last year, Senator Portman and I did an investigation on
    the pricing of an opioid overdose reversal drug called EVZIO,
    manufactured by Kaleo. Kaleo increased the price of EVZIO from $575 in
    2014 to $4,100 in 2017. We found that the best price Medicare was able
    to get for EVZIO, about $4,000, was much higher than the price other
    Federal programs and private insurers were able to get. It seemed that
    Kaleo was able to get this higher price of $4,000 from Medicare by
    helping doctors fill out paperwork showing that the drug was medically
    necessary, even though there are cheaper alternatives on the market. As
    a result of the investigation, Kaleo announced it will bring a generic
    version of the drug to market at only $168 per pack. Are any of your
    companies providing medical necessity paperwork to doctors in order to
    get your drugs covered by Medicare?

        Answer. Like other pharmaceutical companies, we offer a sample
    letter of medical necessity that offices can complete using their own
    clinical judgment regarding the medical and clinical rationale for
    submission to the insurance company or PBM. We also research and
    provide payer-specific forms required to provide medical necessity
    information such as payer-specific prior authorization forms.

        Question. In 2017, the Rand Corporation estimated that biosimilar
    drugs, which are competitors to complex, biologic drugs, could save the
    United States more than $50 billion over the next decade. Some of you
    have also argued that increasing the use of biosimilar drugs would help
    lower drugs costs for consumers and taxpayers. What is delaying the
    uptake of biosimilar drugs in the United States? What policies do you
    recommend to increase the development of biosimilar drugs?

        Answer. The goal of biosimilar policy should be to lower costs for
    the health-care system and patients, and not simply to encourage
    biosimilar uptake without regard to price. The current open and
    competitive environment supports price competition and biosimilar
    uptake as appropriate. For example, the net price of infliximab
    products, including the innovator product REMICADE', is
    falling. Furthermore, the uptake of infliximab biosimilars in the U.S.
    is consistent with branded biologic launches of immunology products,
    including those that provide a clinical benefit over the standard of
    care.

        Biologics are used in patients with serious, chronic conditions,
    many of whom have taken years to become stable on a branded product.
    Health-care providers and patients may naturally be hesitant to switch
    medicines in these circumstances. The approval of an interchangeable
    biosimilar may address some of the physician and patient reservations
    about switching a stable patient to a non-interchangeable biosimilar.

        The biosimilars pipeline is strong and a diverse group of
    companies--traditional pharmaceutical manufacturers as well as
    manufacturers focused on biosimilars--is investing in the space. For
    example, in the immunology therapeutic area alone, at least 18
    biosimilars are currently in clinical development or undergoing FDA
    review.

        We fully support a regulatory framework for FDA review and approval
    of biosimilars and interchangeable biosimilars with standards and
    policies that are science-based and rooted in patient safety.
    Ultimately, the uptake of biosimilars will be reliant on competitive
    pricing and on patient and prescriber confidence. Provider and patient
    confidence can be strengthened by the application of rigorous review
    standards, including the robust approach to interchangeability that FDA
    is pursuing and appropriate standards regarding biosimilar to
    biosimilar switching.

        Biosimilar manufacturers need access to samples of reference
    products to perform comparative testing required to demonstrate
    biosimilarity or interchangeability. We cooperate with manufacturers of
    generic drugs and biosimilars so they have access to samples of our
    medicines at reasonable, market-based prices. To facilitate access to
    product samples while fostering efficiencies in the delivery and
    oversight of healthcare, we believe that manufacturers should identify
    for FDA a point of contact to facilitate access to samples for each
    approved reference product. When a Risk Evaluation and Mitigation
    Strategy (REMS) is in place, the REMS should facilitate the safe use of
    medicine and ensure access for appropriate patients; it should not be
    used to hinder provision of product samples for use in developing a
    generic or biosimilar. We believe FDA should finalize draft guidance,
    issued December 2018, describing a process for FDA determination that
    protocols pertaining to biosimilarity and interchangeability testing
    contain safety protections comparable to an applicable REMS with
    limited distribution elements. A letter from FDA stating comparable
    protections exist and indicating FDA would not consider it to be a
    violation of the REMS to provide samples to the biosimilar manufacturer
    provides needed assurances for reference product manufacturers about
    both the safe use of our products and regulatory compliance.

        The Purple Book is an essential resource for many stakeholders and
    should be enhanced to provide timely information to stakeholders, to
    clarify practices regarding substitution, and to provide information to
    assure the appropriate use of biosimilars and interchangeable products.
    In addition, the Purple Book should include detailed information about
    approved biosimilars and interchangeable biosimilars, including, for
    example, a description or listing of pivotal clinical trials considered
    in FDA's approval of the biosimilar.

                                     ______

                 Questions Submitted by Hon. Benjamin L. Cardin
        Question. The United States is one of the only countries in the
    world to allow prescription drug manufacturers to advertise directly to
    consumers through magazines, billboards, radio, and television
    commercials. While I will not argue that it is beneficial to educate
    consumers about an unfamiliar disease and encourage them to seek
    medical help, most commercials from all of your companies recommend
    asking about a specific brand name drug, not a medical condition.
    Furthermore, even if your advertisements follow all FDA rules and list
    medication side effects, they also almost always list these while a
    smiling, apparently healthy person is walking on a beach.

        Researchers say that this type of imagery, combined with viewing
    hours of drug commercials each month, leads consumers to underestimate
    the risks associated with medications. For the past decade, studies
    have shown that aggressive direct-to-consumer advertising is associated
    with rising drug prices and an increase in inappropriate drug
    prescriptions.

        Since researchers have concluded that consumers are
    misunderstanding the benefits and risks described in your ads, what
    further policies could help you and your colleagues ensure that you are
    educating patients in a clear manner?

        Answer. At Janssen, we believe patients can get and stay healthier
    when they are well informed about their conditions and treatment
    options. We provide accurate, up-to-date educational materials in
    language that is clear and understandable for consumers to help
    patients facing diseases our medicines treat and to help patients who
    take our medicines understand how to use them properly. Our product-
    specific communications, including our DTC advertising, are designed to
    encourage appropriate dialogue between patients and healthcare
    providers about the risks and benefits of treatment.

        We believe acting ethically and responsibly is not only the right
    thing to do but also the right way to do business. We follow all
    relevant laws and regulations regarding the promotion of prescription
    drug products and submit promotional materials to the U.S. Food and
    Drug Administration at the time of initial publication or
    dissemination.

        We are always open to ways to improve our communication, including
    DTC, to ensure patients better understand the benefits and risks of our
    medicines.
               pharmaceutical companies continue to raise prices
        Question. As you are well aware, high prescription drug prices are
    the number one concern for Americans and their families. According to
    the Organisation for Economic Co-operation and Development, the average
    American spends around $1,208 annually on prescription drugs. There
    have been several instances where brand name or even generic drugs that
    have been on the market for years continue to increase in price.

        One of the most well-known examples is Mylan's increase of the
    price of EpiPen from less than $100 in 2007 to more than $600 in 2016.
    Another example, is the ever-increasing price of insulin. Sanofi
    increased the price of a vial of Lantus from $88.20 in 2007 to $307.20
    in 2017. And those are just a small sample of price increases.

        Why don't we see price decreases for drugs that have been on the
    market for years without new formulations or added benefit?

        Answer. In fact, net price does often decrease, sometimes quite
    significantly, for medicines that have been on the market for years
    because of competition from other, newer medicines for the same
    condition. Competition brings down price for payers such as PBMs and
    insurers, although unfortunately patients often do not benefit from the
    lower net price.

        It is also important to note that biopharmaceutical innovation
    paves the way for the introduction of generic medicines, which enables
    medicine costs to be reduced over time. In the U.S., medicines lose
    patent protection, on average, about 12 years after they are
    introduced. When that happens, prices generally drop significantly,
    giving patients ongoing access to effective therapies at a lower cost.
                                 pay for delay
        Question. Pay for delay is a tactic that more and more branded drug
    manufacturers have been using to stifle competition from lower-cost
    generic manufacturers. This allows you to sidestep competition by
    offering patent settlements that pay generic companies not to bring
    lower-cost alternatives to market.

        These pay-for-delay patent settlements benefit both brand-name
    pharmaceutical companies by helping them avoid costly patent litigation
    and general manufacturers by rewarding them a hefty sum to delay
    entering the market with a cheaper drug alternative. However, these
    deals do not benefit consumers. According to an FTC study, these
    anticompetitive deals cost consumers and taxpayers $3.5 billion in
    higher drug costs every year.

        Does your company partake in pay-for-delay settlements?

        Answer. We have not entered into patent settlement agreements that
    require payment of money to a generic manufacturer.

        Question. Why would a pharmaceutical company enter into a pay-for
    delay agreement?

        Answer. We have not entered into patent settlement agreements that
    require payment of money to a generic manufacturer and, therefore, we
    cannot speculate as to why other companies might enter into such
    agreements in specific cases.

        Question. Do you think these agreements stifle competition and
    prevent generic alternatives to your branded medications?

        Answer. We have not entered into patent settlement agreements that
    require payment of money to a generic manufacturer, so we do not have
    direct experience with their competitive impacts. However, we believe
    that the competitive impact of any individual settlement agreement must
    be evaluated on a case-by-case basis. The current legal framework--FTC
    oversight and judicial review on a case-by-case basis--is intended to
    identify any patent settlement that is anti-competitive.
                                drug rebate rule
        Question. In January, the Department of Health and Human Services'
    (HHS) Office of Inspector General (OIG) promulgated a new regulation to
    remove regulatory safe harbor protections under the Anti-Kickback
    Statute (AKS) for rebates on prescription drugs rebates paid by
    manufactures to PBMs under Medicare Part D and for Medicaid managed
    care organizations (MCOs). The OIG proposal attempts to ban most
    rebates by eliminating their regulatory protections.

        The rule is predicted to increase net drug costs in its early
    years. The CMS actuaries estimate it would cost $196 billion over 10
    years. Despite this high price tag, the beneficiary benefits are
    limited. The proposed rule notes that under the CMS Actuary's analysis,
    the majority of beneficiaries would see an increase in their total out-
    of-pocket payments and premium costs; reductions in total cost sharing
    will exceed total premium increases.

        I wanted to ask a question about the administration's rebate rule,
    which I understand that many of the drug manufacturers, and your main
    trade association, strongly support. According to an analysis of the
    rule by the Office of Actuaries at CMS, drug manufacturers are likely
    to initially retain 15 percent of the current rebates as higher net
    drug prices.

        Given that estimate, can you provide the committee with any
    assurances that prices will not increase under this proposed rule?

        Answer. Depending on whether elimination of rebates applies to the
    entire market or only to those related to Federal health plans and
    assuming rebates are not replaced by high fees or other costs that
    offset the amount saved, we expect to lower list prices or offer
    discounts for pass-through at the point of sale. In either case, we
    would need to renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.

                                     ______

                   Questions Submitted by Hon. Sherrod Brown
        Question. As I understand it, 2 years ago PhRMA updated its
    membership standards to require member companies to meet two new
    criteria: (1) each company must meet a 3-year average global research
    and development to sales ratio of 10 percent or greater, and (2) each
    company must spend at least $200 million on R&D per year over a 3-year
    average. As a result of these changes, several companies who continue
    to operate under business models that prioritize price gouging over
    innovation, left PhRMA.

        Given your company's role in setting a higher standard for R&D,
    would you support a more even playing field by raising the minimum bar
    for R&D across the entire pharmaceutical sector, in particular for
    companies that participate in government programs such as Medicare and
    Medicaid?

        Answer. We are proud to set a high standard for R&D investment. In
    2018 Janssen invested $8.4 billion globally in research and
    development. This investment in R&D was 86 percent more than we spent
    on sales and marketing. However, we would not support a policy that
    requires a certain amount of R&D spending for a manufacturer's products
    to be covered by Medicare and Medicaid because we would not want to
    deny patients access to needed medication based on the investment
    decisions of these drug companies.

        Question. According to an article recently published in the Journal
    of the American Medical Association, medical marketers spend nearly $30
    billion dollars in 2016, up from $17 billion in 1997. Direct-to-
    Consumer (DTC) advertising had the biggest percentage increase: from
    $2.1 billion, or 11.9% of all medical marketing, in 1997 to $9.6
    billion, or 32% of total spending, in 2016.

        Can you please provide what your ratio of spending on sales and
    marketing to research and development is today?

        Answer. In 2018, the pharmaceutical segment of Johnson & Johnson
    invested 86 percent more in R&D globally ($8.4B) than we spent on
    global sales and marketing ($4.5B).
                                 price-gouging
        Question. Sanofi, as I understand it, has made a pledge to the
    public to limit its price increases to the national health expenditures
    growth projection.

        Would your company commit to a cap on annual price increases as
    part of your PhRMA membership criteria?

        Answer. In 1993, the Pharmaceutical Manufacturers Association (PMA,
    now the Pharmaceutical Research and Manufacturers of America or PhRMA)
    asked the Department of Justice (``DOJ'') Antitrust Division to review
    a proposal for a PMA effort to ask member companies to commit
    voluntarily to limiting price increases on their entire line of
    prescription medicines in any calendar year to an amount not to exceed
    the increase in the Consumer Price Index (CPI). In its response, the
    DOJ Antitrust Division stated that, ``[T]he Department believes that
    the proposed program would violate the antitrust laws. . . . The
    Supreme Court has. . . made clear that agreements that set maximum
    prices are as equally illegal as agreements that set minimum prices.''
    The DOJ noted that it ``intends to bring suit to challenge the program
    if PMA and its members go forward with this proposal.'' Therefore, we
    are unable to commit to such a cap as part of PhRMA membership
    requirements due to likely enforcement action by the DOJ.

        Question. What policies would you propose to help ensure lower
    launch prices for new drugs?

        Answer. We support rebate reforms that ensure patients benefit from
    negotiated rebates and discounts--$150 billion in 2017 alone--and, as a
    result, have patients see lower out-of-pocket costs at the pharmacy.

        Depending on whether elimination of rebates applies to the entire
    market or only to those related to Federal health plans and assuming
    rebates are not replaced by high fees or other costs that offset the
    amount saved, we expect to lower list prices or offer discounts for
    pass-through at the point of sale. In either case, we would need to
    renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.
                                  transparency
        Question. In many of your testimonies, you mentioned that the
    current system of pharmacy benefit manager (PBM) back-end rebates do
    not rarely results in a scenario where the PBM passes on savings to
    consumers at the point of sale (POS). The administration recently
    proposed a rule to eliminate the anti-kickback statute safe harbor
    protections for these drug rebates.

        Do you agree that greater transparency should be required to
    understand how manufacturers and PBMs are negotiating prices and
    rebates to ensure that savings are passed down to beneficiaries?

        Answer. We believe that a point-of-sale discount model will make
    price reductions offered by the manufacturer more transparent because
    these discounts will be directly reflected in patient out-of-pocket
    cost at the pharmacy. However, we do not believe that the proposal will
    improve transparency with respect to fees or mark-ups to the price of
    drugs added elsewhere in the supply chain.

        Depending on whether elimination of rebates applies to the entire
    market or only to those related to Federal health plans and assuming
    rebates are not replaced by high fees or other costs that offset the
    amount saved, we expect to lower list prices or offer discounts for
    pass-through at the point of sale.
                                      pbms
        Question. An Axios article from March 7, 2019 highlights the fact
    that, while ``pharmaceutical companies put a lot of the blame for high
    drug prices on pharmacy benefit managers,'' many large pharmaceutical
    companies ``rely on PBMs to manage their own health-care benefits.''

        In your role as an employer, does your company contract with a
    pharmaceutical benefit manager (PBM) to administer the prescription
    drug benefits for your employees and negotiate lower drug costs on your
    behalf?

        Answer. As an employer, we design our own pharmacy benefit program
    and contract with a PBM for administration and to negotiate on our
    behalf.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, how do you utilize the
    rebates your PBM negotiates to lower health-care costs or drug costs
    for your employee plans and what does your company do with that
    savings? Specifically, do the savings go toward lowing premiums?

        Answer. We use any savings to offset total plan costs, enhance
    benefits, and lower premium and out-of-pocket costs for our employees.
    In order to ensure our employees have affordable access to medicine, we
    have a monthly per prescription out-of-pocket cap.

        Question. For those of you who do use a PBM to help manage the
    prescription drug benefit for your employees, does your PBM offer
    point-of-sale rebates to your employees?

        Answer. We are exploring the possibility of offering point-of-sale
    rebates with our PBM.

                                     ______

                 Questions Submitted by Hon. Sheldon Whitehouse
        Question. Please describe any policy changes you support that would
    result in your company lowering the list prices of its drugs.

        Answer. We support rebate reforms that ensure patients benefit from
    negotiated rebates and discounts-- $150 billion in 2017 alone--and, as
    a result, have patients see lower out-of-pocket costs at the pharmacy.

        Depending on whether elimination of rebates applies to the entire
    market or only to those related to Federal health plans and assuming
    rebates are not replaced by high fees or other costs that offset the
    amount saved, we expect to lower list prices or offer discounts for
    pass-through at the point of sale. In either case, we would need to
    renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-of-sale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.

        Question. How much does your company's research and development
    portfolio rely on taxpayer-funded research conducted by the National
    Institutes of Health (NIH)? How many of your company's products are
    based, at least in part, on NIH research, and how many are the result
    of research funded solely by your company?

        Answer. The NIH plays an important role in medical research,
    primarily funding basic research on medical problems. The
    pharmaceutical industry is responsible for developing the solutions--
    undertaking the long, financially risky, and costly process to discover
    a compound and develop new medicines that meet the stringent safety and
    efficacy requirements of the FDA. In those instances where NIH
    contributes to a product that is brought to market, NIH would receive
    any contracted license fees or royalties.

        Question. In each of the last 5 years, how much has your company
    spent on research and development versus the advertising and marketing
    of your products?

        Answer. Below is a chart including global Janssen R&D and Sales and
    Marketing expenditures over the last 5 years. Sales and marketing
    includes expenses related to: (1) selling, (2) marketing management,
    (3) market and consumer research, and (4) advertising and promotion.

    ------------------------------------------------------------------------
                                       2014    2015    2016    2017    2018
    ------------------------------------------------------------------------
    Janssen R&D                        $6.2B   $6.8B     $7B   $7.9B   $8.4B
    ------------------------------------------------------------------------
    Janssen Sales and Marketing        $4.5B   $4.6B   $4.5B   $4.2B   $4.5B
    ------------------------------------------------------------------------

        Question. During the hearing, you mentioned that your company would
    be likely to lower the list prices of its drugs if the recent proposal
    by the Trump administration to change the current system of rebates was
    extended to the private market.

        If the policy was extended to the private market, how large would
    the list price reductions be relative to the size of the rebates your
    company is currently providing?

        How will this proposal affect how your company sets the list prices
    for new drug products?

        Answer. Depending on whether elimination of rebates applies to the
    entire market or only to those related to Federal health plans and
    assuming rebates are not replaced by high fees or other costs that
    offset the amount saved, we expect to lower list prices or offer
    discounts for pass-through at the point of sale. In either case, we
    would need to renegotiate our agreements with customers.

        The degree to which we can convert current rebates to list price
    reductions or point-ofsale discounts will depend upon the details of
    the final regulation and the reactions of other stakeholders in the
    supply chain. We are concerned that PBMs may seek to replace rebate
    revenue with new and increasing fees or may seek to shift costs among
    supply chain participants through service fees.

        Question. If the proposal is finalized and not extended to the
    private market, will your company make any list price reductions? If
    so, how large would the reductions be relative to the size of the
    rebates your company is currently providing?

        Answer. If elimination of rebates applies only to Medicare and
    Medicaid Managed Care and assuming rebates are not replaced by high
    fees or other costs that offset the amount saved, we expect to offer
    discounts for pass-through at the point of sale. To do so, we would
    need to renegotiate our agreements with customers.

        The degree to which we can convert current rebates to point-of-sale
    discounts will depend upon the details of the final regulation and the
    reactions of other stakeholders in the supply chain. We are concerned
    that PBMs may replace rebate revenue with new and increasing fees or
    may shift costs among supply chain participants through service fees.

                                     ______

                    Question Submitted by Hon. Maggie Hassan
        Question. In June of 2018, the Medicaid and CHIP Payment and Access
    Commission (MACPAC) unanimously recommended under Recommendation 1.1 in
    their annual report to Congress that Congress remove the statutory
    requirement that manufacturers blend the average manufacturer price
    (AMP) of a brand drug and its authorized generic.\1\
    ---------------------------------------------------------------------------
        \1\ MACPAC, ``Improving Operations of the Medicaid Drug Rebate
    Program,'' https://www.macpac.gov/wp-content/uploads/2018/06/Improving-
    Operations-of-the-Medicaid-Drug-Rebate-Program.pdf.

        This requirement created an unintended loophole. Rather than use
    the price of the authorized generic, drug companies can sell its
    authorized generic to a corporate subsidiary at an artificially lower
    price, and use that lower price to bring down the AMP, which in turn
    ---------------------------------------------------------------------------
    lowers the rebate obligation.

        Does your company engage in this practice? Has your company ever
    engaged in this practice in the past?

        Answer. We do not include authorized generic internal transfer
    prices to an affiliate when calculating Average Manufacturer Price for
    the branded product. Under previous versions of the statute and CMS
    guidance, we have at times in the past included in Average Manufacturer
    Price the transfer prices of our authorized generic sold to an
    affiliate.

                                     ______

               Questions Submitted by Hon. Catherine Cortez Masto
        Question. As a portion of your revenue, for what percentage of the
    drugs in your portfolio do you offer no rebates? Based on the drugs in
    your pipeline, do you foresee that portion growing? For those drugs is
    your list price equal to your net price?

        Answer. The information requested is confidential and competitively
    sensitive. As such, potentially responsive information is not available
    for public disclosure.

        Question. Do you invest more in R&D than you generate in US sales
    revenue? Please include specific figures.

        Answer. Janssen is one of the world's top R&D investors in any
    industry, anywhere in the world. In 2018 we invested $8.4 billion in
    pharmaceutical R&D globally. Our pharmaceutical revenue in the U.S. was
    $23.3 billion. We invested 86 percent more in pharmaceutical R&D ($8.4
    billion) than we spent on pharmaceutical global sales and marketing
    ($4.5 billion).

        Question. Do you invest more in R&D than you spend on marketing and
    administration? What company functions do you consider to be included
    in administration? Please include specific figures.

        Answer. Johnson & Johnson is comprised of three business segments:
    pharmaceuticals (Janssen), medical devices, and consumer products. In
    its financial statements, Johnson & Johnson reports a global total
    figure across all segments for Sales, Marketing and Administration
    (``SM&A''). This figure combines marketing, sales, and administrative
    expenses such as insurance, legal, finance, and product distribution.
    In 2018, that global, cross-sector SM&A expenditure was $22.54 billion.
    The total global, cross-sector R&D investment by J&J in 2018 was $10.78
    billion.

        Johnson & Johnson does not report SM&A by business segment.
    Janssen, the pharmaceutical segment of J&J, invested $8.4 billion in
    R&D globally in 2018 and spent $4.5 billion on marketing and sales
    globally.

        Question. Do you invest more in R&D than you spend on marketing and
    sales? What company functions do you consider to be included in sales?
    Please include specific figures.

        Answer. In 2018, we invested 86 percent more in pharmaceutical R&D
    ($8.4 billion) than we spent on pharmaceutical global sales and
    marketing ($4.5 billion). Sales and marketing includes: (1) our
    expenses related to selling, (2) marketing management, (3) market and
    consumer research, and (4) advertising and promotion.

        Question. Why do you advertise for the drugs you manufacture? What
    factors do you consider in choosing which drugs you advertise?

        Answer. We believe direct-to-consumer communication, including
    advertising, can empower patients with information to help them have
    appropriate discussions with their healthcare providers, including
    dialogue about the risks and benefits of treatment. We provide
    accurate, up-to-date educational materials to help patients facing
    diseases our medicines treat and to help patients who take our
    medicines understand how to use them properly.

        We believe acting ethically and responsibly is not only the right
    thing to do but also the right way to do business. We follow all
    relevant laws and regulations regarding the promotion of prescription
    drug products and submit promotional materials to the U.S. Food and
    Drug Administration at the time of initial publication or
    dissemination.

        We work to communicate in ways that will be most valuable in
    empowering patients to have appropriate dialogue with their healthcare
    providers.

        We consider the availability of information and awareness of
    treatment options. We build a communication plan that can include a
    variety of channels, with direct-to-consumer advertising being one
    channel among many we may use.

                                     ______

     Janssen Biotech, Inc. Monetary and Product Contributions to U.S.-based
                     Charitable Organizations Full Year 2014
    (Payments made from January 1, 2014 to December 31, 2014)--Amended March
                                    19, 2019
    ------------------------------------------------------------------------
                                        Payment
      Donation     Payee      Payee      Amount     Payment    Project Title/
        Type                 Address     (USD)        Date      Description
    ------------------------------------------------------------------------
    Monetary     100       4631           $1,000    8/29/2014  100 Black Men
                  Black     Delmar                              of Metro St.
                  Men (of   Boulevard                           Louis, St.
                  Metro     , St.                               Louis, MO
                  St.       Louis, MO
                  Louis)    63108
    ------------------------------------------------------------------------
    Monetary     Abington  515              $300    8/29/2014  Abington Art
                  Art       Meetingho                           Center,
                  Center    use Road                            Jenkintown,
                            Jenkintow                           PA (2014
                            n, PA                               Janssen
                            19046                               Cares
                                                                Volunteer
                                                                Days)
    ------------------------------------------------------------------------
    Monetary     Aldie     11 Welden        $300    9/10/2014  Aldie
                  Foundat   Drive                               Foundation,
                  ion       Doylestow                           Doylestown,
                  Inc.      n, PA                               PA Janssen
                            18901                               Cares
                                                                Volunteer
                                                                Days
    ------------------------------------------------------------------------
    Monetary     American  2600 US        $1,000    4/21/2014  Run for Dad
                  Cancer    Highway 1                           Prostate
                  Society   North                               Cancer event
                            North                               in Hamilton,
                            Brunswick                           NJ
                            , NJ
                            08902
    ------------------------------------------------------------------------
    Monetary     Arthriti  115 NE         $5,000    8/29/2014  Arthritis
                  s         100th                               Foundation,
                  Foundat   Suite                               Seattle, WA--
                  ion       #350                                Great West
                            Seattle,                            Region JBRs
                            WA 98125
    ------------------------------------------------------------------------
    Monetary     Arthriti  1876           $6,000   11/10/2014  Jingle Bell
                  s         Minnehaha                           Run/Walks
                  Foundat   Avenue                              Upper
                  ion       West St.                            Midwest
                            Paul, MN
                            55104
    ------------------------------------------------------------------------
    Monetary     Arthriti  35 East       $10,000    8/29/2014  AF, Chicago,
                  s         Wacker                              IL 2014
                  Foundat   Drive                               Heartland
                  ion       Suite                               Region
                            2260                                Jingle Bell
                            Chicago,                            Runs and
                            IL 60601                            Walks
    ------------------------------------------------------------------------
    Monetary     Arthriti  4300           $7,000   12/22/2014  Arthritis
                  s         McArthur                            Foundation,
                  Foundat   Suite 245                           Dallas, TX--
                  ion       Dallas,                             JBRs South
                            TX 75209                            Central
                                                                Region
    ------------------------------------------------------------------------
    Monetary     Arthriti  4530 Park      $5,000    8/29/2014  Arthritis
                  s         Road                                Foundation,
                  Foundat   Charlotte                           Charlotte,
                  ion       , NC                                NC--2014
                            29209                               JBRs
    ------------------------------------------------------------------------
    Monetary     Arthriti  4630           $7,500    10/3/2014  Arthritis
                  s         Richmond                            Foundation,
                  Foundat   Road                                Cleveland,
                  ion       Suite 240                           OH JBRs
                            Cleveland
                            , OH
                            44128
    ------------------------------------------------------------------------
    Monetary     Arthriti  800 West      $12,500   11/13/2014  Jingle Bell
                  s         Sixth                               Run/Walks,
                  Foundat   Street                              Los Angeles
                  ion       Suite                               CA
                            1250 Los
                            Angeles,
                            CA 90017
    ------------------------------------------------------------------------
    Monetary     Arthriti  8383 North     $1,000   11/13/2014  Arthritis
                  s         Davis                               Foundation,
                  Foundat   Highway                             Pensacola,
                  ion       Pensacola                           FL--Jacksonv
                            , FL                                ille JBR
                            32514
    ------------------------------------------------------------------------
    Monetary     Arthriti  8383 North     $1,000   11/13/2014  Arthritis
                  s         Davis                               Foundation,
                  Foundat   Highway                             Pensacola,
                  ion       Pensacola                           FL for
                            , FL                                Pensacola
                            32514                               JBR/W
    ------------------------------------------------------------------------
    Monetary     Arthriti  8383 North     $1,500   11/13/2014  Arthritis
                  s         Davis                               Foundation,
                  Foundat   Highway                             Pensacola,
                  ion       Pensacola                           FL--Orlando
                            , FL                                Jingle Bell
                            32514                               Run & Walk
    ------------------------------------------------------------------------
    Monetary     Arthriti  111 South      $2,500    4/18/2014  Walk to Cure
                  s         Independe                           Arthritis,
                  Foundat   nce Mall                            Philadelphia
                  ion,      E Suite                             , PA, May
                  Inc.      500                                 17, 2014
                            Philadelp
                            hia, PA
                            19106
    ------------------------------------------------------------------------
    Monetary     Arthriti  115 NE         $5,000     6/9/2014  Eight Walks
                  s         100th                               to Cure
                  Foundat   Suite                               Arthritis in
                  ion,      #350                                the Great
                  Inc.      Seattle,                            West Region
                            WA 98125
    ------------------------------------------------------------------------
    Monetary     Arthriti  122 East      $50,000     4/4/2014  NE Region
                  s         42nd                                Jingle Bell
                  Foundat   Street                              Runs 2014
                  ion,      18th
                  Inc.      Floor New
                            York, NY
                            10168
    ------------------------------------------------------------------------
    Monetary     Arthriti  1876           $3,500     4/4/2014  Arthritis
                  s         Minnehaha                           Foundation's
                  Foundat   Avenue                              2014 Walks
                  ion,      West St.                            in MN, WI
                  Inc.      Paul, MN                            and ND
                            55104
    ------------------------------------------------------------------------
    Monetary     Arthriti  209 10th       $2,000    4/21/2014  Arthritis
                  s         Avenue                              Foundation
                  Foundat   South                               Walks to
                  ion,      Suite 228                           Cure
                  Inc.      Nashville                           Arthritis in
                            , TN                                TN and AL
                            37203
    ------------------------------------------------------------------------
    Monetary     Arthriti  29 Crafts      $3,500    4/21/2014  Walks to Cure
                  s         Street                              Arthritis in
                  Foundat   Suite 450                           CT, RI, NH,
                  ion,      Newton,                             and MA
                  Inc.      MA 02458
    ------------------------------------------------------------------------
    Monetary     Arthriti  35 East       $12,000    4/21/2014  Walks to Cure
                  s         Wacker                              Arthritis in
                  Foundat   Drive                               IL, IN, IA,
                  ion,      Suite                               KS, MO, NE
                  Inc.      2260
                            Chicago,
                            IL 60601
    ------------------------------------------------------------------------
    Monetary     Arthriti  400              $500     6/9/2014  2014 Walk to
                  s         Hibiscus                            Cure
                  Foundat   Street                              Arthritis,
                  ion,      West Palm                           Lake Worth,
                  Inc.      Beach, FL                           FL
                            33401
    ------------------------------------------------------------------------
    Monetary     Arthriti  408 12th         $500    4/18/2014  Walk to Cure
                  s         Street                              Arthrits,
                  Foundat   West                                Sarasota,
                  ion,      Bradenton                           FL, May 17,
                  Inc.      , FL                                2014
                            34205
    ------------------------------------------------------------------------
    Monetary     Arthriti  4300           $4,000    4/21/2014  South Central
                  s         McArthur                            Region Walks
                  Foundat   Suite 245                           to Cure
                  ion,      Dallas,                             Arthritis
                  Inc.      TX 75209
    ------------------------------------------------------------------------
    Monetary     Arthriti  4720          $10,000    4/18/2014  Arthritis
                  s         Montgomer                           Walks--Mid
                  Foundat   y Lane                              Atlantic
                  ion,      Suite 300                           Region--DE,
                  Inc.      Bethesda,                           MD, DC, VA,
                            MD 20814                            NC, and SC.
    ------------------------------------------------------------------------
    Monetary     Arthriti  800 West      $10,000    6/25/2014  Walks to Cure
                  s         6th                                 Arthritis in
                  Foundat   Street                              CA, AZ, and
                  ion,      Suite                               HI
                  Inc.      1250 Los
                            Angeles,
                            CA 90017
    ------------------------------------------------------------------------
    Monetary     Arthriti  8383 North       $500    3/17/2014  2014 Walk to
                  s         Davis                               Cure
                  Foundat   Highway                             Arthritis
                  ion,      Pensacola                           Pensacola FL
                  Inc.      , FL
                            32514
    ------------------------------------------------------------------------
    Monetary     Big       2875 York        $300    6/24/2014  Janssen Cares
                  Brother   Road                                Volunteers
                  s Big     Jamison,                            Days--Commun
                  Sisters   PA 18929                            ity Service
                                                                at Big
                                                                Brothers Big
                                                                Sisters,
                                                                Jamison, PA
    ------------------------------------------------------------------------
    Monetary     Bowmans   1635 River       $300    8/29/2014  Bowman's Hill
                  Hill      Road New                            Wild Flower
                  Wildflo   Hope, PA                            Preserve,
                  wer       18938                               New Hope, PA
                  Preserv                                       (2014 JCVD)
                  e
    ------------------------------------------------------------------------
    Monetary     Bringing  940 West       $2,500   10/28/2014  Bringing Hope
                  Hope      Valley                              Home Inc.,
                  Home      Road                                Wayne, PA
                  Inc.      Wayne, PA
                            19087
    ------------------------------------------------------------------------
    Monetary     Cancer    121 Avenue     $2,000    4/21/2014  Cancer Care's
                  Care,     of the                              6th Annual
                  Inc.      Americas                            Healing
                            6th Floor                           Hearts
                            New York,                           Family
                            NY 10013                            Bereavement
                                                                Camp,
                                                                Milford, PA
    ------------------------------------------------------------------------
    Monetary     Cancer    121 Avenue    $10,000    4/21/2014  2014-2015
                  Care,     of the                              Edition of
                  Inc.      Americas                            ``A Helping
                            6th Floor                           Hand: The
                            New York,                           Resource
                            NY 10013                            Guide for
                                                                People with
                                                                Cancer.''
    ------------------------------------------------------------------------
    Monetary     Cancer    200 Kirk         $600    6/25/2014  Janssen Cares
                  Support   Road                                Volunteer
                  Communi   Warminste                           Days--commun
                  ty        r, PA                               ity service
                  Gilda's   18974                               at Gilda's
                  Club                                          Club June 24
                  Warmins                                       and June 26,
                  ter, PA                                       2014
    ------------------------------------------------------------------------
    Monetary     Cancer    4100           $2,500    10/3/2014  Cancer
                  Support   Chamounix                           Support
                  Communi   Drive                               Community of
                  ty of     Philadelp                           Philadelphia
                  Philade   hia, PA                             ,
                  lphia     19131                               Warminister,
                                                                PA
    ------------------------------------------------------------------------
    Monetary     Children  34th and       $5,000    10/3/2014  CHOP
                  s         Civic                               Philadelphia
                  Hospita   Center                              , PA Child
                  l of      Blvd.                               Life Program
                  Philade   Philadelp
                  lphia     hia, PA
                  Foundat   19104-
                  ion       4399
    ------------------------------------------------------------------------
    Monetary     Chrohn's  386 Park      $15,000    8/29/2014  Crohn's and
                  and       Avenue                              Colitis
                  Colitis   South                               Foundation,
                  Foundat   17th                                New York,
                  ion       Floor New                           NY--Camp
                            York, NY                            Oasis
    ------------------------------------------------------------------------
    Monetary     Communit  300B          $20,000   10/15/2014  Community
                  y         Lawrence                            Volunteers
                  Volunte   Drive                               in Medicine,
                  ers in    West                                West
                  Medicin   Chester,                            Chester, PA
                  e Inc.    PA 19380
    ------------------------------------------------------------------------
    Monetary     Crohns    116 Wilson     $5,000   11/13/2014  Buds N Suds
                  and       Pike                                Benefit
                  Colitis   Circle                              Concert
                  Foundat   Brentwood                           Nashville,
                  ion of    , TN                                TN
                  America   37027
    ------------------------------------------------------------------------
    Monetary     Crohns    116 Wilson     $5,000   11/13/2014  Donate A
                  and       Pike                                Photo
                  Colitis   Circle                              Awareness
                  Foundat   Brentwood                           Campaign at
                  ion of    , TN                                ACG Fall
                  America   37027                               2014
    ------------------------------------------------------------------------
    Monetary     Crohns    386 Park     $135,000    4/22/2014  Take Steps
                  and       Avenue                              Walks
                  Colitis   South                               Nationwide
                  Foundat   17th
                  ion of    Floor New
                  America   York, NY
    ------------------------------------------------------------------------
    Monetary     Crohns    9 Lake         $3,000    4/18/2014  CCFA 's Camp
                  and       Bellevue                            Oasis for
                  Colitis   Drive                               IBD
                  Foundat   Suite 203                           Pediatric
                  ion of    Bellevue,                           Patients,
                  America   WA 98005                            Longbranch,
                                                                WA
    ------------------------------------------------------------------------
    Monetary     Crohn's   386 Park       $5,000    8/29/2014  CCFA, NY, NY
                  and       Avenue                              (DDW
                  Colitis   South                               Awareness)
                  Foundat   17th
                  ion of    Floor New
                  America   York, NY
    ------------------------------------------------------------------------
    Monetary     Delaware  215 South      $3,000    9/10/2014  Delaware
                  Valley    16th                                Valley
                  Science   Street,                             Science
                  Council   Philadelp                           Council,
                            hia PA                              STEM
                            19102                               Programs
    ------------------------------------------------------------------------
    Monetary     Delaware  215 South     $21,300     4/4/2014  Delaware
                  Valley    16th                                Valley
                  Science   Street,                             Science
                  Fairs,    Philadelp                           Fairs Tri-
                  Inc.      hia PA                              State
                            19102                               Competition,
                                                                Oaks, PA
    ------------------------------------------------------------------------
    Monetary     Educatio  454 Maple      $5,000    10/3/2014  Education-
                  n-Plus    Terrace                             Plus Inc.,
                  Inc.      Ardmore,                            Philadelphia
                            PA                                  , PA Read
                                                                Now Program
    ------------------------------------------------------------------------
    Monetary     Franklin  222 North     $10,000    10/3/2014  Franklin
                  Institu   20th                                Institute,
                  te        Street                              Philadelphia
                            Philadelp                           , PA
                            hia, PA
                            19103
    ------------------------------------------------------------------------
    Monetary     Girl      330 Manor      $4,000    10/3/2014  Girl Scouts
                  Scouts    Road                                of Eastern
                  of        Miquon,                             PA, Miquon,
                  Eastern   PA 19444                            PA
                  Pennsyl
                  vania
                  Inc.
    ------------------------------------------------------------------------
    Monetary     Green     1368          $15,000    10/3/2014  Green
                  Valleys   Prizer                              Valleys,
                  Assocat   Road                                Pottstown,
                  ion of    Pottstown                           PA (EITC
                  Southea   , PA                                participant)
                  stern     19465
                  Pennsyl
                  vania
    ------------------------------------------------------------------------
    Monetary     Hatboro   440 South        $300     9/4/2014  Hatboro Area
                  Area      York Road                           YMCA,
                  YMCA      Hatboro,                            Hatboro, PA
                            PA 19040                            (2014 Jansen
                                                                Cares V.D.)
    ------------------------------------------------------------------------
    Monetary     Hatboro   229              $300    8/29/2014  Hatboro-
                  Horsham   Meetingho                           Horsham
                  Educati   use Road                            Educational
                  onal      Hatboro-                            Foundation,
                  Foundat   Horsham,                            Horsham, PA
                  ion       PA 19044
    ------------------------------------------------------------------------
    Monetary     Hatboro   229           $25,000    8/29/2014  Hatboro-
                  Horsham   Meetingho                           Horsham Ed.
                  Educati   use Road                            Foundation
                  onal      Hatboro-                            (EITC),
                  Foundat   Horsham,                            Horsham, PA
                  ion       PA 19044
    ------------------------------------------------------------------------
    Monetary     Impact    2979             $300    8/29/2014  JBI Impact
                  Thrift    Bethlehem                           Thrift
                  Sortes    Pike                                Sortes,
                  Inc.      Montgomer                           Inc.,
                            yville,                             Montgomeryvi
                            PA                                  lle, PA
    ------------------------------------------------------------------------
    Monetary     Integrat  532            $1,000     4/4/2014  2014 Belmont
                  ed        Broadholl                           Stakes Blue
                  Medical   ow Road                             Ribbon Run
                  Foundat   Suite                               for Prostate
                  ion,      142A                                Cancer,
                  Inc.      Melville,                           Melville, NY
                            NY 11747
    ------------------------------------------------------------------------
    Monetary     Internat  6144 Clark    $10,000   12/24/2014  International
                  ional     Center                              Waldenstroms
                  Waldens   Avenue                              Macroglobuli
                  troms     Sarasota,                           nemia
                  Macrogl   FL 34238                            Foundation,
                  obuline                                       Sarasota, FL
                  mia
                  Foundat
                  ion
    ------------------------------------------------------------------------
    Monetary     Junior    522 South      $5,000    10/3/2014  Junior
                  Achieve   Walnut                              Achievement,
                  ment of   Street                              Wayne, PA
                  Delawar   Wilmingto                           (Horsham
                  e         n, DE                               Scools)
                  Valley    19801
    ------------------------------------------------------------------------
    Monetary     Leukemia  555 North    $175,000    6/16/2014  LLS
                  and       Lane                                Nationwide
                  Lympho    Suite                               Light the
                  Society   5010                                Night Walks
                  , Inc.    Conshohoc
                            ken, PA
                            19428
    ------------------------------------------------------------------------
    Monetary     Metropol  2323          $15,000    10/3/2014  MANNA,
                  itan      Ranstead                            Philadelphia
                  Area      Street                              , PA
                  Neighbo   Philadelp
                  rhood     hia, PA
                  Nurtrit   19103
                  ion
                  Allianc
                  e
    ------------------------------------------------------------------------
    Monetary     National  PO Box 303     $2,500    8/29/2014  National
                  Ovarian   Holicong,                           Ovarian
                  Cancer    PA 18928                            Cancer
                  Coaliti                                       Coalition
                  on Inc.                                       Inc.,
                                                                Holicong, PA
    ------------------------------------------------------------------------
    Monetary     National  6600 SW       $50,000   11/13/2014  National
                  Psorias   2nd                                 Psoriasis
                  is        Avenue                              Foundation,
                  Foundat   Suite 300                           Portland OR--
                  ion       Portland,                           Compliments
                            OR 97223                            are
                                                                Contagious
    ------------------------------------------------------------------------
    Monetary     Open      350 Main         $300    8/29/2014  Royersford
                  Door      Street                              Outreach
                            Royersfor                           Open Door
                            d, PA                               (Janssen
                            19468                               Cares V.D.),
                                                                Royersford,
                                                                PA
    ------------------------------------------------------------------------
    Monetary     Perkiome  1 West           $300    8/29/2014  Perkioment
                  n         Skippack                            Watershed
                  Watersh   Pike                                Conservancy,
                  ed        Schwenksv                           Schwenksvill
                  Conserv   ille, PA                            e, PA
                  ancy      19473
    ------------------------------------------------------------------------
    Monetary     Philadel  325           $10,000    10/3/2014  Philadelphia
                  phia      Chestnut                            Reads, Inc.,
                  Reads,    Street                              Philadelphia
                  Inc.      Philadelp                           , PA (EITC)
                            hia, PA
                            19106
    ------------------------------------------------------------------------
    Monetary     Premier   PO Box 93      $5,000    10/3/2014  Premier Cares
                  Cares     Pleasant                            Foundation,
                  Foundat   Valley,                             Inc.
                  ion       NY 12569
                  Inc.
    ------------------------------------------------------------------------
    Monetary     Prostate  7009 S.        $1,000    8/29/2014  Prostate
                  Cancer    Potomac                             Cancer
                  Educati   Street                              Education
                  on        Centennia                           Council,
                  Council   l, CO                               Centennial,
                            80112                               CO
    ------------------------------------------------------------------------
    Monetary     Prostate  500           $10,000    4/21/2014  Prostate
                  Health    Victory                             Health
                  Educati   Road                                Education
                  on        Quincy,                             Network
                  Network   MA 02170                            (PHEN) Sixth
                  , Inc.                                        Annual
                                                                Father's Day
                                                                Rally
                                                                Nationwide
    ------------------------------------------------------------------------
    Monetary     Rebuidli  PO Box         $5,000    6/13/2014  Mantua Block
                  ng        42752                               Build,
                  Togethe   Philadelp                           Philadelphia
                  r         hia, PA                             , PA
                  Philade   19101-
                  lphia     2752
    ------------------------------------------------------------------------
    Monetary     Retired   925            $7,000   10/15/2014  RSVP, Blue
                  Senior    Harvest                             Bell, PA
                  Volunte   Drive
                  er        Suite 100
                  Program   Blue
                  of        Bell, PA
                  Montgom   19422
                  ery
                  County
    ------------------------------------------------------------------------
    Monetary     Riverben  1950           $5,000     6/9/2014  Outreach to
                  d         Spring                              Children/
                  Environ   Mill Road                           Access to
                  mental    Gladwyne,                           Nature
                  Educati   PA 19035                            Education
                  on                                            for local
                  Center                                        elementary
                                                                school in
                                                                Norristown,
                                                                PA
    ------------------------------------------------------------------------
    Monetary     Special   2800           $4,000   12/31/2014  Special
                  Equestr   Street                              Equestrians,
                  ians      Road                                Warrington,
                            Warringto                           PA
                            n, PA
                            18976
    ------------------------------------------------------------------------
    Monetary     The       34th           $2,000    4/18/2014  5th Annual
                  Childre   Street                              Walk for
                  ns        Civic                               Hope,
                  Hospita   Center                              Veteran's
                  l of      Boulevard                           Park,
                  Philade   Philadelp                           Hamilton,
                  lphia     hia, PA                             NJ,
                  Foundat   19104                               benefitting
                  ion                                           IBD Research
                                                                at CHOP
    ------------------------------------------------------------------------
    Monetary     The       4275           $3,000     6/9/2014  Hands-On
                  Giving    County                              Helping by
                  Tree      Line Road                           Children
                            Suite 138
                            Chalfont,
                            PA 18914
    ------------------------------------------------------------------------
    Monetary     The       2600          $10,000    4/21/2014  Hubert J. P.
                  Melmark   Wayland                             Schoemaker
                  Charita   Road                                Classic,
                  ble       Berwyn,                             October 6,
                  Foundat   PA 19312                            2014,
                  ion                                           Berwyn, PA
    ------------------------------------------------------------------------
    Monetary     Trustees  University     $7,000   10/15/2014  WXPN (Trutees
                  of the    of                                  of the U of
                  Univers   Pennsylva                           PA),
                  ity of    nia                                 Philadelphia
                  Pennsyl   Philadelp                           , PA
                  vania     hia, PA
                            19104
    ------------------------------------------------------------------------
    Monetary     United    1709         $223,382   12/22/2014  United Way
                  Way of    Benjamin                            Campaign
                  Greater   Franklin                            Match
                  Philade   Parkway
                  lphia     Philadelp
                  and       hia, PA
                  Souther   19103
                  n New
                  Jersey
    ------------------------------------------------------------------------
    Monetary     Us Too    5003           $1,000    9/10/2014  Us Too
                  Interna   Fairview                            Internationa
                  tional    Ave.                                , Des
                            Downers                             Plaines, IL
                            Grove, IL
                            60515
    ------------------------------------------------------------------------
    Monetary     Wissahic  12 Morris      $2,603    6/25/2014  New
                  kon       Road                                wildflower
                  Valley    Ambler,                             meadow
                  Watersh   PA 19002                            development
                  ed                                            via Janssen
                  Associa                                       Cares
                  tion                                          Volunteer
                                                                Days.
    ------------------------------------------------------------------------
    Monetary     Wissahic  12 Morris      $1,400    4/21/2014  Community
                  kon       Road                                Service
                  Valley    Ambler,                             Project for
                  Watersh   PA 19002                            JBI's Bridge
                  ed                                            to
                  Associa                                       Employment
                  tion,                                         program;
                  Inc.                                          mentors and
                                                                students
                                                                planting
                                                                trees and
                                                                shrubs for
                                                                water
                                                                conservation
                                                                at
                                                                Wissahickon
                                                                Valley
                                                                Watershed
    ------------------------------------------------------------------------
    Janssen has also made financial donations to independent charitable
      foundations that assist patients who are underinsured and in financial
      need with treatment-related expenses. In keeping with our donor
      agreements and applicable regulatory guidance, we will only disclose
      aggregate data on our charitable giving and do not publicize
      information on donations to specific foundations and disease states.
      In 2014, we contributed approximately $40 million in donations to
      independent charitable foundations, enabling them to provide
      assistance with medication-related copays to patients with cancer
      diseases.

    ----------------------------------------------------------------------------------------------------------------

    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $84,591,419    3/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $86,924,535    6/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $78,551,321    9/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $86,312,829   12/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Updatd February 24, 2017

    Janssen Pharmaceuticals, Inc. Monetary and Product Contributions to U.S.-
                  based Charitable Organizations Full Year 2014
            (Payments made from January 1, 2014 to December 31, 2014)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    180      1                 $1,000    9/22/2014  Youth
                 Turnin   Bethany                                Helpline
                 g        Road,                                  Hunterdon,
                 Lives    Buildin                                Mercer, and
                 Around   g 3                                    Somerset
                 , Inc.   Suite                                  Operations
                          42
                          Hazlet,
                          NJ
                          07730
    ------------------------------------------------------------------------
    Monetary    A        P.O. Box          $2,500    12/4/2014  A Woman's
                 Woman'   299                                    Place
                 s        Doylest                                Prevention
                 Place    own, PA                                Project
                          18901
    ------------------------------------------------------------------------
    Monetary    Adult    872 E               $300     8/4/2014  Cost
                 Day      Main                                   associated
                 Center   Street                                 with 2014
                 of       Bridgew                                Janssen
                 Somers   ater,                                  Cares
                 et       NJ                                     volunteer
                 County   08807                                  activity
    ------------------------------------------------------------------------
    Monetary    Allies,  1262              $7,500   11/17/2014  Greensleeves
                 Inc.     Whiteho                                Flemington
                          rse-                                   Expansion
                          Hamilto                                Environment
                          n                                      al
                          Square                                 Stewardship
                          Road                                   Program
                          Buildin
                          g A,
                          Suite
                          101
                          Hamilto
                          n, NJ
                          08690
    ------------------------------------------------------------------------
    Monetary    America  100 West          $5,000    5/27/2014  2014 EXPO
                 n        Station                                Pittsburgh
                 Diabet   Square
                 es       Drive
                 Associ   Suite
                 ation    1900
                          Pittsbu
                          rgh, PA
                          15219
    ------------------------------------------------------------------------
    Monetary    America  1160             $30,000   12/10/2014  Diabetes
                 n        Route                                  Interventio
                 Diabet   22 East                                n Project
                 es       Suite                                  ($20,000),
                 Associ   103                                    and
                 ation    Bridege                                Community
                          water,                                 Outreach
                          NJ                                     Education
                          08807                                  ($10,000)
    ------------------------------------------------------------------------
    Monetary    America  1701            $125,000   12/10/2014  American
                 n        North                                  Diabetes
                 Diabet   Beaureg                                Association
                 es       ard                                    's Outcomes-
                 Associ   Street                                 based
                 ation    Alexand                                Community
                          ria, VA                                Programs
                          22311                                  Targeted to
                                                                 High Risk
                                                                 Populations
    ------------------------------------------------------------------------
    Monetary    America  1 Union           $5,000   10/16/2014  Fundraising
                 n        Street                                 event
                 Heart    Suite                                  support to
                 Associ   301                                    benefit
                 ation    Robbins                                general
                          ville,                                 mission of
                          NJ                                     organizatio
                          08691                                  n.
    ------------------------------------------------------------------------
    Monetary    America  1000             $20,000   12/10/2014  Partnership
                 n        Wilson                                 for
                 Psychi   Bouleva                                Workplace
                 atric    rd                                     Mental
                 Founda   Suite                                  Health ICU:
                 tion     1825                                   Improving
                          Arlingt                                Emotional
                          on, VA                                 Health
                          22208
    ------------------------------------------------------------------------
    Monetary    America  1000            $100,000   12/10/2014  Typical or
                 n        Wilson                                 Troubled?
                 Psychi   Bouleva                                Student
                 atric    rd                                     Mental
                 Founda   Suite                                  Health
                 tion     1825                                   Education
                          Arlingt                                Program
                          on, VA
                          22208
    ------------------------------------------------------------------------
    Monetary    America  1000            $225,000   12/10/2014  Campaign by
                 n        Wilson                                 Psychiatris
                 Psychi   Bouleva                                ts and
                 atric    rd                                     Judges to
                 Founda   Suite                                  Reduce the
                 tion     1825                                   Overreprese
                          Arlingt                                ntation of
                          on, VA                                 Incarserate
                          22208                                  d
                                                                 Individuals
                                                                 with SMI
    ------------------------------------------------------------------------
    Monetary    America  707              $15,000   10/20/2014  Support for
                 n Red    Alexand                                the
                 Cross    er Road                                American
                          Princet                                Red Cross
                          on, NJ                                 Disaster
                          08550                                  Cycle
                                                                 Services
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    America  Central          $20,000    3/14/2014  Support to
                 n Red    New                                    American
                 Cross    Jersey                                 Red Cross
                          707                                    Disaster
                          Alexand                                Relief
                          er Road                                Services
                          Suite
                          101
                          Princet
                          on, NJ
                          08540-
                          6331
    ------------------------------------------------------------------------
    Monetary    Anchor   482                 $418     1/9/2014  General
                 House,   Centre                                 Operating
                 Inc.     Street                                 Support
                          Trenton
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Anderso  PO Box           $17,500   10/22/2014  Integrated
                 n        134 532                                Care
                 House    County                                 Management
                          Rd. 523
                          Whiteho
                          use, NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    Ann      595 West          $9,500    12/4/2014  Ann
                 Silver   State                                  Silverman
                 man      Street                                 Community
                 Commun   Doylest                                Health
                 ity      own, PA                                Clinic for
                 Health   18901                                  Bucks
                 Clinic                                          County
                                                                 residents
    ------------------------------------------------------------------------
    Monetary    Arc of   141               $5,000    9/22/2014  Fundraising
                 Somers   South                                  event
                 et       Main                                   support to
                 County   Street                                 benefit
                          Manvill                                general
                          e, NJ                                  mission of
                          08835                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Arc of   141               $4,000    10/1/2014  Respite
                 Somers   South                                  Services
                 et       Main                                   for
                 County   Street                                 Families
                          Manvill                                with
                          e, NJ                                  Children
                          08835                                  with
                                                                 Disabilitie
                                                                 s
    ------------------------------------------------------------------------
    Monetary    Arthrit  500 E.            $1,500     7/1/2014  The
                 is       Morehea                                Community
                 Servic   d                                      Arthritis/
                 es       Street                                 Diabetes
                          Suite                                  Project--ta
                          320                                    rgeting
                          Charlot                                women with
                          te, NC                                 Type II
                          28202                                  Diabetes
    ------------------------------------------------------------------------
    Monetary    Asian    180 W             $2,000    8/28/2014  Cardiovascul
                 Health   Washing                                ar Health
                 Coalit   ton                                    Screenings
                 ion      Street                                 for Low-
                          Suite                                  Income,
                          1000                                   Limited-
                          Chicago                                English
                          , IL                                   Speaking At-
                          60602                                  Risk
                                                                 Diabetic
                                                                 Asian
                                                                 Immigrants
                                                                 and
                                                                 Refugees in
                                                                 Chicago
    ------------------------------------------------------------------------
    Monetary    Associa  819               $9,000    8/15/2014  Parital Care
                 tion     Alexand                                Rehabilitat
                 for      er Road                                ion and
                 Advanc   Princet                                Support
                 ement    on, NJ                                 Services
                 of       08540
                 Mental
                 Health
    ------------------------------------------------------------------------
    Monetary    Associa  2400 N           $20,000   11/17/2014  Spirit of
                 tion     Street                                 the Heart:
                 of       NW                                     Community
                 Black    Sutie                                  Inverventio
                 Cardio   249                                    n to
                 logist   Washing                                Improve
                 s        ton, DC                                Cardiovascu
                          20037                                  lar Health
                                                                 of
                                                                 Underserved
                                                                 Patients
                                                                 with AFIB
    ------------------------------------------------------------------------
    Monetary    Athens   7 N.              $2,500     6/6/2014  The
                 Mental   Congres                                Gathering
                 Health   s St                                   Place case
                 , Inc.   Athens,                                management
                          OH                                     services
                          45701                                  program for
                                                                 community
                                                                 drop-in
                                                                 center for
                                                                 adults with
                                                                 mental
                                                                 illness
    ------------------------------------------------------------------------
    Monetary    Autism   1060              $1,000    8/28/2014  Community
                 Speaks   State                                  Partner
                          Road                                   15th Annual
                          2nd                                    Central New
                          Floor                                  Jersey Walk
                          Princet                                Now for
                          on, NJ                                 Autism
                          08540                                  Speaks
    ------------------------------------------------------------------------
    Monetary    B More   5 East            $5,000    8/15/2014  Support of
                 Clubho   Frankli                                B'More
                 use,     n                                      Clubhouse
                 Inc.     Street                                 which
                          Baltimo                                offers
                          re, MD                                 members
                          21202                                  meaningful
                                                                 work,
                                                                 friendship,
                                                                 and links
                                                                 to stable
                                                                 housing,
                                                                 education
                                                                 and other
                                                                 resources
    ------------------------------------------------------------------------
    Monetary    Bay      66 Canal          $5,000    6/12/2014  Bay Cove
                 Cove     Street                                 Wellness
                 Human    Boston,                                Center to
                 Servic   MA                                     assist
                 es,      02114                                  diverse low-
                 Inc.                                            income
                                                                 clients who
                                                                 are working
                                                                 towards
                                                                 recovery
                                                                 from severe
                                                                 mental
                                                                 illness
    ------------------------------------------------------------------------
    Monetary    Bear     1162                $500   10/15/2014  Bear Tavern
                 Tavern   Bear                                   Elementary
                 Parent   Tavern                                 School
                 s        Road                                   Science
                 Associ   Titusvi                                Fair
                 ation    lle, NJ
                          08560
    ------------------------------------------------------------------------
    Monetary    Big      2875              $6,500   10/14/2014  School-Based
                 Brothe   York                                   Mentoring
                 rs Big   Road                                   Program
                 Sister   Jamison
                 s of     , PA
                 Bucks    18929
                 County
    ------------------------------------------------------------------------
    Monetary    Big      2 West            $7,500    10/1/2014  Big Brothers
                 Brothe   Washing                                Big Sisters
                 rs Big   ton                                    Youth
                 Sister   Avenue                                 Mentoring
                 s Of     Suite                                  Program-
                 Hunter   210 PO                                 Somerset
                 don      Box 123                                County
                 Somers   Washing
                 et and   ton, NJ
                 Warren   07882
                 County
    ------------------------------------------------------------------------
    Monetary    Big      535 East          $8,000    8/26/2014  Big Brothers
                 Brothe   Frankli                                Big Sisters
                 rs Big   n                                      of Mercer
                 Sister   Street                                 County
                 s of     Trenton                                Youth
                 Mercer   , NJ                                   Mentoring
                 County   08610                                  Program
    ------------------------------------------------------------------------
    Monetary    Boys     212              $22,500   10/14/2014  Career
                 and      Centre                                 Launch
                 Girls    Street                                 (Career
                 Club     Trenton                                Exploration
                 of       , NJ                                   , Work
                 Trento   08611                                  Readiness,
                 n and                                           HS
                 Mercer                                          Graduation,
                 County                                          and Career
                                                                 Pathway
                                                                 Program)
    ------------------------------------------------------------------------
    Monetary    Bridgeh  950 S.            $4,000    6/12/2014  Recovery
                 aven,    First                                  Connection
                 Inc.     Street                                 program
                          Louisvi
                          lle, KY
                          40203
    ------------------------------------------------------------------------
    Monetary    Bridgew  615 N.            $5,000    12/4/2014  Self-
                 ay       Broad                                  Sufficiency
                 Rehabi   Street                                 Fund for
                 litati   Elizabe                                Somerset,
                 on       th, NJ                                 Mercer and
                 Servic   07208                                  Hunterdon
                 es                                              residents
    ------------------------------------------------------------------------
    Monetary    Bristol  120               $7,500   12/10/2014  ArtRageous
                 Rivers   Radclif                                Summer Camp
                 ide      fe
                 Theate   Street
                 r Co,    P O Box
                 Inc.     1250
                          Bristol
                          , PA
                          19007
    ------------------------------------------------------------------------
    Monetary    Broward  305              $10,000    5/27/2014  Affordable
                 County   Southea                                Rental
                 Commun   st 18th                                Housing
                 ity      Court                                  program
                 Develo   Fort
                 pment    Lauderd
                 Corpor   ale, FL
                 ation    33316
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Bucks    1069              $5,000   11/17/2014  Bucks County
                 County   Jackson                                Housing
                 Housin   ville                                  Group's
                 g        Road                                   Veterans
                 Group    Ivyland                                Housing
                          , PA                                   Assistance
                          18974                                  Program
    ------------------------------------------------------------------------
    Monetary    Catholi  Diocese           $5,000     7/1/2014  On My Own--
                 c        of                                     Supportive
                 Charit   Trenton                                Housing
                 ies      Delawar                                Program
                          e House                                Services
                          Mental                                 program
                          Health
                          Service
                          s 25
                          Ikea
                          Drive
                          Westham
                          pton,
                          NJ
                          08060
    ------------------------------------------------------------------------
    Monetary    Catholi  Diocese          $17,500     7/7/2014  Partners In
                 c        of                                     Recovery
                 Charit   Trenton                                program
                 ies      Delawar
                          e House
                          Mental
                          Health
                          Service
                          s 25
                          Ikea
                          Drive
                          Westham
                          pton,
                          NJ
                          08060
    ------------------------------------------------------------------------
    Monetary    Catholi  212                  $75    1/28/2014  Employee
                 c        Ninth                                  directed
                 Charit   Street                                 donation in
                 ies      Pittsbu                                lieu of
                 Dioces   rgh,                                   company
                 e of     Pennsyl                                holiday
                 Pittsb   vania                                  gift
                 urgh     15222
    ------------------------------------------------------------------------
    Monetary    Catholi  212                  $75    12/3/2014  Employee
                 c        Ninth                                  directed
                 Charit   Street                                 donation in
                 ies      Pittsbu                                lieu of
                 Dioces   rgh,                                   company
                 e of     Pennsyl                                holiday
                 Pittsb   vania                                  gift
                 urgh     15222
    ------------------------------------------------------------------------
    Monetary    Catholi  920               $4,000   10/16/2014  CYO's Broad
                 c        South                                  St. Trenton
                 Youth    Broad                                  Center
                 Organi   Street                                 After
                 zation   Trenton                                School
                 of       , NJ                                   Program's
                 Mercer   08611                                  (ASP)
                 County                                          Tutoring
                                                                 Project
    ------------------------------------------------------------------------
    Monetary    Center   11                  $300     8/4/2014  Cost
                 for      Minneak                                associated
                 Educat   oning                                  with 2014
                 ional    Road                                   Janssen
                 Advanc   Fleming                                Cares
                 ement    ton, NJ                                volunteer
                          08822                                  activity
    ------------------------------------------------------------------------
    Monetary    Center   11               $15,000   10/20/2014  Employment
                 for      Minneak                                Training
                 Educat   oning                                  program
                 ional    Road                                   enhancement
                 Advanc   Fleming                                s
                 ement    ton, NJ
                          08822
    ------------------------------------------------------------------------
    Monetary    Center   Harzfeld         $10,000    9/16/2014  PAINS:
                 for      Buildin                                National
                 Practi   g 1111                                 Pain
                 cal      Main                                   Strategy
                 Bioeth   Street,                                Roll-Out
                 ics      Suite                                  Meeting
                          500
                          Kansas
                          City,
                          MO
                          64105-2
                          116
    ------------------------------------------------------------------------
    Monetary    Chabad   PO Box            $1,000     5/9/2014  ``We Care''
                 Lubavi   29                                     Educational
                 tch of   Princet                                Series
                 Mercer   on, NJ
                 County   08542
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Child    204 N.            $2,000    10/1/2014  Adolescent
                 Home     West                                   Prenatal
                 and      Street                                 and
                 Commun   #101                                   Parenting
                 ity      Doylest                                Continuum
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    Childre  635              $10,000   10/20/2014  CUNA and
                 n's      South                                  Body and
                 Home     Clinton                                Soul
                 Societ   Avenue                                 Prenatal
                 y of     Trenton                                Health
                 New      , NJ                                   Education
                 Jersey   08611                                  Program
    ------------------------------------------------------------------------
    Monetary    Childre  Roebling          $5,000     5/7/2014  Fundraising
                 n's      Market                                 event
                 Home     Complex                                support to
                 Societ   635                                    benefit
                 y of     South                                  general
                 New      Clinton                                mission of
                 Jersey   Avenue                                 organizatio
                          Trenton                                n
                          , NJ
                          08611-
                          1831
    ------------------------------------------------------------------------
    Monetary    Christi  PO Box            $2,500    12/3/2014  Pajama Bags
                 nes      190                                    for Kids in
                 Hope     Hopewel                                Need in
                 for      l, NJ                                  Mercer
                 Kids     08525                                  County
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    College  2000             $22,500   10/14/2014  Nursing
                 of New   Penning                                Merit
                 Jersey   ton                                    Scholarship
                          Road                                   s ($10,000)
                          P.O.                                   and
                          Box                                    Educational
                          7718                                   Opportunity
                          Ewing,                                 Fund
                          NJ                                     Promise
                          08628                                  Awards
                                                                 ($12,500)
    ------------------------------------------------------------------------
    Monetary    Colorad  PO Box            $2,500     8/1/2014  Peer
                 o        6336                                   Workforce
                 Mental   Denver,                                Initiative
                 Wellne   CO
                 ss       80206
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box            $5,000   11/17/2014  Rise Summer
                 ty       88 116                                 Healthy
                 Action   North                                  Food
                 Servic   Main                                   Initiative
                 e        Street                                 for low
                 Center   Hightst                                income
                 , Inc.   own, NJ                                youth
                          08520
    ------------------------------------------------------------------------
    Monetary    Communi  4059              $5,000   10/23/2014  Arts for
                 ty       Skyron                                 Seniors
                 Conser   Drive                                  ($3,000)
                 vatory   Doylest                                and Music
                 of       own, PA                                Therapy
                 Music    18902                                  ($2,000)
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box          $150,000   12/12/2014  Johnson &
                 ty       338                                    Johnson
                 Founda   Morrist                                Somerset
                 tion     own, NJ                                County
                 of New   07963                                  Contributio
                 Jersey                                          ns Fund to
                                                                 support
                                                                 healthcare
                                                                 and basic
                                                                 needs of
                                                                 residents
                                                                 in Somerset
                                                                 and
                                                                 Hunterdon
                                                                 Counties
    ------------------------------------------------------------------------
    Monetary    Communi  P.O. Box         $11,500   10/13/2014  Each One,
                 ty       15176                                  Teach One:
                 Health   407                                    An Evidence
                 Coalit   Crutchf                                Based
                 ion,     ield                                   Diabetes
                 Inc.     Street                                 Self-
                          Durham,                                Management
                          NC                                     Workshop
                          27704                                  and
                                                                 Community
                                                                 Leaders
                                                                 Training
    ------------------------------------------------------------------------
    Monetary    Communi  199              $12,000    5/27/2014  Pathway to
                 ty       Pomeroy                                Recovery
                 Hope,    Road                                   residential
                 Inc.     Parsipp                                programs
                          any, NJ                                ($10,000)
                          07054                                  and The
                                                                 Mental
                                                                 Health
                                                                 Educational
                                                                 Forum and
                                                                 Wellness
                                                                 Fair
                                                                 ($2,000)
    ------------------------------------------------------------------------
    Monetary    Communi  199              $13,000    11/5/2014  Hope for
                 ty       Pomeroy                                Veterans
                 Hope,    Road                                   and Valley
                 Inc.     Parsipp                                Brook
                          any, NJ                                Village for
                          07054                                  Veterans
    ------------------------------------------------------------------------
    Monetary    Communi  310 W.            $7,500   10/20/2014  Social
                 ty       State                                  Security
                 Justic   Street                                 Services
                 e        3rd                                    and
                 Center   Floor                                  Veterans
                 , Inc.   Trenton                                Assistance
                          , NJ                                   Project
                          08618
    ------------------------------------------------------------------------
    Monetary    Communi  507 E.            $4,000     7/1/2014  Compeer
                 ty       College                                Program of
                 Mental   Street                                 Johnson
                 Health   Iowa                                   County
                 Center   City,
                 For      IA
                 Mid-     52240
                 Easter
                 n Iowa
                 dba
                 Compee
                 r
                 Progra
                 m,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Compeer  259               $2,500    7/29/2014  Compeer
                 Roches   Monroe                                 Rochester
                 ter,     Avenue                                 Youth and
                 Inc.     Rochest                                Family
                          er, NY                                 Mentoring
                          14607                                  Program
    ------------------------------------------------------------------------
    Monetary    Compeer  259               $3,000     7/1/2014  Compeer
                 , Inc.   Monroe                                 Senior
                          Avenue                                 Partners
                          Suite                                  program
                          340
                          Rochest
                          er, NY
                          14607
    ------------------------------------------------------------------------
    Monetary    Contact  60 S.             $8,500    12/4/2014  CRISIS
                 of       Main                                   HOTLINES
                 Mercer   Street                                 and Online
                 County   Penning                                Emotional
                 New      ton, NJ                                Support:
                 Jersey   08534                                  CRISIS CHAT
                 , Inc.                                          and
                                                                 TxtToday
    ------------------------------------------------------------------------
    Monetary    Contact  60 South          $1,000    3/17/2014  Annual
                 of       Main                                   Senior
                 Mercer   Street                                 Volunteer
                 County   Penning                                Recognition
                 New      ton, NJ                                Brunch,
                 Jersey   08534                                  ``Volunteer
                 , Inc.                                          s Are
                                                                 Heroes!''
    ------------------------------------------------------------------------
    Monetary    Court    1450             $12,500   10/14/2014  CASA of
                 Appoin   Parksid                                Mercer
                 ted      e                                      Child
                 Specia   Avenue                                 Advocacy
                 l        Suite                                  Program for
                 Advoca   22                                     Abused and
                 tes      Ewing,                                 Neglected
                          NJ                                     Children
                          08638
    ------------------------------------------------------------------------
    Monetary    D&R      P.O. Box            $250     2/3/2014  23rd Annual
                 Canal    2 Rocky                                D&R Canal
                 Watch    Hill,                                  Watch 5K
                          NJ                                     Fun Run
                          08553
    ------------------------------------------------------------------------
    Monetary    Deborah  212               $1,000    8/28/2014  2015 Women's
                 Hospit   Trenton                                Heart
                 al       Road                                   Health
                 Founda   Browns                                 Symposium
                 tion     Mills,
                          NJ
                          08015
    ------------------------------------------------------------------------
    Monetary    Delawar  14                  $300     8/4/2014  Cost
                 e        Michael                                associated
                 River    McCorri                                with 2014
                 Steamb   stin                                   Janssen
                 oat      Road                                   Cares
                 Floati   Hamilto                                volunteer
                 ng       n, NJ                                  activity
                 Classr   08690
                 oom,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Delawar  14                $4,000    11/3/2014  Environmenta
                 e        Michael                                l education
                 River    McCorri                                for
                 Steamb   stin                                   underfunded
                 oat      Road                                   and
                 Floati   Hamilto                                underserved
                 ng       n, NJ                                  schools and
                 Classr   08690                                  youth
                 oom,                                            groups
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Depress  5                 $1,000    3/17/2014  DBSA NJ
                 ion      Village                                Mutual Aid
                 and      Court                                  Support
                 Bipola   Lawrenc                                Group
                 r        eville,                                Facilitator
                 Suppor   NJ                                     Training
                 t        08648
                 Allian
                 ce
    ------------------------------------------------------------------------
    Monetary    Detroit  10                $5,000    8/25/2014  Managing
                 Centra   Peterbo                                SPMI and
                 l City   ro                                     Chronic
                 Commun   Profess                                Disease
                 ity      ional
                 Mental   Buildin
                 Health   g
                 , Inc.   Detroit
                          , MI
                          48201
    ------------------------------------------------------------------------
    Monetary    Didi     4760              $3,500     5/7/2014  Healthy
                 Hirsch   South                                  Inglewood
                 Mental   Sepulve                                Project
                 Health   da
                 Servic   Bouleva
                 es       rd
                          Culver
                          City,
                          CA
                          90230
    ------------------------------------------------------------------------
    Monetary    Dress    3131              $9,000   10/13/2014  Dress for
                 for      Princet                                Success
                 Succes   on                                     Mercer
                 s        Pike,                                  County--Job
                          Buildin                                Readiness
                          g 4,                                   Program
                          Suite                                  Expansion
                          209                                    Project--To
                          Lawrenc                                ols to
                          eville,                                Succeed
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Eden     2                 $5,000   10/14/2014  2015 Eden
                 Autism   Merwick                                Autism
                 Servic   Road                                   Services
                 es       Princet                                Princeton
                 Founda   on, NJ                                 Lecture
                 tion     08540                                  Series on
                                                                 Autism
    ------------------------------------------------------------------------
    Monetary    Elijah'  211                 $850     5/7/2014  General
                 s        Livings                                Operating
                 Promis   ton                                    Support
                 e        Ave.
                          New
                          Brunswi
                          ck, NJ
                          08901
    ------------------------------------------------------------------------
    Monetary    Emma     670               $3,500     7/1/2014  Mental
                 Norton   North                                  Health
                 Servic   Robert                                 Recovery
                 es       Street                                 Skills
                          St.                                    Training
                          Paul,                                  and
                          MN                                     Medication
                          55101-                                 Support at
                          2523                                   Emma Norton
                                                                 Residence
    ------------------------------------------------------------------------
    Monetary    Enable,  13                $6,000    11/5/2014  Connect with
                 Inc.     Roszel                                 Enable
                          Road,                                  program
                          Suite
                          B110
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Every    Fred              $8,500   11/17/2014  Every Child
                 Child    Vereen,                                Valued
                 Valued   Jr.                                    After
                 A NJ     Communi                                School
                 Nonpro   ty                                     Program
                 fit      Center
                 Corpor   175
                 ation    Johnson
                          Avenue
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Everybo  PO Box            $2,000   11/17/2014  Coming Up
                 dy       3127                                   for AIRTM
                 Loves    Princet
                 Kenny    on, NJ
                 Projec   08543
                 t,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Faith    39                $1,000    9/22/2014  Responsible
                 Christ   Somerse                                Fatherhood
                 ian      t Drive                                Empowerment
                 Counse   Willing                                Workshop
                 ling     boro,
                 Center   NJ
                          08046
    ------------------------------------------------------------------------
    Monetary    Family   1931              $8,000    5/27/2014  Behavioral
                 Guidan   Notting                                Healthcare
                 ce       ham Way                                Services
                 Center   Hamilto                                for the
                 Corpor   n, NJ                                  Chronically
                 ation    08619                                  Mentally
                                                                 Ill
    ------------------------------------------------------------------------
    Monetary    Family   1 AAA            $15,000   11/17/2014  Get FIT
                 Resour   Dr.                                    Youth
                 ce       Suite                                  program
                 Networ   203
                 k        Trenton
                          , NJ
                          08691
    ------------------------------------------------------------------------
    Monetary    Family   1 AAA             $1,000     5/9/2014  Fundraising
                 Resour   Drive                                  event
                 ce       Suite                                  support to
                 Networ   203                                    benefit
                 k        Trenton                                general
                          , NJ                                   mission of
                          08691                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Family   4                 $7,500     6/6/2014  Emergency
                 Servic   Corners                                Homeless
                 e        tone                                   Shelter
                 Associ   Drive                                  Community
                 ation    Langhor                                Nurse
                 of       ne, PA                                 Educator
                 Bucks    19047
                 County
    ------------------------------------------------------------------------
    Monetary    Family   790 Park          $4,000    5/27/2014  STEPS to
                 Servic   Avenue                                 Wellness
                 e        Hunting                                Program
                 League   ton, NY
                 , Inc.   11743
    ------------------------------------------------------------------------
    Monetary    Federat  Administ          $1,000     5/9/2014  The Big Nosh
                 ion of   rative                                 Vocational
                 Organi   Offices                                Services
                 zation   One                                    Program
                 s        Farming
                          dale
                          Road
                          Route
                          109
                          West
                          Babylon
                          , NY
                          11704
    ------------------------------------------------------------------------
    Monetary    Forsyth  61                   $75    12/3/2014  Employee
                 Humane   Miller                                 directed
                 Societ   Street                                 donation in
                 y        Winston-                               lieu of
                          Salem,                                 company
                          NC                                     holiday
                          21704                                  gift
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $7,000   11/17/2014  The ``I'm
                 ion of   Lawrenc                                still
                 Morris   eville                                 here''
                 Hall/    Road                                   approach to
                 St.      Lawrenc                                managing
                 Lawren   eville,                                challenging
                 ce       NJ                                     behaviors
                          08648                                  in Grace
                                                                 Garden.
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $2,500   11/17/2014  Fundraising
                 ion of   Lawrenc                                event
                 Morris   eville                                 support to
                 Hall/    Road                                   benefit
                 St.      Lawrenc                                general
                 Lawren   eville,                                mission of
                 ce       NJ                                     organizatio
                          08648                                  n
    ------------------------------------------------------------------------
    Monetary    Gateway  11901             $9,500     7/1/2014  Support for
                 Homes,   Reedy                                  a Nurse
                 Inc.     Branch                                 Practitione
                          Road                                   r to
                          Chester                                provide
                          field,                                 comprehensi
                          VA                                     ve
                          23838                                  personalize
                                                                 d health
                                                                 education
                                                                 and
                                                                 counseling
    ------------------------------------------------------------------------
    Monetary    Georgia  246               $1,500    6/18/2014  Consumer
                 Mental   Sycamor                                scholarship
                 Health   e                                      s to attend
                 Consum   STreet                                 the 23rd
                 er       Suite                                  Annual
                 Networ   160                                    Statewide
                 k        Decatur                                Consumer
                          , GA                                   Conference,
                          30030                                  ``Year of
                                                                 the Peer''
    ------------------------------------------------------------------------
    Monetary    Girl     201               $2,000    12/3/2014  Robotics
                 Scouts   Grove                                  Program
                 Heart    Street
                 of New   Westfie
                 Jersey   ld, NJ
                 , Inc.   07090
    ------------------------------------------------------------------------
    Monetary    Good     38 Elm            $1,000   12/19/2014  Peer Support
                 Grief,   Street                                 Program--Pr
                 Inc.     Morrist                                inceton
                          own, NJ
                          07960
    ------------------------------------------------------------------------
    Monetary    Grand    700 Lawn            $100    2/11/2014  Memorial
                 View     Avenue                                 donation
                 Health   Sellers
                 Founda   ville,
                 tion     PA
                          18960
    ------------------------------------------------------------------------
    Monetary    Gulf     13228 N.            $100    5/27/2014  Memorial
                 Ridge    Central                                donation
                 Counci   Avenue
                 l Boy    Tampa,
                 Scouts   FL
                 of       33612-
                 Americ   3462
                 a
    ------------------------------------------------------------------------
    Monetary    Habitat  31 Oak            $4,000   11/17/2014  Women Build
                 for      Avenue,                                 A Brush
                 Humani   Suite                                  with
                 ty of    100                                    Kindness
                 Greate   Chalfon
                 r        t, PA
                 Bucks    18914
    ------------------------------------------------------------------------
    Monetary    Habitat  6860                $800    8/15/2014  Costs
                 for      Cortona                                associated
                 Humani   Drive,                                 with 2014
                 ty of    Suite A                                Janssen
                 Southe   Goleta,                                Cares
                 rn       CA                                     Volunteer
                 Santa    93117                                  Activity
                 Barbar
                 a
    ------------------------------------------------------------------------
    Monetary    Hamilto  1315              $9,500   12/12/2014  A.C.T.
                 n Area   Whiteho                                (Actively
                 YMCA     rse-                                   Changing
                          Mercerv                                Together)
                          ille                                   Program
                          Road
                          Hamilto
                          n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    Heart    78                $2,000   12/19/2014  HealthCare
                 to       Ditmars                                Portfolio
                 Hearts   Avenue                                 Program
                 , Inc.   Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Heartla  4750 N.           $7,500    8/15/2014  Pathways
                 nd       Sherida                                Home,
                 Health   n Road                                 supportive
                 Outrea   Chicago                                housing
                 ch       , IL                                   program for
                          60640                                  those
                                                                 living with
                                                                 mental
                                                                 health
                                                                 issues
    ------------------------------------------------------------------------
    Monetary    HiTops,  21                $7,000   11/17/2014  HiTOPS'
                 Inc.     Wiggins                                Dating
                          Street                                 Violence
                          Princet                                Risk-
                          on, NJ                                 Reduction
                          08540                                  and
                                                                 Prevention
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880             $20,000   10/20/2014  24-Hour and
                 nt       Princet                                Emergency
                          on                                     Childcare
                          Avenue                                 Center:
                          Lawrenc                                Providing
                          eville,                                Care
                          NJ                                     ``Around
                          08648                                  the Time
                                                                 Clock''
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880             $10,000   10/27/2014  Huchet House
                 nt       Princet
                          on
                          Avenue
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Hopewel  35                $1,000    9/16/2014  Hopewell
                 l        Princet                                Elementary
                 Elemen   on Ave                                 Science
                 tary     Hopewel                                Fair 2015
                 School   l, NJ
                 Parent   08525
                 Teache
                 r
                 Organi
                 zation
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Hopewel  PO Box            $3,500    6/12/2014  Scholarship
                 l        553                                    for a
                 Valley   Penning                                Hopewell
                 Educat   ton, NJ                                Valley
                 ion      08534                                  Regional
                 Founda                                          School
                 tion                                            District
                                                                 graduating
                                                                 student
                                                                 ($1,000), I
                                                                 Dream a
                                                                 World: 15
                                                                 Day Artist
                                                                 Residency
                                                                 ($2500)
    ------------------------------------------------------------------------
    Monetary    Horizon  120 S.            $1,000     5/7/2014  Philly Has
                 House,   30th                                   Talent
                 Inc.     St.                                    outreach
                          Philade                                and
                          lphia,                                 awareness
                          PA                                     event
                          19104
    ------------------------------------------------------------------------
    Monetary    Hunterd  1410              $2,500    9/22/2014  Fundraising
                 on       Route                                  event
                 County   22 West                                support to
                 YMCA     Annanda                                benefit
                          le, NJ                                 general
                          08801                                  mission of
                                                                 organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Institu  PO Box            $3,500   10/14/2014  IWWWE
                 te of    7869                                   Nursing
                 Wonder   West                                   Experiences
                 ful      Trenton                                hip Program
                 Women    , NJ
                 Workin   08628
                 g for
                 Empowe
                 rment
    ------------------------------------------------------------------------
    Monetary    Interfa  3635              $5,000    8/28/2014  Fundraising
                 ith      Quakerb                                event
                 Caregi   ridge                                  support to
                 vers     Road                                   benefit
                 Trento   Suite                                  general
                 n,       16                                     mission of
                 Inc.     Hamilto                                organizatio
                          n, NJ                                  n
                          08619
    ------------------------------------------------------------------------
    Monetary    Interfa  3635             $15,000   10/14/2014  Neighbors
                 ith      Quakerb                                Helping
                 Caregi   ridge                                  Neighbors
                 vers     Road                                   program to
                 Trento   Suite                                  support
                 n,       16                                     elderly and
                 Inc.     Hamilto                                disabled in
                          n, NJ                                  Mercer
                          08619                                  County
    ------------------------------------------------------------------------
    Monetary    Isles,   10 Wood           $9,000   11/17/2014  Trenton
                 Inc.     Street                                 ReHEET
                          Trenton                                (Residentia
                          , NJ                                   l, Health,
                          08618                                  Energy, and
                                                                 Environment
                                                                 al
                                                                 Treatment)
    ------------------------------------------------------------------------
    Monetary    Jewish   707               $7,500    12/4/2014  Mercer
                 Family   Alexand                                County
                 and      er Road                                Caregiver
                 Childr   Suite                                  Help Line
                 en's     102                                    and
                 Servic   Princet                                Caregiver
                 e of     on, NJ                                 Services
                 Greate   08540
                 r
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Junior   4365              $7,800   12/10/2014  2015 J&J
                 Achiev   Route 1                                Pharma Day
                 ement    South                                  Program
                 of New   2nd
                 Jersey   Floor
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Karis    1361              $3,500     6/6/2014  Direct
                 Commun   Detroit                                support of
                 ity      St.                                    the Karis
                          Denver,                                Community
                          CO                                     Continuum
                          80206                                  of Care
                                                                 Programs in
                                                                 lieu of
                                                                 event
                                                                 sponsorship
    ------------------------------------------------------------------------
    Monetary    Kidsbri  4556              $4,500    9/22/2014  Kidsbridge
                 dge,     South                                  Anti-
                 Inc.     Broad                                  Bullying
                          Street                                 Life Skills
                          2nd                                    Program for
                          Floor                                  At-Risk
                          Trenton                                Children in
                          , NJ                                   Trenton at
                          08620                                  the
                                                                 Elementary
                                                                 School
                                                                 Level
    ------------------------------------------------------------------------
    Monetary    Laguna   362              $12,000    5/27/2014  Diabetes
                 Beach    Third                                  Program for
                 Commun   Street                                 Disadvantag
                 ity      Laguna                                 ed
                 Clinic   Beach,                                 Individuals
                          CA
                          92651
    ------------------------------------------------------------------------
    Monetary    Latin    669               $3,500   12/10/2014  Door to
                 Americ   Chamber                                Health/
                 an       s                                      Puerta de
                 Legal    Street                                 Salud
                 Defens   Suite B                                program
                 e And    Trenton
                 Educat   , NJ
                 ional    08611
                 Fund,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Lawrenc  PO Box            $2,710    10/1/2014  Engaging
                 e        6531 17                                Budding
                 Townsh   Philips                                Engineers
                 ip       Ave.                                   at
                 Educat   Lawrenc                                Lawrencevil
                 ion      eville,                                le
                 Founda   NJ                                     Elementary
                 tion,    08648                                  School:
                 Inc.                                            enhancing
                                                                 the third
                                                                 grade STEM
                                                                 curriculum.
    ------------------------------------------------------------------------
    Monetary    Leyden   10001             $5,000    7/18/2014  Health Home
                 Family   Grand                                  and
                 Servic   Avenue                                 Integrated
                 e and    Frankli                                Care =
                 Mental   n Park,                                Innovation
                 Health   IL                                     program
                 Center   60131
    ------------------------------------------------------------------------
    Monetary    Liberta  5245              $6,500    12/4/2014  Psychiatric
                 e,       Bensale                                Services
                 Inc.     m                                      for Women
                          Bouleva                                Recovering
                          rd                                     from
                          Bensale                                Substance
                          m, PA                                  Use
                          19020                                  Disorders
    ------------------------------------------------------------------------
    Monetary    LifeTie  LifeTies          $5,150   11/17/2014  The
                 s,       , Inc.                                 Transgender
                 Inc.     2205                                   Youth
                          Penning                                Health
                          ton                                    Services
                          Road                                   Project:
                          Ewing,                                 Staff
                          NJ                                     Training
                          08638                                  and Mentor
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    Literac  55                $2,500   12/18/2014  Early
                 y and    Primros                                Childhood:
                 Life,    e                                      Building
                 Inc.     Circle                                 Blocks for
                          Princet                                the Future
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Literac  121               $5,000    12/3/2014  Adult
                 y New    Chestnu                                Literacy
                 Jersey   t                                      Program in
                 , Inc.   Street                                 Mercer
                          Suite                                  County
                          203
                          Roselle
                          , NJ
                          07203
    ------------------------------------------------------------------------
    Monetary    Literac  120               $4,000   11/17/2014  Literate
                 y        Findern                                Moms,
                 Volunt   e Ave--                                Stable
                 eers     Box 7                                  Futures
                 of       Bridgew                                program
                 Somers   ater,
                 et       NJ
                 County   08807
    ------------------------------------------------------------------------
    Monetary    Main     8                 $2,500     7/1/2014  Accessible
                 Street   Marcell                                Care for
                 Counse   a                                      Schizoaffec
                 ling     Avenue                                 tive
                 Center   West                                   Disorder
                          Orange,
                          NJ
                          07052
    ------------------------------------------------------------------------
    Monetary    Mary's   15                   $75    3/17/2014  Employee
                 Place    Broadwa                                directed
                 By The   y Ocean                                donation in
                 Sea      Grove,                                 lieu of
                          NJ                                     company
                          07756                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Massach  130               $2,500     6/6/2014  Peer Support
                 usetts   Bowdoin                                Whole
                 Associ   Street                                 Health
                 ation    Boston,                                Resiliency
                 for      MA                                     Program
                 Mental   02108
                 Health
                 Inc.
    ------------------------------------------------------------------------
    Monetary    McCarte  91                $9,500   11/17/2014  OnStage
                 r        Univers                                Seniors: A
                 Theatr   ity                                    Community
                 e        Place                                  Project of
                 Center   Princet                                McCarter
                          on, NJ                                 Theatre
                          08450
    ------------------------------------------------------------------------
    Monetary    Meals    5 Walter            $300     8/4/2014  Cost
                 On       Foran                                  associated
                 Wheels   Bouleva                                with 2014
                 in       rd                                     Janssen
                 Hunter   Suite                                  Cares
                 don,     2006                                   volunteer
                 Inc.     Fleming                                activity
                          ton, NJ
                          08822
    ------------------------------------------------------------------------
    Monetary    Meals    180              $15,000   10/22/2014  Meals-on-
                 on       Ewingvi                                Wheels
                 Wheels   lle                                    Program
                 of       Road
                 Trento   Ewing,
                 n        NJ
                 Ewing    08638
    ------------------------------------------------------------------------
    Monetary    Mental   1431              $1,000     6/6/2014  2014 Mental
                 Health   North                                  Health
                 Americ   Delawar                                Symposium
                 a        e                                      and Annual
                          Street                                 Meeting
                          Indiana
                          polis,
                          IN
                          46202
    ------------------------------------------------------------------------
    Monetary    Mental   2000             $90,000   12/10/2014  Building
                 Health   North                                  Skills of
                 Americ   Beaureg                                Caregivers
                 a        ard                                    to Assist
                          Street                                 People
                          6th                                    Living with
                          Floor                                  Schizophren
                          Alexand                                ia through
                          ria, VA                                Social Self-
                          22311                                  Directed
                                                                 Care
    ------------------------------------------------------------------------
    Monetary    Mental   70 E.             $1,500    8/28/2014  Mental
                 Health   Lake                                   Health and
                 Americ   Street                                 Wellness
                 a        Suite                                  Fair/
                          900                                    Chicago
                          Chicago                                Area
                          , IL                                   Resource
                          60601                                  Guide
    ------------------------------------------------------------------------
    Monetary    Mental   2211             $15,000     8/1/2014  School
                 Health   Norfolk                                Behavioral
                 Americ   Suite                                  Health
                 a of     810                                    Initiative
                 Greate   Houston
                 r        , TX
                 Housto   77098
                 n
    ------------------------------------------------------------------------
    Monetary    Mental   1385 S.           $2,500     7/1/2014  Pro Bono
                 Health   Colorad                                Counseling
                 Americ   o                                      and
                 a of     Bouleva                                Referral
                 Colora   rd                                     Program
                 do       Suite
                          610
                          Denver,
                          CO
                          80222
    ------------------------------------------------------------------------
    Monetary    Mental   2323 W.          $10,000    7/11/2014  Get
                 Health   Fifth                                  Connected
                 Americ   Avenue                                 Wellness
                 a of     Suite                                  program
                 Frankl   160
                 in       Columbu
                 County   s, OH
                          43204
    ------------------------------------------------------------------------
    Monetary    Mental   100               $5,000     7/1/2014  What is
                 Health   Edgewoo                                Schizophren
                 Americ   d                                      ia?
                 a of     Avenue                                 Educational
                 Georgi   Suite                                  Forum
                 a        502
                          Atlanta
                          , GA
                          30303
    ------------------------------------------------------------------------
    Monetary    Mental   1210 San          $2,500     7/1/2014  Mental
                 Health   Antonio                                Health
                 Americ   Street                                 Education
                 a of     Suite                                  and
                 Texas    200                                    Advocacy
                          Austin,                                Campaign
                          TX
                          78757
    ------------------------------------------------------------------------
    Monetary    Mental   475               $2,500    5/27/2014  Mental
                 Health   Clevela                                Health
                 Associ   nd                                     Education
                 ation    Avenue                                 for Support
                          N Suite                                Systems
                          222
                          Saint
                          Paul,
                          MN
                          55104
    ------------------------------------------------------------------------
    Monetary    Mental   870               $7,500     8/1/2014  Reducing the
                 Health   Market                                 Stigma and
                 Associ   Street                                 Discriminat
                 ation    Suite                                  ion of
                          928 San                                Mental
                          Francis                                Illness
                          co, CA                                 within
                          94102                                  Multi-
                                                                 cultural
                                                                 Communities
    ------------------------------------------------------------------------
    Monetary    Mental   100 West          $1,500     7/1/2014  13th Annual
                 Health   10th                                   Community
                 Associ   Street                                 Mental
                 ation    Suite                                  Health
                 in       600                                    Conference-
                 Delawa   Wilming                                -Back to
                 re       ton, DE                                Basics:
                          19801                                  Mind, Body
                                                                 and Spirit
    ------------------------------------------------------------------------
    Monetary    Mental   100 West          $1,000    8/15/2014  Bronze
                 Health   10th                                   sponsor
                 Associ   Street                                 2014 E-
                 ation    Suite                                  Racing the
                 in       600                                    Blues 5K
                 Delawa   Wilming                                Run/Walk
                 re       ton, DE                                10K Run
                          19801
    ------------------------------------------------------------------------
    Monetary    Mental   330 S.            $5,000     8/1/2014  Schizophreni
                 Health   Greene                                 a and
                 Associ   St,                                    Schizo-
                 ation    Suite B-                               Affective
                 In       12                                     Supportive
                 Greens   Greensb                                Services
                 boro,    oro, NC
                 Inc.     27401
    ------------------------------------------------------------------------
    Monetary    Mental   88                $1,000    8/28/2014  Silver
                 Health   Pompton                                Sponsor 7th
                 Associ   Ave.                                   Annual Walk
                 ation    Verona,                                for
                 in New   NJ                                     Wellness
                 Jersey   07044                                  and
                                                                 Recovery
    ------------------------------------------------------------------------
    Monetary    Mental   617               $2,500     6/5/2014  Support
                 Health   Garden                                 Mental
                 Associ   Street                                 Wellness
                 ation    Santa                                  Center
                 in       Barbara
                 Santa    , CA
                 Barbar   93101
                 a
                 County
    ------------------------------------------------------------------------
    Monetary    Mental   3701              $8,000     8/1/2014  Mental
                 Health   Latrobe                                Health
                 Associ   Drive,                                 First Aid
                 ation    Suite                                  Training
                 of       140                                    for
                 Centra   Charlot                                Mecklenburg
                 l        te, NC                                 County
                 Caroli   28211                                  Sheriff's
                 nas                                             Office
                 Inc
    ------------------------------------------------------------------------
    Monetary    Mental   1301             $10,000    9/17/2014  Health Care
                 Health   York                                   Reform
                 Associ   Road                                   Parity
                 ation    Suite                                  Initiative
                 of       505
                 Maryla   Lutherv
                 nd,      ille,
                 Inc.     MD
                          21093
    ------------------------------------------------------------------------
    Monetary    Mental   2335              $1,000     7/1/2014  Open Doors
                 Health   Tamiami                                Open Minds--
                 Associ   Trail                                  Cultural
                 ation    North                                  Competency
                 of       (Ninth                                 Educational
                 Southw   Street)                                Program
                 estern   Suite                                  Promoting
                 Florid   404                                    Wellness
                 a        Naples,                                and
                          FL                                     Recovery
                          34103                                  Through
                                                                 Inclusion
    ------------------------------------------------------------------------
    Monetary    Mental   580               $1,000    2/13/2014  Supporting
                 Health   White                                  sponsor
                 Associ   Plains                                 2014 MHA on
                 ation    Road                                   the Move:
                 of       Tarryto                                Run/Walk
                 Westch   wn, NY
                 ester    10591
    ------------------------------------------------------------------------
    Monetary    Mental   1870              $1,000    7/24/2014  Copper
                 Health   South                                  sponsor for
                 Associ   Boulder                                the 20th
                 ation    Avenue                                 Annual
                 Oklaho   Tulsa,                                 Zarrow
                 ma       OK                                     Mental
                          74119-                                 Health
                          5234                                   Symposium,
                                                                 ``All
                                                                 Things
                                                                 Prevention'
                                                                 '
    ------------------------------------------------------------------------
    Monetary    Mental   555N.             $4,000    8/15/2014  MHA Housing
                 Health   Woodlaw                                Initiative:
                 Associ   n,                                     Ensuring
                 ation    Suite                                  Housing for
                 Reside   3105                                   Our Most
                 ntial    Wichita                                Vulnerable
                 Care     , KS                                   Populations
                 Inc.     67208
    ------------------------------------------------------------------------
    Monetary    Mental   4141 E.           $7,500     7/1/2014  Enhancement
                 Health   Dickens                                of The
                 Center   on                                     Downstairs
                 of       Place                                  program
                 Denver   Denver,
                          CO
                          80222
    ------------------------------------------------------------------------
    Monetary    Mental   3809             $10,000    6/24/2014  Outreach and
                 Illnes   Rosewoo                                Behavioral
                 s        d Dr.                                  Healthcare
                 Recove   P.O.                                   for
                 ry       Box                                    Homeless
                 Center   4246                                   Individuals
                 , Inc.   Columbi                                with Mental
                          a, SC                                  Illness
                          29240
    ------------------------------------------------------------------------
    Monetary    Mercer   3150              $7,500    12/4/2014  Integrating
                 Allian   Brunswi                                healthcare
                 ce to    ck Pike                                access into
                 End      Lawrenc                                operation
                 Homele   eville,                                of the
                 ssness   NJ                                     Mercer
                          08648-                                 County
                          2420                                   Service
                                                                 Access
                                                                 Center for
                                                                 Homeless
                                                                 Individuals
    ------------------------------------------------------------------------
    Monetary    Mercer   PO Box            $3,950   11/17/2014  Z.O.M.B.I.E.
                 County   17202                                  : Zooming
                 Commun   Trenton                                in On
                 ity      , NJ                                   Making
                 Colleg   08690                                  Biology
                 e                                               Interactive
                 Founda                                          and
                 tion                                            Engaging--(
                                                                 Peer Tutor
                                                                 support)
    ------------------------------------------------------------------------
    Monetary    Mercer   Growth            $7,500    8/11/2014  Data Through
                 Region   Partner                                Action:
                 al       ship of                                Education
                 Econom   Central                                and Tourism
                 ic       Jersey,                                Initiatives
                 Develo   Inc. 1A                                Throughout
                 pment    Quakerb                                Central New
                 Founda   ridge                                  Jersey
                 tion,    Plaza
                 Inc.     Drive,
                          Suite 2
                          Mercerv
                          ile, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    Mercer   151              $20,000    9/22/2014  Food Bank--
                 Street   Mercer                                 Healthy
                 Friend   Street                                 Choices
                 s        Trenton
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Merrima  60                  $800    8/26/2014  Costs
                 ck       Island                                 associated
                 Valley   Street                                 with 2014
                 Habita   2nd                                    Janssen
                 t for    Floor                                  Cares
                 Humani   East                                   volunteer
                 ty       Lawrenc                                activity
                          e, MA
                          01840
    ------------------------------------------------------------------------
    Monetary    Metropo  1 North           $1,500     8/4/2014  Adult Mental
                 litan    Dearbor                                Health
                 Family   n                                      Wellness
                 Servic   Chicago                                Initiative
                 es       , IL
                          60602
    ------------------------------------------------------------------------
    Monetary    Michael  1115                $100   12/19/2014  Memorial
                 Stern    Broadwa                                Donation
                 Parkin   y,
                 son's    Suite
                 Resear   1200
                 ch       New
                 Founda   York,
                 tion     NY
                          10010
    ------------------------------------------------------------------------
    Monetary    Middle   P.O. Box         $15,000   10/14/2014  Outreach
                 Earth    8045                                   Program and
                          520                                    Community
                          North                                  Youth
                          Bridge                                 Centers
                          Street
                          Bridgew
                          ater,
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    Midland  60                $7,500    9/22/2014  Midland
                 Adult    Industr                                Helping
                 Servic   ial                                    Hands
                 es,      Parkway                                Employment
                 Inc.     PO Box                                 Training
                          5026                                   Program
                          North
                          Branch,
                          NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Millhil  101              $15,000    11/5/2014  Trenton
                 l        Oakland                                PEERS--Teen
                 Child    Street                                 Education
                 and      Trenton                                and
                 Family   , NJ                                   Empowerment
                          08618                                  Program
    ------------------------------------------------------------------------
    Monetary    Millhil  101-A               $300     8/4/2014  Cost
                 l        Oakland                                associated
                 Founda   Street                                 with 2014
                 tion,    Trenton                                Janssen
                 Inc.     , NJ                                   Cares
                          08618                                  volunteer
                                                                 activity
    ------------------------------------------------------------------------
    Monetary    Minding  2083              $5,000    3/17/2014  2014 Minding
                 our      Lawrenc                                Our
                 Busine   eville                                 Business
                 ss,      Rd                                     Summer
                 Inc.     Lawrenc                                Program:
                          eville,                                Bridge to
                          NJ                                     the Future
                          08648                                  for Mercer
                                                                 County
                                                                 Youth
    ------------------------------------------------------------------------
    Monetary    Morven   55                $5,000   10/14/2014  Morven
                 Museum   Stockto                                Museum and
                 and      n                                      Garden
                 Garden   Street                                 Summer
                          Princet                                Internship
                          on, NJ                                 Program for
                          08540                                  Isles of
                                                                 Trenton
                                                                 Youths
    ------------------------------------------------------------------------
    Monetary    Mount    73 North         $12,500    9/22/2014  Mount Carmel
                 Carmel   Clinton                                Guild Home
                 Guild    Avenue                                 Health
                          Trenton                                Nursing
                          , NJ                                   Program
                          08609
    ------------------------------------------------------------------------
    Monetary    NAMI--C  1904              $1,000    5/27/2014  Consumer,
                 VA       Byrd                                   Public, and
                 Centra   Ave                                    Provider
                 l        Richmon                                Education:
                 Virgin   d, VA                                  Peer to
                 ias      23230                                  Peer and In
                 Voice                                           Our Own
                 On                                              Voice
                 Mental                                          Programs
                 Illnes
                 s
    ------------------------------------------------------------------------
    Monetary    NAMI     1012              $1,000    2/13/2014  Bronze
                 Arkans   Autumn                                 sponsor
                 as       Rd                                     2014
                          Suite 1                                Arkansas
                          Little                                 NAMIWalk
                          Rock,
                          AR
                          72211
    ------------------------------------------------------------------------
    Monetary    NAMI     2400              $1,000     5/9/2014  Bronze
                 Delawa   West                                   sponsor
                 re       4th St.                                12th Annual
                          Wilming                                NAMI
                          ton, DE                                Delaware
                          19805                                  Walk
    ------------------------------------------------------------------------
    Monetary    NAMI     P.O. Box          $1,000    7/18/2014  Purchase of
                 Lansin   26101                                  books for
                 g,       Lansing                                family
                 Inc.     , MI                                   education,
                          48909                                  communicati
                                                                 on
                                                                 enhancement
                                                                 and support
    ------------------------------------------------------------------------
    Monetary    NAMI     3371              $2,500    1/14/2014  Silver
                 Mercer   Brunswi                                sponsor
                 NJ       ck Pike                                NAMI Mercer
                          Suite                                  Walk 2014
                          124
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    NAMI     3371              $9,500     6/6/2014  Education
                 Mercer   Brunswi                                and Support
                 NJ       ck Pike                                Programs
                          Suite
                          124
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    NAMI     3371              $2,500   12/10/2014  Silver
                 Mercer   Brunswi                                sponsor
                 NJ       ck Pike                                2015 NAMI
                          Suite                                  Mercer Walk
                          124
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    NAMI of  2100              $5,000     7/1/2014  Educational
                 DuPage   Manches                                and
                 County   ter                                    supportive
                 Illino   Road                                   services
                 is       Buildin                                programs to
                          g B                                    include
                          Suite                                  community
                          925                                    outreach,
                          Wheaton                                school
                          , IL                                   connections
                          60187                                  , hospital
                                                                 education,
                                                                 educational
                                                                 courses,
                                                                 NAMI
                                                                 Connection,
                                                                 MICAP,
                                                                 Family
                                                                 Support
                                                                 Group and
                                                                 other
                                                                 resources
    ------------------------------------------------------------------------
    Monetary    NAMI of  One                 $500    8/15/2014  Bronze
                 Lake     Victori                                sponsor
                 County   a Sq.,                                 2014 NAMI
                          Ste.                                   Lake
                          260                                    County's
                          Painesv                                Strides for
                          ille,                                  Awareness
                          OH                                     Walk
                          44077
    ------------------------------------------------------------------------
    Monetary    NAMI of  100 West          $1,000    3/17/2014  Bronze
                 PA       Main                                   sponsor
                 Montgo   Street                                 2014
                 mery     Suite                                  Greater
                 County   204                                    Philadelphi
                          Lansdal                                a NAMIWalk
                          e, PA
                          19446
    ------------------------------------------------------------------------
    Monetary    NAMI     1750              $1,000     5/9/2014  Bronze
                 St.      South                                  sponsor
                 Louis    Brentwo                                2014
                          od                                     NAMIWalks
                          Blvd.,
                          Suite
                          511 St.
                          Louis,
                          MO
                          63144
    ------------------------------------------------------------------------
    Monetary    NAMI     PO Box            $1,000     3/6/2014  Bronze
                 Summit   462                                    sponsor
                 County   Cuyahog                                NAMIWalks
                          a                                      2014
                          Falls,
                          OH
                          44321
    ------------------------------------------------------------------------
    Monetary    NAMI     5251              $1,000    2/13/2014  Bronze
                 Ventur   Verdugo                                sponsor
                 a        Road,                                  NAMIWalk
                 County   Suite K                                Ventura
                          PO Box                                 County 2014
                          1613
                          Camaril
                          lo, CA
                          93011
    ------------------------------------------------------------------------
    Monetary    NAMI     217               $1,000    5/27/2014  Bronze
                 Waukes   Wiscons                                sponsor
                 ha       in Ave                                 2014
                          Suite                                  NAMIWalks
                          300                                    in Waukesha
                          Waukesh
                          a, WI
                          53186
    ------------------------------------------------------------------------
    Monetary    Nationa  90 Park           $2,500   10/23/2014  26th Annual
                 l        Avenue                                 New York
                 Allian   16                                     Mental
                 ce for   Floor                                  Health
                 Resear   New                                    Research
                 ch on    York,                                  Symposium
                 Schizo   NY
                 phreni   10016
                 a and
                 Depres
                 sion
    ------------------------------------------------------------------------
    Monetary    Nationa  1 Bangor          $1,000    5/16/2014  Supporter
                 l        Street                                 sponsor
                 Allian   Augusta                                2014 NAMI
                 ce for   , ME                                   Maine Walk
                 the      04330                                  for Mental
                 Mental                                          Health
                 ly Ill                                          Awareness
    ------------------------------------------------------------------------
    Monetary    Nationa  10630             $1,000    9/16/2014  Silver
                 l        Little                                 sponsor
                 Allian   Patuxen                                NAMI
                 ce for   t                                      Maryland
                 the      Parkway                                2014 Annual
                 Mental   Columbi                                Education
                 ly Ill   a, MD                                  Conference
                          21044
    ------------------------------------------------------------------------
    Monetary    Nationa  1225             $10,000     5/9/2014  NAMI Ohio's
                 l        Dublin                                 Medication
                 Allian   Road;                                  Access
                 ce for   Ste.                                   Initiative
                 the      125
                 Mental   Columbu
                 ly Ill   s, OH
                          43215
    ------------------------------------------------------------------------
    Monetary    Nationa  1536              $7,500     7/1/2014  ``Ending the
                 l        West                                   Silence''
                 Allian   Chicago                                training
                 ce for   Avenue                                 for
                 the      Chicago                                students
                 Mental   , IL                                   regarding
                 ly Ill   60622                                  mental
                                                                 illness and
                                                                 brain
                                                                 disorders
                                                                 ($6000) and
                                                                 Special and
                                                                 Restorative
                                                                 Programming
                                                                 for
                                                                 individuals
                                                                 living with
                                                                 Mental
                                                                 Illness
                                                                 ($1500)
    ------------------------------------------------------------------------
    Monetary    Nationa  1562              $1,000    3/17/2014  Bronze
                 l        Route                                  sponsor
                 Allian   130                                    2014
                 ce for   North                                  NAMIWalks
                 the      Brunswi                                New Jersey:
                 Mental   ck, NJ                                 Step
                 ly Ill   08902                                  Forward for
                                                                 Our Heroes
    ------------------------------------------------------------------------
    Monetary    Nationa  1562              $2,500     7/1/2014  2014
                 l        Route                                  Conference:
                 Allian   130                                    Expanding
                 ce for   North                                  Horizons
                 the      Brunswi
                 Mental   ck, NJ
                 ly Ill   08902
    ------------------------------------------------------------------------
    Monetary    Nationa  237               $1,000    12/3/2014  Bronze
                 l        Fernwoo                                sponsor
                 Allian   d Blvd                                 2015
                 ce for   Suite                                  NAMIWALKS,
                 the      101                                    Changing
                 Mental   Fern                                   minds one
                 ly Ill   Park,                                  step at a
                          FL                                     time.
                          32730
    ------------------------------------------------------------------------
    Monetary    Nationa  309 West          $1,000    3/17/2014  Bronze
                 l        Millbro                                sponsor
                 Allian   ok Road                                2014
                 ce for   Suite                                  NAMIWalks
                 the      121
                 Mental   Raleigh
                 ly Ill   , NC
                          27609
    ------------------------------------------------------------------------
    Monetary    Nationa  3250              $1,000     3/6/2014  Bronze
                 l        Wilshir                                sponsor
                 Allian   e Blvd                                 2014
                 ce for   Ste                                    NAMIWalks
                 the      1501                                   Los Angeles
                 Mental   Los                                    County
                 ly Ill   Angeles
                          , CA
                          90010
    ------------------------------------------------------------------------
    Monetary    Nationa  3440              $1,000     7/1/2014  Bronze
                 l        Viking                                 sponsor
                 Allian   Drive,                                 Northern
                 ce for   Suite                                  California
                 the      104A                                   NAMI Walk
                 Mental   Sacrame                                2015
                 ly Ill   nto, CA
                          95827
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $50,000   12/10/2014  Crisis
                 l        Fairfax                                Interventio
                 Allian   Drive                                  n Team
                 ce for   Suite                                  Technical
                 the      100                                    Assistance
                 Mental   Arlingt                                and
                 ly Ill   on, VA                                 Statewide
                          22203                                  Expansion
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $35,000   12/10/2014  Multicultura
                 l        Fairfax                                l Action
                 Allian   Drive                                  Center
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $40,000   12/10/2014  NAMI Basics
                 l        Fairfax                                Education
                 Allian   Drive                                  Program
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  498               $9,500    8/14/2014  NAMI
                 l        Georget                                Lexington
                 Allian   own                                    Advocacy,
                 ce for   Street                                 Education,
                 the      Suite                                  Outreach
                 Mental   201                                    and Support
                 ly Ill   Lexingt                                ($8,500),
                          on, KY                                 bronze
                          40508                                  sponsor
                                                                 2014 Walk
                                                                 ($1,000)
    ------------------------------------------------------------------------
    Monetary    Nationa  576               $1,000    1/15/2014  Bronze
                 l        Farming                                sponsor
                 Allian   ton                                    2014
                 ce for   Avenue                                 NAMIWalks
                 the      Hartfor
                 Mental   d, CT
                 ly Ill   06105
    ------------------------------------------------------------------------
    Monetary    Nationa  800               $1,000     5/7/2014  Bronze
                 l        Transfe                                sponsor
                 Allian   r Road                                 NAMIWalks
                 ce for   Suite                                  2014
                 the      31
                 Mental   Saint
                 ly Ill   Paul,
                          MN
                          55114
    ------------------------------------------------------------------------
    Monetary    Nationa  800               $1,000     7/1/2014  NAMI
                 l        Transfe                                Connections
                 Allian   r Road                                 Training
                 ce for   Suite
                 the      31
                 Mental   Saint
                 ly Ill   Paul,
                          MN
                          55114
    ------------------------------------------------------------------------
    Monetary    Nationa  99 Pine           $3,000    8/28/2014  2014 NAMI-
                 l        St.                                    NYS
                 Allian   Suite                                  Education
                 ce for   302                                    Conference-
                 the      Albany,                                United We
                 Mental   NY                                     Stand:
                 ly Ill   12207                                  Shaping our
                                                                 Future.
    ------------------------------------------------------------------------
    Monetary    Nationa  Kentucky          $1,000     7/1/2014  Community
                 l        Affilia                                Sponsor
                 Allian   te c/o                                 2014 Annual
                 ce for   Somerse                                Conference,
                 the      t                                      ``Advocatin
                 Mental   Communi                                g for
                 ly Ill   ty                                     Change
                          College                                Together''
                          808
                          Montice
                          llo
                          Street
                          Somerse
                          t, KY
                          42501
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000    7/24/2014  Family-to-
                 l        22697                                  Family and
                 Allian   2601                                   Peer-to-
                 ce for   Cold                                   Peer
                 the      Spring                                 Education
                 Mental   Road                                   programs
                 ly Ill   Indiana
                          polis,
                          IN
                          46222-
                          0697
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000   10/23/2014  Bronze
                 l        66270                                  sponsor
                 Allian   Houston                                2015
                 ce for   , TX                                   NAMIWalks
                 the      77274                                  Greater
                 Mental                                          Houston
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000     7/1/2014  Bronze
                 l        8260                                   sponsor
                 Allian   Richmon                                2014
                 ce for   d, VA                                  NAMIWalks
                 the      23218                                  Virginia
                 Mental
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  Scott             $1,000    5/16/2014  Bronze
                 l        County                                 sponsor
                 Allian   1706                                   2014
                 ce for   Brady                                  NAMIWalk
                 the      Street                                 Greater
                 Mental   Suite                                  Mississippi
                 ly Ill   200                                    Valley
                          Davenpo
                          rt, IA
                          52803
    ------------------------------------------------------------------------
    Monetary    Nationa  The               $1,000    3/17/2014  Bronze
                 l        Schraff                                sponsor
                 Allian   t's                                    2014
                 ce for   Center                                 NAMIWalks
                 the      529                                    Massachuset
                 Mental   Main                                   ts
                 ly Ill   Street
                          Suite
                          1M17
                          Boston,
                          MA
                          02129
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $1,000     7/1/2014  Mental
                 l        West                                   Illness
                 Allian   25th                                   Peer
                 ce for   Street                                 Support and
                 the      6th                                    Education
                 Mental   Floor                                  programs
                 ly       Clevela
                 Ill--G   nd, OH
                 reater   44113
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $1,000    8/12/2014  Bronze
                 l        West                                   sponsor
                 Allian   25th                                   2014
                 ce for   Street                                 NAMIWalks
                 the      6th                                    for the
                 Mental   Floor                                  Mind of
                 ly       Clevela                                America
                 Ill--G   nd, OH                                 Greater
                 reater   44113                                  Cleveland
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  5911              $1,000    8/12/2014  Bronze
                 l        Meredit                                sponsor
                 Allian   h Drive                                2014 NAMI
                 ce for   Suite E                                IOWA
                 the      Des                                    NAMIWalk
                 Mental   Moines,
                 ly       IA
                 Ill--I   50322-
                 owa      1903
    ------------------------------------------------------------------------
    Monetary    Nationa  2753              $1,000    1/15/2014  Bronze
                 l        West                                   sponsor
                 Allian   Central                                2014
                 ce for   Avenue                                 NAMIWalk
                 the      Toledo,
                 Mental   OH
                 ly Ill   43606
                 of
                 Greate
                 r
                 Toledo
    ------------------------------------------------------------------------
    Monetary    Nationa  505               $1,000    2/13/2014  Bronze
                 l        Eighth                                 sponsor
                 Allian   Avenue                                 NAMIWalks
                 ce for   Suite                                  NYC 2014
                 the      1103                                   Walk/Run
                 Mental   New
                 ly Ill   York,
                 of New   NY
                 York     10018
                 City
    ------------------------------------------------------------------------
    Monetary    Nationa  1981              $1,000    11/5/2014  Bronze
                 l        Marcus                                 sponsor
                 Allian   Ave,                                   2015 Long
                 ce for   C117                                   Island/
                 the      Lake                                   Queens
                 Mental   Success                                NAMIWalk
                 ly Ill   , NY                                   for Mental
                 Queens/  11042                                  Health
                 Nassau
    ------------------------------------------------------------------------
    Monetary    Nationa  of                $1,000    8/12/2014  Bronze
                 l        Butler                                 sponsor
                 Allian   County                                 2014
                 ce on    5963                                   National
                 Mental   Boymel                                 Alliance on
                 Illnes   Drive                                  Mental
                 s        Fairfie                                Illness of
                          ld, OH                                 Butler
                          45014                                  County
                                                                 NAMIWalks
    ------------------------------------------------------------------------
    Monetary    Nationa  1150              $3,500    5/15/2014  Peer PALS
                 l        South                                  program
                 Allian   Bascom
                 ce on    Ave.,
                 Mental   Ste 24,
                 Illnes   San
                 s        Jose,
                 Santa    CA
                 Clara    95128
                 County
    ------------------------------------------------------------------------
    Monetary    Nationa  P O Box           $6,000    5/16/2014  27 Annual
                 l Art    350891                                 National
                 Exhibi   Miami                                  Art
                 tions    Fl                                     Exhibition
                 of the   33135                                  by the
                 Mental                                          Mentally
                 ly                                              Ill
                 Ill,
                 Inc
    ------------------------------------------------------------------------
    Monetary    Nationa  110 N.           $30,000   11/17/2014  STOP THE
                 l        Washing                                CLOT,
                 Blood    ton                                    SPREAD THE
                 Clot     Street                                 WORD VTE
                 Allian   Suite                                  Awareness
                 ce       328                                    and
                          Rockvil                                Advocacy
                          le, MD                                 Initiative
                          20850                                  : Patient
                                                                 Toolkit
                                                                 ($15,000),
                                                                 and
                                                                 Specialty
                                                                 Magazines
                                                                 ($15,000)
    ------------------------------------------------------------------------
    Monetary    Nationa  110               $7,500    3/17/2014  Education
                 l        North                                  briefing,
                 Blood    Washing                                ``So You
                 Clot     ton                                    Think You
                 Allian   Street                                 Can't Get A
                 ce       Suite                                  Blood Clot?
                          328 B                                  Think
                          Rockvil                                Again!''
                          le, MD
                          20850
    ------------------------------------------------------------------------
    Monetary    Nationa  1701 K           $20,000   12/10/2014  Prescription
                 l        Street                                 Drug Abuse
                 Counci   NW,                                    and Pain
                 l for    Suite                                  Management
                 Behavi   400                                    Initiative
                 oral     Washing
                 Health   ton, DC
                          20006
    ------------------------------------------------------------------------
    Monetary    Nationa  1701 K           $60,000   12/10/2014  Same Day
                 l        Street                                 Access
                 Counci   NW,                                    Initiative
                 l for    Suite
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20006
    ------------------------------------------------------------------------
    Monetary    Nationa  1701 K           $35,000   12/10/2014  Early Onset
                 l        Street                                 Psychosis
                 Counci   NW,                                    Initiative
                 l for    Suite
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20006
    ------------------------------------------------------------------------
    Monetary    Nationa  1701 K           $50,000   12/10/2014  Health
                 l        Street                                 Justice
                 Counci   NW,                                    Learning
                 l for    Suite                                  Initiative
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20006
    ------------------------------------------------------------------------
    Monetary    Nationa  1701 K           $75,000   12/10/2014  2015 Policy
                 l        Street                                 Action
                 Counci   NW,                                    Center
                 l for    Suite
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20006
    ------------------------------------------------------------------------
    Monetary    Nationa  1701 K           $30,000   12/10/2014  Leadership
                 l        Street                                 Development
                 Counci   NW,                                    Initiatives
                 l for    Suite
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20006
    ------------------------------------------------------------------------
    Monetary    Nationa  949 W.           $16,500    12/3/2014  Academic
                 l        State                                  Creative
                 Junior   Street                                 Engagement
                 Tennis   Trenton                                Program
                 and      , NJ                                   ($6,500.00)
                 Learni   08618                                  ,
                 ng of                                           Benefactor
                 Trento                                          sponsor
                 n                                               2015 Annual
                                                                 Gala
                                                                 ($10,000.00
                                                                 )
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $10,000   11/19/2014  Patient
                 l        Easter                                 Navigator
                 Stroke   Lane,                                  Program /
                 Associ   Suite B                                Stroke
                 ation    Centenn                                Recovery
                          ial, CO                                Navigator
                          80112
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $62,290   11/19/2014  Web-based
                 l        Easter                                 health
                 Stroke   Lane,                                  game,
                 Associ   Suite B                                ``Stroke
                 ation    Centenn                                and
                          ial, CO                                Nonvalvular
                          80112                                  Atrial
                                                                 Fibrillatio
                                                                 n: Beating
                                                                 Your Odds''
    ------------------------------------------------------------------------
    Monetary    New      444 W.            $6,000    3/17/2014  Support
                 Founda   Frontag                                Health and
                 tion     e Road                                 Wellness
                 Center   Northfi                                Program,
                          eld, IL                                benefitting
                          60093--                                clients who
                          3009                                   are
                                                                 managing a
                                                                 co-morbid
                                                                 diagnosis
    ------------------------------------------------------------------------
    Monetary    New      275 Rt.           $4,000    3/17/2014  New Jersey
                 Jersey   10                                     Parent's
                 Parent   East,                                  Caucus
                 s        Suite                                  Outreach RV
                 Caucus   220-414                                Tour and
                          Succasu                                Professiona
                          nna, NJ                                l Parent
                          07876                                  Advocacy
                                                                 Training
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    NewBrid  PO Box            $2,000     7/1/2014  Day
                 ge       336 (7                                 Treatment
                 Servic   Industr                                Program for
                 es,      ial                                    Adults
                 Inc.     Road,
                          Pequann
                          ock, NJ
                          07440)
                          Pompton
                          Plains,
                          NJ
                          07444
    ------------------------------------------------------------------------
    Monetary    NHS      620 E.            $5,000    5/27/2014  Hollywood
                 Human    Germant                                Beauty
                 Servic   own                                    Salon
                 es       Pike                                   Documentary
                 Founda   Lafayet                                Project--po
                 tion     te                                     st
                 Inc      Hill,                                  production
                          PA                                     costs
                          19444
    ------------------------------------------------------------------------
    Monetary    Northea  334               $2,500    8/26/2014  Healthy Food
                 st       River                                  for Healthy
                 Organi   Road                                   Communities
                 c        Hillsbo
                 Farmin   rough,
                 g        NJ
                 Associ   08844
                 ation
                 of NJ
    ------------------------------------------------------------------------
    Monetary    Notre    1835                $100    8/18/2014  Memorial
                 Dame     Catasau                                donation
                 of       qua
                 Bethle   Road
                 hem      Bethleh
                 School   em, PA
                          18018
    ------------------------------------------------------------------------
    Monetary    Oldies   PO Box               $75    3/17/2014  Employee
                 But      361                                    directed
                 Goodie   Newingt                                donation in
                 s        on, VA                                 lieu of
                 Cocker   22122                                  company
                 Rescue                                          holiday
                 , Inc.                                          gift
    ------------------------------------------------------------------------
    Monetary    One      1977              $3,500   11/17/2014  Wish
                 Simple   North                                  Program:
                 Wish     Olden                                  Education
                          Ave,                                   Fund for
                          #292                                   Aging Out
                          Trenton                                Youth
                          , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Open     14 Lake           $2,000    7/18/2014  Support to
                 Road     Court                                  provide the
                          Fleming                                homebound
                          ton, NJ                                elderly and
                          08822                                  people with
                                                                 disabilitie
                                                                 s or mental
                                                                 illness
                                                                 with
                                                                 stimulating
                                                                 and
                                                                 enriching
                                                                 activities
                                                                 that would
                                                                 otherwise
                                                                 be
                                                                 unavailable
                                                                 to them
    ------------------------------------------------------------------------
    Monetary    Our      2626 E              $100     8/4/2014  Memorial
                 Hospic   17th                                   Donation
                 e of     Street
                 South    Columbu
                 Centra   s, IN
                 l        47201
                 Indian
                 a
    ------------------------------------------------------------------------
    Monetary    Passage  211               $5,000   12/15/2014  The State
                 Theatr   Mercer                                 Street
                 e        Street                                 Project
                 Compan   PO Box
                 y Inc.   967
                          Trenton
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    PEI      231                 $300     8/4/2014  Cost
                 Kids     Lawrenc                                associated
                          e Road                                 with 2014
                          Lawrenc                                Janssen
                          eville,                                Cares
                          NJ                                     volunteer
                          08648                                  activity
    ------------------------------------------------------------------------
    Monetary    PEI      231              $17,500   10/14/2014  Comprehensiv
                 Kids     Lawrenc                                e Juvenile
                          e Road                                 Offenders
                          Lawrenc                                Outreach
                          eville,                                Services
                          NJ                                     (CJOOS)
                          08648                                  program
    ------------------------------------------------------------------------
    Monetary    Penning  PO Box            $1,000    5/30/2014  Fundrasining
                 ton      628                                    event
                 Day,     Penning                                support to
                 Inc.     ton, NJ                                benefit
                          08534                                  general
                                                                 mission of
                                                                 organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    People   140 East          $2,500   10/22/2014  People and
                 And      Hanover                                Stories
                 Storie   Street                                 with Mercer
                 s--Gen   Trenton                                County
                 te Y     , NJ                                   Seniors
                 Cuento   08608
                 s Inc.
    ------------------------------------------------------------------------
    Monetary    Planned  PO Box            $4,000     7/1/2014  Whole-Health
                 Living   4755                                   and
                 Assist   Austin,                                Wellness
                 ance     TX                                     Program
                 Networ   78765
                 k of
                 Centra
                 l
                 Texas
    ------------------------------------------------------------------------
    Monetary    Planned  13151             $2,500    8/26/2014  Education
                 Living   Emily                                  and Social
                 Assist   Road,                                  Skills
                 ance     Suite                                  Development
                 Networ   240                                    Program
                 k of     Dallas,
                 North    TX
                 Texas,   75240
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Plansma  118 West          $3,500    9/16/2014  2014
                 rt NJ    State                                  Corporate
                          Trenton                                membership
                          , NJ                                   renewal
                          08608                                  donation to
                                                                 support
                                                                 efforts
                                                                 around
                                                                 sound land
                                                                 use
                                                                 planning
    ------------------------------------------------------------------------
    Monetary    Princet  15               $25,000   12/12/2014  Path to
                 on       Princes                                Impact--Cap
                 Area     s Road                                 acity
                 Commun   Lawrenc                                Building
                 ity      eville,                                Program
                 Founda   NJ
                 tion,    08648
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Princet  123 E.           $15,000   11/17/2014  Hunger
                 on       Hanover                                Prevention
                 Outrea   St.                                    and
                 ch       Trenton                                Nutrition
                 Projec   , NJ                                   Education
                 ts /     08608                                  ($10,000)
                 Crisis                                          and Housing
                 Minist                                          Stability
                 ry of                                           Services
                 Mercer                                          ($5,000)
                 County
    ------------------------------------------------------------------------
    Monetary    Princet  45                $2,500   10/29/2014  Living
                 on       Stockto                                Healthy for
                 Senior   n St                                   Older
                 Resour   Princet                                Adults
                 ce       on, NJ
                 Center   08540
    ------------------------------------------------------------------------
    Monetary    Princet  350              $10,000    9/22/2014  United
                 on-      Alexand                                Leaders of
                 Blairs   er Road                                Tomorrow
                 town     Princet                                (ULOT) at
                 Center   on, NJ                                 Trenton
                 Inc.     08540                                  Central
                                                                 High School-
                                                                 West Campus
    ------------------------------------------------------------------------
    Monetary    Printma  440               $5,000   10/20/2014  Roving Press
                 king     River
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Printma  440              $15,000   10/20/2014  Combat Paper
                 king     River                                  NJ
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Project  1515              $5,000    7/18/2014  Mental
                 HOME     Fairmou                                Health/
                          nt                                     Recovery
                          Avenue                                 Treatment
                          Philade                                Services
                          lphia,                                 for Adults
                          PA                                     Who Have
                          19130                                  Experienced
                                                                 Homelessnes
                                                                 s
    ------------------------------------------------------------------------
    Monetary    Raritan  P.O. Box          $8,000   11/17/2014  WaterWays
                 Headwa   273                                    Environment
                 ters     Gladsto                                al
                 Associ   ne, NJ                                 Education
                 ation    07934                                  Program
    ------------------------------------------------------------------------
    Monetary    Raritan  118              $20,000    11/5/2014  Promoting
                 Valley   Lamingt                                Access to
                 Commun   on Road                                STEM and
                 ity      Branchb                                Nursing
                 Colleg   urg, NJ                                Education
                 e        08876                                  at Raritan
                 Founda                                          Valley
                 tion                                            Community
                                                                 College:
                                                                 Nursing
                                                                 Scholarship
                                                                 s
                                                                 ($10,000),
                                                                 Galileo
                                                                 Scholarship
                                                                 s ($5,000),
                                                                 Textbooks
                                                                 ($2,500),
                                                                 STEM
                                                                 Institute
                                                                 ($2,500)
    ------------------------------------------------------------------------
    Monetary    Regions  640               $5,000     5/9/2014  Mental
                 Hospit   Jackson                                Health Drug
                 al       Street                                 Assistance
                 Founda   St.                                    Program
                 tion     Paul,
                          MN
                          55101
    ------------------------------------------------------------------------
    Monetary    Regions  640              $12,500     5/9/2014  Make It OK
                 Hospit   Jackson                                Campaign to
                 al       Street                                 fight
                 Founda   St.                                    stigma
                 tion     Paul,
                          MN
                          55101
    ------------------------------------------------------------------------
    Monetary    Rescue   98               $25,000    9/22/2014  Emergency
                 Missio   Carroll                                Services
                 n of     Street,                                program
                 Trento   PO Box
                 n        790
                          Trenton
                          , NJ
                          08605
    ------------------------------------------------------------------------
    Monetary    Resourc  427                 $300     8/4/2014  Cost
                 e        Homeste                                associated
                 Center   ad Road                                with 2014
                 Of       Hillsbo                                Janssen
                 Somers   rough,                                 Cares
                 et,      NJ                                     volunteer
                 Inc      08844                                  activity
    ------------------------------------------------------------------------
    Monetary    Rider    2083             $20,000    11/5/2014  Urban STEM
                 Univer   Lawrenc                                ($10,000),
                 sity     eville                                 Janssen
                          Road                                   Science and
                          Lawrenc                                Business
                          eville,                                Scholarship
                          NJ                                     s ($7,500),
                          08648                                  Environment
                                                                 al
                                                                 Symposium
                                                                 ($2,500)
    ------------------------------------------------------------------------
    Monetary    Riverbe  PO Box            $5,000     7/1/2014  In-SHAPE
                 nd       2032                                   Program
                 Commun   Concord
                 ity      , NH
                 Mental   03302-
                 Health   2032
                 Inc
    ------------------------------------------------------------------------
    Monetary    Riversi  4 South           $7,500   10/20/2014  Riverside
                 de       Union                                  Symphonia
                 Sympho   Street                                 Senior
                 nia      P.O.                                   Outreach
                 Inc      Box 650                                Program
                          Lambert
                          ville,
                          NJ
                          08530
    ------------------------------------------------------------------------
    Monetary    San      2789              $5,000    5/27/2014  San
                 Franci   25th                                   Francisco
                 sco      Street                                 Collaborati
                 Genera   Suite                                  ve Court's
                 l        2028 PO                                Behavioral
                 Hospit   Box                                    Health
                 al       410836                                 Court--Supp
                 Founda   San                                    orted
                 tion     Francis                                Employment
                          co, CA                                 and
                          94110                                  Motivationa
                                                                 l
                                                                 Incentives
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    Schizop  PO Box            $2,500    8/15/2014  2014
                 hrenia   941222                                 National
                 And      Houston                                Conference,
                 Relate   , TX                                   ``Call to
                 d        77094-                                 Action:
                 Disord   8222                                   Shattering
                 ers                                             Stigma''
                 Allian
                 ce Of
                 Americ
                 a
    ------------------------------------------------------------------------
    Monetary    SERV     20                $5,000    5/27/2014  12th Annual
                 Founda   Scotch                                 SERV
                 tion,    Road                                   Recovery NJ
                 Inc.     Ewing,                                 conference
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    SERV     20                $5,000    5/27/2014  SERV
                 Founda   Scotch                                 Foundation
                 tion,    Road                                   Scholarship
                 Inc.     Ewing,                                 Fund
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    Shannon  PO Box              $500    8/28/2014  Donation in
                 Daley    1271 36                                lieu of
                 Memori   Indian                                 event
                 al       Run                                    sponsorship
                 Fund     Whiteho                                to help
                          use                                    local area
                          Station                                residents
                          , NJ                                   battling
                          08889                                  serious
                                                                 ailments
                                                                 and their
                                                                 families
                                                                 facing
                                                                 hardship
    ------------------------------------------------------------------------
    Monetary    Sharing  1920              $2,000    7/31/2014  Art program
                 Place    10th                                   at the 1920
                 Inc      Avenue                                 Club
                          South
                          P.O.
                          Box
                          55945
                          Birming
                          ham, AL
                          35255
    ------------------------------------------------------------------------
    Monetary    Sisters  1201              $1,000     2/3/2014  Blue Ribbon
                 Networ   Hamilto                                sponsor
                 k of     n                                      2014 Health
                 Centra   Street                                 Summit and
                 l New    Somerse                                Breakfast
                 Jersey   t, NJ
                          08873
    ------------------------------------------------------------------------
    Monetary    Sisters  1201              $5,000    8/28/2014  Fundraising
                 Networ   Hamilto                                event
                 k of     n                                      support to
                 Centra   Street                                 benefit
                 l New    Somerse                                general
                 Jersey   t, NJ                                  mission of
                          08873                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Somerse  PO Box              $100   11/12/2014  Memorial
                 t        3000                                   donation
                 County   Somervi
                 Office   lle, NJ
                 on       08876-
                 Aging    1262
    ------------------------------------------------------------------------
    Monetary    Somerse  49                  $680     2/3/2014  General
                 t Home   Brahma                                 Operating
                 for      Avenue                                 Support
                 Tempor   Bridgew
                 arily    ater,
                 Displa   NJ
                 ced      08807
                 Childr
                 en
    ------------------------------------------------------------------------
    Monetary    Somerse  49                $7,500   10/20/2014  Street
                 t Home   Brahma                                 Smart--HIV
                 for      Avenue                                 Prevention
                 Tempor   Bridgew                                program
                 arily    ater,                                  within
                 Displa   NJ                                     Somerset
                 ced      08807                                  county
                 Childr
                 en
    ------------------------------------------------------------------------
    Monetary    St.      501 St              $100    1/14/2014  Memorial
                 Jude's   Jude                                   Donation
                 Childr   Place
                 en's     Memphis
                 Resear   , TN
                 ch       38105
                 Hospit
                 al
    ------------------------------------------------------------------------
    Monetary    St.      One              $15,000   10/20/2014  Providing
                 Mary     Summit                                 Food for
                 Medica   Square,                                School-Age
                 l        Suite                                  Children
                 Center   300                                    Living in
                 Founda   1717                                   Poverty:
                 tion     Langhor                                The St.
                          ne-                                    Mary
                          Newtown                                Backpacks
                          Road                                   for Kids
                          Langhor                                Program
                          ne, PA
                          19047
    ------------------------------------------------------------------------
    Monetary    Stony    31 Titus         $15,000    11/5/2014  StreamWatch:
                 Brook    Mill                                   Science in
                 Millst   Road                                   the Service
                 one      Penning                                of
                 Waters   ton, NJ                                Conservatio
                 hed      08534                                  n
                 Associ
                 ation
    ------------------------------------------------------------------------
    Monetary    SWIM     120               $2,000    9/22/2014  Program
                 Inc.     Findern                                Development
                          e                                      Project in
                          Avenue                                 Somerset
                          Bridgew                                and
                          ater,                                  Hunterdon
                          NJ                                     Counties--V
                          08807                                  olunteer
                                                                 Training in
                                                                 aquatic
                                                                 exercise
                                                                 for the
                                                                 disabled,
                                                                 administrat
                                                                 ive
                                                                 training
                                                                 for
                                                                 coordinator
                                                                 s and co-
                                                                 coordinator
                                                                 s, and
                                                                 sensitivity
                                                                 training
    ------------------------------------------------------------------------
    Monetary    TASK,    72\1/2\          $25,000   10/14/2014  TASK Meal
                 Inc.     Escher                                 Service
                          Street,                                Program
                          P.O.
                          Box 872
                          Trenton
                          , NJ
                          08605
    ------------------------------------------------------------------------
    Monetary    The      Paul              $9,500    10/1/2014  Arts Council
                 Arts     Robeson                                of
                 Counci   Center                                 Princeton
                 l of     for the                                Community
                 Prince   Arts                                   Outreach
                 ton      102                                    programs
                          Withers                                for youth
                          poon                                   and seniors
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      2020              $2,000   11/17/2014  Art for
                 Center   Burnt                                  Special
                 for      Mills                                  Needs
                 Contem   Road                                   Children
                 porary   Bedmins
                 Art      ter, NJ
                          07921
    ------------------------------------------------------------------------
    Monetary    The      19               $13,500    9/22/2014  Clinically-
                 Center   Dellwoo                                managed,
                 For      d Lane                                 residential
                 Great    Somerse                                treatment
                 Expect   t, NJ                                  program for
                 ations   08873                                  homeless,
                                                                 pregnant/
                                                                 parenting
                                                                 adult women
                                                                 in
                                                                 substance
                                                                 use
                                                                 recovery,
                                                                 and their
                                                                 children
                                                                 ($10,000),
                                                                 Annual Gala
                                                                 ($3,500)
    ------------------------------------------------------------------------
    Monetary    The      1040              $5,000     7/1/2014  Jail
                 Edinbu   Waltham                                Diversion
                 rg       Street                                 Program
                 Center   Lexingt
                          on, MA
                          02421-
                          8033
    ------------------------------------------------------------------------
    Monetary    The      8150 N.          $40,000   11/17/2014  HeartGuide--
                 Mended   Central                                Patient
                 Hearts   Express                                Resource
                 , Inc.   way,                                   and
                          Suite                                  Visiting
                          M2248                                  Program
                          Dallas,
                          TX
                          75206
    ------------------------------------------------------------------------
    Monetary    The      401                 $500    1/14/2014  Flash Lite
                 Mental   Cypress                                sponsor
                 Health   Street                                 2014 Lite
                 Center   Manches                                Up The Nite
                 Of       ter, NH                                Run/Walk
                 Greate   03103                                  for Mental
                 r                                               Health 5k
                 Manche
                 ster
    ------------------------------------------------------------------------
    Monetary    The      400                 $300    8/26/2014  Costs
                 Pennsb   Pennsbu                                associated
                 ury      ry                                     with 2014
                 Societ   Memoria                                Janssen
                 y        l Road                                 Cares
                          Morrisv                                volunteer
                          ille,                                  activity
                          PA
                          19067
    ------------------------------------------------------------------------
    Monetary    The      P.O. Box          $5,000    12/3/2014  The
                 Prince   2063                                   Princeton
                 ton      Princet                                Festival
                 Festiv   on, NJ                                 Intergenera
                 al       08543                                  tional
                                                                 Opera
                                                                 Workshop
                                                                 for Teens
                                                                 and their
                                                                 Families
    ------------------------------------------------------------------------
    Monetary    Thomas   101 West         $10,000    11/5/2014  Scholarships
                 Edison   State                                  for Nursing
                 State    Street                                 Students
                 Colleg   Trenton                                Enrolled in
                 e        , NJ                                   Thomas
                 Founda   08608                                  Edison
                 tion                                            State
                                                                 College's
                                                                 Accelerated
                                                                 Second
                                                                 Degree BSN
                                                                 Program.
    ------------------------------------------------------------------------
    Monetary    Trenton  PO Box            $1,500    9/22/2014  Financial
                 Commun   5206                                   Aid to
                 ity      Trenton                                subsidize
                 Music    , NJ                                   tuition
                 School   08638                                  costs for
                                                                 families
                                                                 qualifying
                                                                 based on
                                                                 family size
                                                                 and income--
                                                                 music
                                                                 instruction
                                                                 s for
                                                                 students
    ------------------------------------------------------------------------
    Monetary    Trenton  635               $3,500   11/17/2014  Trenton
                 Educat   South                                  Education
                 ion      Clinton                                Dance
                 Dance    Avenue                                 Institute
                 Instit   Trenton                                program for
                 ute      , NJ                                   at-risk
                          08611                                  youth in
                                                                 Trenton
    ------------------------------------------------------------------------
    Monetary    Trenton  218 N            $10,000   10/23/2014  Inroads for
                 Health   Broad                                  Health:
                 Team     St                                     Taking it
                 Inc      Trenton                                to the
                          , NJ                                   Streets
                          08608
    ------------------------------------------------------------------------
    Monetary    Trinity  22                $9,000   11/17/2014  Mental
                 Counse   Stockto                                Health and
                 ling     n                                      Wellness
                 Servic   Street                                 Programs
                 es       Trinity
                          Counsel
                          ing
                          Service
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Truist/  Departme         $32,261   12/12/2014  Truist
                 Fronts   nt                                     processing
                 tream,   CH16952                                fee for
                 Inc.     Palatin                                total 2014
                          e, IL                                  United Way
                          60055-                                 Campaign
                          6952                                   (fee
                                                                 associated
                                                                 with NJ
                                                                 companies)
    ------------------------------------------------------------------------
    Monetary    Twiligh  P.O. Box          $5,000   11/17/2014  Simple Needs
                 t Wish   1042 11                                Wish
                 Founda   Duane                                  Granting
                 tion     Road                                   Program
                          Doylest                                Expansion
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    UIH      4 North           $7,500   10/14/2014  Community of
                 Family   Broad                                  Health for
                 Partne   Street                                 Men
                 rs       2nd
                          Floor
                          Trenton
                          , NJ
                          08618-
                          4408
    ------------------------------------------------------------------------
    Monetary    United   9-25              $9,000    8/26/2014  Princeton
                 Negro    Alling                                 Committee
                 Colleg   St.                                    of UNCF
                 e Fund   Second                                 Scholarship
                          Floor                                  -Scholarshi
                          Newark,                                p support
                          NJ                                     for
                          07102                                  deserving
                                                                 STEM
                                                                 students in
                                                                 Mercer or
                                                                 Somerset
                                                                 Counties
    ------------------------------------------------------------------------
    Monetary    United   P.O. Box        $607,875   12/12/2014  Company
                 Way      418607                                 match to
                 Worldw   Boston,                                employee
                 ide      MA                                     United Way
                          02241-                                 campaign
                          8607                                   for NJ
                                                                 based
                                                                 commercial
                                                                 companies
                                                                 of Janssen
                                                                 Pharmaceuti
                                                                 cal
                                                                 Companies
                                                                 of Johnson
                                                                 & Johnson
                                                                 less Truist
                                                                 processing
                                                                 fee
    ------------------------------------------------------------------------
    Monetary    US Pain  670               $7,500    12/4/2014  INvisible
                 Founda   newfiel                                Project
                 tion     d
                          street
                          suite b
                          middlet
                          own, CT
                          06457
    ------------------------------------------------------------------------
    Monetary    Valeo    5401 SW           $5,000    7/18/2014  Services for
                 Behavi   7th                                    Employment
                 oral     Street                                 Success
                 Health   Topeka,                                Program
                 Care     KS                                     serving
                 Inc      66606                                  consumers
                                                                 with
                                                                 Schizophren
                                                                 ia and
                                                                 other
                                                                 severe
                                                                 mental
                                                                 illness
    ------------------------------------------------------------------------
    Monetary    Volunte  P.O. Box          $8,500    10/1/2014  SkillsConnec
                 er       615                                    t skills
                 Connec   Princet                                based
                 t        on, NJ                                 community
                          08542                                  volunteer
                                                                 program
    ------------------------------------------------------------------------
    Monetary    West     120               $2,000     7/1/2014  Young Adults
                 Bergen   Chestnu                                with
                 Mental   t                                      Schizophren
                 Health   Street                                 ia Young
                 care     Ridgewo                                Adult Track
                          od, NJ                                 of the
                          07450-                                 Partial
                          2500                                   Care
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    West     120                 $300     8/4/2014  Cost
                 Bergen   Chestnu                                associated
                 Mental   t                                      with 2014
                 Health   Street                                 Janssen
                 care     Ridgewo                                Cares
                          od, NJ                                 Volunteer
                          07450-                                 Activity
                          2500
    ------------------------------------------------------------------------
    Monetary    West     PO Box            $5,000    9/22/2014  STEM
                 Windso   280                                    Excellence
                 r        West                                   in
                 Plains   Windsor                                Education
                 boro     , NJ                                   Grant
                 Educat   08550-                                 Program
                 ion      0280
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Womansp  1530              $2,500   10/20/2014  Emergency
                 ace      Brunswi                                Domestic
                          ck                                     Violence
                          Avenue                                 Shelter
                          Lawrenc                                program
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Wounded  4899                $100    5/16/2014  Memorial
                 Warrio   Belfort                                Donation
                 r        Road
                 Projec   Suite
                 t        300
                          Jackson
                          ville,
                          FL
                          32256
    ------------------------------------------------------------------------
    Monetary    Wounded  4899                 $75    12/3/2014  Employee
                 Warrio   Belfort                                directed
                 r        Road                                   donation in
                 Projec   Suite                                  lieu of
                 t        300                                    company
                          Jackson                                holiday
                          ville,                                 gift
                          FL
                          32256
    ------------------------------------------------------------------------
    Monetary    YMCA of  431               $7,500   12/10/2014  The YMCA of
                 Trento   Penning                                Trenton's
                 n        ton                                    Stars of
                          Avenue                                 Science
                          Trenton                                Program
                          , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Young    349 W.            $3,500   10/20/2014  College
                 Schola   State                                  Preparatory
                 rs'      St                                     Program
                 Instit   Trenton
                 ute      , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    YWCA     59 Paul           $3,000   11/17/2014  Breast
                 Prince   Robeson                                Cancer
                 ton      Place                                  Resource
                          Princet                                Center--Wom
                          on, NJ                                 en of
                          08540                                  Wisdom
                                                                 (WOW)
                                                                 Program
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $490,904    3/19/2014  Product
                 res      Hamilto                                Donation
                 Founda   n                                      for
                 tion     Avenue                                 Humanitaria
                          Stamfor                                n Relief in
                          d, CT                                  the U.S.,
                          06902                                  El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Honduras,
                                                                 Nicaragua,
                                                                 Cambodia,
                                                                 Pakistan,
                                                                 and Peru.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $834,365    3/19/2014  Product
                 res      Hamilto                                Donation
                 Founda   n                                      for
                 tion     Avenue                                 Humanitaria
                          Stamfor                                n Relief in
                          d, CT                                  Guatemala,
                          06902                                  El
                                                                 Salvador,
                                                                 Honduras,
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $383,214   10/23/2014  Product
                 res      Hamilto                                Donation in
                 Founda   n Ave                                  support of
                 tion     Stamfor                                Disaster
                          d, CT                                  Response
                          06902
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $233,871    12/3/2014  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Malawi,
                                                                 Tanzania,
                                                                 West Bank,
                                                                 Armenia,
                                                                 Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Nicaragua,
                                                                 Peru,
                                                                 Tanzania
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $100,985    12/3/2014  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Malawi,
                                                                 Tanzania,
                                                                 Armenia,
                                                                 Dominican
                                                                 Republic,
                                                                 Colombia
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $825,981    11/6/2014  Product
                 res      Hamilto                                Donations
                 Founda   n Ave                                  for
                 tion     Stamfor                                Humanitaria
                          d, CT                                  n Aid for
                          06902                                  Armenia,
                                                                 Dominican
                                                                 Republic,
                                                                 Gaza,
                                                                 Pakistan,
                                                                 West Bank
                                                                 and
                                                                 Tanzania.
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $2,389,565     8/4/2014  Product
                 res      Hamilto                                Donation in
                 Founda   n Ave                                  support of
                 tion     Stamfor                                Humanitan
                          d, CT                                  Aid for the
                          06902                                  U.S.,
                                                                 Afghanistan
                                                                 ,
                                                                 Bangladesh,
                                                                 Pakistan,
                                                                 and Peru.
    ------------------------------------------------------------------------
    Product     Catholi  33-01             $5,279    12/3/2014  Pharmaceutic
                 c        Elevent                                al Product
                 Medica   h                                      Donation
                 l        Street                                 for
                 Missio   Long                                   Humanitaria
                 n        Island                                 n Aid in
                 Board    City,                                  Haiti
                          NY
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $665,263    3/19/2014  Product
                 Relief   Patera                                 Donation to
                 Intern   Lane                                   support
                 ationa   Santa                                  Humanitaria
                 l        Barbara                                n Relief in
                          , CA                                   Haiti,
                          93117                                  Dominican
                                                                 Republic,
                                                                 Honduras,
                                                                 Paraguay,
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $614,185    3/19/2014  Product
                 Relief   Patera                                 Donation to
                 Intern   Lane                                   support
                 ationa   Santa                                  Humanitaria
                 l        Barbara                                n Relief in
                          , CA                                   Haiti,
                          93117                                  Dominican
                                                                 Republic,
                                                                 and
                                                                 Paraguay.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $116,610    2/27/2014  Humanitarian
                 Relief   Patera                                 Aid for
                 Intern   Lane                                   Obstetric
                 ationa   Santa                                  Fistula
                 l        Barbara                                program.
                          , CA
                          93117
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $322,359    11/6/2014  Humanitarian
                 Relief   Patera                                 Aid for
                 Intern   Lane                                   Ghana,
                 ationa   Santa                                  Paraguay,
                 l        Barbara                                and Peru.
                          , CA
                          93117
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $2,354,643    12/3/2014  Pharmaceutic
                 Relief   Patera                                 al Product
                 Intern   Lane                                   Donation
                 ationa   Santa                                  for
                 l        Barbara                                Disaster
                          , CA                                   Response
                          93117                                  and/or
                                                                 Humanitaria
                                                                 n Aid in
                                                                 Dominican
                                                                 Republic,
                                                                 Guatemala,
                                                                 Nicaragua,
                                                                 Peru,
                                                                 Panama,
                                                                 Paraguay
                                                                 and United
                                                                 States
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $30,164    12/3/2014  Pharmaceutic
                 Relief   Patera                                 al Product
                 Intern   Lane                                   Donation
                 ationa   Santa                                  for
                 l        Barbara                                Humanitaria
                          , CA                                   n Aid in
                          93117                                  Nicaragua,
                                                                 Peru
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $2,093,905     8/5/2014  Humanitarian
                 Relief   Patera                                 Aid for
                 Intern   Lane                                   Haiti,
                 ationa   Santa                                  Paraguay,
                 l        Barbara                                and U.S.
                          , CA
                          93117
    ------------------------------------------------------------------------
    Product     Heart    1021             $72,493    3/19/2014  Product
                 to       Pacific                                Donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 Humanitaria
                 ationa   City,                                  n Relief in
                 l        KS                                     Papua New
                          66102                                  Guinea and
                                                                 Cameroon.
    ------------------------------------------------------------------------
    Product     Heart    1021             $33,156   12/18/2014  Pharmaceutic
                 to       Pacific                                al Product
                 Heart    Avenue                                 donation
                 Intern   Kansas                                 for Ebola
                 ationa   City,                                  Treatment
                 l        KS                                     Unit in
                          66102                                  Liberia
    ------------------------------------------------------------------------
    Product     Heart    1021             $46,435    12/3/2014  Pharmaceutic
                 to       Pacific                                al Product
                 Heart    Avenue                                 donation
                 Intern   Kansas                                 for
                 ationa   City,                                  humanitaria
                 l        KS                                     n relief in
                          66102                                  Papua New
                                                                 Guinea
    ------------------------------------------------------------------------
    Product     Johnson  One         $380,566,479    3/15/2014  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One          $87,387,455   12/15/2014  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One          $74,577,911    9/15/2014  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     MAP      4700            $772,428     1/9/2014  Donation for
                 Intern   Glynco                                 Medical
                 ationa   Parkway                                Mission
                 l        Brunswi                                Pack Plus
                          ck, GA                                 Program
                          31525
    ------------------------------------------------------------------------
    Product     MAP      4700             $26,142     1/9/2014  Donation for
                 Intern   Glynco                                 the Medical
                 ationa   Parkway                                Mission
                 l        Brunswi                                Pack Plus
                          ck, GA                                 Program
                          31525
    ------------------------------------------------------------------------
    Product     MAP      4700             $26,394    12/3/2014  Pharmaceutic
                 Intern   Glynco                                 al Product
                 ationa   Parkway                                Donation to
                 l        Brunswi                                support the
                          ck, GA                                 Medical
                          31525                                  Mission
                                                                 Pack Plus
    ------------------------------------------------------------------------
    Product     Mercy    15862             $8,397    3/19/2014  Product
                 Ships    State                                  Donation in
                 Intern   Highway                                support of
                 ationa   110                                    Humanitaria
                 l        North                                  n Relief in
                 Operat   Lindale                                West
                 ions     , TX                                   Africa.
                 Center   75771
    ------------------------------------------------------------------------
    Product     New      1                $13,297     8/4/2014  Product
                 Jersey   Riversi                                Donation.
                 Academ   de
                 y of     Drive
                 Aquati   Camden,
                 c        NJ
                 Scienc   08103-
                 es       1037
    ------------------------------------------------------------------------
    Product     Project  255             $149,962    3/19/2014  Product
                 Hope     Carter                                 Donation in
                          Hall                                   support of
                          Lane                                   Humanitaria
                          Millwoo                                n Relief in
                          d, VA                                  Kosovo,
                          22646                                  Macedonia,
                                                                 and
                                                                 Tajikistan.
    ------------------------------------------------------------------------
    Product     Project  255             $768,245    3/10/2014  Product
                 Hope     Carter                                 Donation
                          Hall                                   for
                          Lane                                   Humanitaria
                          Millwoo                                n Relief in
                          d, VA                                  Tajikistan.
                          22646
    ------------------------------------------------------------------------
    Product     Project  255             $821,994    3/10/2014  Product
                 Hope     Carter                                 Donation
                          Hall                                   for
                          Lane                                   Humanitaria
                          Millwoo                                n Aid in
                          d, VA                                  Tajikistan.
                          22646
    ------------------------------------------------------------------------
    Similar payments to the same organization may appear in this report as
      contributions may be distributed in multiple payments.

      Janssen Therapeutics, Division of Janssen Products, LP, Monetary and
     Product Contributions to U.S.-based Charitable Organizations Full Year
                                      2014
    (Payments made from January 1, 2014 to December 31, 2014)--Amended March
                                    19, 2019
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    Aboundi  South             $1,500    3/24/2014  HEALTHY U! .
                 ng       Bouleva                                . . HEALTHY
                 Prospe   rd                                     US!
                 rty      Dallas,
                          TX
                          75215
    ------------------------------------------------------------------------
    Monetary    Acercam  827               $7,000    6/16/2014  ContraSIDA
                 iento    Wildwoo                                (Against
                 Hispan   d                                      AIDS)
                 o de     Avenue
                 Caroli   Suite
                 na del   200
                 Sur      Columbi
                          a, SC
                          29203
    ------------------------------------------------------------------------
    Monetary    Aid for  515               $5,000    11/7/2014  New York
                 AIDS     Greenwi                                Immigrant
                 Intern   ch                                     AIDS Link
                 ationa   Street                                 Program
                 l        New
                          York,
                          NY
                          10013
    ------------------------------------------------------------------------
    Monetary    AIDS     75 Amory         $10,000    11/7/2014  Viral
                 Action   Street                                 Hepatitis
                 Commit   Boston,                                Access
                 tee      MA                                     Project
                          02119                                  (VHAP)
    ------------------------------------------------------------------------
    Monetary    AIDS     75 Amory         $15,000     3/5/2014  Mental
                 Action   Street                                 Health
                 Commit   Boston,                                Program/
                 tee      MA                                     Charitable
                          02119                                  Contributio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Aids     575              $20,000     7/9/2014  HIV Health
                 Commun   Eighth                                 Literacy
                 ity      Avenue                                 Program
                 Resear   Suite                                  (HHLP)
                 ch       502 New
                 Initia   York,
                 tive     NY
                 of       10018
                 Americ
                 a
                 (ACRIA
                 )
    ------------------------------------------------------------------------
    Monetary    AIDS     6260              $4,500   10/27/2014  Wall Talk
                 Founda   Westpar                                HIV/
                 tion     k Drive                                Hepatitis C
                 Housto   Houston                                Co-
                 n        , TX                                   Infection
                          77057
    ------------------------------------------------------------------------
    Monetary    AIDS     411              $30,000    7/10/2014  Road to
                 Founda   South                                  Health:
                 tion     Wells                                  Promoting
                 of       Street                                 Successful
                 Chicag   Suite                                  Implementat
                 o        300                                    ion of
                          Chicago                                Health Care
                          , IL                                   Reform for
                          60607                                  People
                                                                 Living with
                                                                 HIV/AIDS in
                                                                 Illinois
    ------------------------------------------------------------------------
    Monetary    AIDS     7215              $5,000   12/15/2014  Case
                 Servic   Cameron                                Management
                 e of     Road
                 Austin   Austin,
                          TX
                          78752
    ------------------------------------------------------------------------
    Monetary    AIDS     17982             $3,000    8/18/2014  HIV Medical
                 Servic   Sky                                    Case
                 es       Park                                   Management
                 Center   Circle
                 of       Irvine,
                 Orange   CA
                 County   92614
    ------------------------------------------------------------------------
    Monetary    AIDS     7215              $5,000     4/4/2014  Case
                 Servic   Cameron                                Management
                 es of    Road                                   Program
                 Austin   Austin,
                          TX
                          78752
    ------------------------------------------------------------------------
    Monetary    AIDS     1424 K          $250,000   11/10/2014  Access to
                 United   Street,                                Care (A2C)
                          NW                                     Initiative
                          Washing
                          ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Allianc  825               $5,000     7/8/2014  Group Home
                 e for    Colorad                                Care for
                 Housin   o                                      Homeless
                 g and    Bouleva                                Persons
                 Healin   rd                                     with HIV/
                 g        Suite                                  AIDS at
                          100 Los                                Soldano
                          Angeles                                House and
                          , CA                                   Casa de
                          90041                                  Corazon
    ------------------------------------------------------------------------
    Monetary    Bay      701 Oak           $2,400    1/17/2014  Youth
                 Area     Street                                 Engagement
                 Young    San                                    Program/
                 Positi   Francis                                Charitable
                 ves      co, CA                                 contributio
                          94117                                  n
    ------------------------------------------------------------------------
    Monetary    Bay      701 Oak           $5,000    11/7/2014  Patient Peer
                 Area     Street                                 Navigator
                 Young    San
                 Positi   Francis
                 ves      co, CA
                          94117
    ------------------------------------------------------------------------
    Monetary    Bienest  5326 E           $15,000    11/5/2014  General
                 ar       Beverly                                Organizatio
                 Human    Road                                   nal Support
                 Servic   Los
                 es Inc   Angeles
                          , CA
                          90022
    ------------------------------------------------------------------------
    Monetary    Caring   19591 S.         $20,000    8/18/2014  Patients
                 Ambass   Alberta                                CHOICES--Ch
                 adors    Beaverc                                anging
                          reek,                                  Hepatitis
                          OR                                     through
                          97004                                  Outreach,
                                                                 Information
                                                                 ,
                                                                 Comprehensi
                                                                 ve
                                                                 Education,
                                                                 and Support
    ------------------------------------------------------------------------
    Monetary    Catholi  3009              $5,000    11/7/2014  The Home
                 c        Lake                                   Place
                 Charit   Brook
                 ies of   Bouleva
                 East     rd
                 Tennes   Knoxvil
                 see      le, TN
                          37909
    ------------------------------------------------------------------------
    Monetary    Chicago  1925              $5,000    2/21/2014  Connect2Care
                 House    North                                  (C2C) /
                 and      Clybour                                Charitable
                 Social   n Suite                                Contributio
                 Servic   401                                    n
                 e        Chicago
                 Agency   , IL
                          60614
    ------------------------------------------------------------------------
    Monetary    Chicago  1925             $10,000   12/15/2014  Connect2Care
                 House    North
                 and      Clybour
                 Social   n Suite
                 Servic   401
                 e        Chicago
                 Agency   , IL
                          60614
    ------------------------------------------------------------------------
    Monetary    Christi  2440             $15,000   12/15/2014  CHANGE for
                 e's      Third                                  Women
                 Place    Avenue                                 Program
                          San
                          Diego,
                          CA
                          92101
    ------------------------------------------------------------------------
    Monetary    Communi  677 Ala           $3,000    3/24/2014  HIV and Hep
                 ty       Moana                                  C
                 Health   Bouleva                                Prevention
                 Outrea   rd                                     in Drug-
                 ch       Suite                                  Using
                 Work     226                                    Community/
                 to       Honolul                                Charitable
                 Preven   u, HI                                  Contributio
                 t AIDS   96813                                  n
    ------------------------------------------------------------------------
    Monetary    Desert   1695 N.           $5,000    1/17/2014  Case
                 Aids     Sunrise                                Management/
                 Projec   Way                                    Charitable
                 t        Palm                                   Contributio
                          Springs                                n
                          , CA
                          92262
    ------------------------------------------------------------------------
    Monetary    Fund     121              $25,000    11/5/2014  Get SMART
                 For      Avenue                                 About
                 The      of the                                 Hepatitis C
                 City     America
                 of New   s 6th
                 York     Floor
                 Inc      New
                          York,
                          NY
                          10013
    ------------------------------------------------------------------------
    Monetary    Gay      446 West         $15,000    11/7/2014  Community
                 Men's    33rd                                   Education
                 Health   Street                                 and
                 Crisis   New                                    Treatment
                          York,                                  as
                          NY                                     Prevention
                          10001                                  Program
    ------------------------------------------------------------------------
    Monetary    HARM     South            $50,000    4/18/2014  Hepatitis C
                 Reduct   Bouleva                                Innovations
                 ion      rd                                     Network/
                 Coalit   Dallas,                                Charitbale
                 ion      TX                                     Contributio
                          75215                                  n
    ------------------------------------------------------------------------
    Monetary    Health   1211             $75,000    3/17/2014  ``C Change''
                 Federa   Chestnu                                Program
                 tion     t
                 of       Street
                 Philad   Suite
                 elphia   801
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Hep C    601              $15,000    6/17/2014  HepC
                 Allian   Busines                                Education
                 ce       s Loop                                 and
                          70 West                                Testing--Th
                          Columbi                                e Kansas
                          a, MO                                  Project
                          65203
    ------------------------------------------------------------------------
    Monetary    Hep C    1325             $10,000    3/14/2014  Expanding
                 Connec   South                                  Efforts to
                 tion     Colorad                                Locate
                          o                                      Undiagnosed
                          Bouleva                                HCV
                          rd                                     Patients
                          Suite                                  and Link to
                          302                                    Care
                          Denver,
                          CO
                          80222
    ------------------------------------------------------------------------
    Monetary    Hepatit  35 East          $25,000    7/25/2014  The
                 is C     38th                                   Hepatitis C
                 Mentor   Street                                 Patient
                 and      New                                    Assistance
                 Suppor   York,                                  Program
                 t        NY
                 Group,   10016
                 Inc
    ------------------------------------------------------------------------
    Monetary    HIV      100               $5,000    3/12/2014  The
                 Aids     Edgewoo                                EmpowerLink
                 Empowe   d                                      Program
                 rment    Avenue
                 Resour   NE
                 ce       Suite
                 Center   1020
                 for      Atlanta
                 Young    , GA
                 Women,   30303-
                 Inc.     3065
    ------------------------------------------------------------------------
    Monetary    Housing  57                $5,000   11/13/2014  The
                 Works    Willoug                                Undetectabl
                          hby                                    es--HIV
                          Street                                 Viral
                          Brookly                                Suppression
                          n, NY                                  Initiative
                          11201
    ------------------------------------------------------------------------
    Monetary    Howard   4025 N.          $10,000    7/25/2014  Hepatitis C
                 Brown    Sherida                                Medical
                 Health   n                                      Management
                 Center   Street                                 and Support
                          Chicago                                for People
                          , IL                                   who Inject
                          60613                                  Drugs
    ------------------------------------------------------------------------
    Monetary    Iris     2348              $7,500    2/21/2014  Hepatitis C
                 House    Adam                                   Testing,
                          Clayton                                Education
                          Powell                                 and
                          Jr                                     Connection
                          Bouleva                                to Care
                          rd New                                 programs/
                          York,                                  Charitbale
                          NY                                     Contributio
                          10030                                  n
    ------------------------------------------------------------------------
    Monetary    J&J      One          $11,200,000   12/19/2014  Global
                 Family   Johnson                                Public
                 of       &                                      Health
                 Compan   Johnson                                programs in
                 ies      Plaza,                                 South
                 Contri   New                                    Africa and
                 bution   Brunswi                                Uganda (HIV
                 s Fund   ck, NJ                                 and TB)
                          08933
    ------------------------------------------------------------------------
    Monetary    Josephs  1730              $5,000    3/13/2014  Care and
                 House    Lanier                                 Intensive
                          Place                                  Treatment
                          NW                                     Adherence
                          Washing                                Support for
                          ton, DC                                People with
                          20009                                  HIV
    ------------------------------------------------------------------------
    Monetary    Kansas   3515              $5,000   12/15/2014  Reducing
                 City     Broadwa                                Risks
                 Free     y                                      through
                 Health   Kansas                                 Health
                 Clinic   City,                                  Education
                          MO
                          64111
    ------------------------------------------------------------------------
    Monetary    Legacy   4054              $5,000   10/27/2014  Mission
                 Counse   McKinne                                Support
                 ling     y                                      Legacy
                 Center   Avenue                                 Counseling
                          Dallas,                                Center
                          TX
                          75204
    ------------------------------------------------------------------------
    Monetary    Maine    35                $5,000    6/23/2014  Harm
                 Genera   Medical                                Reduction
                 l        Center                                 Program:
                 Health   Parkway                                HIV and HCV
                          Augusta                                Prevention
                          , ME
                          04330
    ------------------------------------------------------------------------
    Monetary    Making   60 Clif           $5,000   12/15/2014  Imani Park
                 It       Prescod                                Transitiona
                 Possib   Lane                                   l Housing
                 e to     Edison,                                Program
                 End      NJ
                 Homele   08817
                 ssness
    ------------------------------------------------------------------------
    Monetary    Minorit  5149              $7,500    2/21/2014  ``The Bridge
                 y AIDS   West                                   Program''
                 Projec   Jeffers
                 t        on
                          Blvd.
                          Los
                          Angeles
                          , CA
                          90016
    ------------------------------------------------------------------------
    Monetary    NAESM,   2140              $5,000    6/16/2014  The D.C.
                 Inc.     Martin                                 Project
                          Luther
                          King Jr
                          Drive
                          Atlanta
                          , GA
                          30310
    ------------------------------------------------------------------------
    Monetary    Nashvil  633               $5,000    5/13/2014  Outreach,
                 le       Thompso                                Testing,
                 CARES    n Lane                                 Linkage to
                          Nashvil                                Care, and
                          le, TN                                 Supportive
                          37204                                  Services
                                                                 for young
                                                                 AA gay/
                                                                 bisexual or
                                                                 other MSM
    ------------------------------------------------------------------------
    Monetary    Nationa  2140              $7,000   12/15/2014  Project
                 l AIDS   Martin                                 Impact
                 Educat   Luther
                 ion      King
                 and      Jr. SW
                 Servic   Atlanta
                 es for   , GA
                 Minori   30310
                 ties
    ------------------------------------------------------------------------
    Monetary    Nationa  580             $175,000    4/18/2014  NATAP HIV,
                 l AIDS   Broadwa                                HCV/HIV
                 Treatm   y Suite                                Coinfetion
                 ent      1010                                   and Hep C
                 Advoca   New                                    Care and
                 cy       York,                                  Treatment
                 Projec   NY                                     Education/
                 t        10012                                  Information
                 (NATAP                                          and Policy/
                 )                                               Advocacy
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    Nationa  444             $125,000    3/17/2014  Affordable
                 l        North                                  Care Act
                 Allian   Capitol                                (ACA),
                 ce of    Street,                                Viral
                 State    NW                                     Hepatitis,
                 and      Suite                                  and Ryan
                 Territ   339                                    White/ADAP
                 orial    Washing                                Public
                 AIDS     ton, DC                                Policy and
                 Direct   20001                                  Technical
                 ors                                             Assistance
                                                                 Projects/
                                                                 Charitable
                                                                 Contributio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Nationa  444             $150,000   12/18/2014  2015
                 l        North                                  Affordable
                 Allian   Capitol                                Care Act
                 ce of    Street,                                (ACA),
                 State    NW                                     Viral
                 and      Suite                                  Hepatitis,
                 Territ   339                                    and Ryan
                 orial    Washing                                White/ADAP
                 AIDS     ton, DC
                 Direct   20001
                 ors
    ------------------------------------------------------------------------
    Monetary    New      44 South          $5,000     8/7/2014  Community
                 Jersey   Street,                                Based
                 AIDS     Morrist                                Services
                 Servic   own NJ
                 es       07960
    ------------------------------------------------------------------------
    Monetary    North    5 Center         $10,000     2/3/2014  Living Well
                 Shore    Street                                 with
                 Health   Glouces                                Hepatitis C
                 Projec   ter, MA
                 t,       01930
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nova     2946              $5,000    6/23/2014  En Direccion
                 Salud    Sleepyh                                Positiva
                          ollow                                  Spanish-
                          Road                                   Speaking
                          Suite                                  HIV/AIDS
                          4A                                     Support
                          Falls                                  Group
                          Church,
                          VA
                          22044
    ------------------------------------------------------------------------
    Monetary    OPAT     1192              $2,500    3/12/2014  Infectious
                 Outcom   Smith                                  Disease
                 es       Street                                 Hepatitis C
                 Regist   Honolul                                Virus (HCV)
                 ry       u, HI                                  Education,
                          96817                                  Screening,
                                                                 Pre/Post
                                                                 Education
                                                                 and Linkage
                                                                 to Care
                                                                 2014-2015 /
                                                                 Charitable
                                                                 Contributio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Patient  421             $750,000   12/16/2014  Patient
                 Advoca   Butler                                 Advocate
                 te       Farm                                   Foundation'
                 Founda   Road                                   s Co-Pay
                 tion     Hampton                                Relief
                          , VA                                   (CPR)
                          23666                                  Program
                                                                 Hepatitis C
                                                                 Silo
    ------------------------------------------------------------------------
    Monetary    Patient  421           $5,000,000    1/14/2014  Patient
                 Advoca   Butler                                 Advocate
                 te       Farm                                   Foundation'
                 Founda   Road                                   s Co-Pay
                 tion     Hampton                                Relief
                          , VA                                   (CPR)
                          23666                                  Program-
                                                                 Hepatitis C
                                                                 Silo
    ------------------------------------------------------------------------
    Monetary    Philade  1233             $10,000     7/9/2014  2014 AIDS
                 lphia    Locust                                 Education
                 FIGHT    Street                                 Month
                          3rd
                          Floor
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Project  273              $25,000    6/25/2014  Think Tank
                 Inform   Ninth                                  to Provide
                          Street                                 Technical
                          San                                    Assistance
                          Francis                                to Ten
                          co, CA                                 Jurisdictio
                          94103                                  ns on the
                                                                 Use of HIV
                                                                 Surveillanc
                                                                 e to
                                                                 Support
                                                                 Linkage and
                                                                 Retention
                                                                 in Care and
                                                                 Treatment
    ------------------------------------------------------------------------
    Monetary    Project  273              $40,000     7/1/2014  The Support
                 Inform   Ninth                                  Partnership
                          Street
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $40,000     7/4/2014  Mission
                 Inform   Ninth                                  Support for
                          Street                                 Project
                          San                                    Inform /
                          Francis                                Charitable
                          co, CA                                 Contributio
                          94103                                  n
    ------------------------------------------------------------------------
    Monetary    Project  273              $25,000   12/15/2014  Educational
                 Inform   Ninth                                  and Policy
                          Street                                 Activities
                          San                                    to Support
                          Francis                                Hepatitis C
                          co, CA                                 Care
                          94103                                  Linkage
    ------------------------------------------------------------------------
    Monetary    Project  2929 NE           $2,000    3/12/2014  Many Men,
                 Link     6                                      Many Voices
                 of       Avenue                                 (3MV) and
                 South    Wilton                                 Many Women,
                 Florid   Manors,                                Many Voices
                 a,       FL                                     (3WV)
                 Inc.     33334
    ------------------------------------------------------------------------
    Monetary    Project  530 W             $5,000   11/13/2014  Transitional
                 Transi   Street                                 Housing
                 tions    Road
                          Warmins
                          ter, PA
                          18974
    ------------------------------------------------------------------------
    Monetary    Provide  1150             $40,000     7/4/2014  Providence
                 nce      Varnum                                 Hepatitis C
                 Health   St. NE                                 Program
                 Founda   Washing
                 tion     ton, DC
                          20721
    ------------------------------------------------------------------------
    Monetary    Ryan     1775 T           $10,000    4/25/2014  HEPATITIS:
                 White    Street                                 Education,
                 CARE     NW                                     Advocacy
                 Act      Washing                                and
                 Title    ton, DC                                Leadership
                 II       20009                                  (HEAL)
                 Commun
                 ity
                 AIDS
                 Nation
                 al
                 Networ
                 k (T
                 II
                 CANN)
    ------------------------------------------------------------------------
    Monetary    San      1035             $30,000    8/25/2014  The
                 Franci   Market                                 Stonewall
                 sco      Street                                 Project
                 AIDS     San
                 Founda   Francis
                 tion     co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Southwe  300               $5,000     3/1/2014  HIV Care in
                 st       Southwe                                a Safety
                 Boulev   st                                     Net Clinic/
                 ard      Bouleva                                Charitable
                 Family   rd                                     Contributio
                 Health   Kansas                                 n
                 Care,    City,
                 Inc      KS
                          66103
    ------------------------------------------------------------------------
    Monetary    Special  605 W             $5,000    1/28/2014  Asian
                 Servic   Olympic                                Pacific
                 e for    Bouleva                                AIDS
                 Groups   rd                                     Interventio
                 , Inc.   Suite                                  n Team
                          600 Los                                (APAIT)
                          Angeles                                Charitable
                          , CA                                   Contributio
                          90015                                  n
    ------------------------------------------------------------------------
    Monetary    The      17 Davis         $60,000     3/5/2014  Florida
                 AIDS     Bouleva                                Hepatitis
                 Instit   rd                                     Education
                 ute      Suite                                  and
                          403                                    Advocacy
                          Tampa,                                 Network
                          FL                                     (FHEAN) and
                          33606                                  health web
                                                                 portal
                                                                 (www.HepInf
                                                                 oNow.org) /
                                                                 Charitable
                                                                 Contributio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    The      17 Davis         $50,000     7/9/2014  Protecting
                 AIDS     Bouleva                                and
                 Instit   rd                                     enhancing
                 ute      Suite                                  the
                          403                                    Hepatitis C
                          Tampa,                                 and the HIV/
                          FL                                     AIDS
                          33606                                  national
                                                                 and state
                                                                 programs
                                                                 and
                                                                 policies in
                                                                 the U.S.
    ------------------------------------------------------------------------
    Monetary    The      121              $40,000    4/18/2014  The SHE
                 Fund     Avenue                                 Initiative
                 for      of the
                 the      America
                 City     s 6th
                 of New   Floor
                 York     New
                          York,
                          NY
                          10013
    ------------------------------------------------------------------------
    Monetary    The      330              $15,000    7/22/2014  The Well
                 Well     Grace                                  Project's
                 Projec   Glen                                   Online
                 t        Nellysf                                Resources
                          ord, VA                                for Women
                          22958                                  and HIV
    ------------------------------------------------------------------------
    Monetary    Tides    835              $20,000   11/25/2014  Website:
                 Center   Solano                                 HCVAdvocate
                          Street
                          West
                          Sacrame
                          nto, CA
                          95605
    ------------------------------------------------------------------------
    Monetary    TPA      5537 N           $20,000     7/9/2014  Total Care
                 Networ   Broadwa                                Portal
                 k        y
                 Incorp   Chicago
                 orated   , IL
                 -Test    60640
                 Positi
                 ve
                 Aware
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    Treatme  261 5th          $40,000    6/17/2014  Case Studies
                 nt       Avenue                                 Project
                 Action   Suite
                 Group    2110
                 (TAG)    New
                          York,
                          NY10016
    ------------------------------------------------------------------------
    Monetary    Univers  c/o UC           $15,000     3/5/2014  ``Linkage To
                 ity of   San                                    Care, After
                 Califo   Diego                                  HIV
                 rnia,    AIDS                                   Testing''/
                 San      Researc                                Charitable
                 Diego    h                                      Contributio
                          Institu                                n
                          te 9500
                          Gilman
                          Drive
                          #0716
                          La
                          Jolla,
                          CA
                          92093-
                          0716
    ------------------------------------------------------------------------
    Monetary    Victory  965              $10,000     2/3/2014  Prevention,
                 Progra   Massach                                Education,
                 ms,      usetts                                 and Health
                 Inc.     Avenue                                 Connections
                          Boston,                                Services
                          MA                                     for People
                          02118                                  with HIV/
                                                                 AIDS.
    ------------------------------------------------------------------------
    Monetary    VT       187               $5,000    3/13/2014  HIV Care and
                 Commit   Saint                                  Support
                 tee      Paul                                   Program
                 For      Street                                 Across
                 AIDS     Burling                                Vermont
                 Resour   ton, VT
                 ces      05401
                 Educ
                 and
                 Servic
                 es
    ------------------------------------------------------------------------
    Monetary    Wright   8101              $5,000     3/3/2014  Case
                 House    Cameron                                Management
                 Wellne   Road                                   for HIV/HCV
                 ss       Suite                                  Clients
                 Center   105
                          Austin,
                          TX
                          78754
    ------------------------------------------------------------------------
    Janssen has also made financial donations to independent charitable
      foundations that assist patients who are underinsured and in financial
      need with treatment-related expenses. In keeping with our donor
      agreements and applicable regulatory guidance, we will only disclose
      aggregate data on our charitable giving and do not publicize
      information on donations to specific foundations and disease states.
      In 2014, we contributed approximately $5.8 million in donations to
      independent charitable foundations, enabling them to provide
      assistance with medication-related copays to patients with infectious
      diseases.

    ----------------------------------------------------------------------------------------------------------------

    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &           $5,615,443    3/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &           $9,794,392    6/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $26,177,458    9/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $58,375,988   12/15/2013  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------

     Janssen Biotech, Inc. Monetary and Product Contributions to U.S.-based
                    Charitable Organizations Full Year 2015
      (Payments made from January 1, 2015 to December 31, 2015)--Amended on
                                February 24, 2017
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date     Description
    ------------------------------------------------------------------------
    Monetary    100      4631              $2,000    7/17/2015  The 100
                 Black    Delmar                                 Black Men
                 Men of   St.                                    of
                 Metrop   Louis,                                 Metropolita
                 olitan   Missour                                n St. Louis
                 St.      i 63108                                Community
                 Louis                                           Health Day
                                                                 Featuring
                                                                 Prostate
                                                                 Cancer Run/
                                                                 Walk
    ------------------------------------------------------------------------
    Monetary    100      4631              $1,800   12/23/2015  The 100
                 Black    Delmar                                 Black Men
                 Men of   St.                                    of
                 Metrop   Louis,                                 Metropolita
                 olitan   Missour                                n St. Louis
                 St.      i 63108                                Community
                 Louis                                           Health Day
                                                                 Featuring
                                                                 Prostate
                                                                 Cancer Run/
                                                                 Walk
    ------------------------------------------------------------------------
    Monetary    Achieve  104               $5,625    12/4/2015  Achieve Now:
                 Now      Gladsto                                Bringing
                          ne                                     Students Up
                          Street                                 to Grade
                          Philade                                Level
                          lphia,                                 Reading
                          PA
                          19148
    ------------------------------------------------------------------------
    Monetary    America  Manasqua         $10,000     4/8/2015  Road To
                 n        n, NJ                                  Recovery
                 Cancer   08736                                  Program
                 Societ
                 y,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    America  Manasqua          $1,000    5/27/2015  2015 Run for
                 n        n, NJ                                  Dad
                 Cancer   08736
                 Societ
                 y,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    America  1626              $1,000     7/8/2015  American
                 n        Locust                                 Cancer
                 Cancer   Street                                 Society,
                 Societ   Philade                                Relay For
                 y,       lphia,                                 Life of the
                 Inc.     PA                                     Wissahickon
                          19103                                  Valley,
                                                                 Ambler, PA
    ------------------------------------------------------------------------
    Monetary    Arthrit  National        $225,000     6/5/2015  Sponsorship
                 is       Office                                 of 117
                 Founda   1330 W.                                Jingle Bell
                 tion     Peachtr                                Run events,
                          ee St.,                                reaching
                          N.W.                                   more than
                          Atlanta                                100,000
                          , GA                                   participant
                          30309                                  s and
                                                                 volunteers,
                                                                 across the
                                                                 country
    ------------------------------------------------------------------------
    Monetary    Arthrit  1817              $2,000     6/4/2015  The
                 is       Central                                Community
                 Servic   Avenue                                 Arthritis
                 es       Suite                                  Project of
                          211                                    Charlotte,
                          Charlot                                Mecklenburg
                          te, NC                                 County,
                          28205                                  North
                                                                 Carolina
    ------------------------------------------------------------------------
    Monetary    Cancer   275               $2,000     7/3/2015  Seventh
                 Care,    Seventh                                Annual
                 Inc.     Avenue                                 Healing
                          New                                    Hearts
                          York,                                  Family
                          NY                                     Bereavement
                          10001                                  Camp
                                                                 Milford, PA
    ------------------------------------------------------------------------
    Monetary    Cancer   3                 $5,000    12/2/2015  Oncology
                 Suppor   Crossro                                Support
                 t        ads                                    Groups
                 Commun   Drive
                 ity      Bedmins
                 Centra   ter, NJ
                 l New    07921
                 Jersey
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk          $1,000    7/10/2015  Paws 4 Life
                 Suppor   Road PO                                Dog Walk,
                 t        Box                                    Warminster
                 Commun   3187                                   PA
                 ity of   Warmins
                 Philad   ter, PA
                 elphia   18974
                 (forme
                 rly
                 Gilda'
                 s Club
                 Bucks/
                 Mont
                 Counti
                 es)
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk          $2,500   10/23/2015  Celebration
                 Suppor   Road PO                                of Hope: A
                 t        Box                                    Free, Full-
                 Commun   3187                                   Day,
                 ity of   Warmins                                Educational
                 Philad   ter, PA                                and
                 elphia   18974                                  Inspiration
                 (forme                                          al
                 rly                                             Conference
                 Gilda'                                          for Greater
                 s Club                                          Philadelphi
                 Bucks/                                          a-Area
                 Mont                                            Cancer
                 Counti                                          Patients,
                 es)                                             Survivors,
                                                                 and
                                                                 Caregivers
    ------------------------------------------------------------------------
    Monetary    Center   1900              $2,000     7/9/2015  Project for
                 for      Cherry                                 Medically
                 Child    Street                                 Needy
                 Advoca   Philade                                Children
                 tes      lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    Childre  6380              $7,500    3/17/2015  Children's
                 ns       Flank                                  Cancer
                 Cancer   Drive,                                 Recovery
                 Recove   Suite                                  Foundation'
                 ry       400                                    s Bear-Able
                 Founda   Harrisb                                Gift
                 tion     urg, PA                                Program:
                          17112                                  administere
                                                                 d to the
                                                                 Children's
                                                                 Hospital of
                                                                 Philadelphi
                                                                 a
    ------------------------------------------------------------------------
    Monetary    Childre  6380              $7,500   12/22/2015  Bear-Able
                 ns       Flank                                  Gifts
                 Cancer   Drive,                                 program
                 Recove   Suite
                 ry       400
                 Founda   Harrisb
                 tion     urg, PA
                          17112
    ------------------------------------------------------------------------
    Monetary    Childre  The               $1,000   12/23/2015  General
                 n's      Childre                                Operating
                 Hospit   n's                                    Support for
                 al of    Hospita                                The Center
                 Philad   l of                                   for
                 elphia   Philade                                Pediatric
                 Founda   lphia                                  Inflammator
                 tion     Foundat                                y Bowel
                          ion                                    Disease
                          Attn:
                          Staci
                          Carney,
                          Associa
                          te
                          Directo
                          r,
                          Corpora
                          te and
                          Foundat
                          ion
                          Relatio
                          ns 100
                          Penn
                          Square
                          East
                          8th
                          Floor,
                          Suite
                          8050
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Childre  The              $12,000     4/8/2016  Family Care
                 n's      Childre                                Binder
                 Hospit   n's                                    Program at
                 al of    Hospita                                The
                 Philad   l of                                   Children's
                 elphia   Philade                                Hospital of
                 Founda   lphia                                  Philadelphi
                 tion     Foundat                                a
                          ion                                    Philadelphi
                          Attn:                                  a, PA
                          Staci
                          Carney,
                          Associa
                          te
                          Directo
                          r,
                          Corpora
                          te and
                          Foundat
                          ion
                          Relatio
                          ns 100
                          Penn
                          Square
                          East
                          8th
                          Floor,
                          Suite
                          8050
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Childre  The               $6,000     4/8/2016  6th Annual
                 n's      Childre                                Walk for
                 Hospit   n's                                    Hope
                 al of    Hospita                                benefiting
                 Philad   l of                                   IBD
                 elphia   Philade                                research at
                 Founda   lphia                                  The
                 tion     Foundat                                Children's
                          ion                                    Hospital of
                          Attn:                                  Philadelphi
                          Staci                                  a, Veterans
                          Carney,                                Park,
                          Associa                                Hamilton,
                          te                                     NJ
                          Directo
                          r,
                          Corpora
                          te and
                          Foundat
                          ion
                          Relatio
                          ns 100
                          Penn
                          Square
                          East
                          8th
                          Floor,
                          Suite
                          8050
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Communi  300B             $20,000    12/8/2015  Free Medical
                 ty       Lawrenc                                and Dental
                 Volunt   e Drive                                Care to
                 eers     West                                   Uninsured,
                 in       Chester                                Low-Income
                 Medici   , PA                                   Individuals
                 ne       19380                                  and
                                                                 Families
                                                                 Who Live or
                                                                 Work in
                                                                 Chester
                                                                 County.
                                                                 Community
                                                                 Volunteers
                                                                 in Medicine
                                                                 is located
                                                                 in West
                                                                 Chester, PA
    ------------------------------------------------------------------------
    Monetary    Crohns   733             $135,000     6/5/2015  CCFA Take
                 and      Third                                  Steps Walk/
                 Coliti   Avenue                                 Run
                 s        Suite
                 Founda   510 New
                 tion     York,
                 of       NY
                 Americ   10017
                 a
    ------------------------------------------------------------------------
    Monetary    Crohn's  733              $18,000     7/7/2015  Camp Oasis--
                 and      Third                                  Program is
                 Coliti   Avenue                                 hosted at
                 s        Suite                                  12 campsite
                 Founda   510 New                                locations
                 tion     York,                                  across the
                 of       NY                                     country
                 Americ   10017
                 a,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Delawar  236              $21,500    3/20/2015  Delaware
                 e        Randell                                Valley
                 Valley   Hall                                   Science
                 Scienc   3141                                   Fairs
                 e        Chestnu                                Philadelphi
                 Fairs,   t                                      a, PA
                 Inc.     Street
                          Philade
                          lphia,
                          PA
                          19104
    ------------------------------------------------------------------------
    Monetary    Family   2001            $250,000   12/21/2015  Family Reach
                 Reach    Route                                  Programmati
                 Founda   46,                                    c Support
                 tion     Suite
                          310
                          Parsipp
                          any, NJ
                          07054
    ------------------------------------------------------------------------
    Monetary    Family   2001             $20,000   12/21/2015  Family Reach
                 Reach    Route                                  Foundation
                 Founda   46,                                    General
                 tion     Suite                                  Support
                          310
                          Parsipp
                          any, NJ
                          07054
    ------------------------------------------------------------------------
    Monetary    Friends  113 West          $3,000   12/14/2015  Homelessness
                 Associ   Chestnu                                to
                 ation    t                                      Independenc
                 For      Street                                 e
                 Care     West                                   Initiative
                 and      Chester
                 Protec   , PA
                 tion     19380
                 Of
                 Childr
                 en
    ------------------------------------------------------------------------
    Monetary    Friends  815 West            $825    9/23/2015  Employee
                 of the   7th                                    directed
                 Queen    Street                                 donation in
                 City     Plainfi                                Lieu of
                 Academ   eld, NJ                                holiday
                 y        07063                                  gift
                 Charte
                 r
                 School
    ------------------------------------------------------------------------
    Monetary    Georgia  Alpharet          $1,500    8/12/2015  Georgia
                 Prosta   ta, GA                                 Prostate
                 te       30022                                  Cancer Free
                 Cancer                                          Screening
                 Coalit                                          Event
                 ion,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Georgia  Alpharet          $1,700   12/23/2015  Georgia
                 Prosta   ta, GA                                 Prostate
                 te       30022                                  Cancer Free
                 Cancer                                          Screening
                 Coalit                                          Event
                 ion,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Girl     330               $3,000   12/14/2015  GSEP STEM
                 Scouts   Manor                                  Programming
                 of       Road
                 Southe   Miquon,
                 astern   PA
                 Pennsy   19444
                 lvania
    ------------------------------------------------------------------------
    Monetary    Girl     501 S.            $1,250    5/27/2015  16th Annual
                 Scouts   College                                Women of
                 of the   Avenue                                 Distinction
                 Chesap   Newark,                                Program and
                 eake     DE                                     Celebration
                 Bay      19713
                 Counci
                 l,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Great    PO Box            $5,000   12/14/2015  GVNC
                 Valley   82 4251                                Environment
                 Nature   State                                  al
                 Center   Road                                   Education
                          Devault                                Programs
                          , PA                                   with
                          19432                                  Schools-
                                                                 Water
                                                                 Quality,
                                                                 Pond,
                                                                 Stream and
                                                                 Habitat
                                                                 Study
    ------------------------------------------------------------------------
    Monetary    Green    1368             $15,000    12/8/2015  Watershed
                 Valley   Prizer                                 Education
                 s        Road                                   Programs
                 Associ   Pottsto
                 ation    wn, PA
                          19465
    ------------------------------------------------------------------------
    Monetary    Habitat  P.O. Box          $1,000   10/27/2015  Habitat for
                 for      1452                                   Humanity of
                 Humani   621                                    Chester
                 ty of    Lumber                                 County
                 Cheste   Street
                 r        Coatesv
                 County   ille,
                 , Inc.   PA
                          19320
    ------------------------------------------------------------------------
    Monetary    Habitat  1829 N.           $5,000   12/14/2015  Habitat for
                 For      19th                                   Humanity
                 Humani   Street                                 Philadelphi
                 ty       Philade                                a
                 Philad   lphia,                                 Homeownersh
                 elphia   PA                                     ip Program
                 , Inc.   19121
    ------------------------------------------------------------------------
    Monetary    Hatboro- 229              $25,000    12/2/2015  STEM
                 Horsha   Meeting                                Programs
                 m        house                                  for Hatboro-
                 Educat   Road                                   Horsham
                 ional    Horsham                                Students
                 Founda   , PA
                 tion     19044
    ------------------------------------------------------------------------
    Monetary    Hope     129                 $300    9/21/2015  Costs
                 for      Yerger                                 associated
                 Kids,    Road                                   with 2015
                 Inc.     Schwenk                                Janssen
                          sville,                                Cares
                          PA                                     Volunteer
                          19473                                  Activity
    ------------------------------------------------------------------------
    Monetary    Kids     26071             $3,000     9/4/2015  Support
                 Connec   Merit                                  Groups for
                 ted      Circle,                                Children of
                          #103                                   Cancer
                          Laguna                                 Patients
                          Hills,                                 Costa Mesa,
                          CA                                     Ca Brea, Ca
                          92653-                                 Santa Ana,
                          7016                                   Ca Laguna
                                                                 Hills, Ca
                                                                 La Jolla,
                                                                 Ca
                                                                 Temecula,
                                                                 Ca
    ------------------------------------------------------------------------
    Monetary    Metropo  2323             $20,000    12/7/2015  Medically
                 litan    Ranstea                                Appropriate
                 Area     d                                      Meals for
                 Neighb   Street                                 People with
                 orhood   Philade                                Critical
                 Nutrit   lphia,                                 Illnesses
                 ion      PA
                 Allian   19103
                 ce
                 (MANNA
                 )
    ------------------------------------------------------------------------
    Monetary    Montgom  340              $10,000   12/15/2015  Bridge to
                 ery      DeKalb                                 Employment
                 County   Pike                                   Program
                 Commun   Blue                                   Enhancement
                 ity      Bell,                                  through
                 Colleg   PA                                     Strategies
                 e        19422                                  for Success
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Movembe  Culver            $5,000    5/22/2015  Movember is
                 r        City,                                  a national
                 Founda   CA                                     US campaign
                 tion     90232                                  where we
                                                                 ask men to
                                                                 grow
                                                                 moustaches
                                                                 to raise
                                                                 awareness
                                                                 and funds
                                                                 for men's
                                                                 health
    ------------------------------------------------------------------------
    Monetary    Multipl  51 Locus          $5,000    7/10/2015  2015 MMRF
                 e        Avenue                                 Team for
                 Myelom   Suite                                  Cures: New
                 a        201                                    York City
                 Resear   Norwalk                                5K Walk/Run
                 ch       , CT
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  51 Locus          $5,000    7/10/2015  2015 MMRF
                 e        Avenue                                 Team for
                 Myelom   Suite                                  Cures:
                 a        201                                    Philadelphi
                 Resear   Norwalk                                a 5K Walk/
                 ch       , CT                                   Run
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  383 Main         $10,000    7/13/2015  MMRF Team
                 e        Avenue                                 for Cures
                 Myelom   5th                                    Sponsor--NY
                 a        Floor                                  C Marathon,
                 Resear   Norwalk                                (NY, NY)
                 ch       , CT                                   and Fenway
                 Founda   06851                                  Spartan
                 tion                                            Race
                                                                 (Boston, MA
                                                                 )
    ------------------------------------------------------------------------
    Monetary    Nationa  4719              $2,500     4/8/2015  17th Annual
                 l        Reed                                   Break the
                 Ovaria   Road                                   Silence on
                 n        #150                                   Ovarian
                 Cancer   Holicon                                Cancer
                 Coalit   g, PA                                  Philadelphi
                 ion--C   18928                                  a, PA
                 entral
                 Ohio
                 Chapte
                 r
    ------------------------------------------------------------------------
    Monetary    Nationa  6600 SW          $75,000    4/14/2015  2015 Team
                 l        02nd                                   NPF Walk--
                 Psoria   Avenue,                                National
                 sis      Ste.                                   (19 U.S.
                 Founda   300                                    cities)
                 tion     Portlan
                          d, OR
                          97223
    ------------------------------------------------------------------------
    Monetary    Pennypa  7005                $300    9/21/2015  Costs
                 ck       Sheaff                                 associated
                 Farm     Lane                                   with 2015
                 and      Fort                                   Janssen
                 Educat   Washing                                Cares
                 ion      ton, PA                                Volunteer
                 Center   19034                                  Activity
    ------------------------------------------------------------------------
    Monetary    Project  1515              $1,000    12/2/2015  Mental
                 HOME     Fairmou                                Health and
                          nt                                     Recovery
                          Avenue                                 Services
                          Philade                                for
                          lphia,                                 Individuals
                          PA                                     Who Have
                          19130                                  Experienced
                                                                 Homelessnes
                                                                 s
    ------------------------------------------------------------------------
    Monetary    Prostat  7009 S.          $30,000    7/13/2015  Prostate
                 e        Potomac                                Cancer
                 Cancer   Street                                 Disparities
                 Educat   Suite                                  Outreach
                 ion      125                                    Program--A
                 Counci   Centenn                                national,
                 l        ial, CO                                ten city
                          80112                                  event
    ------------------------------------------------------------------------
    Monetary    Prostat  7009 S.          $20,000   12/23/2015  Prostate
                 e        Potomac                                Cancer
                 Cancer   Street                                 Disparities
                 Educat   Suite                                  Outreach
                 ion      125                                    Program--A
                 Counci   Centenn                                national,
                 l        ial, CO                                ten city
                          80112                                  event
    ------------------------------------------------------------------------
    Monetary    Rebuild  P.O. Box          $6,000    3/17/2015  House Build
                 ing      42752
                 Togeth   Philade
                 er       lphia,
                 Philad   PA
                 elphia   19101-
                          2752
    ------------------------------------------------------------------------
    Monetary    Retired  925              $10,000    3/20/2015  RSVP's My
                 and      Harvest                                Free Tutor
                 Senior   Drive,                                 (MFT) and
                 Volunt   Suite                                  Family
                 eer      100                                    Literacy
                 Progra   Blue                                   Volunteer
                 m of     Bell,                                  Program
                 Montgo   PA                                     (FLVP)
                 mery     19422
                 County
    ------------------------------------------------------------------------
    Monetary    Retired  925               $5,000     7/9/2015  RSVP's
                 and      Harvest                                Protege and
                 Senior   Drive,                                 America
                 Volunt   Suite                                  Reads/
                 eer      100                                    Writes
                 Progra   Blue                                   Programs
                 m of     Bell,
                 Montgo   PA
                 mery     19422
                 County
    ------------------------------------------------------------------------
    Monetary    Retired  925              $10,000    12/7/2015  RSVP's
                 and      Harvest                                Family
                 Senior   Drive,                                 Literacy
                 Volunt   Suite                                  Volunteer
                 eer      100                                    Program
                 Progra   Blue                                   (FLVP) and
                 m of     Bell,                                  My Free
                 Montgo   PA                                     Tutor (MFT)
                 mery     19422                                  virtual
                 County                                          STEM
                                                                 tutoring
                                                                 and career
                                                                 awareness
                                                                 program.
    ------------------------------------------------------------------------
    Monetary    Riverbe  1950              $6,000     7/3/2015  Outreach to
                 nd       Spring                                 Children/
                 Enviro   Mill                                   Access to
                 nmenta   Road                                   Nature
                 l        Gladwyn                                (Norristown
                 Educat   e, PA                                  , PA)
                 ion      19035
                 Center
    ------------------------------------------------------------------------
    Monetary    Sandy    2010              $2,000    5/15/2015  11th Annual
                 Rollma   West                                   Sandy
                 n        Chester                                Sprint 5K/
                 Ovaria   Pike                                   10K Run/
                 n        Suite                                  Walk
                 Cancer   300
                 Founda   Haverto
                 tion,    wn, PA
                 Inc.     19083
    ------------------------------------------------------------------------
    Monetary    Senior   536                 $500    8/12/2015  2015 Meals
                 Adult    George                                 On Wheels
                 Activi   St.                                    Outrunning
                 ties     Norrist                                Senior
                 Center   own, PA                                Hunger 5k/
                 of       19401                                  3k. Mont Co
                 Montgo                                          Comm
                 mery                                            College,
                 County                                          Blue Bell,
                                                                 PA. Meals
                                                                 On Wheels
                                                                 of the
                                                                 Senior
                                                                 Adult
                                                                 Activities
                                                                 Center of
                                                                 Montgomery
                                                                 County
                                                                 impacts
                                                                 homebound
                                                                 seniors in
                                                                 Central,
                                                                 North Penn
                                                                 and the
                                                                 Eastern
                                                                 Montgomery
                                                                 Co areas.
    ------------------------------------------------------------------------
    Monetary    Senior   536                 $300    8/20/2015  Costs
                 Adult    George                                 associated
                 Activi   St.                                    with 2015
                 ties     Norrist                                Janssen
                 Center   own, PA                                Cares
                 of       19401                                  Volunteer
                 Montgo                                          Activity
                 mery
                 County
    ------------------------------------------------------------------------
    Monetary    Special  2800                $300    8/20/2015  Costs
                 Equest   Street                                 associated
                 rians    Road                                   with 2015
                          P.O.                                   Janssen
                          Box                                    Cares
                          1001                                   Volunteer
                          Warring                                Activity
                          ton, PA
                          18976
    ------------------------------------------------------------------------
    Monetary    Special  2800              $4,000    9/23/2015  Special
                 Equest   Street                                 Equestrians
                 rians    Road                                   Equine
                          P.O.                                   Assisted
                          Box                                    Learning
                          1001                                   and
                          Warring                                Therapeutic
                          ton, PA                                Riding
                          18976                                  Program
                                                                 Warrington,
                                                                 PA
    ------------------------------------------------------------------------
    Monetary    Starfin  4015             $10,000    3/20/2015  Youth
                 der      Main                                   Development
                 Founda   Street                                 through
                 tion     Philade                                Soccer and
                          lphia,                                 Education
                          PA                                     Philadelphi
                          19127                                  a, PA
    ------------------------------------------------------------------------
    Monetary    Stop     2501             $40,700    5/22/2015  Janssen
                 Hunger   Clark                                  Biotech and
                 Now      Street,                                Stop Hunger
                          Suite                                  Now Engage
                          301                                    Employee
                          Raleigh                                Volunteers
                          , NC                                   in Dallas,
                          27607                                  Texas
    ------------------------------------------------------------------------
    Monetary    The      222              $10,000   11/26/2015  Corporate
                 Frankl   North                                  Membership
                 in       20th
                 Instit   Street
                 ute      Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    The      Gwynedd           $3,000     7/3/2015  General
                 Giving   Valley,                                Operating
                 Tree     PA                                     Support
                          19437
    ------------------------------------------------------------------------
    Monetary    The      2600             $10,000     4/8/2015  Hubert J.P.
                 Melmar   Wayland                                Schoemaker
                 k        Road                                   Classic
                 Charit   Berwyn,
                 able     PA
                 Founda   19312
                 tion
    ------------------------------------------------------------------------
    Monetary    The      2600                $300    8/21/2015  Costs
                 Melmar   Wayland                                associated
                 k        Road                                   with 2015
                 Charit   Berwyn,                                Janssen
                 able     PA                                     Cares
                 Founda   19312                                  Volunteer
                 tion                                            Activity
    ------------------------------------------------------------------------
    Monetary    The      400                 $300    8/20/2015  Costs
                 Pennsb   Pennsbu                                associated
                 ury      ry                                     with 2015
                 Societ   Memoria                                Janssen
                 y        l Road                                 Cares
                          Morrisv                                Volunteer
                          ille,                                  Activity
                          PA
                          19067
    ------------------------------------------------------------------------
    Monetary    Trustee  3025              $5,000   12/23/2015  WXPN
                 s Of     Walnut                                 Musicians
                 The      Street                                 On Call
                 Univer   Philade
                 sity     lphia,
                 Of       PA
                 Pennsy   19104
                 lvania
    ------------------------------------------------------------------------
    Monetary    United   1709            $260,045   12/23/2015  United Way
                 Way of   Benjami                                Campaign
                 Southe   n                                      Match
                 astern   Frankli
                 Pennsy   n
                 lvania   Parkway
                          Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    Us Too   5003              $1,000     4/8/2015  11th Annual
                 Intern   Fairvie                                SEA Blue
                 ationa   w Ave.                                 Prostate
                 l,       Downers                                Cancer 5K
                 Inc.     Grove,                                 Run and
                          IL                                     Celebration
                          60515                                  Walk in
                                                                 Chicago, IL
    ------------------------------------------------------------------------
    Monetary    Zero     515 King         $75,000     4/8/2015  ZERO
                 The      Street,                                Prostate
                 Projec   Suite                                  Cancer Run/
                 t To     420                                    Walk Series
                 End      Alexand                                40-plus
                 Prosta   ria, VA                                cities
                 te       22314                                  nationwide
                 Cancer                                          running
                                                                 from March
                                                                 to November
                                                                 2015
    ------------------------------------------------------------------------
    Monetary    Zero     515 King          $8,000   10/23/2015  ZERO
                 The      Street,                                Baltimore
                 Projec   Suite                                  Free
                 t To     420                                    Prostate
                 End      Alexand                                Cancer
                 Prosta   ria, VA                                Screening
                 te       22314                                  Program
                 Cancer
    ------------------------------------------------------------------------
    Janssen has also made financial donations to independent charitable
      foundations that assist patients who are underinsured and in financial
      need with treatment-related expenses. In keeping with our donor
      agreements and applicable regulatory guidance, we will only disclose
      aggregate data on our charitable giving and do not publicize
      information on donations to specific foundations and disease states.
      In 2015, we contributed $29.5 million in donations to independent
      charitable foundations, enabling them to provide assistance with
      medication-related copays to patients with cancer and autoimmune
      diseases.

    ----------------------------------------------------------------------------------------------------------------

    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $87,940,000    3/15/2015  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $69,856,000    6/15/2015  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $60,259,000    9/15/2015  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $70,842,000   12/15/2015  Patient Assistance
                           Patient Assistance    Johnson Plaza, New                               Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Updated February 24, 2017

    Janssen Pharmaceuticals, Inc. Monetary and Product Contributions to U.S.-
                  based Charitable Organizations Full Year 2015
            (Payments made from January 1, 2015 to December 31, 2015)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date     Description
    ------------------------------------------------------------------------
    Monetary    180      1                 $1,000    11/3/2015  Youth
                 Turnin   Bethany                                Helpline
                 g        Road,
                 Lives    Buildin
                 Around   g 3,
                 , Inc.   Suite
                          42
                          Hazlet,
                          NJ
                          07730
    ------------------------------------------------------------------------
    Monetary    Adult    872. E.             $600    8/20/2015  Costs
                 Day      Main                                   associated
                 Center   Street                                 with 2015
                 of       Bridgew                                Janssen
                 Somers   ater,                                  Cares
                 et       NJ                                     Volunteer
                 County   08807                                  Activity
    ------------------------------------------------------------------------
    Monetary    Advanci  1005              $2,500   10/23/2015  College
                 ng       Whitehe                                Aspire and
                 Opport   ad Road                                Inquire
                 unitie   Extensi                                Program
                 s,       on,
                 Inc.     Suite 1
                          Ewing,
                          NJ
                          08520
    ------------------------------------------------------------------------
    Monetary    Allies,  1262              $7,500   11/16/2015  Project Grow-
                 Inc.     Whiteho                                Allies Farm
                          rse-                                   Program
                          Hamilto                                located on
                          n                                      the Grounds
                          Square                                 of Mercer
                          Road                                   County
                          Buildin                                Community
                          g A,                                   College,
                          Suite                                  West
                          101                                    Windsor, NJ
                          Hamilto
                          n, NJ
                          08690
    ------------------------------------------------------------------------
    Monetary    America  6500                $600    1/22/2015  Employee
                 n        Sugarlo                                directed
                 Cancer   af                                     donation in
                 Societ   Parkway                                lieu of
                 y        , Suite                                company
                          260                                    holiday
                          Duluth,                                gift
                          GA
                          30097
    ------------------------------------------------------------------------
    Monetary    America  Buffalo             $100    3/12/2015  Memorial
                 n        Hope                                   donation
                 Cancer   Lodge
                 Societ   197
                 y        Summer
                          Street
                          Buffalo
                          , NY
                          14222
    ------------------------------------------------------------------------
    Monetary    America  1160             $30,000   10/29/2015  Diabetes
                 n        Route                                  Interventio
                 Diabet   22 East                                n Project
                 es       Suite                                  ($30K) and
                 Associ   103                                    the General
                 ation    Bridege                                Education
                          water,                                 Outreach
                          NJ                                     ($10K)
                          08807
    ------------------------------------------------------------------------
    Monetary    America  1701            $125,000    12/8/2015  American
                 n        North                                  Diabetes
                 Diabet   Beaureg                                Association
                 es       ard                                    's What Can
                 Associ   Street                                 I Eat?
                 ation,   Alexand                                Choices for
                 Inc.     ria, VA                                People with
                          22311                                  Type 2
                                                                 Diabetes
    ------------------------------------------------------------------------
    Monetary    America  1392 CR          $30,000   12/23/2015  Atrial
                 n        2740,                                  Fibrillatio
                 Founda   Decatur                                n Patient
                 tion     , TX                                   Education
                 For      76234-                                 and Support
                 Womens   7401
                 Health
    ------------------------------------------------------------------------
    Monetary    America  7272             $10,000    12/8/2015  Garden State
                 n        Greenvi                                Go Red For
                 Heart    lle                                    Women
                          Avenue                                 Luncheon
                          Dallas,
                          TX
                          75231
    ------------------------------------------------------------------------
    Monetary    America  1000            $210,000   12/17/2015  Judges'
                 n        Wilson                                 Leadership
                 Psychi   Blvd,                                  Initiative-
                 atric    Suite                                  Psychiatric
                 Founda   1825                                   Leadership
                 tion     Arlingt                                for
                          on, VA                                 Criminal
                          22209                                  Justice
                                                                 (JLI/PLCJ)
    ------------------------------------------------------------------------
    Monetary    America  1000             $35,000   12/17/2015  Partnership
                 n        Wilson                                 for
                 Psychi   Blvd,                                  Workplace
                 atric    Suite                                  Mental
                 Founda   1825                                   Health
                 tion     Arlingt
                          on, VA
                          22209
    ------------------------------------------------------------------------
    Monetary    America  1000            $100,000   12/17/2015  Typical or
                 n        Wilson                                 Troubled?
                 Psychi   Blvd,                                  Student
                 atric    Suite                                  Mental
                 Founda   1825                                   Health
                 tion     Arlingt                                Education
                          on, VA                                 Program
                          22209
    ------------------------------------------------------------------------
    Monetary    America  707              $94,250   12/17/2015  Effort to
                 n Red    Alexand                                support
                 Cross    er Road                                disaster
                          Princet                                relief
                          on, NJ                                 american
                          08550                                  military
                                                                 families,
                                                                 health and
                                                                 safety
                                                                 services,
                                                                 internation
                                                                 al aid, and
                                                                 blood
                                                                 donation
                                                                 services
                                                                 within
                                                                 central New
                                                                 Jersey and
                                                                 across the
                                                                 US
    ------------------------------------------------------------------------
    Monetary    AmeriCa  88                $4,600    12/8/2015  General
                 res      Hamilto                                mission
                 Founda   n Ave                                  support
                 tion     Stamfor
                          d, CT
                          06902
    ------------------------------------------------------------------------
    Monetary    Anchor   482                 $812    4/16/2015  General
                 House,   Centre                                 Operating
                 Inc.     Street                                 Support
                          Trenton
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Anderso  PO Box              $300    8/19/2015  Costs
                 n        134 532                                associated
                 House    Route                                  with 2015
                          523                                    Janssen
                          Whiteho                                Cares
                          use                                    Volunteer
                          Station                                Activity
                          , NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    Anderso  532              $19,000    12/3/2015  Integrated
                 n        County                                 Care
                 House    Road                                   Management
                          523
                          P.O.
                          Box 134
                          Whiteho
                          use
                          Station
                          , NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    Ann      595 West          $9,500   11/12/2015  Ann
                 Silver   State                                  Silverman
                 man      Street                                 Community
                 Commun   Doylest                                Health
                 ity      own, PA                                Clinic for
                 Health   18901                                  Bucks
                 Clinic                                          County
                                                                 residents
    ------------------------------------------------------------------------
    Monetary    Arc      141               $3,500    11/2/2015  Fundraising
                 Founda   South                                  event
                 tion     Main                                   support to
                 Of       Street                                 benefit
                 Somers   Manvill                                general
                 et       e, NJ                                  mission of
                 County   08835                                  organizatio
                 , Inc.                                          n
    ------------------------------------------------------------------------
    Monetary    Associa  819               $9,000   11/16/2015  Partial Care
                 tion     Alexand                                Day
                 for      er Road                                Treatment,
                 Advanc   Princet                                Physical
                 ement    on, NJ                                 Health
                 of       08540                                  Expansion
                 Mental
                 Health
    ------------------------------------------------------------------------
    Monetary    Athens   7 N.              $1,000     7/1/2015  Mental
                 Mental   Congres                                Health
                 Health   s St.                                  Awarenss
                 , Inc.   Athens,                                Event: 2nd
                          OH                                     Annual
                          45701                                  Community
                                                                 Illuminatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Autism   1060              $1,000   11/16/2015  Autism
                 Speaks   State                                  Resource
                          Road                                   Fair
                          2nd                                    Sponsor
                          Floor                                  2016
                          Princet                                Central NJ
                          on, NJ                                 Walk Now
                          08540                                  for Autism
                                                                 Speaks
    ------------------------------------------------------------------------
    Monetary    Bay      66 Canal          $5,000    6/22/2015  Bay Cove
                 Cove     St                                     Wellness
                 Human    Boston,                                Center to
                 Servic   MA                                     assist
                 es,      02114                                  diverse low-
                 Inc.                                            income
                                                                 clients who
                                                                 are working
                                                                 towards
                                                                 recovery
                                                                 from severe
                                                                 mental
                                                                 illness
    ------------------------------------------------------------------------
    Monetary    Bentley  PO Box              $300    8/11/2015  Costs
                 Commun   1093                                   associated
                 ity      Belle                                  with 2015
                 Servic   Mead,                                  Janssen
                 es,      NJ                                     Cares
                 Inc.     08502                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Big      2875              $6,500   11/16/2015  The STEM
                 Brothe   York                                   School
                 rs Big   Road                                   Mentoring
                 Sister   Jamison                                program
                 s of     , PA                                   (Centennial
                 Bucks    18966                                  , Bensalem,
                 County                                          Bristol
                                                                 Township,
                                                                 and
                                                                 Pennsbury
                                                                 school
                                                                 districts
                                                                 in Bucks
                                                                 County, PA)
    ------------------------------------------------------------------------
    Monetary    Big      2 West            $7,500   10/13/2015  Big Brothers
                 Brothe   Washing                                Big Sisters
                 rs Big   ton                                    of
                 Sister   Avenue,                                Hunterdon
                 s of     Suite                                  Somerset
                 Hunter   210 PO                                 and Warren
                 don      Box 123
                 Somers   Washing
                 et and   ton, NJ
                 Warren   07882
                 Counti
                 es
    ------------------------------------------------------------------------
    Monetary    Big      535 East          $6,500    9/28/2015  Youth
                 Brothe   Frankli                                Mentoring
                 rs Big   n                                      Program
                 Sister   Street                                 Support
                 s of     Trenton
                 Mercer   , NJ
                 County   08610
    ------------------------------------------------------------------------
    Monetary    Boys     212              $22,500    12/8/2015  Career
                 and      Centre                                 Launch
                 Girls    Street
                 Club     Trenton
                 of       , NJ
                 Trento   08611
                 n and
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Bristol  120               $7,500   11/12/2015  ArtRageous
                 Rivers   Radclif                                Theatre
                 ide      fe                                     Arts
                 Theate   Street                                 Education
                 r Co,    Bristol                                Program
                 Inc.     , PA
                          19007
    ------------------------------------------------------------------------
    Monetary    Broward  305 SE           $12,500    7/21/2015  Affordable
                 County   18th                                   Rental
                 Commun   Court                                  Housing
                 ity      Fort                                   program
                 Develo   Lauderd
                 pment    ale, FL
                 Corpor   33316
                 ation,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Bucks    1069              $5,000   11/16/2015  Bucks County
                 County   Jackson                                Veterans
                 Housin   ville                                  Housing
                 g        Road                                   Assistance
                 Group    Ivyland                                Program
                          , PA
                          18974
    ------------------------------------------------------------------------
    Monetary    Caminar  2600 S.           $2,500     4/9/2015  First Annual
                          El                                     Mental
                          Camino                                 Health
                          Real,                                  Symposium:
                          Suite                                  New
                          200 San                                Research in
                          Mateo,                                 Mental
                          CA                                     Health and
                          94403                                  its Impact
                                                                 on
                                                                 Treatment
    ------------------------------------------------------------------------
    Monetary    Camp     P.O. Box         $10,000   12/11/2015  Camp Odayin--
                 Odayin   2068                                   a camp with
                          Stillwa                                heart
                          ter, MN
                          55082
    ------------------------------------------------------------------------
    Monetary    Carrier  PO Box              $300    8/19/2015  Costs
                 Clinic   147 252                                associated
                          Route                                  with 2015
                          601                                    Janssen
                          Belle                                  Cares
                          Mead,                                  Volunteer
                          NJ                                     Activity
                          08502
    ------------------------------------------------------------------------
    Monetary    Catholi  25 Ikea           $4,000    10/2/2015  Catholic
                 c        Drive                                  Charities,
                 Charit   Westham                                Diocese of
                 ies      pton,                                  Trenton On
                          NJ                                     My Own--
                          08060                                  Supportive
                                                                 Housing
                                                                 Program
                                                                 Services
    ------------------------------------------------------------------------
    Monetary    Catholi  25 Ikea          $15,000    10/6/2015  Partners In
                 c        Drive                                  Recovery
                 Charit   Westham
                 ies      pton,
                          NJ
                          08060
    ------------------------------------------------------------------------
    Monetary    Catholi  920               $4,000   11/16/2015  CYO's Broad
                 c        South                                  St. Center
                 Youth    Broad                                  After
                 Organi   Street                                 School
                 zation   Trenton                                Program
                 of       , NJ                                   Tutoring
                 Mercer   08611                                  Project
                 County
    ------------------------------------------------------------------------
    Monetary    Center   11                  $600    8/19/2015  Costs
                 for      Minneak                                associated
                 Educat   oning                                  with 2015
                 ional    Road                                   Janssen
                 Advanc   Fleming                                Cares
                 ement    ton, NJ                                Volunteer
                          08822                                  activity
    ------------------------------------------------------------------------
    Monetary    Center   11               $12,000   11/25/2015  CORE Values
                 for      Minneak                                job
                 Educat   oning                                  readiness
                 ional    Road                                   program
                 Advanc   Fleming
                 ement    ton, NJ
                          08822
    ------------------------------------------------------------------------
    Monetary    Child    204 N.            $3,000    9/28/2015  Teen
                 Home     West                                   Prenatal
                 and      Street                                 and
                 Commun   #101                                   Parenting
                 ity      Doylest                                Continuum
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    Childre  635               $5,000    3/30/2015  Fundraising
                 n's      South                                  event
                 Home     Clinton                                support to
                 Societ   Avenue                                 benefit
                 y of     Trenton                                general
                 New      , NJ                                   mission of
                 Jersey   08611                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Childre  635               $5,000   12/22/2015  Fundraising
                 n's      South                                  event
                 Home     Clinton                                support to
                 Societ   Avenue                                 benefit
                 y of     Trenton                                general
                 New      , NJ                                   mission of
                 Jersey   08611                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Childre  635              $10,000   12/22/2015  CUNA and
                 n's      South                                  Body and
                 Home     Clinton                                Soul
                 Societ   Avenue                                 Prenatal
                 y of     Trenton                                Health
                 New      , NJ                                   Education
                 Jersey   08611                                  Program
    ------------------------------------------------------------------------
    Monetary    Cit      111 S.            $3,000   10/13/2015  Silver level
                 Intern   Highlan                                sponsor of
                 ationa   d St.                                  the 2016
                 l,       Box 71                                 Internation
                 Inc.     Memphis                                al
                          , TN                                   Conference
                          38111
    ------------------------------------------------------------------------
    Monetary    College  50 Milk          $20,000    12/8/2015  Assessing
                 Diabet   St 16th                                the unmet
                 es       Floor                                  needs of
                 Networ   Boston,                                young
                 k,       MA                                     adults with
                 Inc.     02109                                  diabetes on
                                                                 college
                                                                 campuses
    ------------------------------------------------------------------------
    Monetary    College  2000             $22,500   12/17/2015  Nursing
                 of New   Penning                                Merit
                 Jersey   ton                                    Scholarship
                          Road                                   s ($10,000)
                          P.O.                                   and
                          Box                                    Educational
                          7718                                   Opportunity
                          Ewing,                                 Fund
                          NJ                                     Promise
                          08628                                  Awards
                                                                 ($12,500)
    ------------------------------------------------------------------------
    Monetary    Colorad  1031              $2,500    7/28/2015  Peer Support
                 o        33rd                                   Coach
                 Mental   Street,                                Training
                 Wellne   Suite
                 ss       237
                 Networ   Denver,
                 k        CO
                          80205
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box            $5,000    8/18/2015  Rise Summer
                 ty       88 116                                 Healthy
                 Action   North                                  Food
                 Servic   Main                                   Initiative
                 e        Street                                 for low
                 Center   Hightst                                income
                 , Inc.   own, NJ                                youth.
                          08520
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box          $200,000   11/25/2015  Johnson &
                 ty       338                                    Johnson
                 Founda   Morrist                                Somerset
                 tion     own, NJ                                County
                 of New   07963                                  Companies
                 Jersey                                          Contributio
                                                                 n Fund at
                                                                 the
                                                                 Community
                                                                 Foundation
                                                                 of NJ
    ------------------------------------------------------------------------
    Monetary    Communi  15                $7,000   12/25/2015  Donation to
                 ty       Highlan                                be split
                 Health   d                                      evenly
                 Charit   Avenue                                 across
                 ies      Matawan                                charitable
                          , NJ                                   organizatio
                          07747                                  ns which
                                                                 serve
                                                                 patients in
                                                                 their
                                                                 therapeutic
                                                                 areas
    ------------------------------------------------------------------------
    Monetary    Communi  P.O. Box         $16,000   11/24/2015  Each One,
                 ty       15176                                  Teach One:
                 Health   407                                    An Evidence
                 Coalit   Crutchf                                Based
                 ion,     ield                                   Diabetes
                 Inc.     Street                                 Self-
                          Durham,                                Management
                          NC                                     Workshop
                          27704                                  and
                                                                 Community
                                                                 Leaders
                                                                 Training
    ------------------------------------------------------------------------
    Monetary    Communi  959              $12,000    5/15/2015  Pathway to
                 ty       Route                                  Recovery
                 Hope,    46                                     Residential
                 Inc.     East,                                  Programs
                          Suite                                  ($10,000)
                          402                                    The Annual
                          Parsipp                                Learning
                          any, NJ                                Forum on
                          07054                                  Mental
                                                                 Health and
                                                                 Wellness
                                                                 Fair
                                                                 ($2,000)
    ------------------------------------------------------------------------
    Monetary    Communi  959              $12,000    10/6/2015  Hope for
                 ty       Route                                  Veterans
                 Hope,    46                                     and Valley
                 Inc.     East,                                  Brook
                          Suite                                  Village for
                          402                                    Veterans
                          Parsipp
                          any, NJ
                          07054
    ------------------------------------------------------------------------
    Monetary    Communi  310 W.            $5,000    9/28/2015  Making the
                 ty       State                                  Invisible
                 Justic   Street,                                Visible--Le
                 e        3rd                                    gal
                 Center   Floor                                  Services
                 , Inc.   Trenton                                for the
                          , NJ                                   Underserved
                          08618
    ------------------------------------------------------------------------
    Monetary    Communi  507 E.            $4,000     7/1/2015  Compeer
                 ty       College                                Program of
                 Mental   Street                                 Johnson
                 Health   Iowa                                   County,
                 Center   City,                                  Iowa
                 For      IA
                 Mid-     52245
                 Easter
                 n Iowa
                 dba
                 Compee
                 r
                 Progra
                 m,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Compeer  259               $2,500    7/16/2015  Youth and
                 Roches   Monroe                                 Family
                 ter,     Avenue                                 Mentoring
                 Inc.     Rochest                                Program--Fa
                          er, NY                                 mily
                          14607                                  Support
    ------------------------------------------------------------------------
    Monetary    Contact  60 S.             $5,000    8/18/2015  Fundraising
                 Of       Main                                   event
                 Mercer   Street                                 support to
                 County   Penning                                benefit
                 New      ton, NJ                                general
                 Jersey   08534                                  mission of
                 , Inc.                                          organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Contact  60 S.             $8,500    12/1/2015  CRISIS
                 Of       Main                                   HOTLINE,
                 Mercer   Street                                 CRISIS
                 County   Penning                                CHAT, and
                 New      ton, NJ                                TxtToday
                 Jersey   08534                                  Programs
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    CONTACT  P.O. Box          $3,500    5/14/2015  Crisis
                 We       2376                                   Interventio
                 Care,    Westfie                                n for
                 Inc.     ld, NJ                                 Nonprofessi
                          07091                                  onals for
                                                                 People
                                                                 Experiencin
                                                                 g Psychosis
    ------------------------------------------------------------------------
    Monetary    Court    1450             $15,000   11/13/2015  CASA of
                 Appoin   Parksid                                Mercer
                 ted      e                                      County
                 Specia   Avenue,                                Child
                 l        Suite                                  Advocacy
                 Advoca   22                                     Program for
                 tes      Suite                                  Abused and
                          22                                     Neglected
                          Ewing,                                 Children
                          NJ
                          08638
    ------------------------------------------------------------------------
    Monetary    Daytop   362               $2,500   12/10/2015  Daytop of NJ
                 Villag   Sunset                                 at Crawford
                 e Of     Rd                                     House--work
                 New      Skillma                                readiness
                 Jersey   n, NJ                                  initiative
                 , Inc.   08558
    ------------------------------------------------------------------------
    Monetary    Deborah  212               $2,000    11/3/2015  Women's
                 Hospit   Trenton                                Heart
                 al       Road                                   Health
                 Founda   Browns                                 Symposium
                 tion     Mills,
                          NJ
                          08015
    ------------------------------------------------------------------------
    Monetary    Delawar  14                  $300    8/19/2015  Costs
                 e        Michael                                associated
                 River    McCorri                                with 2015
                 Steamb   stin                                   Janssen
                 oat      Road                                   Cares
                 Floati   Hamilto                                Volunteer
                 ng       n, NJ                                  Activity
                 Classr   08690
                 oom,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Delawar  14                $4,900   11/16/2015  Environmenta
                 e        Michael                                l education
                 River    McCorri                                for
                 Steamb   stin                                   underfunded
                 oat      Road                                   and
                 Floati   Hamilto                                underserved
                 ng       n, NJ                                  schools and
                 Classr   08690                                  youth
                 oom,                                            groups
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Denver   3501 E               $75     2/6/2015  Employee
                 Rescue   46th                                   directed
                 Missio   Avenue                                 donation in
                 n        Denver,                                lieu of
                          CO                                     company
                          80216                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Depress  C/O               $1,000     6/4/2015  DBSA NJ
                 ion      David                                  Annual
                 and      Mizenko                                Conference
                 Bipola   5                                      for Support
                 r        Village                                Group
                 Suppor   Ct                                     Participant
                 t        Lawrenc                                s
                 Allian   eville,
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Depress  C/O               $1,000     6/4/2015  DBSA NJ
                 ion      David                                  Mutual Aid
                 and      Mizenko                                Support
                 Bipola   5                                      Group
                 r        Village                                Facilitator
                 Suppor   Ct                                     Training
                 t        Lawrenc
                 Allian   eville,
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Desert   1695 N.           $3,500    7/28/2015  Quality of
                 Aids     Sunrise                                life
                 Projec   Way                                    services
                 t        Palm                                   for
                          Springs                                patients
                          , CA                                   with
                          92262                                  schizophren
                                                                 ia and
                                                                 schizo-
                                                                 affective
                                                                 disorders
    ------------------------------------------------------------------------
    Monetary    Detroit  10                $5,000    7/16/2015  InSHAPE
                 Centra   Peterbo                                Program
                 l City   ro                                     (Individual
                 Commun   Detroit                                ized Self
                 ity      , MI                                   Health
                 Mental   48201                                  Action Plan
                 Health                                          for
                 , Inc.                                          Empowerment
                                                                 )
    ------------------------------------------------------------------------
    Monetary    Detroit  645                 $750     2/9/2015  Employee
                 Metrop   Griswol                                directed
                 olitan   d,                                     donation in
                 Bar      Suite                                  lieu of
                 Associ   1356                                   company
                 ation    Detroit                                holiday
                 Founda   , MI                                   gift
                 tion     48226
    ------------------------------------------------------------------------
    Monetary    Diabete  13               $15,000   10/21/2015  Medical
                 s        Sunflow                                Assistance
                 Founda   er                                     and Patient
                 tion     Avenue,                                Support
                          Suite                                  Services
                          1010
                          Paramus
                          , NJ
                          07652
    ------------------------------------------------------------------------
    Monetary    Diabete  13                $5,000   12/11/2015  Medical
                 s        Sunflow                                Assistance
                 Founda   er                                     and Patient
                 tion     Avenue,                                Support
                          Suite                                  Services
                          1010
                          Paramus
                          , NJ
                          07652
    ------------------------------------------------------------------------
    Monetary    Diabete  319 N.           $20,000    12/1/2015  DiabetesSist
                 s        Weber                                  ers'
                 Sister   Road,                                  Minority
                 s        pmb                                    Initiative
                          #163
                          Bolingb
                          rook,
                          IL
                          60490
    ------------------------------------------------------------------------
    Monetary    Dress    3131              $9,000   11/16/2015  Roads to
                 for      Princet                                Success:
                 Succes   on                                     The Latina
                 s        Pike,                                  Literacy
                          Buildin                                Mobile
                          g 4,                                   Program.
                          Suite
                          209
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Emory    Rollins          $10,000   12/23/2015  Emory Latino
                 Univer   School                                 Diabetes
                 sity     of                                     Education
                          Public                                 Program
                          Health                                 (ELDEP)
                          1518
                          Clifton
                          Rd, NE
                          Room
                          606
                          Atlanta
                          , GA
                          30322
    ------------------------------------------------------------------------
    Monetary    Emory    Rollins          $12,500   12/23/2015  Emory Latino
                 Univer   School                                 Diabetes
                 sity     of                                     Education
                          Public                                 Program
                          Health                                 (ELDEP)
                          1518
                          Clifton
                          Rd, NE
                          Room
                          606
                          Atlanta
                          , GA
                          30322
    ------------------------------------------------------------------------
    Monetary    Enable,  13                $7,500   11/12/2015  Connect with
                 Inc.     Roszel                                 Enable
                          Road,
                          Suite
                          B110
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Every    Fred              $9,000   11/16/2015  Every Child
                 Child    Vereen,                                Valued
                 Valued   Jr.                                    After
                 A NJ     Communi                                School
                 Nonpro   ty                                     Program
                 fit      Center
                 Corpor   175
                 ation    Johnson
                          Avenue
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Everybo  PO Box            $4,000   11/16/2015  Coming Up
                 dy       3127                                   for AIRTM
                 Loves    Princet
                 Kenny    on, NJ
                 Projec   08543
                 t,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Family   1931              $9,000     6/4/2015  Outpatient
                 Guidan   Notting                                Mental
                 ce       ham Way                                Health
                 Center   Hamilto                                Treatment
                 Corpor   n, NJ                                  for the
                 ation    08619                                  Chronically
                                                                 Mentally
                                                                 Ill
    ------------------------------------------------------------------------
    Monetary    Family   1931                $300    6/26/2015  Costs
                 Guidan   Notting                                associated
                 ce       ham Way                                with 2015
                 Center   Hamilto                                Janssen
                 Corpor   n, NJ                                  Cares
                 ation    08619                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Family   1931                $300    9/24/2015  Costs
                 Guidan   Notting                                associated
                 ce       ham Way                                with 2015
                 Center   Hamilto                                Janssen
                 Corpor   n, NJ                                  Cares
                 ation    08619                                  Volunteer
                                                                 Activity
                                                                 September
    ------------------------------------------------------------------------
    Monetary    Family   1 AAA            $10,000    10/2/2015  Get FIT @
                 Resour   Dr.                                    YMCA
                 ce       Suite
                 Networ   203
                 k        Trenton
                          , NJ
                          08691
    ------------------------------------------------------------------------
    Monetary    Family   4                 $9,500   11/16/2015  Nursing
                 Servic   Corners                                services at
                 e        tone                                   the
                 Associ   Drive                                  emergency
                 ation    Langhor                                homelss
                 of       ne, PA                                 shelter
                 Bucks    19047
                 County
    ------------------------------------------------------------------------
    Monetary    Family   790 Park          $4,000    4/16/2015  STEPS to
                 Servic   Avenue                                 Wellness
                 e        Hunting                                program
                 League   ton, NY
                 , Inc.   11743
    ------------------------------------------------------------------------
    Monetary    Federat  One               $1,000    4/16/2015  Big Nosh
                 ion of   Farming                                Vocational
                 Organi   dale                                   Services
                 zation   Road
                 s        West
                          Babylon
                          , NY
                          11704
    ------------------------------------------------------------------------
    Monetary    Feed     Central              $75    1/14/2015  Employee
                 More,    Virgini                                directed
                 Inc.     a Food                                 donation in
                          Bank                                   lieu of
                          1415                                   company
                          Rhoadmi                                holiday
                          ller                                   gift
                          Street
                          Richmon
                          d, VA
                          23220
    ------------------------------------------------------------------------
    Monetary    Feed     333 N.               $75    2/25/2015  Employee
                 the      Meridia                                directed
                 Childr   n                                      donation in
                 en,      Avenue                                 lieu of
                 Inc.     Oklahom                                company
                          a City,                                holiday
                          OK                                     gift
                          73107
    ------------------------------------------------------------------------
    Monetary    Forsyth  61                   $75   11/19/2015  Employee
                 Humane   Miller                                 directed
                 Societ   Street                                 donation in
                 y        Winston-                               lieu of
                          Salem,                                 Company
                          NC                                     Holiday
                          21704                                  gift
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $2,000   11/16/2015  Fundraising
                 ion of   Lawrenc                                event
                 Morris   eville                                 support to
                 Hall/    Road                                   benefit
                 St.      Lawrenc                                general
                 Lawren   eville,                                mission of
                 ce       NJ                                     organizatio
                          08648                                  n
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $7,500   11/16/2015  Communicatin
                 ion of   Lawrenc                                g for
                 Morris   eville                                 Success
                 Hall/    Road
                 St.      Lawrenc
                 Lawren   eville,
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $1,000    3/30/2015  Silver
                 n        47th                                   sponsor
                 House    Street                                 Fountain
                          New                                    House
                          York,                                  Wellness
                          NY                                     Campaign
                          10036                                  and One in
                                                                 Four 5K
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $5,000   10/13/2015  Fundraising
                 n        47th                                   event
                 House    Street                                 support to
                          New                                    benefit
                          York,                                  general
                          NY                                     mission of
                          10036                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Gateway  11901             $7,500    7/16/2015  Support for
                 Homes,   Reedy                                  an
                 Inc.     Branch                                 Occupationa
                          Road                                   l Therapist
                          Chester
                          field,
                          VA
                          23238
    ------------------------------------------------------------------------
    Monetary    Georgia  246               $1,500     7/1/2015  Consumer
                 Mental   Sycamor                                scholarship
                 Health   e St.                                  s to attend
                 Consum   Suite                                  the 24th
                 er       260                                    Annual
                 Networ   Decatur                                Statewide
                 k        , GA                                   Consumer
                          30030                                  Conference
    ------------------------------------------------------------------------
    Monetary    Girl     1171              $2,000    12/3/2015  GSHNJ
                 Scouts   Route                                  Robotics
                 Heart    28                                     Program
                 of New   North                                  Expansion--
                 Jersey   Branch,                                Make It and
                 , Inc.   NJ                                     Take It
                          08876
    ------------------------------------------------------------------------
    Monetary    Greater  16 W.           $100,000   12/22/2015  Greater
                 Trento   Lafayet                                Trenton
                 n        te St.                                 Initiative
                          Trenton                                operating
                          , NJ                                   activities
                          08608                                  in support
                                                                 of its
                                                                 strategic
                                                                 plan for
                                                                 2015 and
                                                                 2016
    ------------------------------------------------------------------------
    Monetary    Grounds  80                $7,200   12/15/2015  Supporting
                 for      Sculpto                                Wellness
                 Sculpt   rs Way                                 Walks for
                 ure      Hamilto                                Low Income
                          n, NJ                                  Seniors
                          08619
    ------------------------------------------------------------------------
    Monetary    Habitat  601 N             $7,500   11/16/2015  Community
                 for      Clinton                                Development
                 Humani   Ave                                    Grant for 7-
                 ty--Tr   Trenton                                Plex Build
                 enton    , NJ
                 Area     08638-
                          3446
    ------------------------------------------------------------------------
    Monetary    Habitat  31 Oak            $4,000   11/16/2015  Women Build
                 for      Ave                                    Homes and
                 Humani   Chalfon                                Strong
                 ty of    t, PA                                  Families
                 Greate   18914
                 r
                 Bucks
    ------------------------------------------------------------------------
    Monetary    Habitat  212 Yost            $300    8/24/2015  Costs
                 for      Bouleva                                associated
                 Humani   rd                                     with 2015
                 ty of    Suite A                                Janssen
                 Greate   Pittsbu                                Cares
                 r        rgh, PA                                Volunteer
                 Pittsb   15221                                  Activity
                 urgh
    ------------------------------------------------------------------------
    Monetary    Hamilto  1315             $15,000   12/15/2015  Healthy
                 n Area   Whiteho                                Living
                 YMCA     rse-                                   Programs:
                          Mercerv                                Diabetes
                          ille                                   Prevention
                          Road                                   Program
                          Hamilto                                ($7,500.00)
                          n, NJ                                  , ACT
                          08619                                  ($7,500.00)
    ------------------------------------------------------------------------
    Monetary    Heart    1325 G           $20,000    1/19/2015  Improving
                 Rhythm   Street                                 Health
                 Societ   NW,                                    Literacy
                 y,       Suite                                  and Health
                 Inc.     400                                    Information
                          Washing                                in Atrial
                          ton, DC                                Fibrillatio
                          20005                                  n and
                                                                 Stroke
                                                                 Patients
    ------------------------------------------------------------------------
    Monetary    Heartla  4750 N.           $7,500    7/16/2015  Pathways
                 nd       Sherida                                Home,
                 Health   n Road                                 supportive
                 Outrea   Chicago                                housing
                 ch       , IL                                   program for
                          60640                                  those
                                                                 living with
                                                                 mental
                                                                 health
                                                                 conditions
    ------------------------------------------------------------------------
    Monetary    Henders  4740              $5,800     8/5/2015  Mental
                 on       North                                  Health
                 Behavi   State                                  First Aid:
                 oral     Road 7                                 Helping
                 Health   Lauderd                                Persons in
                          ale                                    Need
                          Lakes,
                          FL
                          33319
    ------------------------------------------------------------------------
    Monetary    HiTops,  21                $6,000   11/12/2015  HiTops'
                 Inc.     Wiggins                                Adolescent
                          Street                                 Women and
                          Princet                                Girls'
                          on, NJ                                 Sexual
                          08540                                  Health
                                                                 Programming
    ------------------------------------------------------------------------
    Monetary    Homecar  240                 $100     8/5/2015  Memorial
                 e and    North                                  donation
                 Hospic   Radnor-
                 e        -Cheste
                 Founda   r Road,
                 tion     Suite
                          100
                          Radnor,
                          PA
                          19087-
                          5174
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880                $365    7/10/2015  Costs
                 nt       Princet                                associated
                          on Ave.                                with 2015
                          Lawrenc                                Janssen
                          eville,                                Cares
                          NJ                                     Volunteer
                          08648                                  Activity
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880              $9,000   10/13/2015  Huchet House
                 nt       Princet
                          on Ave.
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Hopewel  35                  $750   11/16/2015  Hopewell
                 l        Princet                                Elementary
                 Elemen   on                                     Science
                 tary     Avenue                                 Fair 2016
                 School   Hopewel
                 Parent   l, NJ
                 Teache   08525
                 r
                 Organi
                 zation
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Hopewel  P.O. Box            $750   12/21/2015  ``aMAZing
                 l        145                                    Pumpkin
                 Valley   Hopewel                                Carve''
                 Arts     l, NJ                                  Exhibition
                 Counci   08525
                 l,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Hopewel  PO Box            $5,400    7/27/2015  Scholarship
                 l        553                                    for a
                 Valley   Penning                                Hopewell
                 Educat   ton, NJ                                Valley
                 ion      08534                                  Regional
                 Founda                                          School
                 tion                                            District
                                                                 graduating
                                                                 student
                                                                 ($1,000),
                                                                 district-
                                                                 wide
                                                                 workshops
                                                                 on
                                                                 childhood
                                                                 mental
                                                                 health
                                                                 ($4,400)
    ------------------------------------------------------------------------
    Monetary    Hopewel  48                $2,500    2/12/2015  Hopewell
                 l        Orchard                                Valley
                 Valley   Avenue                                 Rides
                 Senior   Penning
                 Founda   ton, NJ
                 tion     08534
    ------------------------------------------------------------------------
    Monetary    Humane   1201                 $75     2/3/2015  Employee
                 Societ   Macklin                                directed
                 y of     d                                      donation in
                 Missou   Avenue                                 lieu of
                 ri       St.                                    company
                          Louis,                                 holiday
                          MO                                     gift
                          63110
    ------------------------------------------------------------------------
    Monetary    Hunterd  1410                $300    8/19/2015  Costs
                 on       Route                                  associated
                 County   22 West                                with 2015
                 YMCA     Annanda                                Janssen
                          le, NJ                                 Cares
                          08801                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Hunterd  1410              $2,500   10/13/2015  Fundraising
                 on       Route                                  event
                 County   22 West                                support to
                 YMCA     Annanda                                benefit
                          le, NJ                                 general
                          08801                                  mission of
                                                                 organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Hunterd  8 Main           $10,000    4/20/2015  Prescription
                 on       Street                                 Drug Abuse
                 Drug     Fleming                                Education
                 Awaren   ton, NJ                                and
                 ess      08822                                  Evaluation
                 Progra                                          Project.
                 m,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Hunterd  111 Mine          $1,000    12/8/2015  Stewardship
                 on       Street                                 of the
                 Land     Fleming                                Hunterdon
                 Trust    ton, NJ                                Land
                          08822                                  Trust's
                                                                 Dvoor Farm
                                                                 Preserve
    ------------------------------------------------------------------------
    Monetary    Institu  P.O. Box          $3,500    10/2/2015  Nursing
                 te of    7869                                   Experiences
                 Wonder   West                                   hip Program
                 ful      Trenton
                 Women    , NJ
                 Workin   08628
                 g For
                 Empowe
                 rment
    ------------------------------------------------------------------------
    Monetary    Interfa  3635             $15,000   11/13/2015  Neighbors
                 ith      Quakerb                                Helping
                 Caregi   ridge                                  Neighbors
                 vers     Rd.                                    Program
                 Trento   Suite
                 n,       16
                 Inc.     Hamilto
                          n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    Isles,   10 Wood           $7,500   11/16/2015  Healthy
                 Inc.     Street                                 Homes
                          Trenton                                Training to
                          , NJ                                   Reduce
                          08618                                  Asthma and
                                                                 Lead
    ------------------------------------------------------------------------
    Monetary    Jewish   707                 $300    7/14/2015  Costs
                 Family   Alexand                                associated
                 and      er                                     with 2015
                 Childr   Road,                                  Janssen
                 en's     Suite                                  Cares
                 Servic   102                                    Volunteer
                 e of     Princet                                Activity
                 Greate   on, NJ
                 r        08540
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Jewish   707               $7,500   12/15/2015  Mercer
                 Family   Alexand                                County
                 and      er                                     Caregiver
                 Childr   Road,                                  Help Line
                 en's     Suite                                  and
                 Servic   102                                    Caregiver
                 e of     Princet                                Services
                 Greate   on, NJ                                 2016
                 r        08540
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Jewish   707              $10,000   12/15/2015  Fundraising
                 Family   Alexand                                event
                 and      er                                     support to
                 Childr   Road,                                  benefit
                 en's     Suite                                  general
                 Servic   102                                    mission of
                 e of     Princet                                organizatio
                 Greate   on, NJ                                 n
                 r        08540
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Johnson  One           $6,000,000    6/29/2015  Funding to
                 &        Johnson                                support the
                 Johnso   &                                      Johnson &
                 n        Johnson                                Johnson
                 Patien   Plaza                                  Patient
                 t        New                                    Assistance
                 Assist   Brunswi                                Foundation
                 ance     ck, NJ                                 (JJPAF) to
                 Founda   08933                                  help fund
                 tion                                            their
                                                                 mission to
                                                                 provide
                                                                 pharmaceuti
                                                                 cal product
                                                                 to needy
                                                                 patients on
                                                                 a
                                                                 nondiscrimi
                                                                 natory
                                                                 basis
                                                                 without
                                                                 charge
    ------------------------------------------------------------------------
    Monetary    Junior   4365              $5,850    9/25/2015  2016 J&J
                 Achiev   Route 1                                Pharma Day
                 ement    South,                                 Program
                 of New   2nd
                 Jersey   flr.
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Kansas   1919                $450    1/10/2015  Employee
                 Foodba   East                                   directed
                 nk       Douglas                                donation in
                 Wareho   Wichita                                lieu of
                 use      , KS                                   company
                          67211                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Kidsbri  4556              $7,500    9/28/2015  Kidsbridge
                 dge,     South                                  Anti-
                 Inc.     Broad                                  Bullying
                          St, 2nd                                Life Skills
                          Floor                                  Program for
                          Trenton                                At-Risk
                          , NJ                                   Children in
                          08620                                  Trenton at
                                                                 the
                                                                 Elementary
                                                                 School
                                                                 Level
    ------------------------------------------------------------------------
    Monetary    Lawrenc  PO Box            $2,500   11/16/2015  WaterBotics:
                 e        6531 17                                An
                 Townsh   Philips                                underwater
                 ip       Ave.                                   robotics
                 Educat   Lawrenc                                program for
                 ion      eville,                                6th grade
                 Founda   NJ                                     students in
                 tion,    08648                                  Lawrence
                 Inc.                                            Township
                                                                 Public
                                                                 Schools
    ------------------------------------------------------------------------
    Monetary    Leyden   10001 W           $5,000    6/23/2015  Peer Support
                 Family   Grand                                  Center
                 Servic   Ave
                 e and    Frankli
                 Mental   n Park,
                 Health   IL
                 Center   60131
    ------------------------------------------------------------------------
    Monetary    Literac  55                $2,500   11/12/2015  Early
                 y And    Primros                                Childhood--
                 Life,    e                                      Building
                 Inc.     Circle                                 Blocks for
                          Princet                                the Future
                          on, NJ                                 Program
                          08540
    ------------------------------------------------------------------------
    Monetary    Literac  121               $5,000    9/28/2015  Adult
                 y New    Chestnu                                Literacy
                 Jersey   t                                      Program
                 , Inc.   Street
                          Suite
                          203
                          Roselle
                          , NJ
                          07203
    ------------------------------------------------------------------------
    Monetary    Literac  120               $4,000    12/1/2015  Let's Talk
                 y        Findern                                About
                 Volunt   e Ave--                                Health
                 eers     Box 7                                  Literacy
                 of       Bridgew
                 Somers   ater,
                 et       NJ
                 County   08807
    ------------------------------------------------------------------------
    Monetary    Main     8                 $2,500    4/16/2015  Serious
                 Street   Marcell                                Mental
                 Counse   a                                      Disorders:
                 ling     Avenue                                 Improving
                 Center   West                                   Access to
                          Orange,                                Treatment
                          NJ                                     Without
                          07052                                  Insurance
                                                                 As an
                                                                 Obstacle
    ------------------------------------------------------------------------
    Monetary    Massach  15                $4,000    2/25/2015  Changing
                 usetts   Vernon                                 Minds and
                 Clubho   Street                                 Improving
                 use      Waltham                                Lives of
                 Coalit   , MA                                   People with
                 ion      02453                                  Mental
                                                                 Illness
                                                                 Project
    ------------------------------------------------------------------------
    Monetary    McCarte  91               $12,000   12/15/2015  OnStage
                 r        Univers                                Seniors: A
                 Theatr   ity                                    Community
                 e        Place                                  Project of
                 Compan   Princet                                McCarter
                 y        on, NJ                                 Theatre
                          08450
    ------------------------------------------------------------------------
    Monetary    Meals    5 Walter            $300    8/20/2015  Costs
                 On       Foran                                  associated
                 Wheels   Blvd                                   with 2015
                 In       Suite                                  Janssen
                 Hunter   2006                                   Cares
                 don,     Fleming                                Volunteer
                 Inc.     ton, NJ                                Activity
                          08822
    ------------------------------------------------------------------------
    Monetary    Meals    320              $15,000    10/2/2015  Meals on
                 on       Hollowb                                Wheels
                 Wheels   rook                                   Program
                 of       Drive
                 Trento   Ewing,
                 n        NJ
                 Ewing    08638
    ------------------------------------------------------------------------
    Monetary    Mental   2000 N.          $90,000   12/17/2015  It's My
                 Health   Beaureg                                Life:
                 Americ   ard St.                                Social Self
                 a        6th                                    Directed
                          Floor                                  Care
                          Alexand
                          ria, VA
                          22311
    ------------------------------------------------------------------------
    Monetary    Mental   2221             $15,000    7/27/2015  School
                 Health   Norfolk                                Behavioral
                 Americ   , Suite                                Health
                 a of     810                                    Initiative
                 Greate   Houston
                 r        , TX
                 Housto   77098
                 n
    ------------------------------------------------------------------------
    Monetary    Mental   2323 W           $10,000     8/6/2015  Get
                 Health   5th                                    Connected
                 Americ   Ave.                                   program
                 a of     Suite
                 Frankl   160
                 in       Columbu
                 County   s, OH
                          43204
    ------------------------------------------------------------------------
    Monetary    Mental   205               $1,500     9/4/2015  2015 Montana
                 Health   Haggert                                Mental
                 Americ   y Lane,                                Health
                 a of     Suite                                  Policy
                 Montan   170                                    Summit
                 a        Bozeman
                          , MT
                          59715
    ------------------------------------------------------------------------
    Monetary    Mental   1210 San          $2,500    8/10/2015  Mental
                 Health   Antonio                                Health
                 Americ   , Suite                                Education
                 a of     200                                    and
                 Texas    Austin,                                Advocacy
                          TX                                     Campaign
                          78701
    ------------------------------------------------------------------------
    Monetary    Mental   100 W.            $1,000    4/16/2015  Bronze
                 Health   10th                                   sponsor
                 Associ   St.                                    2015 E-
                 ation    Ste.                                   Racing the
                 in       600                                    Blues for
                 Delawa   Wilming                                Mental
                 re       ton, DE                                Health
                          19801
    ------------------------------------------------------------------------
    Monetary    Mental   100 W.            $1,500    9/25/2015  Annual
                 Health   10th                                   Community
                 Associ   St.                                    Mental
                 ation    Ste.                                   Health
                 in       600                                    Conference-
                 Delawa   Wilming                                -Understand
                 re       ton, DE                                ing Mental
                          19801                                  Wellness
    ------------------------------------------------------------------------
    Monetary    Mental   617               $2,500    5/22/2015  Support of
                 Health   Garden                                 the Mental
                 Associ   Street                                 Wellness
                 ation    Santa                                  Center
                 in       Barbara
                 Santa    , CA
                 Barbar   93101
                 a
                 County
    ------------------------------------------------------------------------
    Monetary    Mental   3701              $7,500     6/4/2015  ParentVOICE:
                 Health   Latrobe                                Bringing
                 Associ   Drive,                                 Hope to
                 ation    Suite                                  Families in
                 of       140                                    Need
                 Centra   Charlot
                 l        te, NC
                 Caroli   28211
                 nas,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Mental   1301             $10,000    7/27/2015  Equitable
                 Health   York                                   Access to
                 Associ   Road,                                  Effective
                 ation    Suite                                  Care
                 of       505                                    Project--(p
                 Maryla   Lutherv                                rint, web,
                 nd,      ille,                                  media,
                 Inc.     MD                                     salaries)
                          21093
    ------------------------------------------------------------------------
    Monetary    Mental   580               $1,000    2/25/2015  Supporting
                 Health   White                                  sponsor
                 Associ   Plains                                 2015 MHA on
                 ation    Road                                   the Move:
                 of       Suite                                  Run/Walk
                 Westch   510
                 ester    Tarryto
                          wn, NY
                          10591
    ------------------------------------------------------------------------
    Monetary    Mental   1870              $2,000    4/16/2015  Costs
                 Health   South                                  associated
                 Associ   Boulder                                with Peer
                 ation    Avenue                                 Outreach
                 Oklaho   Tulsa,                                 Services
                 ma       OK                                     program
                          74119
    ------------------------------------------------------------------------
    Monetary    Mental   555 N             $4,000    6/22/2015  MHA Housing
                 Health   Woodlaw                                Initiative:
                 Associ   n, Ste.                                Ensuring
                 ation    3105                                   Housing for
                 Reside   Wichita                                Our Most
                 ntial    , KS                                   Vulnerable
                 Care,    67208                                  Populations
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Mental   3809             $10,000    7/28/2015  Outreach and
                 Illnes   Rosewoo                                Behavioral
                 s        d Drive                                Healthcare
                 Recove   PO Box                                 for
                 ry       4246                                   Homeless
                 Center   Columbi                                Individuals
                 , Inc.   a, SC                                  with Mental
                          29240                                  Illness
    ------------------------------------------------------------------------
    Monetary    Mercer   3150              $8,000   11/16/2015  Integrating
                 Allian   Brunswi                                housing and
                 ce to    ck Pike                                healthcare
                 End      Lawrenc                                access for
                 Homele   eville,                                veteran and
                 ssness   NJ                                     senior
                          08648-                                 homeless
                          2420                                   populations
                                                                 in the
                                                                 Trenton/
                                                                 Mercer
                                                                 CEASE
                                                                 HOMELESSNES
                                                                 S System
    ------------------------------------------------------------------------
    Monetary    Mercer   PO Box           $19,500   12/15/2015  Supporting
                 County   17202                                  STEM
                 Commun   Trenton                                Education:
                 ity      , NJ                                   Making
                 Colleg   08690                                  Physics
                 e                                               Available
                 Founda                                          to Students
                 tion                                            at the
                                                                 James
                                                                 Kerney
                                                                 Campus at
                                                                 Trenton
    ------------------------------------------------------------------------
    Monetary    Mercer   151                 $300    7/10/2015  Costs
                 Street   Mercer                                 associated
                 Friend   Street                                 with 2015
                 s        Trenton                                Janssen
                          , NJ                                   Cares
                          08611                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Mercer   151              $20,000   10/23/2015  Food Bank-
                 Street   Mercer                                 Food
                 Friend   Street                                 Distributio
                 s        Trenton                                n Programs
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Middle   P.O. Box         $15,000   11/24/2015  Outreach
                 Earth    8045                                   Program and
                          520                                    Community
                          North                                  Youth
                          Bridge                                 Centers
                          Street
                          Bridgew
                          ater,
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    MIDJers  1A                $1,500   11/23/2015  Urban Youth
                 ey       Quakerb                                Employment
                 Center   ridge                                  Initiative
                 for      Plaza
                 Econom   Drive,
                 ic       Suite 2
                 Develo   Hamilto
                 pment    n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    Midland  60                $7,500    10/6/2015  Midland
                 Adult    Industr                                Meals on
                 Servic   ial                                    Wheels
                 es,      Parkway                                Employment
                 Inc.     PO Box                                 Training
                          5026                                   Program
                          North
                          Branch,
                          NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Mighty   10th and            $100    5/14/2015  Memorial
                 Rivers   Poplar                                 Donation
                 Region   Cairo,
                 al       IL
                 Worshi   62914
                 p
                 Center
    ------------------------------------------------------------------------
    Monetary    Millhil  101              $15,000    10/2/2015  Millhill
                 l        Oakland                                Trenton
                 Child    Street                                 PEERS
                 and      Trenton
                 Family   , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Millhil  101               $5,000    10/2/2015  Trenton Area
                 l        Oakland                                Stakeholder
                 Child    Street                                 s
                 and      Trenton
                 Family   , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Minding  2083              $5,000     6/4/2015  Minding Our
                 Our      Lawrenc                                Business
                 Busine   eville                                 Summer
                 ss,      Road                                   Program: A
                 Inc.     Lawrenc                                Bridge to
                          eville,                                the Future
                          NJ                                     for Mercer
                          08648                                  County Low-
                                                                 Income
                                                                 Youth
    ------------------------------------------------------------------------
    Monetary    Morven   55                $5,000    9/28/2015  Morven
                 Museum   Stockto                                Museum and
                 and      n                                      Garden
                 Garden   Street                                 Summer
                          Princet                                Internship
                          on, NJ                                 Program for
                          08540                                  Isles of
                                                                 Trenton
                                                                 Youths
    ------------------------------------------------------------------------
    Monetary    Mount    73 North         $15,000    11/2/2015  Mount Carmel
                 Carmel   Clinton                                Guild Home
                 Guild    Avenue                                 Health
                          Trenton                                Nursing
                          , NJ                                   Program
                          08609
    ------------------------------------------------------------------------
    Monetary    NAMI--C  1904              $2,000    4/10/2015  Community
                 VA       Byrd                                   Mental
                 Centra   Avenue,                                Health
                 l        Suite                                  Education
                 Virgin   207                                    and Social
                 ia's     (POB                                   Inclusion
                 Voice    18086)
                 on       Richmon
                 Mental   d, VA
                 Illnes   23230
                 s
    ------------------------------------------------------------------------
    Monetary    Nami     1401 I-           $1,000     7/1/2015  Bronze
                 Alabam   85                                     sponsor
                 a        Parkway                                2015 NAMI
                          , Suite                                Alabama
                          A                                      Walk
                          Montgom
                          ery, AL
                          36106
    ------------------------------------------------------------------------
    Monetary    NAMI     2400 W.           $1,000    2/12/2015  Bronze
                 Delawa   4th St.                                sponsor
                 re       Wilming                                2015
                          ton, DE                                NAMIWalks
                          19805                                  Delaware
    ------------------------------------------------------------------------
    Monetary    NAMI     3371              $9,500    8/18/2015  Education
                 Mercer   Brunswi                                and Support
                 NJ       ck                                     Programs
                          Pike,
                          Suite
                          124
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    NAMI     85 N.             $1,000     8/6/2015  Bronze
                 New      State                                  sponsor
                 Hampsh   Street                                 2015
                 ire      Concord                                NAMIWalks
                          , NH                                   New
                          03301                                  Hampshire
    ------------------------------------------------------------------------
    Monetary    NAMI of  2100              $7,500    7/28/2015  Living Room-
                 DuPage   Manches                                Peer to
                 County   ter Rd,                                Peer
                 Illino   Bldg B,                                program
                 is       Suite
                          925
                          Wheaton
                          , IL
                          60187
    ------------------------------------------------------------------------
    Monetary    NAMI of  One               $1,500     7/1/2015  Start to
                 Lake     Victori                                Finish
                 County   a Sq.,                                 sponsor
                          Ste.                                   2015
                          260                                    Strides for
                          Painesv                                Awareness
                          ille,                                  Walk
                          OH
                          44077
    ------------------------------------------------------------------------
    Monetary    NAMI of  One               $2,000     7/1/2015  Supporting
                 Lake     Victori                                Families
                 County   a Sq.,                                 and
                          Ste.                                   Individuals
                          260                                    Impacted by
                          Painesv                                Schizophren
                          ille,                                  ia: NAMI
                          OH                                     Family-to-
                          44077                                  Family
                                                                 Education
    ------------------------------------------------------------------------
    Monetary    NAMI of  100 W.            $1,000    2/13/2015  Bronze
                 PA       Main                                   sponsor
                 Montgo   Street                                 2015
                 mery     Suite                                  Greater
                 County   204                                    Philadelphi
                          Lansdal                                a NAMIWalk
                          e, PA
                          19446
    ------------------------------------------------------------------------
    Monetary    NAMI of  6122 E            $1,000   12/15/2015  Bronze
                 Southe   22nd St                                sponsor
                 rn       Tucson,                                2016
                 Arizon   AZ                                     Southern
                 a        85711                                  Arizona
                                                                 NAMIWalks
    ------------------------------------------------------------------------
    Monetary    NAMI     1750 S.           $1,000    2/27/2015  Bronze
                 St.      Brentwo                                sponsor
                 Louis    od                                     2015 St.
                          Blvd.                                  Louis
                          Suite                                  NAMIWalks
                          511 St.
                          Louis,
                          MO
                          63144
    ------------------------------------------------------------------------
    Monetary    NAMI     150               $1,000    5/14/2015  Bronze
                 Summit   Cross                                  sponsor
                 County   Street,                                2015
                          Akron                                  NAMIWalks
                          Ohio
                          44311
                          PO Box
                          462,
                          Cuyahog
                          a
                          Falls,
                          Ohio
                          44222
                          Akron,
                          OH
                          44311
    ------------------------------------------------------------------------
    Monetary    NAMI     5251              $1,000    3/13/2015  Bronze
                 Ventur   Verdugo                                sponsor
                 a        Way, #K                                2015
                 County   (PO Box                                NAMIWalk
                          1613)                                  Ventura
                          Camaril                                County
                          lo, CA
                          93011
    ------------------------------------------------------------------------
    Monetary    NAMI     217               $1,000    6/10/2015  Bronze
                 Waukes   Wiscons                                sponsor
                 ha       in Ave                                 2015
                          Suite                                  NAMIWalks
                          300                                    in Waukesha
                          Waukesh
                          a, WI
                          53186
    ------------------------------------------------------------------------
    Monetary    Nationa  90 Park           $2,500    8/10/2015  27th Annual
                 l        Avenue                                 New York
                 Allian   16                                     Mental
                 ce for   Floor                                  Health
                 Resear   New                                    Research
                 ch on    York,                                  Symposium
                 Schizo   NY
                 phreni   10016
                 a and
                 Depres
                 sion
    ------------------------------------------------------------------------
    Monetary    Nationa  90 Park           $2,500    9/13/2015  Meet the
                 l        Avenue                                 Scientist:
                 Allian   16                                     A Virtual
                 ce for   Floor                                  Q&A Webinar
                 Resear   New                                    Series
                 ch on    York,
                 Schizo   NY
                 phreni   10016
                 a and
                 Depres
                 sion
    ------------------------------------------------------------------------
    Monetary    Nationa  100               $1,000    1/20/2015  Bronze
                 l        Clearbr                                sponsor
                 Allian   ook                                    2015 NAMI
                 ce for   Drive                                  Walks
                 the      Elmsfor                                Westchester
                 Mental   d, NY
                 ly Ill   10523
    ------------------------------------------------------------------------
    Monetary    Nationa  576               $1,000    1/20/2015  Bronze
                 l        Farming                                sponsor
                 Allian   ton                                    2015 NAMI
                 ce for   Avenue                                 Connecticut
                 the      Hartfor                                Walk
                 Mental   d, CT
                 ly Ill   06105
    ------------------------------------------------------------------------
    Monetary    Nationa  3250              $1,000    2/13/2015  Bronze
                 l        Wilshir                                sponsor
                 Allian   e                                      2015
                 ce for   Blvd.,                                 NAMIWalk
                 the      Suite                                  Los Angeles
                 Mental   1501                                   County
                 ly Ill   Los
                          Angeles
                          , CA
                          90010
    ------------------------------------------------------------------------
    Monetary    Nationa  309 W.            $1,000    2/25/2015  Bronze
                 l        Millbro                                sponsor
                 Allian   ok                                     2015
                 ce for   Road,                                  NAMIWalks
                 the      Suite
                 Mental   121
                 ly Ill   Raleigh
                          , NC
                          27609
    ------------------------------------------------------------------------
    Monetary    Nationa  1706              $1,000    3/12/2015  Bronze
                 l        Brady                                  sponsor
                 Allian   Street                                 2015
                 ce for   Suite                                  NAMIWalk
                 the      101                                    Greater
                 Mental   Davenpo                                Mississippi
                 ly Ill   rt, IA                                 Valley
                          52803
    ------------------------------------------------------------------------
    Monetary    Nationa  5095              $1,000    3/12/2015  Bronze
                 l        Murphy                                 sponsor
                 Allian   Canyon                                 2015 San
                 ce for   Road,                                  Diego
                 the      Suite                                  County NAMI
                 Mental   320 San                                Walk
                 ly Ill   Diego,
                          CA
                          92123
    ------------------------------------------------------------------------
    Monetary    Nationa  The               $1,000    3/30/2015  Bronze
                 l        Schraff                                sponsor
                 Allian   t's                                    2015
                 ce for   Center,                                NAMIWalks
                 the      529                                    Massachuset
                 Mental   Main                                   ts
                 ly Ill   Street
                          Suite
                          1M17
                          Boston,
                          MA
                          02129
    ------------------------------------------------------------------------
    Monetary    Nationa  800               $5,000    4/17/2015  Understandin
                 l        Transfe                                g
                 Allian   r Road                                 Psychosis:
                 ce for   #31 St.                                Resources
                 the      Paul,                                  and
                 Mental   MN                                     Recovery
                 ly Ill   55114
    ------------------------------------------------------------------------
    Monetary    Nationa  3250              $5,000    5/14/2015  Crisis
                 l        Wilshir                                Interventio
                 Allian   e                                      n Team
                 ce for   Blvd.,                                 training
                 the      Suite                                  for Custody
                 Mental   1501                                   Program for
                 ly Ill   Los                                    Los Angeles
                          Angeles                                County
                          , CA                                   Sheriff's
                          90010                                  Department
    ------------------------------------------------------------------------
    Monetary    Nationa  1225             $10,000    5/14/2015  2015 State
                 l        Dublin                                 Conference
                 Allian   Road,
                 ce for   Suite
                 the      125
                 Mental   Columbu
                 ly Ill   s, OH
                          43215
    ------------------------------------------------------------------------
    Monetary    Nationa  1 Bangor          $1,000    6/10/2015  Supporter
                 l        Street                                 sponsor
                 Allian   Augusta                                2015 NAMI
                 ce for   , ME                                   Maine
                 the      04330                                  Annual
                 Mental                                          Awareness
                 ly Ill                                          Walk Walk
                                                                 the Walk to
                                                                 Start the
                                                                 Talk
    ------------------------------------------------------------------------
    Monetary    Nationa  3440              $1,000    6/10/2015  Bronze
                 l        Viking                                 sponsor
                 Allian   Drive                                  2016
                 ce for   Suite                                  Northern
                 the      104                                    California
                 Mental   Sacrame                                NAMI Walk
                 ly Ill   nto, CA
                          95827
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000    7/15/2015  Platinum
                 l        550039                                 level
                 Allian   Birming                                sponsor
                 ce for   ham, AL                                NAMI
                 the      35255-                                 Birmingham
                 Mental   0039                                   2015 Walk
                 ly Ill                                          for Mental
                                                                 Health
    ------------------------------------------------------------------------
    Monetary    Nationa  808               $1,000    7/15/2015  2015 Annual
                 l        Montice                                Conference,
                 Allian   llo                                    ``Shatterin
                 ce for   Street                                 g the
                 the      Somerse                                Stigma--Fac
                 Mental   t, KY                                  ts vs.
                 ly Ill   42501                                  Fiction--Ho
                                                                 w Much Do
                                                                 You Know?''
    ------------------------------------------------------------------------
    Monetary    Nationa  1536 W            $6,000    7/16/2015  Coming out
                 l        Chicago                                Proud
                 Allian   Chicago                                Program
                 ce for   , IL
                 the      60642
                 Mental
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000    7/20/2015  2015 Mental
                 l        4096                                   Health
                 Allian   2206 N.                                Awareness
                 ce for   Gordon                                 Conference
                 the      Street                                 (MHAC)
                 Mental   Alvin,
                 ly Ill   TX
                          77512
    ------------------------------------------------------------------------
    Monetary    Nationa  2059              $1,000    7/28/2015  Bronze
                 l        Atwood                                 sponsor
                 Allian   Avenue                                 2015 Dane
                 ce for   Madison                                County
                 the      , WI                                   NAMIWalk
                 Mental   53704
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  P.O Box           $1,500    8/25/2015  Silver
                 l        8260                                   sponsor
                 Allian   Richmon                                2015
                 ce for   d, VA                                  NAMIWalks
                 the      23226                                  Virginia
                 Mental
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  99 Pine           $4,000    8/28/2015  2015 NAMI-
                 l        St.                                    NYS
                 Allian   Suite                                  Education
                 ce for   302                                    Conference-
                 the      Albany,                                Redefining
                 Mental   NY                                     Recovery:
                 ly Ill   12207                                  New
                                                                 Challenges,
                                                                 New
                                                                 Opportuniti
                                                                 es, New
                                                                 Hopes
    ------------------------------------------------------------------------
    Monetary    Nationa  2601              $2,000    8/28/2015  Support of
                 l        Cold                                   the 2015
                 Allian   Spring                                 NAMI
                 ce for   Road                                   Indiana
                 the      P.O.                                   State
                 Mental   Box                                    Conference
                 ly Ill   22697
                          Indiana
                          polis,
                          IN
                          46222
    ------------------------------------------------------------------------
    Monetary    Nationa  1562              $2,500    9/25/2015  Healing
                 l        Route                                  Ourselves,
                 Allian   130                                    Healing
                 ce for   North                                  Others:
                 the      Brunswi                                NAMI NJ
                 Mental   ck, NJ                                 2015 Annual
                 ly Ill   08902                                  Conference
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $75,000   12/17/2015  NAMI
                 l        Fairfax                                Helpline
                 Allian   Drive
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $50,000   12/17/2015  NAMI
                 l        Fairfax                                Multicultur
                 Allian   Drive                                  al Action
                 ce for   Suite                                  Center
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $1,000    6/10/2015  Bronze
                 l        West                                   sponsor
                 Allian   25th                                   NAMIWalks
                 ce for   Street,                                2015
                 the      #600
                 Mental   Clevela
                 ly       nd, OH
                 Ill--G   44113
                 reater
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $2,000    6/23/2015  Mental
                 l        West                                   Illness
                 Allian   25th                                   Peer
                 ce for   Street,                                Support and
                 the      #600                                   Education
                 Mental   Clevela                                programs
                 ly       nd, OH
                 Ill--G   44113
                 reater
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  2753              $1,000    2/13/2015  Bronze
                 l        West                                   sponsor
                 Allian   Central                                2015 NAMI
                 ce for   Avenue                                 Walk
                 the      Toledo,
                 Mental   OH
                 ly Ill   43606
                 of
                 Greate
                 r
                 Toledo
    ------------------------------------------------------------------------
    Monetary    Nationa  505 8th           $1,000    2/25/2015  Bronze
                 l        Avenue,                                sponsor
                 Allian   Ste                                    2015
                 ce for   1103                                   NAMIWalks
                 the      New                                    NYC
                 Mental   York,
                 ly Ill   NY
                 of New   10018
                 York
                 City
    ------------------------------------------------------------------------
    Monetary    Nationa  1981              $1,000   11/17/2015  Bronze
                 l        Marcus                                 sponsor
                 Allian   Ave,                                   2016 Long
                 ce for   C117                                   Island/
                 the      Lake                                   Queens/
                 Mental   Success                                NAMIWalks
                 ly Ill   , NY
                 Queens/  11042
                 Nassau
    ------------------------------------------------------------------------
    Monetary    Nationa  5963              $1,000    7/27/2015  Bronze
                 l        Boymel                                 sponsor
                 Allian   Dr.                                    2015
                 ce on    Fairfie                                National
                 Mental   ld, OH                                 Alliance on
                 Illnes   45014                                  Mental
                 s                                               Illness of
                                                                 Butler
                                                                 County
                                                                 NAMIWAlk
    ------------------------------------------------------------------------
    Monetary    Nationa  324A              $1,000     1/9/2015  Gold sponsor
                 l        Springf                                of the 2015
                 Allian   ield                                   NAMI-WM
                 ce on    Street                                 Annual
                 Mental   Agawam,                                Walkathon:
                 Illnes   MA                                     A Journey
                 s        01001                                  of Hope and
                 Wester                                          Recovery
                 n
                 Mass.,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $6,000    4/16/2015  28 Annual
                 l Art    350891                                 National
                 Exhibi   Miami,                                 Art
                 tions    FL                                     Exhibition
                 of the   33135                                  by the
                 Mental                                          Mentally
                 ly                                              Ill
                 Ill,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  110 N            $30,000    12/1/2015  MY BLOOD
                 l        Washing                                CLOT--An
                 Blood    ton St.                                Online
                 Clot     Suite                                  Resource
                 Allian   328                                    for
                 ce       Rockvil                                Patients
                          le, MD                                 and
                          20850                                  Caregivers
                                                                 Managing
                                                                 Life with
                                                                 VTE
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $75,000   12/17/2015  2016 Policy
                 l        Street                                 Action
                 Counci   NW,                                    Center
                 l for    Suite
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $75,000   12/17/2015  Early Onset
                 l        Street                                 Psychosis
                 Counci   NW,                                    Project
                 l for    Suite
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $75,000   12/17/2015  Health
                 l        Street                                 Justice
                 Counci   NW,                                    Learning
                 l for    Suite                                  Initiative
                 Behavi   400
                 oral     Washing
                 Health   ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Nationa  949 W.            $7,500   11/16/2015  Academic
                 l        State                                  Creative
                 Junior   Street                                 Engagement
                 Tennis   Trenton                                (ACE) and
                 and      , NJ                                   STEM Pilot
                 Learni   08618                                  Program
                 ng of
                 Trento
                 n
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E              $100    11/3/2015  Memorial
                 l        Easter                                 Donation
                 Stroke   Lane,
                 Associ   Suite B
                 ation    Centenn
                          ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $15,000    12/3/2015  Navigator
                 l        Easter                                 training,
                 Stroke   Lane,                                  program
                 Associ   Suite B                                development
                 ation    Centenn                                , services
                          ial, CO                                delivered,
                          80112                                  participant
                                                                 materials
                                                                 and
                                                                 resources,
                                                                 and
                                                                 outcomes
                                                                 measurement
                                                                 .
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $35,000    12/4/2015  Develop a
                 l        Easter                                 multi-
                 Stroke   Lane,                                  channel
                 Associ   Suite B                                marketing
                 ation    Centenn                                plan
                          ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    New      P.O. Box          $1,500    12/8/2015  Fundraising
                 Jersey   7683                                   event
                 Capita   Trenton                                support to
                 l        , NJ                                   benefit
                 Philha   08628                                  general
                 rmonic                                          mission of
                 Orches                                          organizatio
                 tra,                                            n
                 Inc.
    ------------------------------------------------------------------------
    Monetary    New      275 Rt.           $4,000     7/1/2015  NJPC
                 Jersey   10 East                                Strengtheni
                 Parent   Suite                                  ng Family
                 s        220-414                                and Youth
                 Caucus   Succasu                                Involvement
                          nna, NJ                                Conference
                          07876                                  and
                                                                 Professiona
                                                                 l Parent
                                                                 Advocacy
                                                                 Training
    ------------------------------------------------------------------------
    Monetary    NewBrid  7                 $2,000    6/10/2015  NewBridge
                 ge       Industr                                Day
                 Servic   ial                                    Treatment
                 es,      Road                                   Program for
                 Inc.     Pequann                                Adults
                          ock, NJ
                          07440
    ------------------------------------------------------------------------
    Monetary    Ohio     433                  $75     2/6/2015  Employee
                 Great    Canal                                  directed
                 Dane     Ct                                     donation in
                 Rescue   Watervi                                lieu of
                          lle, OH                                company
                          43566                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Paralyz  2235                 $75     2/6/2015  Employee
                 ed       Enterpr                                directed
                 Vetera   ise                                    donation in
                 ns of    Drive,                                 lieu of
                 Americ   Suite                                  company
                 a        3501                                   holiday
                          Westche                                gift
                          ster,
                          IL
                          60154
    ------------------------------------------------------------------------
    Monetary    Parent   P.O. Box          $2,000    12/8/2015  Steinert
                 Booste   3352                                   High
                 r USA    Mercerv                                Robotics
                 dba      ille,                                  FIRST FRC
                 Steine   NJ                                     Team 2180
                 rt       08690                                  Parents
                 High                                            Association
                 Roboti
                 cs
                 Parent
                 s
                 Associ
                 ation
    ------------------------------------------------------------------------
    Monetary    Partner  888              $10,700   12/15/2015  General
                 s in     Commonw                                mission
                 Health   ealth                                  support of
                          Ave,                                   organizatio
                          3rd                                    n
                          Floor
                          Boston,
                          MA
                          02215
    ------------------------------------------------------------------------
    Monetary    Passage  PO Box            $5,000    12/8/2015  The State
                 Theatr   967                                    Street
                 e        Trenton                                Project
                 Compan   , NJ
                 y,       08608
                 Inc.
    ------------------------------------------------------------------------
    Monetary    PEI      231                 $300    8/27/2015  Costs
                 Kids     Lawrenc                                associated
                          e Road                                 with 2015
                          Lawrenc                                Janssen
                          eville,                                Cares event
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    PEI      231              $17,500   10/27/2015  Comprehensiv
                 Kids     Lawrenc                                e Juvenile
                          e Road                                 Offenders
                          Lawrenc                                Outreach
                          eville,                                Services
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    People   140 E             $2,500   11/16/2015  People and
                 And      Hanover                                Stories
                 Storie   Street                                 with Mercer
                 s--Gen   Trenton                                County
                 te Y     , NJ                                   Seniors
                 Cuento   08608
                 s,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Plansma  118 West          $3,500     6/4/2015  2015
                 rt NJ    State                                  Corporate
                          PlanSma                                membership
                          rt NJ                                  renewal
                          Trenton                                donation to
                          , NJ                                   support
                          08608                                  efforts
                                                                 around
                                                                 sound land
                                                                 use
                                                                 planning
    ------------------------------------------------------------------------
    Monetary    Princet  P.O. Box          $1,500   10/30/2015  Giving Voice
                 on       145 190                                To
                 Girl     Nassau                                 Communities
                 Choir    Street,                                : PGC's
                          Lower                                  Music
                          Level                                  Afterschool
                          Princet                                Program
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    Princet  78 LEIGH          $5,000   11/16/2015  PNS Role
                 on       AVE                                    Models for
                 Nurser   PRINCET                                Health
                 y        ON, NJ
                 School   08542
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Princet  123 E.           $12,500   12/15/2015  Hunger
                 on       Hanover                                Prevention
                 Outrea   St.                                    and
                 ch       Trenton                                Nutrition
                 Projec   , NJ                                   Education
                 ts /     08608                                  ($7,500.00)
                 Crisis                                          Healthy
                 Minist                                          Living and
                 ry of                                           Housing
                 Mercer                                          Stability
                 County                                          Services
                                                                 ($5,000.00)
    ------------------------------------------------------------------------
    Monetary    Princet  P.O. Box          $2,500    12/8/2015  Princeton
                 on       250                                    Symphony
                 Sympho   Princet                                Orchestra @
                 ny       on, NJ                                 Isles Youth
                 Orches   08542                                  Institute--
                 tra                                             a series of
                                                                 interactive
                                                                 music
                                                                 appreciatio
                                                                 n programs
    ------------------------------------------------------------------------
    Monetary    Princet  13                $7,500   11/16/2015  Princeton-
                 on-      Roszel                                 Blairstown
                 Blairs   Road,                                  Center's
                 town     Suite                                  2015-16
                 Center   C204A                                  Summer
                 , Inc.   Princet                                Bridge
                          on, NJ                                 Program for
                          08540-                                 Mercer
                          7137                                   County At-
                                                                 Risk Youth
    ------------------------------------------------------------------------
    Monetary    Printma  440               $5,000    11/3/2015  Roving Press
                 king     River
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Printma  440              $15,000   11/24/2015  Combat paper
                 king     River                                  of NJ
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    PTA New  171 Old           $3,000     8/5/2015  Fundraising
                 Jersey   Turnpik                                event
                 Congre   e Road                                 support to
                 ss Of    Califon                                benefit
                 Parent   , NJ                                   general
                 s and    07830                                  mission of
                 Teache                                          organizatio
                 rs                                              n
    ------------------------------------------------------------------------
    Monetary    Raritan  P.O. Box          $8,000    12/1/2015  WaterWays
                 Headwa   273                                    Environment
                 ters     Gladsto                                al
                 Associ   ne, NJ                                 Education
                 ation    07934                                  Program
    ------------------------------------------------------------------------
    Monetary    Raritan  118              $20,000   11/24/2015  Promoting
                 Valley   Lamingt                                Access to
                 Commun   on Road                                STEM,
                 ity      Branchb                                Nursing and
                 Colleg   urg, NJ                                Community
                 e        08844                                  Health
                                                                 Education
                                                                 at Raritan
                                                                 Valley
                                                                 Community
                                                                 College
    ------------------------------------------------------------------------
    Monetary    ReDisco  901 NE            $7,500    6/23/2015  Same-Day
                 ver      Indepen                                Access to
                          dence                                  Care
                          Avenue                                 program
                          Lees
                          Summit,
                          MO
                          64086
    ------------------------------------------------------------------------
    Monetary    Regions  640              $15,000    7/21/2015  Make It OK
                 Hospit   Jackson                                Stigma
                 al       Street,                                Campaign
                 Founda   MS
                 tion     11202C
                          St.
                          Paul,
                          MN
                          55101
    ------------------------------------------------------------------------
    Monetary    Rescue   98                $5,000    1/14/2015  Fundraising
                 Missio   Carroll                                event
                 n of     Street,                                support to
                 Trento   PO Box                                 benefit
                 n        790                                    general
                          Trenton                                mission of
                          , NJ                                   organizatio
                          08605                                  n
    ------------------------------------------------------------------------
    Monetary    Rescue   98               $25,000    10/2/2015  Emergency
                 Missio   Carroll                                services
                 n of     Street,                                program
                 Trento   PO Box
                 n        790
                          Trenton
                          , NJ
                          08605
    ------------------------------------------------------------------------
    Monetary    Rider    2083             $20,000   11/24/2015  STEM
                 Univer   Lawrenc                                Program;
                 sity     eville                                 Janssen
                          Road                                   Science and
                          Lawrenc                                Business
                          eville,                                Scholarship
                          NJ                                     s;
                          08648                                  Shakesperia
                                                                 n at Rider
    ------------------------------------------------------------------------
    Monetary    Riverbe  3 N.              $5,000    5/22/2015  InSHAPE
                 nd       State                                  Program
                 Commun   Street,
                 ity      PO Box
                 Mental   2032
                 Health   Concord
                 , Inc.   , NH
                          03301
    ------------------------------------------------------------------------
    Monetary    Riversi  4 South           $9,300   11/16/2015  Riverside
                 de       Union                                  Symphonia
                 Sympho   Street                                 Senior
                 nia,     P.O.                                   Outreach
                 Inc.     Box 650                                Program
                          Lambert
                          ville,
                          NJ
                          08530
    ------------------------------------------------------------------------
    Monetary    San      445               $5,000    5/14/2015  Culinary,
                 Antoni   Recolet                                Education
                 o        a Rd.                                  and
                 Clubho   San                                    Nutrition
                 use,     Antonio                                Program--Nu
                 Inc.     , TX                                   tritious
                          78216                                  meals,
                                                                 culinary
                                                                 training,
                                                                 pre-
                                                                 vocational
                                                                 education,
                                                                 employment
                                                                 placement
    ------------------------------------------------------------------------
    Monetary    San      2789-             $5,000    4/16/2015  MHRC Client
                 Franci   25th                                   Wellness
                 sco      Street,                                Enhancement
                 Genera   #2028                                  Project
                 l        PO Box
                 Hospit   410836
                 al       San
                 Founda   Francis
                 tion     co, CA
                          94110
    ------------------------------------------------------------------------
    Monetary    SAVE A   900                 $300   10/13/2015  Costs
                 Friend   Herront                                associated
                 to       own                                    with 2015
                 Homele   Road                                   Janssen
                 ss       Princet                                Cares
                 Animal   on, NJ                                 Volunteer
                 s        08540                                  Event
    ------------------------------------------------------------------------
    Monetary    Save     501              $66,700   12/22/2015  Support
                 The      Kings                                  efforts to
                 Childr   Highway                                give
                 en       East,                                  children a
                 U.S.     Suite                                  healthy
                 Headqu   400                                    start, the
                 arters   Fairfie                                opportunity
                          ld, CT                                 to learn
                          06825                                  and
                                                                 protection
                                                                 from harm
                                                                 (child
                                                                 protection,
                                                                 education,
                                                                 emergency
                                                                 response,
                                                                 health and
                                                                 nutrition,
                                                                 hunger and
                                                                 livelihoods
                                                                 , HIV and
                                                                 AIDS)
    ------------------------------------------------------------------------
    Monetary    Schizop  602 Pink          $2,500    7/16/2015  2015
                 hrenia   Azalea                                 Conference,
                 And      Trl PO                                 ``Schizophr
                 Relate   Box                                    enia: It's
                 d        941222                                 Global''
                 Disord   Houston
                 ers      , TX
                 Allian   77094-
                 ce Of    8222
                 Americ   Houston
                 a        , TX
                          77079-
                          1123
    ------------------------------------------------------------------------
    Monetary    Scripps  10140            $30,000   12/23/2015  Dulce
                 Founda   Campus                                 Prevention:
                 tion     Point                                  A Diabetes
                 for      Drive                                  Early
                 Medici   Suite                                  Prevention
                 ne and   200 San                                Program
                 Scienc   Diego,
                 e        CA
                          92121
    ------------------------------------------------------------------------
    Monetary    Scripps  10140            $25,000   12/23/2015  Project
                 Founda   Campus                                 Dulce
                 tion     Point
                 for      Drive
                 Medici   Suite
                 ne and   200 San
                 Scienc   Diego,
                 e        CA
                          92121
    ------------------------------------------------------------------------
    Monetary    SERV     20                $7,500    9/22/2015  The SERV
                 Founda   Scotch                                 Foundation
                 tion,    Road,                                  Scholarship
                 Inc.     3rd                                    Fund
                          Floor
                          Ewing,
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    SERV     20                $5,000    9/22/2015  13th Annual
                 Founda   Scotch                                 Recovery NJ
                 tion,    Road,                                  Conference
                 Inc.     3rd
                          Floor
                          Ewing,
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    SERV     20                  $300    9/24/2015  Costs
                 Founda   Scotch                                 associated
                 tion,    Road,                                  with 2015
                 Inc.     3rd                                    Janssen
                          Floor                                  Cares
                          Ewing,                                 Volunteer
                          NJ                                     event
                          08628
    ------------------------------------------------------------------------
    Monetary    Shannon  PO Box              $500    12/1/2015  Shannon
                 Daley    1271 36                                Daley
                 Memori   Indian                                 Memorial
                 al       Run                                    Fund
                 Fund     Whiteho                                Charity
                          use                                    Events
                          Station
                          , NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    Sharing  1920              $2,000    5/22/2015  Art and
                 Place,   10th                                   Music
                 Inc.     Avenue                                 Program at
                          South                                  the 1920
                          PO Box                                 Club
                          55945
                          Birming
                          ham, AL
                          35255-
                          5945
    ------------------------------------------------------------------------
    Monetary    Sister   1201              $6,500    10/6/2015  Fundraising
                 Networ   Hamilto                                event
                 k of     n                                      support to
                 Centra   Street                                 benefit
                 l New    Somerse                                general
                 Jersey   t, NJ                                  mission of
                 , Inc.   08873                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Sisters  1201              $1,000     2/6/2015  2015 Health
                 Networ   Hamilto                                Summit and
                 k of     n                                      Breakfast
                 Centra   Street
                 l New    Somerse
                 Jersey   t, NJ
                          08873
    ------------------------------------------------------------------------
    Monetary    Somerse  1810              $8,292    12/1/2015  Teaching
                 t        Burnt                                  Social
                 Hills    Mills                                  Skills
                 Learni   Road
                 ng       Bedmins
                 Instit   ter, NJ
                 ute      07921
    ------------------------------------------------------------------------
    Monetary    Somerse  49                $1,250    1/20/2015  2014 Steps
                 t Home   Brahma                                 for Giving
                 for      Avenue,                                Program
                 Tempor   P.O.
                 arily    Box
                 Displa   6871
                 ced      Bridgew
                 Childr   ater,
                 en       NJ
                          08807-
                          0871
    ------------------------------------------------------------------------
    Monetary    Somerse  49                $7,500    5/22/2015  Fundraising
                 t Home   Brahma                                 event
                 for      Avenue,                                support to
                 Tempor   P.O.                                   benefit
                 arily    Box                                    general
                 Displa   6871                                   mission of
                 ced      Bridgew                                organizatio
                 Childr   ater,                                  n
                 en       NJ
                          08807-
                          0871
    ------------------------------------------------------------------------
    Monetary    Somerse  49                $7,500   11/25/2015  Street
                 t Home   Brahma                                 Smart--HIV/
                 for      Avenue,                                AIDS and
                 Tempor   P.O.                                   STD
                 arily    Box                                    Prevention
                 Displa   6871
                 ced      Bridgew
                 Childr   ater,
                 en       NJ
                          08807-
                          0871
    ------------------------------------------------------------------------
    Monetary    St.      208                 $100    2/13/2015  Memorial
                 France   Bound                                  donation
                 s        Brook
                 Cabrin   Avenue
                 i        Piscata
                 Church   way, NJ
                          08854
    ------------------------------------------------------------------------
    Monetary    St.      One              $15,000    12/8/2015  Providing
                 Mary     Summit                                 Food for
                 Medica   Square,                                School-Age
                 l        Suite                                  Children
                 Center   300                                    Living in
                 Founda   1717                                   Poverty in
                 tion     Langhor                                Bucks
                          ne-                                    County: The
                          Newtown                                St. Mary
                          Road                                   Backpacks
                          Langhor                                for Kids
                          ne, PA                                 Program
                          19047
    ------------------------------------------------------------------------
    Monetary    Stony    31 Titus         $15,000   11/13/2015  StreamWatch
                 Brook    Mill                                   Volunteer
                 Millst   Road                                   Water
                 one      Penning                                Quality
                 Waters   ton, NJ                                Monitoring
                 hed      08534                                  Program
                 Associ
                 ation
    ------------------------------------------------------------------------
    Monetary    T-1      8216             $35,000   11/25/2015  Type 2
                 Today,   Princet                                Education
                 Inc.     on-                                    for Type 1
                          Glendal                                Families
                          e Road,
                          PMB 200
                          West
                          Chester
                          , OH
                          45069
    ------------------------------------------------------------------------
    Monetary    TASK,    72\1/2\             $300    6/23/2015  Costs
                 Inc.     Escher                                 associated
                          Street,                                with 2015
                          P.O.                                   Janssen
                          Box 872                                Cares
                          Trenton                                Volunteer
                          , NJ                                   Activity
                          08605
    ------------------------------------------------------------------------
    Monetary    TASK,    72\1/2\          $25,000    10/8/2015  Trenton Area
                 Inc.     Escher                                 Soup
                          Street,                                Kitchen
                          P.O.                                   Meal
                          Box 872                                Service
                          Trenton                                Program
                          , NJ
                          08605
    ------------------------------------------------------------------------
    Monetary    TASK,    72\1/2\          $20,700   12/15/2015  Support
                 Inc.     Escher                                 hunger
                          Street,                                program in
                          P.O.                                   the Trenton
                          Box 872                                area,
                          Trenton                                programs to
                          , NJ                                   encourage
                          08605                                  self-
                                                                 sufficiency
                                                                 and improve
                                                                 the quality
                                                                 of life of
                                                                 their
                                                                 patrons
    ------------------------------------------------------------------------
    Monetary    The      Paul              $5,000   11/13/2015  Communiversi
                 Arts     Robeson                                ty ArtsFest
                 Counci   Center                                 2016
                 l of     for the
                 Prince   Arts
                 ton      102
                          Withers
                          poon
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      Paul             $10,000   11/16/2015  Community
                 Arts     Robeson                                outreach
                 Counci   Center                                 programs
                 l of     for the                                for youth
                 Prince   Arts                                   and seniors
                 ton      102
                          Withers
                          poon
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      2020              $2,000    12/1/2015  ``Art for
                 Center   Burnt                                  Children
                 for      Mills                                  with Autism
                 Contem   Road                                   Spectrum
                 porary   Bedmins                                Disorder
                 Art      ter, NJ                                and Special
                          07921                                  Needs''
    ------------------------------------------------------------------------
    Monetary    The      19                  $300    8/19/2015  Costs
                 Center   Dellwoo                                associated
                 For      d Lane                                 with 2015
                 Great    Somerse                                Janssen
                 Expect   t, NJ                                  Cares
                 ations   08873                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    The      19               $13,500   10/21/2015  Trauma-
                 Center   Dellwoo                                informed,
                 For      d Lane                                 residential
                 Great    Somerse                                treatment
                 Expect   t, NJ                                  for
                 ations   08873                                  homeless,
                                                                 pregnant/
                                                                 parenting
                                                                 adult women
                                                                 in
                                                                 substance
                                                                 use
                                                                 recovery,
                                                                 and their
                                                                 children.
    ------------------------------------------------------------------------
    Monetary    The      1040              $5,000    6/23/2015  Jail
                 Edinbu   Waltham                                Diversion
                 rg       Street                                 Program
                 Center   Lexingt
                          on, MA
                          02421
    ------------------------------------------------------------------------
    Monetary    The      8150 N.          $40,000    12/4/2015  VTE
                 Mended   Central                                Education
                 Hearts   Express                                and
                 , Inc.   way,                                   Outreach
                          Suite                                  Program
                          M2248
                          Dallas,
                          TX
                          75206
    ------------------------------------------------------------------------
    Monetary    The      401                 $500     3/2/2015  Flash Lite
                 Mental   Cypress                                sponsor
                 Health   Street                                 2015 Lite
                 Center   Manches                                up the Nite
                 Of       ter, NH                                for Mental
                 Greate   03103                                  Health Run/
                 r                                               Walk
                 Manche
                 ster
    ------------------------------------------------------------------------
    Monetary    The      P.O. Box          $7,500   11/16/2015  Arts
                 Prince   2063                                   education
                 ton      Princet                                and
                 Festiv   on, NJ                                 community
                 al       08543                                  engagement
                                                                 programs
    ------------------------------------------------------------------------
    Monetary    Thomas   101 West         $12,000   11/13/2015  Scholarships
                 Edison   State                                  for
                 State    Street                                 Students
                 Colleg   Trenton                                Enrolled in
                 e        , NJ                                   the
                 Founda   08608                                  Accelerated
                 tion                                            Second
                                                                 Degree BSN
                                                                 Program at
                                                                 Thomas
                                                                 Edison
                                                                 State
                                                                 College's
                                                                 W. Cary
                                                                 Edwards
                                                                 School of
                                                                 Nursing
    ------------------------------------------------------------------------
    Monetary    TPTO     51 South          $1,000   11/16/2015  2016
                 Inc--T   Timberl                                Timberlane
                 imberl   ane                                    Science and
                 ane      Drive,                                 Engineering
                 Parent   Penning                                Fair
                 Teache   ton NJ
                 r        08534
                 Organi   Penning
                 zation   ton, NJ
                          08534
    ------------------------------------------------------------------------
    Monetary    Trenton  P.O. Box          $5,000   11/12/2015  Trenton
                 Commun   5206                                   Community
                 ity      (physic                                Music
                 Music    al                                     School
                 School   address                                Community-
                          : 439                                  Based Music
                          S.                                     Education
                          Broad
                          Street,
                          Ste.
                          90,
                          Trenton
                          NJ
                          08611
                          Trenton
                          , NJ
                          08638
    ------------------------------------------------------------------------
    Monetary    Trenton  635               $3,500   11/16/2015  Trenton
                 Educat   South                                  Education
                 ion      Clinton                                Dance
                 Dance    Avenue                                 Institute
                 Instit   Trenton                                program for
                 ute      , NJ                                   at-risk
                          08611                                  youth in
                                                                 Trenton
    ------------------------------------------------------------------------
    Monetary    Trenton  218 N            $15,000   10/23/2015  Further
                 Health   Broad                                  Inroads for
                 Team,    St                                     Health
                 Inc.     Trenton
                          , NJ
                          08608
    ------------------------------------------------------------------------
    Monetary    Trinity  22                $7,500   11/12/2015  Mental
                 Counse   Stockto                                Health and
                 ling     n                                      Wellness
                 Servic   Street                                 Programs
                 es       Trinity
                          Counsel
                          ing
                          Service
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Twiligh  P.O. Box          $7,500   11/16/2015  Simple Needs
                 t Wish   1042 11                                Wish
                 Founda   Duane                                  Granting
                 tion     Road                                   Program
                          Doylest
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    UIH      4 North           $7,500    9/28/2015  Community of
                 Family   Broad                                  Health for
                 Partne   Street                                 Men Program
                 rs       2nd                                    (Year 2)
                          Floor
                          Trenton
                          , NJ
                          08618-
                          4408
    ------------------------------------------------------------------------
    Monetary    United   9-25              $7,500    9/25/2015  Princeton
                 Negro    Alling                                 Committee
                 Colleg   Street                                 of UNCF
                 e Fund   2nd                                    Scholarship
                          Floor
                          Newark,
                          NJ
                          07102
    ------------------------------------------------------------------------
    Monetary    United   Attn:           $595,877   12/21/2015  Company
                 Way      Finance                                match to
                 Worldw   Operati                                employee
                 ide      on P.O.                                United Way
                          Box                                    campaign
                          418607                                 for NJ
                          Boston,                                based
                          MA                                     commercial
                          02241-                                 companies
                          8607                                   of Janssen
                                                                 Pharmaceuti
                                                                 cal
                                                                 Companies
                                                                 of Johnson
                                                                 & Johnson
    ------------------------------------------------------------------------
    Monetary    Valeo    5401 SW           $3,500    5/22/2015  Creations of
                 Behavi   7th                                    Hope: A
                 oral     Street                                 gallery by
                 Health   Topeka,                                artists
                 Care,    KS                                     experiencin
                 Inc.     66606                                  g mental
                                                                 illness
    ------------------------------------------------------------------------
    Monetary    Volunte  12                $7,500   11/12/2015  SkillsConnec
                 er       Stockto                                t program
                 Connec   n
                 t        Street
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Washing  P.O. Box            $500    2/27/2015  Educational
                 ton      83                                     program
                 Crossi   Titusvi                                focused on
                 ng       lle, NJ                                New Jersey
                 Park     08560                                  in the
                 Associ                                          American
                 ation,                                          Revolutiona
                 Inc.                                            ry War
    ------------------------------------------------------------------------
    Monetary    We Care  3035              $1,500    6/22/2015  Support
                 Arts     Wilming                                Artowork
                          ton                                    program,
                          Pike                                   which aims
                          Ketteri                                to use art
                          ng, OH                                 to help
                          45429                                  enrich
                                                                 lives of
                                                                 the
                                                                 mentally
                                                                 ill
    ------------------------------------------------------------------------
    Monetary    West     120                 $300    8/20/2015  Costs
                 Bergen   Chestnu                                associated
                 Mental   t                                      with 2015
                 Health   Street                                 Janssen
                 care     Ridgewo                                Cares
                          od, NJ                                 Volunteer
                          07450-                                 Activity
                          2500
    ------------------------------------------------------------------------
    Monetary    West     PO Box            $5,000   11/12/2015  Excellence
                 Windso   280                                    in
                 r        West                                   Education
                 Plains   Windsor                                Grant
                 boro     , NJ                                   Program
                 Educat   08550-
                 ion      0280
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Womansp  1530                $300    6/26/2015  Costs
                 ace      Brunswi                                associated
                          ck Ave.                                with 2015
                          Lawrenc                                Janssen
                          eville,                                Cares
                          NJ                                     Volunteer
                          08648                                  Activity
    ------------------------------------------------------------------------
    Monetary    Women's  3200                 $75    1/14/2015  Employee
                 Commun   Hilltop                                directed
                 ity,     Avenue                                 donation in
                 Inc.     Wausau,                                lieu of
                          WI                                     company
                          54401                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Woods    40                $4,000   11/20/2015  Improving
                 Servic   Martin                                 the Health
                 es       Gross                                  of People
                 Founda   Drive                                  with
                 tion     PO box                                 Disabilitie
                          36                                     s at Woods
                          Langhor                                Services
                          ne, PA                                 through
                          19047                                  Enhanced
                                                                 Recreationa
                                                                 l
                                                                 Activities
    ------------------------------------------------------------------------
    Monetary    YMCA of  431               $5,000   11/16/2015  Science in
                 Trento   Penning                                the City--
                 n        ton                                    Minorities
                          Avenue                                 in M.I.N.T.
                          Trenton                                Mentoring
                          , NJ                                   Program
                          08618
    ------------------------------------------------------------------------
    Monetary    Young    349 W.              $300    7/14/2015  Costs
                 Schola   State                                  associated
                 rs'      St                                     with 2015
                 Instit   Trenton                                Janssen
                 ute      , NJ                                   Cares
                          08618                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Zufall   18 West             $300     8/3/2015  Costs
                 Health   Blackwe                                associated
                 Center   ll                                     with 2015
                 , Inc.   Street                                 Janssen
                          Dover,                                 Cares
                          NJ                                     Volunteer
                          07801                                  Activity
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $6,802,406    3/10/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Armenia,
                                                                 Dominican
                                                                 Republic,
                                                                 Gaza,
                                                                 Ghana,
                                                                 Honduras,
                                                                 Nicaragua,
                                                                 Peru, US,
                                                                 West Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $413,439    3/10/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Nicaragua,
                                                                 Peru, US,
                                                                 West Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $292,148     4/2/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Armenia,
                                                                 Columbia,
                                                                 Dominican
                                                                 Republic,
                                                                 Gaza,
                                                                 Lebanon,
                                                                 Nicaragua,
                                                                 West Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $219,598    4/30/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Nepal
                                                                 (2015
                                                                 earthquake
                                                                 relief)
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $673,887     5/5/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n relief in
                          06902                                  Lebanon
                                                                 (ANERA
                                                                 program)
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $279,339    5/20/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n relief in
                          06902                                  Romania,
                                                                 Senegal,
                                                                 United
                                                                 States
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,454,074     6/4/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Lebanon,
                                                                 West Bank,
                                                                 US,
                                                                 Tanzania,
                                                                 Peru,
                                                                 Afghanistan
                                                                 , Colombia,
                                                                 Malawi,
                                                                 Armenia
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $6,800,452    6/29/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Gaza,
                                                                 West Bank,
                                                                 US
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $13,984     8/3/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $54,149,760     8/6/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Armenia,
                                                                 Uzbekistan,
                                                                 US
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $84,124     9/9/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance:
                                                                 disaster
                                                                 relief
                                                                 preparednes
                                                                 s
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $2,921,081    10/5/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Honduras,
                                                                 Peru,
                                                                 Armenia,
                                                                 Tanzania,
                                                                 Senegal,
                                                                 Afghanistan
                                                                 and for
                                                                 disaster
                                                                 preparednes
                                                                 s modules
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,544,676    10/5/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Armenia,
                                                                 Gaza, Peru,
                                                                 Senegal,
                                                                 Tanzania,
                                                                 West Bank,
                                                                 US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $456,654    11/4/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Armenia,
                                                                 Gaza, Peru,
                                                                 Romania,
                                                                 Senegal,
                                                                 Uzbekistan,
                                                                 West Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,070,880   11/18/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $897,021    12/8/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Armenia,
                                                                 Nicaragua,
                                                                 Peru, US
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $48,945   12/21/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in USA
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $2,005,526   12/21/2015  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in USA
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $812,025    3/10/2015  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti,
                          10005                                  Honduras,
                                                                 Jamaica,
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $105,683    3/10/2015  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti,
                          10005                                  Jamaica
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $275,375     6/4/2015  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Jamaica,
                          NY                                     Armenia,
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $313,574    6/29/2015  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in El
                          NY                                     Salvador
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall      $1,612,989    10/9/2015  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala,
                                                                 Honduras,
                                                                 Haiti
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $563,598    10/9/2015  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala,
                                                                 Honduras,
                                                                 Haiti
    ------------------------------------------------------------------------
    Product     Catholi  33-01             $8,754    11/4/2015  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guyana,
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $343,347   12/18/2015  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in El
                          NY                                     Salvador,
                                                                 Dominican
                                                                 Republic,
                                                                 Sierra
                                                                 Leone,
                                                                 Uganda,
                                                                 Guatemala,
                                                                 Guyana,
                                                                 Philippines
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $2,014,130    3/10/2015  Pharmaceutic
                 Relief   Patera                                 al Product
                          Lane                                   Donation
                          Goleta,                                for
                          CA                                     Humanitaria
                          93117                                  n Aid in
                                                                 Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Haiti, US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $274,761    3/10/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Ghana,
                                                                 Guatemala,
                                                                 Nicaragua,
                                                                 US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $17,185     4/2/2015  Pharmaceutic
                 Relief   Patera                                 al Product
                          Lane                                   Donation
                          Goleta,                                for
                          CA                                     Humanitaria
                          93117                                  n Aid in
                                                                 Paraguay
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $13,131     5/4/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Nepal
                                                                 (2015
                                                                 earthquake
                                                                 relief)
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $10,680     5/5/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Congo,
                                                                 Malawi,
                                                                 Mali,
                                                                 Somalia,
                                                                 Tanzania,
                                                                 Zambia
                                                                 (obstetric
                                                                 fistula
                                                                 program)
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $187,713    5/20/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n relief in
                          93117                                  El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Dominican
                                                                 Republic,
                                                                 United
                                                                 States
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $852,327     6/4/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in
                                                                 Paraguay,
                                                                 El
                                                                 Salvador,
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $9,636,065    6/29/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Haiti,
                                                                 India,
                                                                 Jamaica,
                                                                 Paraguay,
                                                                 Armenia,
                                                                 Dominican
                                                                 Republic,
                                                                 Ghana,
                                                                 Guatemala,
                                                                 Hondorus,
                                                                 US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $20,976     8/4/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Paraguay
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $13,878     8/5/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Africa
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $198,318    9/11/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance:
                                                                 disaster
                                                                 relief
                                                                 preparednes
                                                                 s
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $5,543,118   10/12/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in
                                                                 Nicaragua,
                                                                 Sierra
                                                                 Leone,
                                                                 Ghana, US
                                                                 and for
                                                                 disaster
                                                                 preparednes
                                                                 s modules
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $918,456   10/12/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Ghana,
                                                                 Sierra
                                                                 Leone,
                                                                 Nicaragua,
                                                                 US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $81,702    11/4/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in
                                                                 Cambodia,
                                                                 Guatemala,
                                                                 Haiti,
                                                                 Honduras,
                                                                 India,
                                                                 Paraguay
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $27,755   11/25/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Africa
                                                                 (obstetric
                                                                 fistula
                                                                 program)
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $186,387    12/7/2015  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Goleta,                                humanitaria
                          CA                                     n
                          93117                                  assistance
                                                                 in Ecuador,
                                                                 Ghana,
                                                                 Mexico,
                                                                 Jamaica
    ------------------------------------------------------------------------
    Product     Heart    13250 W       $4,874,474    10/6/2015  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Papua New
                                                                 Guinea
    ------------------------------------------------------------------------
    Product     Heart    13250 W       $1,148,070    10/6/2015  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     Johnson  One         $299,754,483   12/31/2015  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     MAP      4700          $2,230,112    2/20/2015  Pharmaceutic
                 Intern   Glynco                                 al Product
                 ationa   Parkway                                Donation to
                 l        Brunswi                                support the
                          ck, GA                                 Medical
                          31525                                  Mission
                                                                 Pack+
                                                                 Program
    ------------------------------------------------------------------------
    Product     MAP      4700          $1,312,483    7/20/2015  Global
                 Intern   Glynco                                 Public
                 ationa   Parkway                                Health
                 l        Brunswi                                programs in
                          ck, GA                                 Sub Saharan
                          31525                                  Africa
                                                                 (HIV)
    ------------------------------------------------------------------------
    Product     MAP      4700             $46,453    9/11/2015  Product
                 Intern   Glynco                                 donations
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance:
                                                                 Medical
                                                                 Mission
                                                                 Pack Plus
                                                                 replenishme
                                                                 nt
    ------------------------------------------------------------------------
    Product     MAP      4700             $35,015   11/25/2015  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 and medical
                                                                 mission
                                                                 pack +
                                                                 program
    ------------------------------------------------------------------------
    Product     MAP      4700            $951,077   12/15/2015  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 (medical
                                                                 mission
                                                                 pack +
                                                                 program)
    ------------------------------------------------------------------------
    Product     US       1300 PA      $29,310,000   12/17/2015  Global
                 Agency   Avenue.                                Public
                 for      , NW,                                  Health
                 Intern   SA-44                                  programs--B
                 ationa   Rm 475-                                edaquiline
                 l        J                                      Donation
                 Develo   Washing                                Program
                 pment    ton, DC
                          20523
    ------------------------------------------------------------------------
    Updated March 24, 2016

      Janssen Therapeutics, Division of Janssen Products, LP, Monetary and
     Product Contributions to U.S.-based Charitable Organizations Full Year
                                      2015
            (Payments made from January 1, 2015 to December 31, 2015)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    Aboundi  2311              $5,000     5/8/2015  Project
                 ng       Martin                                 CONNECT
                 Prospe   Luther
                 rty,     King
                 Inc.     Blvd
                          Dallas,
                          TX
                          75215
    ------------------------------------------------------------------------
    Monetary    Aboundi  2311             $15,000   11/13/2015  Confidential
                 ng       Martin                                 and Mature
                 Prospe   Luther                                 Explanation
                 rty,     King                                   s (C-ME):
                 Inc.     Blvd                                   HCV
                          Dallas,                                Awareness
                          TX                                     for At-Risk
                          75215                                  Adults in
                                                                 South
                                                                 Dallas
    ------------------------------------------------------------------------
    Monetary    Aboundi  2311             $30,000   12/22/2015  Project TEST
                 ng       Martin
                 Prospe   Luther
                 rty,     King
                 Inc.     Blvd
                          Dallas,
                          TX
                          75215
    ------------------------------------------------------------------------
    Monetary    Acercam  827               $7,000     5/8/2015  ContraSIDA
                 iento    Wildwoo                                (Againsts
                 Hispan   d Ave,                                 AIDS)
                 o de     Suite
                 Caroli   200
                 na del   Columbi
                 Sur      a, SC
                          29203
    ------------------------------------------------------------------------
    Monetary    ADAP     PO Box            $5,000    3/16/2015  ADAP
                 Advoca   15275                                  Directory
                 cy       Physica
                          l:312
                          11th
                          Avenue,
                          #21g,
                          New
                          York,
                          NY
                          10001
                          Washing
                          ton, DC
                          20003
    ------------------------------------------------------------------------
    Monetary    Aid For  515              $10,000    7/13/2015  Case
                 AIDS     Greenwi                                Management
                 Intern   ch St                                  Program
                 ationa   New
                 l,       York,
                 Inc.     NY
                          10013
    ------------------------------------------------------------------------
    Monetary    AID      811              $18,259   12/22/2015  Project
                 Upstat   Pendlet                                Healthy
                 e        on                                     Pink Parts
                          Street
                          Bldg.
                          #10
                          Greenvi
                          lle, SC
                          29601
    ------------------------------------------------------------------------
    Monetary    AIDS     75 Amory         $15,000   11/13/2015  Viral
                 Action   Street                                 Hepatitis
                 Commit   Boston,                                Access to
                 tee of   MA                                     Care
                 Massac   02119                                  Project:
                 husett                                          Access to
                 s                                               treatment
    ------------------------------------------------------------------------
    Monetary    AIDS     995               $5,000    7/27/2015  Bridges
                 Care     Northwe                                Project
                 Servic   st
                 e,       Bouleva
                 Inc.     rd
                          Winston
                          Salem,
                          NC
                          27101
    ------------------------------------------------------------------------
    Monetary    AIDS     575 8th          $20,000    7/13/2015  HIV Health
                 Commun   Ave,                                   Literacy
                 ity      Suite                                  Education
                 Resear   502 New                                and
                 ch       York,                                  Training
                 Initia   NY                                     for Service
                 tive     10018                                  Providers
                 of                                              Working
                 Americ                                          with
                 a                                               Vulnerable
                 ACRIA                                           Populations
    ------------------------------------------------------------------------
    Monetary    AIDS     6260              $3,000    5/27/2015  Supportive
                 Founda   Westpar                                Services
                 tion     k Drive
                 Housto   Suite
                 n,       100
                 Inc.     Houston
                          , TX
                          77057
    ------------------------------------------------------------------------
    Monetary    AIDS     200 W.           $40,000    5/20/2015  Road to
                 Founda   Jackson                                Health:
                 tion     Blvd.,                                 Promoting
                 of       Suite                                  Successful
                 Chicag   2100                                   Implementat
                 o        Chicago                                ion of
                          , IL                                   Health Care
                          60606                                  Reform for
                                                                 People
                                                                 Living with
                                                                 HIV/AIDS in
                                                                 Illinois
    ------------------------------------------------------------------------
    Monetary    AIDS     400 N             $5,000    3/12/2015  Case
                 Outrea   Beach                                  Management
                 ch       Street,                                Program for
                 Center   Suite                                  People
                          100 Ft.                                Living with
                          Worth,                                 HIV
                          TX
                          76111
    ------------------------------------------------------------------------
    Monetary    AIDS     1320             $28,020   12/22/2015  Transcend
                 Projec   Webster
                 t of     Street
                 the      oakland
                 East     , CA
                 Bay      96612
    ------------------------------------------------------------------------
    Monetary    AIDS     1424 K          $150,000   11/17/2015  Disseminatio
                 United   Street,                                n of Access
                          NW,                                    to Care and
                          Ste.                                   Retention
                          200                                    in Care
                          Washing                                Best
                          ton, DC                                Practices
                          20005
    ------------------------------------------------------------------------
    Monetary    AIDS     Box 3068          $5,000    3/13/2015  Latino
                 Walk     San                                    Services
                 San      Diego,
                 Diego    CA
                          92163
    ------------------------------------------------------------------------
    Monetary    Alexian  825 W.            $5,000    7/15/2015  Transitional
                 Brothe   Welling                                Living
                 rs       ton                                    Program for
                 Bonave   Chicago                                Homeless
                 nture    , IL                                   Adults with
                 House    60657                                  HIV/AIDS
                                                                 Case
                                                                 Management
                                                                 Services
    ------------------------------------------------------------------------
    Monetary    Alivene  3808              $5,000    5/27/2015  Health and
                 ss       Nicolle                                Wellness
                 Projec   t Ave                                  Program:
                 t,       Minneap                                Aging with
                 Inc.     olis,                                  HIV/AIDS
                          MN
                          55409
    ------------------------------------------------------------------------
    Monetary    Allianc  825               $3,000    5/27/2015  Nurse Case
                 e For    Colorad                                Management
                 Housin   o                                      for
                 g And    Blvd.,                                 Residential
                 Healin   Suite                                  Care
                 g        100 Los                                Facility
                          Angeles                                Serving
                          , CA                                   Homeless
                          90041                                  Persons
                                                                 with HIV/
                                                                 AIDS
    ------------------------------------------------------------------------
    Monetary    Atlanta  P.O. Box         $32,000    4/16/2015  Comprehensiv
                 Harm     92670                                  e HIV and
                 Reduct   Atlanta                                HCV
                 ion      , GA                                   treatment
                 Coalit   30314                                  for IDUs
                 ion
    ------------------------------------------------------------------------
    Monetary    BASIC    432               $5,000    5/15/2015  Fully
                 NWFL,    Magnoli                                Committed
                 INC.     a
                          Avenue
                          Panama
                          City,
                          FL
                          32401
    ------------------------------------------------------------------------
    Monetary    BASIC    432              $29,250   12/22/2015  FULLY
                 NWFL,    Magnoli                                COMMITTED:
                 INC.     a                                      Improving
                          Avenue                                 Linkage to
                          Panama                                 Care and
                          City,                                  Retention
                          FL                                     among Young
                          32401                                  MSM of
                                                                 Color
                                                                 Living with
                                                                 HIV
    ------------------------------------------------------------------------
    Monetary    Bay      701 Oak           $5,000   12/21/2015  Patient Peer
                 Area     Street                                 Navigation
                 Young    San
                 Positi   Francis
                 ves      co, CA
                          94117
    ------------------------------------------------------------------------
    Monetary    Brockto  500               $5,000    3/24/2015  HIV/AIDS
                 n Area   Belmont                                Case
                 Multi-   Street                                 Management
                 Servic   Ste 300                                Initiative
                 es,      Brockto                                and
                 Inc.     n, MA                                  Hepatitis C
                          02301                                  Support
                                                                 Group.
    ------------------------------------------------------------------------
    Monetary    Bronx    540 East         $40,000    3/10/2015  Improving
                 AIDS     Fordham                                Care and
                 Servic   Rd                                     Treatment
                 es,      Bronx,                                 for People
                 Inc.     NY                                     who Inject
                          10458                                  Drugs
                                                                 (PWID) who
                                                                 are Living
                                                                 with HIV
                                                                 and/or
                                                                 Hepatitis C
    ------------------------------------------------------------------------
    Monetary    Caring   PO Box           $40,000    5/20/2015  Hepatitis C
                 Ambass   1748                                   Program
                 adors    Oregon                                 Support
                 Progra   City,
                 m,       OR
                 Inc.     97045
    ------------------------------------------------------------------------
    Monetary    Center   900              $25,000    3/10/2015  Hepatitis
                 for      Avila                                  and HIV
                 Health   Street,                                Navigation
                 Justic   Suite                                  Project--RF
                 e        301,                                   A
                          Los
                          Angeles
                          , CA
                          90012
    ------------------------------------------------------------------------
    Monetary    Central  1785              $5,000   10/12/2015  Increasing
                 Louisi   Jackson                                Timely
                 ana      Street                                 Access to
                 Aids     Alexand                                HIV Care,
                 Suppor   ria, LA                                Testing and
                 t        71301                                  Prevention
                 Servic                                          Services
                 es,
                 Inc.
                 (CLASS
                 )
    ------------------------------------------------------------------------
    Monetary    Coaliti  127 W            $50,000   12/21/2015  Hepatitis C
                 on On    127th                                  Education
                 Positi   street                                 and
                 ve       Suite                                  Services
                 Health   208 New                                Project
                 Empowe   York,
                 rment,   NY
                 Inc.     10027
    ------------------------------------------------------------------------
    Monetary    Coastal  400 Mann         $40,000    3/24/2015  Hepatitis
                 Bend     Street,                                Education
                 AIDS     Suite                                  Program
                 Founda   800                                    (HEP)
                 tion     Corpus
                          Christi
                          , TX
                          78401
    ------------------------------------------------------------------------
    Monetary    Communi  677 Ala           $7,500    10/3/2015  Integrating
                 ty       Moana                                  Hepatitis
                 Health   #226                                   Care
                 Outrea   Honolul                                Coordinatio
                 ch       u, HI                                  n into
                 Work     96813                                  Hawaii AIDS
                 To                                              Service
                 Preven                                          Organizatio
                 t Aids                                          ns
    ------------------------------------------------------------------------
    Monetary    Desert   1695 N.           $5,000    3/16/2015  Get Tested
                 Aids     Sunrise                                Coachella
                 Projec   Way                                    Valley
                 t        Palm
                          Springs
                          , CA
                          92262
    ------------------------------------------------------------------------
    Monetary    Exponen  2                 $5,000   11/16/2015  HEPAware
                 ts,      Washing                                Project
                 Inc.     ton
                          Street,
                          Fourth
                          Floor
                          New
                          York,
                          NY
                          10004
    ------------------------------------------------------------------------
    Monetary    Gay      446 W            $15,000    10/3/2015  HIV
                 Men's    33rd St                                Community
                 Health   New                                    Education
                 Crisis   York,                                  and
                          NY                                     Treatment
                          10001                                  Adherence
                                                                 Support
    ------------------------------------------------------------------------
    Monetary    Gay      446 W            $30,000   12/22/2015  Peer
                 Men's    33rd St                                Navigation
                 Health   New                                    Services
                 Crisis   York,                                  for HIV-
                          NY                                     positive
                          10001                                  Transgender
                                                                 and Gender
                                                                 Non-
                                                                 Conforming
                                                                 Individuals
    ------------------------------------------------------------------------
    Monetary    Harm     22 West          $30,000     6/5/2015  Hepatitis C
                 Reduct   27th                                   and
                 ion      Street                                 Injection
                 Coalit   5th                                    Drug Use
                 ion      Floor                                  Initiative
                          New
                          York,
                          NY
                          10001
    ------------------------------------------------------------------------
    Monetary    Hips     HIPS             $30,000   12/22/2015  Treatment
                          Center                                 Plus: Peer
                          for                                    Based
                          Health                                 Community
                          and                                    Health
                          Achieve                                Worker
                          ment                                   Support to
                          906 H                                  Improve
                          St., NE                                Health
                          Washing                                Outcomes
                          ton, DC                                for Highly
                          20002                                  Marginalize
                                                                 d
                                                                 Transgender
                                                                 Women
    ------------------------------------------------------------------------
    Monetary    Housing  301 West          $7,500    12/8/2015  Hepatitis C
                 Works,   37th                                   Peer
                 Inc.     Street,                                Navigator
                          #3 New                                 Program
                          York,
                          NY
                          10018
    ------------------------------------------------------------------------
    Monetary    Jackson  P.O. Box          $5,000    8/27/2015  JASMYN
                 ville    380103                                 Safety Net
                 Area     923                                    Program
                 Sexual   Peninsu                                Expansion
                 Minori   lar
                 ty       Place
                 Youth    Jackson
                 Networ   ville,
                 k,       FL
                 Inc.     32205
                 (JASMY
                 N)
    ------------------------------------------------------------------------
    Monetary    Legacy   4054              $5,000   12/21/2015  Counseling
                 Counse   McKinne                                services to
                 ling     y                                      individuals
                 Center   Avenue,                                living with
                          Suite                                  HIV/AIDS
                          102
                          Dallas,
                          TX
                          75204
    ------------------------------------------------------------------------
    Monetary    Long     2740             $30,000   12/22/2015  Pride for
                 Island   Martin                                 Youth POZ
                 Crisis   Ave                                    Night
                 Center   Bellmor
                 , Inc.   e, NY
                          11710
    ------------------------------------------------------------------------
    Monetary    Macedon  1835              $5,000    3/24/2015  Peer
                 ia       Centre                                 Navigator
                 Family   Avenue,                                for
                 And      Suite                                  Prevention/
                 Commun   285                                    Case
                 ity      Pittsbu                                Management
                 Enrich   rgh, PA                                Services
                 ment     15219
                 Center
    ------------------------------------------------------------------------
    Monetary    Macedon  1835              $5,000   10/23/2015  Peer
                 ia       Centre                                 Navigator
                 Family   Avenue,                                for
                 And      Suite                                  Prevention/
                 Commun   285                                    Case
                 ity      Pittsbu                                Management
                 Enrich   rgh, PA                                Services
                 ment     15219                                  Implementat
                 Center                                          ion
    ------------------------------------------------------------------------
    Monetary    MCCNY    446 West         $30,000   12/23/2015  Trans in
                 Charit   36th                                   Action
                 ies      Street
                          New
                          York,
                          NY
                          10018
    ------------------------------------------------------------------------
    Monetary    Mendoci  148              $39,870    3/30/2015  Linkage and
                 no       Clara                                  Support
                 County   Ave.                                   Services
                 AIDS     Ukiah,                                 for PWID's
                 Volunt   CA
                 eer      95482
                 Networ
                 k adba
                 Mendoc
                 ino
                 County
                 AIDS/
                 Viral
                 Hepati
                 tis
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    Metropo  3251 3rd         $30,000   12/23/2015  TransHealth
                 litan    Avenue                                 Care
                 Charit   North                                  Coordinatio
                 ies,     Suite#1                                n
                 Inc.     25 St
                          Petersb
                          urg, FL
                          33713
    ------------------------------------------------------------------------
    Monetary    Minorit  5149 W.           $7,500    4/30/2015  ``G.L.A.M.O.
                 y AIDS   Jeffers                                R.''
                 Projec   on Blvd                                Getting
                 t        Los                                    Linked And
                          Angeles                                Managing
                          , CA                                   Our
                          90016                                  Regimen. It
                                                                 is The
                                                                 Missing
                                                                 Link.
    ------------------------------------------------------------------------
    Monetary    Missour  601              $18,000    3/24/2015  General
                 i        Busines                                Charitable
                 Hepati   s Loop                                 Contributio
                 tis C    70                                     n
                 Allian   West,
                 ce       Suite
                          134K,
                          Columbi
                          a, MO
                          65203-
                          2585
    ------------------------------------------------------------------------
    Monetary    Montgom  820 W.           $18,000    3/13/2015  Alabama
                 ery      Wouth                                  eHealth
                 AIDS     Blvd.,                                 Access to
                 Outrea   Montgom                                Rural care
                 ch       ery, AL                                for HIV/
                          36105                                  AIDS and
                                                                 Hepatitis C
    ------------------------------------------------------------------------
    Monetary    Nashvil  633              $18,000   12/22/2015  Brothers
                 le       Thompso                                United
                 CARES,   n Lane                                 Network of
                 Inc.     Nashvil                                Tennessee:
                          le, TN                                 Mobilizatio
                          37204                                  n of Young
                                                                 African
                                                                 American
                                                                 MSM in
                                                                 Rural
                                                                 Middle and
                                                                 East
                                                                 Tennessee
    ------------------------------------------------------------------------
    Monetary    Nationa  2140              $5,000    7/15/2015  Brothers
                 l AIDS   Martin                                 Like Us
                 Educat   Luther                                 (B.L.U.)
                 ion      King                                   Project
                 and      Jr.
                 Servic   Drive
                 es for   Atlanta
                 Minori   , GA
                 ties     30310
    ------------------------------------------------------------------------
    Monetary    Nationa  2140             $30,000   12/22/2015  Be Connected
                 l AIDS   Martin                                 Mentoring
                 Educat   Luther                                 Program
                 ion      King
                 and      Jr.
                 Servic   Drive
                 es for   Atlanta
                 Minori   , GA
                 ties     30310
    ------------------------------------------------------------------------
    Monetary    Nationa  580             $200,000    2/25/2015  Hepatitis C
                 l AIDS   Broadwa                                Project,
                 Treatm   y Suite                                HIV Too
                 ent      1010
                 Advoca   New
                 cy       York,
                 Projec   NY
                 t        10012
    ------------------------------------------------------------------------
    Monetary    Nationa  National        $150,000   11/17/2015  Affordable
                 l        Latino                                 Care Act
                 Allian   AIDS                                   (ACA),
                 ce of    Action                                 Viral
                 State    Network                                Hepatitis,
                 and      and                                    and Ryan
                 Territ   Nationa                                White/ADAP
                 orial    l                                      Public
                 AIDS     Allianc                                Policy and
                 Direct   e of                                   Technical
                 ors      State                                  Assistance
                          and                                    Programs
                          Territo
                          rial
                          AIDS
                          Directo
                          rs 444
                          N
                          Capitol
                          St
                          Suite
                          339
                          Washing
                          ton, DC
                          20001
    ------------------------------------------------------------------------
    Monetary    Nationa  Post              $7,500    7/27/2015  Black LGBT
                 l        Office                                 Health and
                 Black    Box                                    Wellness
                 Justic   71395                                  Initiative
                 e        Washing
                 Coalit   ton, DC
                 ion,     20024
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  1825             $35,000    3/10/2015  Strong
                 l        Connect                                Communities
                 Minori   icut                                   :
                 ty       Avenue,                                Strengtheni
                 AIDS     NW                                     ng
                 Counci   Washing                                connections
                 l        ton, DC                                between
                          20009-                                 communities
                          5721                                   of color
                                                                 and the
                                                                 healthcare
                                                                 providers
                                                                 that serve
                                                                 them.
    ------------------------------------------------------------------------
    Monetary    New      44 South          $5,000    8/27/2015  Support of
                 Jersey   Street                                 case
                 AIDS     Morrist                                management
                 Servic   own, NJ
                 es       07960
    ------------------------------------------------------------------------
    Monetary    Next     99                $5,000    7/27/2015  Next Step
                 Step     Bishop                                 Transitiona
                 Fund,    Allen                                  l Support
                 Inc.     Drive                                  for HIV+
                          Cambrid                                Teens and
                          ge, MA                                 Young
                          02139                                  Adults
    ------------------------------------------------------------------------
    Monetary    Our      2727 SE           $5,000    3/13/2015  NHCP:
                 House    Alder                                  Independent
                 Of       St.                                    Living
                 Portla   Portlan                                Support for
                 nd       d, OR                                  Individuals
                 Incorp   97214                                  with HIV/
                 orated                                          AIDS
    ------------------------------------------------------------------------
    Monetary    Philade  1233             $10,000    6/25/2015  End AIDS
                 lphia    Locust                                 Summit/AIDS
                 Fight    St.                                    Education
                          Philade                                Month 2015
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Project  273              $40,000    3/13/2015  The Support
                 Inform   Ninth                                  Partnership
                          Street
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $65,000    6/12/2015  Mission
                 Inform   Ninth                                  Support for
                          Street                                 Project
                          San                                    Inform
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  P.O. Box          $5,000    10/3/2015  Transitional
                 Transi   4826                                   Supportive
                 tions,   Austin,                                Housing
                 Inc.     TX                                     Programs
                          78765
    ------------------------------------------------------------------------
    Monetary    Resourc  2701              $3,000    5/27/2015  Valor
                 e        Reagan                                 Latino--HIV
                 Center   Street                                 Prevention
                 of       Dallas,                                Program
                 Dallas   TX
                 , Inc.   75219
    ------------------------------------------------------------------------
    Monetary    San      2508             $20,000     8/3/2015  Creating
                 Diego    Histori                                Circles of
                 Human    c                                      Care
                 Dignit   Decatur
                 y        Road
                 Founda   Suite
                 tion     160 San
                          Diego,
                          CA
                          92106
    ------------------------------------------------------------------------
    Monetary    Set      8035 E.           $5,000    10/3/2015  Phenomenal
                 Apart    R.L.                                   Woman
                 Aiming   Thornto                                Program
                 Victor   n Frwy.                                (PWP)
                 iously   Suite
                 To       424
                 Elimat   Dallas,
                 e        TX
                 Diseas   75228
                 es
    ------------------------------------------------------------------------
    Monetary    Sexual   410 7th          $30,000   12/22/2015  Peer
                 Minori   st SE                                  Education:
                 ty       Washing                                Empowering
                 Youth    ton, DC                                young MSM
                 Assist   20003                                  of color to
                 ance                                            end HIV.
                 League
                 (SMYAL
                 ) DBA:
                 Suppor
                 ting
                 and
                 Mentor
                 ing
                 Youth
                 Advoca
                 tes
                 and
                 Leader
                 s
    ------------------------------------------------------------------------
    Monetary    Shanti   730 Polk         $15,000    7/14/2015  Shanti's Hep
                 Projec   Street                                 C Pilot
                 t,       3rd                                    Expansion
                 Inc.     Floor                                  of our HIV
                          San                                    Services
                          Francis                                Program
                          co, CA
                          94109
    ------------------------------------------------------------------------
    Monetary    Someone  1950             $30,000   12/22/2015  Improving
                 Cares    Spectru                                Linkage to
                 Inc Of   m                                      Care and
                 Atlant   Circle                                 Retention
                 a        Ste.                                   among
                          A145                                   Transgender
                          Mariett                                Women and
                          a, GA                                  Gender
                          30067                                  Nonconformi
                                                                 ng People
                                                                 Living with
                                                                 HIV Project
                                                                 title:
                                                                 Transformin
                                                                 g, Renewing
                                                                 and
                                                                 Unifying
                                                                 Transgender
                                                                 Health
                                                                 Project
                                                                 (TRUTH)
    ------------------------------------------------------------------------
    Monetary    Southwe  300               $5,000     9/3/2015  HIV Care in
                 st       Southwe                                a Safety
                 Boulev   st                                     Net Clinic
                 ard      Bouleva                                Setting
                 Family   rd
                 Health   Kansas
                 Care,    City,
                 Inc.     KS
                          66103
    ------------------------------------------------------------------------
    Monetary    Southwe  1101 N.           $4,500    5/15/2015  Hepatitis C
                 st       Central                                Education
                 Center   Avenue,                                and Support
                 For      Suite                                  for High-
                 HIV/     200                                    risk
                 AIDS,    phoenix                                Populations
                 Inc.     , AZ
                          85004
    ------------------------------------------------------------------------
    Monetary    St       808 W.           $40,000    3/10/2015  South L.A.
                 Johns    58th                                   Mobile
                 Well     Street                                 Health--Pee
                 Child    Los                                    r Navigator
                 And      Angeles                                Program for
                 Family   , CA                                   PWID Living
                 Center   90037                                  with HIV
                 , Inc.                                          and/or
                                                                 Hepatitis C
    ------------------------------------------------------------------------
    Monetary    St.      1111             $75,000   12/22/2015  FINISH THE
                 Luke's   Amsterd                                JOB:
                 Roosev   am Ave                                 Providing
                 elt      New                                    HCV care to
                 Hospit   York,                                  current or
                 al       NY                                     former IV
                 Center   10025                                  drug users
                                                                 previously
                                                                 diagnosed
                                                                 through
                                                                 governmenta
                                                                 l testing
                                                                 programs.
    ------------------------------------------------------------------------
    Monetary    The      17 Davis         $65,000    7/14/2015  Ensuring
                 AIDS     Blvd.                                  Adequate
                 Instit   Suite                                  Funding for
                 ute      403                                    Domestic
                          Tampa,                                 HIV/AIDS
                          FL                                     and
                          33606                                  Hepatitis
                                                                 Programs
    ------------------------------------------------------------------------
    Monetary    The Hep  1325 S.          $25,000    5/20/2015  Hepatitis C
                 C        Colorad                                Testing and
                 Connec   o                                      Linkage to
                 tion     Blvd.,                                 Care
                          B-302
                          Denver,
                          CO
                          80222
    ------------------------------------------------------------------------
    Monetary    The      PO Box           $39,000    3/13/2015  The Open
                 Open     99243                                  Door: Peer
                 Door,    Pittsbu                                Support for
                 Inc.     rgh, PA                                HIV
                          15233                                  Engagement
                                                                 and
                                                                 Retention
                                                                 in Care
    ------------------------------------------------------------------------
    Monetary    The      85               $15,000    5/15/2015  Women's HIV
                 Well     Norman                                 Treatment
                 Projec   Avenue,                                Advocacy
                 t        Suite 1                                Development
                          Brookly                                Program
                          n, NY
                          11222
    ------------------------------------------------------------------------
    Monetary    The      85               $15,000    7/21/2015  Charitable
                 Well     Norman                                 Donation
                 Projec   Avenue,                                for Online
                 t        Suite 1                                Resources
                          Brookly                                and Program
                          n, NY                                  Evaluation/
                          11222                                  Outcome
                                                                 Measurement
    ------------------------------------------------------------------------
    Monetary    The      8101              $5,000    7/15/2015  Personal
                 Wright   Cameron                                Disease
                 House    Rd.,                                   Management
                 Wellne   Suite                                  for HIV/
                 ss       105                                    AIDS and
                 Center   Austin,                                HepC
                 , Inc.   TX                                     Clients
                          78754
    ------------------------------------------------------------------------
    Monetary    TPA      5050 N.          $20,000    10/8/2015  Peer Health
                 Networ   Broadwa                                Navigation
                 k        y Suite                                Services
                 Incorp   300
                 orated   Chicago
                 Test     , IL
                 Positi   60640
                 ve
                 Aware
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    TPA      5050 N.          $26,056   12/22/2015  Youth
                 Networ   Broadwa                                Investment
                 k        y Suite
                 Incorp   300
                 orated   Chicago
                 Test     , IL
                 Positi   60640
                 ve
                 Aware
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    Treatme  261              $40,000    5/21/2015  Case Studies
                 nt       Fifth
                 Action   Ave
                 Group,   Suite
                 Inc.     2110
                          New
                          York,
                          NY
                          10016
    ------------------------------------------------------------------------
    Monetary    Univers  UCSF              $7,500    8/27/2015  Mission-
                 ity of   Allianc                                Based
                 Califo   e                                      Support of
                 rnia     Health                                 UCSF
                 San      Project                                Alliance
                 Franci   1855                                   Health
                 sco      Folsom                                 Project
                          Street,                                Services
                          Ste.                                   for People
                          670 Box                                Living With
                          0884                                   or at Risk
                          San                                    of HIV/AIDS
                          Francis
                          co, CA
                          94143
    ------------------------------------------------------------------------
    Monetary    Univers  51                $7,500   10/23/2015  The
                 ity of   Goodman                                Cincinnati
                 Cincin   Drive                                  Exchange
                 nati     Suite                                  Project: A
                          100,                                   Public
                          P.O.                                   Health
                          Box                                    Initiative
                          19970
                          Cincinn
                          ati, OH
                          45219-
                          0970
    ------------------------------------------------------------------------
    Monetary    US       1300 PA       $1,000,000   10/23/2015  Sirturo
                 Agency   Avenue.                                Donation
                 for      , NW,                                  Program--US
                 Intern   SA-44                                  AID
                 ationa   Rm 475-                                Agreement
                 l        J
                 Develo   Washing
                 pment    ton, DC
                          20523
    ------------------------------------------------------------------------
    Monetary    Vermont  P. O.            $40,000    3/10/2015  Expansion of
                 Commit   Box                                    Vermont's
                 tee      5248                                   Services to
                 For      Burling                                Improve
                 Aids     ton, VT                                Care for
                 Resour   05402                                  PWID Living
                 ces                                             with HCV
                 Educat
                 ion
                 and
                 Servic
                 es
    ------------------------------------------------------------------------
    Monetary    Warren-  511 Ruin         $28,800   12/22/2015  Online
                 Vance    Creek                                  Linkage and
                 Commun   Rd STE                                 Retention
                 ity      105                                    Project for
                 Health   Henders                                YMSM
                 Center   on, NC
                 , Inc.   27536
    ------------------------------------------------------------------------
    Monetary    Washing  566 West         $40,000    3/13/2015  Engaging
                 ton      181st                                  High Risk
                 Height   Street,                                Active
                 s        Floor 2                                Injection
                 CORNER   New                                    Drug Users
                 Projec   York,                                  in
                 t        NY                                     Hepatitis C
                          10033                                  testing and
                                                                 Treatment
                                                                 in Northern
                                                                 Manhattan
    ------------------------------------------------------------------------
    Monetary    Wellnes  2921 NE           $5,000    7/15/2015  Sister-to-
                 s        6th Ave                                Sister
                 Center   Wilton
                 of       Manors,
                 South    FL
                 Florid   33334
                 a,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    WORLD    449 15th         $15,000   12/17/2015  2nd CHANCE
                 Women    St.,                                   (Creating a
                 Organi   Suite                                  Healthy and
                 zed to   303                                    Nurturing
                 Respon   Oakland                                Community
                 d to     , CA                                   Environment
                 Life-    94612                                  )
                 threat
                 ening
                 Diseas
                 es
    ------------------------------------------------------------------------
    Product     Johnson  One          $13,174,000    3/15/2013  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza,
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One           $6,019,000    6/15/2013  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza,
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One          $59,199,000    9/15/2013  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza,
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One           $4,718,000   12/15/2013  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza,
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Updated March 24, 2016

      Janssen Biotech, Inc. Monetary and Product Contribution to U.S.-based
                     Charitable Organizations Full Year 2016
            (Payments made from January 1, 2016 to December 31, 2016)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type              Address        (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    Aid For  12271               $300    9/19/2016  Costs
                 Friend   Townsen                                associated
                 s        d Rd                                   with 2016
                          Philade                                Janssen
                          lphia,                                 Cares
                          PA                                     Volunteer
                          19154                                  Activity
    ------------------------------------------------------------------------
    Monetary    America  2310              $1,500    4/11/2016  2016 Run for
                 n        Route                                  Dad,
                 Cancer   34,                                    Awareness
                 Societ   Suite                                  Sponsor
                 y Inc.   1D
                          Manasqu
                          an, NJ
                          08736
    ------------------------------------------------------------------------
    Monetary    America  1626              $1,000    4/15/2016  Relay For
                 n        Locust                                 Life of the
                 Cancer   Street                                 Wissahickon
                 Societ   Philade                                Valley
                 y Inc.   lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    Arthrit  1355            $200,000     6/3/2016  Renewal
                 is       Peachtr                                support of
                 Founda   ee                                     Arthritis
                 tion     Street,                                Foundation
                          Suite                                  Run / Walk
                          600                                    series -
                          Atlanta                                Walk to
                          , GA                                   Cure
                          30309                                  Arthritis
                                                                 and Jingle
                                                                 Bell Run
    ------------------------------------------------------------------------
    Monetary    Arthrit  1355            $100,000    4/11/2016  General
                 is       Peachtr                                Operating
                 Founda   ee                                     Support
                 tion     Street,
                          Suite
                          600
                          Atlanta
                          , GA
                          30309
    ------------------------------------------------------------------------
    Monetary    Arthrit  2280                 $75     3/7/2016  Employee
                 is       South                                  directed
                 Founda   Albion                                 donation in
                 tion,    Street                                 lieu of
                 Great    Denver,                                company
                 West     CO                                     holiday
                 Region   80222-                                 gift
                 , Inc.   4906
    ------------------------------------------------------------------------
    Monetary    Bicol    21019             $1,425     3/8/2016  Employee
                 Founda   47th                                   directed
                 tion     Ave W                                  donation in
                          Lynnwoo                                lieu of
                          d, WA                                  company
                          98036                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk          $2,000    8/17/2016  Paws 4 Life
                 Suppor   Road PO                                Dog Walk
                 t        Box
                 Commun   3187
                 ity of   Warmins
                 Philad   ter, PA
                 elphia   18974
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk          $2,500    8/30/2016  Celebration
                 Suppor   Road PO                                of Hope
                 t        Box
                 Commun   3187
                 ity of   Warmins
                 Philad   ter, PA
                 elphia   18974
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk            $900    9/13/2016  Costs
                 Suppor   Road PO                                associated
                 t        Box                                    with 2016
                 Commun   3187                                   Janssen
                 ity of   Warmins                                Cares
                 Philad   ter, PA                                Volunteer
                 elphia   18974                                  Activity
    ------------------------------------------------------------------------
    Monetary    Cancer   944               $3,500     8/5/2016  Cancer
                 Suppor   Marcon                                 Support and
                 t        Blvd.,                                 Education
                 Commun   #110                                   Allentown,
                 ity of   Allento                                PA
                 the      wn, PA
                 Greate   18109
                 r
                 Lehigh
                 Valley
    ------------------------------------------------------------------------
    Monetary    Canine   PO Box              $300    9/14/2016  Costs
                 Partne   170                                    associated
                 rs for   Cochran                                with 2016
                 Life     ville,                                 Janssen
                          PA                                     Cares
                          19330                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Center   1900              $5,000    5/27/2016  Project for
                 for      Cherry                                 Medically
                 Child    Street                                 Needy
                 Advoca   Philade                                Children
                 tes      lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    Childre  CHOP              $5,000    4/12/2016  7th Annual
                 n's      Foundat                                Walk for
                 Hospit   ion                                    Hope
                 al of    ATTN:                                  benefiting
                 Philad   Holly                                  pediatric
                 elphia   Hubbard/                               Inflammator
                 Founda   Walk                                   y Bowel
                 tion     for                                    Disease
                          Hope                                   Research
                          2016 PO
                          Box
                          40930
                          34th
                          and
                          Civic
                          Center
                          Blvd.
                          Philade
                          lphia,
                          NJ
                          19107
    ------------------------------------------------------------------------
    Monetary    Communi  300B             $20,000   12/14/2016  Free medical
                 ty       Lawrenc                                and dental
                 Volunt   e Drive                                care
                 eers     West                                   services
                 in       Chester                                for
                 Medici   , PA                                   uninsured
                 ne       19380                                  families in
                                                                 Chester
                                                                 County
    ------------------------------------------------------------------------
    Monetary    Crohn's  733             $135,000    2/26/2016  Take Steps
                 and      Third                                  2016 Walk
                 Coliti   Avenue                                 Program
                 s        Suite
                 Founda   510 New
                 tion     York,
                 of       NY
                 Americ   10017
                 a,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Crohn's  733               $5,000    6/13/2016  Disease
                 and      Third                                  State
                 Coliti   Ave,                                   Awareness
                 s        Suite                                  (DSA) Word
                 Founda   510 New                                Cloud
                 tion     York,                                  Activity
                 of       NY
                 Americ   10017
                 a,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Crohn's  733              $18,000    6/13/2016  Camp Oasis
                 and      Third
                 Coliti   Ave,
                 s        Suite
                 Founda   510 New
                 tion     York,
                 of       NY
                 Americ   10017
                 a,
                 Inc.-
                 NY
                 Chapte
                 r
    ------------------------------------------------------------------------
    Monetary    Delawar  236               $5,000    3/21/2016  Teacher
                 e        Randell                                Development
                 Valley   Hall                                   Program
                 Scienc   3141
                 e        Chestnu
                 Fairs,   t
                 Inc.     Street
                          Philade
                          lphia,
                          PA
                          19104
    ------------------------------------------------------------------------
    Monetary    Doernbe  1121 SW              $75    3/21/2016  Employee
                 cher     Salmon                                 directed
                 Childr   St #100                                donation in
                 en's     Portlan                                lieu of
                 Hospit   d, OR                                  company
                 al       97205                                  holiday
                 Founda                                          gift
                 tion
    ------------------------------------------------------------------------
    Monetary    Family   142              $25,000    9/30/2016  Family Reach
                 Reach    Berkele                                Foundation
                 Founda   y                                      General
                 tion     Street,                                Support
                          4th
                          Floor
                          Boston,
                          MA
                          02116
    ------------------------------------------------------------------------
    Monetary    Family   142             $250,000   12/22/2016  Family Reach
                 Reach    Berkele                                Programmati
                 Founda   y                                      c Support
                 tion     Street;
                          4th
                          Floor
                          Boston,
                          MA
                          02116
    ------------------------------------------------------------------------
    Monetary    Food     1501              $5,000   12/15/2016  Year Round
                 Bank     John                                   Youth
                 of       Tipton                                 Feeding
                 South    Blvd                                   Programs
                 Jersey   Pennsau
                          ken
                          Townshi
                          p, NJ
                          08110
    ------------------------------------------------------------------------
    Monetary    Friends  113 West          $3,000   12/26/2016  Outreach to
                 Associ   Chestnu                                Homeless
                 ation    t                                      Families
                 For      Street
                 Care     West
                 and      Chester
                 Protec   , PA
                 tion     19380
                 Of
                 Childr
                 en
    ------------------------------------------------------------------------
    Monetary    Georgia  560               $1,700    4/12/2016  Free
                 Prosta   Barnesl                                Prostate
                 te       ey Lane                                Cancer
                 Cancer   Alphare                                Screening
                 Coalit   tta, GA
                 ion      30022
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Girl     330               $4,000   10/10/2016  Girl Scouts
                 Scouts   Manor                                  of Eastern
                 of       Road                                   Pennsylvani
                 Southe   Miquon,                                a Science,
                 astern   PA                                     Technology,
                 Pennsy   19444                                  Engineering
                 lvania                                          , and Math
                                                                 (STEM)
                                                                 programming
                                                                 .
    ------------------------------------------------------------------------
    Monetary    Green    1368             $15,000   12/15/2016  Watershed
                 Valley   Prizer                                 Science
                 s        Road                                   Education
                 Associ   Pottsto                                Program
                 ation    wn, PA
                          19465
    ------------------------------------------------------------------------
    Monetary    Habitat  1847 E            $2,000    5/30/2016  Building
                 for      Lincoln                                communities
                 Humani   Hwy                                    and
                 ty of    Coatesv                                changing
                 Cheste   ille,                                  lives
                 r        PA
                 County   19320
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Habitat  1829 N.             $300    11/3/2016  Costs
                 For      19th                                   associated
                 Humani   Street                                 with 2016
                 ty       Philade                                Janssen
                 Philad   lphia,                                 Cares
                 elphia   PA                                     Volunteer
                 Inc.     19121                                  Activity
    ------------------------------------------------------------------------
    Monetary    Habitat  1829 N.           $5,000   12/26/2016  Diamond Park
                 For      19th                                   Phase 2--
                 Humani   Street                                 affordable
                 ty       Philade                                housing
                 Philad   lphia,
                 elphia   PA
                 Inc.     19121
    ------------------------------------------------------------------------
    Monetary    Hatboro- 229              $25,000   12/14/2016  STEM
                 Horsha   Meeting                                Programs
                 m        house                                  for Hatboro-
                 Educat   Road                                   Horsham
                 ional    Horsham                                Students
                 Founda   , PA
                 tion     19044
    ------------------------------------------------------------------------
    Monetary    Horsham  PO Box            $1,000     8/5/2016  K9 Program
                 Neighb   621                                    Fit Out and
                 ors      Horsham                                National
                 Associ   , PA                                   Night Out
                 ation    19044                                  Celebration
    ------------------------------------------------------------------------
    Monetary    Junior   994 Old           $7,500    8/18/2016  Junior
                 Achiev   Eagle                                  Achievement
                 ement    School                                 Whole
                 Of       Rd                                     School
                 Delawa   Suite                                  Initiative
                 re       1014
                 Valley   Wayne,
                          PA
                          19087
    ------------------------------------------------------------------------
    Monetary    Kids     26071             $3,000    8/30/2016  Support
                 Connec   Merit                                  Groups for
                 ted      Circle,                                the
                          #103                                   Children of
                          Laguna                                 Cancer
                          Hills,                                 Patients
                          CA
                          92653-
                          7016
    ------------------------------------------------------------------------
    Monetary    Melanom  250                 $100    9/30/2016  Memorial
                 a        Maplefl                                Donation
                 Intern   ower
                 ationa   Road
                 l        Glenmoo
                 Founda   re, PA
                 tion     19343
    ------------------------------------------------------------------------
    Monetary    Metropo  2323             $25,000   12/16/2016  Medically
                 litan    Ranstea                                Appropriate
                 Area     d                                      Meals for
                 Neighb   Street                                 People with
                 orhood   Philade                                Critical
                 Nutrit   lphia,                                 Illnesses
                 ion      PA
                 Allian   19103
                 ce
                 (MANNA
                 )
    ------------------------------------------------------------------------
    Monetary    Mitzvah  1561                $300    9/22/2016  Costs
                 Circle   Gehman                                 associated
                 Founda   Road                                   with 2016
                 tion     Harleys                                Janssen
                          ville,                                 Cares
                          PA                                     Volunteer
                          19438                                  Activity
    ------------------------------------------------------------------------
    Monetary    Mitzvah  1561              $5,000     8/5/2016  Critical
                 Circle   Gehman                                 Needs
                 Founda   Road                                   Support for
                 tion     Harleys                                Individuals
                          ville,                                 and
                          PA                                     Families
                          19438
    ------------------------------------------------------------------------
    Monetary    Montgom  340              $10,000    12/9/2016  The Study of
                 ery      DeKalb                                 Psychology
                 County   Pike                                   as a Guide
                 Commun   Blue                                   to Peer
                 ity      Bell,                                  Mentorship
                 Colleg   PA                                     for BTE--
                 e        19422                                  Wissahickon
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Montgom  340              $23,811    12/9/2016  Bridge to
                 ery      DeKalb                                 Employment-
                 County   Pike                                   -Wissahicko
                 Commun   Blue                                   n
                 ity      Bell,
                 Colleg   PA
                 e        19422
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Mt.      One              $50,000   10/18/2016  Overcoming
                 Sinai    Gustave                                the
                 Medica   L. Levy                                Barriers to
                 l        Place                                  Clinical
                 Center   Box                                    Care for
                          1049                                   Underserved
                          New                                    Multiple
                          York,                                  Myeloma
                          NY                                     Patients
                          10029
    ------------------------------------------------------------------------
    Monetary    Multipl  383 Main         $50,000   12/22/2016  MMRF
                 e        Avenue                                 Endurance
                 Myelom   5th                                    Events
                 a        Floor
                 Resear   Norwalk
                 ch       , CT
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  383 Main        $100,000   12/22/2016  2017 MMRF
                 e        Avenue                                 Team for
                 Myelom   5th                                    Cures 5K
                 a        Floor                                  Walk/Run
                 Resear   Norwalk                                Program
                 ch       , CT
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  383 Main        $275,000   12/22/2016  MMy Ride for
                 e        Avenue                                 a Cure
                 Myelom   5th
                 a        Floor
                 Resear   Norwalk
                 ch       , CT
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  383 Main         $40,000   12/23/2016  MMRF Patient
                 e        Avenue                                 Support
                 Myelom   5th                                    Center
                 a        Floor
                 Resear   Norwalk
                 ch       , CT
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  51 Locus        $100,000    2/23/2016  2016 MMRF
                 e        Avenue                                 Team for
                 Myelom   Suite                                  Cures 5K
                 a        201                                    Walk/Run
                 Resear   Norwalk                                Program
                 ch       , CT
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Multipl  383 Main         $50,000     3/7/2016  2016 MMRF
                 e        Avenue                                 Team for
                 Myelom   5th                                    Cures
                 a        Floor                                  Endurance
                 Resear   Norwalk                                Events
                 ch       , CT                                   Program
                 Founda   06851
                 tion
    ------------------------------------------------------------------------
    Monetary    Nationa  4950              $2,500    4/15/2016  Run/Walk to
                 l        York                                   Break the
                 Ovaria   Rd,                                    Silence on
                 n        Unit                                   Ovarian
                 Cancer   631                                    Cancer
                 Coalit   Holicon
                 ion      g, PA
                 Inc.     18928
    ------------------------------------------------------------------------
    Monetary    Nationa  6600 SW          $50,000     5/3/2016  2016 Team
                 l        92nd                                   NPF Walk
                 Psoria   Ave.,
                 sis      #300
                 Founda   Portlan
                 tion     d, OR
                          97223
    ------------------------------------------------------------------------
    Monetary    NET      499 N.            $1,125     3/4/2016  Employee
                 Treatm   5th                                    directed
                 ent      St.,                                   donation in
                 Servic   Suite A                                lieu of
                 es       Philade                                company
                          lphia,                                 holiday
                          PA                                     gift
                          19123
    ------------------------------------------------------------------------
    Monetary    Philade  1729             $75,000   12/27/2016  STEAM Mural
                 lphia    Mount                                  Initiative
                 Mural    Vernon
                 Arts     Street
                 Progra   Philade
                 m        lphia,
                          PA
                          19130
    ------------------------------------------------------------------------
    Monetary    Project  1515              $1,000   12/16/2016  Mental
                 HOME     Fairmou                                Health and
                          nt                                     Recovery
                          Avenue                                 Services
                          Philade
                          lphia,
                          PA
                          19130
    ------------------------------------------------------------------------
    Monetary    Prostat  7009 S.          $30,000    5/20/2016  Prostate
                 e        Potomac                                Cancer
                 Cancer   Street                                 Disparities
                 Educat   Suite                                  Outreach
                 ion      125                                    Program
                 Counci   Centenn
                 l        ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    Prostat  500              $50,000     2/8/2016  Partnerships
                 e        Victory                                for
                 Health   Road                                   Education,
                 Educat   Quincy,                                Support and
                 ion      MA                                     Outreach
                 Networ   02170
                 k Inc.
    ------------------------------------------------------------------------
    Monetary    Reach    89 South          $5,000   12/21/2016  Preparing
                 Out      Street,                                Families
                 and      Suite                                  for School
                 Read     201                                    Success
                          Boston,
                          MA
                          02111
    ------------------------------------------------------------------------
    Monetary    Rebuild  4355              $5,000    4/12/2016  Mantua Block
                 ing      Orchard                                Build 2016
                 Togeth   Street
                 er       Suite
                 Philad   2R
                 elphia   Philade
                          lphia,
                          PA
                          19124
    ------------------------------------------------------------------------
    Monetary    Regiona  30                  $100    6/10/2016  Memorial
                 l        Milesto                                Donation
                 Hospic   ne Road
                 e and    Danbury
                 Home     , CT
                 Care     06810
                 Center
    ------------------------------------------------------------------------
    Monetary    Retired  901 East          $7,000    5/23/2016  RSVP's
                 and      8th                                    America
                 Senior   Street                                 Reads/
                 Volunt   Suite                                  Writes and
                 eer      200                                    Protege One-
                 Progra   King of                                on-One
                 m of     Prussia                                Mentoring
                 Montgo   , PA                                   Programs.
                 mery     19406
                 County
    ------------------------------------------------------------------------
    Monetary    Retired  901 East         $10,000   12/15/2016  RSVP's
                 and      8th                                    Family
                 Senior   Street                                 Literacy
                 Volunt   Suite                                  Volunteer
                 eer      200                                    Program
                 Progra   King of                                (FLVP) and
                 m of     Prussia                                My Free
                 Montgo   , PA                                   Tutor (MFT)
                 mery     19406                                  virtual
                 County                                          STEM
                                                                 tutoring
                                                                 and career
                                                                 awareness
                                                                 Program.
    ------------------------------------------------------------------------
    Monetary    Riverbe  1950              $6,000     8/5/2016  Outreach to
                 nd       Spring                                 Children/
                 Enviro   Mill                                   Access to
                 nmenta   Road                                   Nature/
                 l        Gladwyn                                Norristown
                 Educat   e, PA                                  Area School
                 ion      19035                                  District
                 Center
    ------------------------------------------------------------------------
    Monetary    Sandy    2010              $2,000   12/14/2016  Sandy Sprint
                 Rollma   West                                   Superhero
                 n        Chester                                5K or 10K
                 Ovaria   Pike,                                  Run/Walk
                 n        Suite
                 Cancer   410
                 Founda   Haverto
                 tion,    wn, PA
                 Inc.     19083
    ------------------------------------------------------------------------
    Monetary    SARC     24 Frank          $9,500    9/22/2016  General
                          Lloyd                                  Operating
                          Wright                                 Support--We
                          Drive A/                               bsite
                          3100 PO
                          Box 406
                          Ann
                          Arbor,
                          MI
                          48105
    ------------------------------------------------------------------------
    Monetary    Special  2800                $300    9/22/2016  Costs
                 Equest   Street                                 associated
                 rians    Road                                   with 2016
                          P.O.                                   Janssen
                          Box                                    Cares
                          1001                                   Volunteer
                          Warring                                Activity
                          ton, PA
                          18976
    ------------------------------------------------------------------------
    Monetary    Special  2800              $4,000   10/10/2016  Special
                 Equest   Street                                 Equestrians
                 rians    Road                                   Equine-
                          P.O.                                   Assisted
                          Box                                    Learning
                          1001                                   and
                          Warring                                Therapeutic
                          ton, PA                                Riding
                          18976                                  Program
    ------------------------------------------------------------------------
    Monetary    Starfin  4015             $10,000    4/19/2016  Starfinder's
                 der      Main                                   Soccer,
                 Founda   Street                                 Education,
                 tion     Philade                                and
                          lphia,                                 Leadership
                          PA                                     Development
                          19127                                  Programs
                                                                 for Youth
    ------------------------------------------------------------------------
    Monetary    The      The              $12,000    4/19/2016  Family Care
                 Childr   Childre                                Binder
                 en's     n's                                    Program
                 Hospit   Hospita
                 al of    l of
                 Philad   Philade
                 elphia   lphia
                 Founda   Foundat
                 tion     ion
                          Attn:
                          Staci
                          Carney,
                          Associa
                          te
                          Directo
                          r,
                          Corpora
                          te and
                          Foundat
                          ion
                          Relatio
                          ns 100
                          Penn
                          Square
                          East
                          8th
                          Floor,
                          Suite
                          8050
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    The      The               $5,000    4/12/2016  Child Life,
                 Childr   Childre                                Education,
                 en's     n's                                    and
                 Hospit   Hospita                                Creative
                 al of    l of                                   Arts
                 Philad   Philade                                Therapy
                 elphia   lphia                                  Program
                 Founda   Foundat
                 tion     ion
                          Attn:
                          Staci
                          Carney,
                          Associa
                          te
                          Directo
                          r,
                          Corpora
                          te and
                          Foundat
                          ion
                          Relatio
                          ns 100
                          Penn
                          Square
                          East
                          8th
                          Floor,
                          Suite
                          8050
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    The      222              $10,000   12/26/2016  Corporate
                 Frankl   North                                  Membership
                 in       20th
                 Instit   St.
                 ute      Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    The      622               $2,000    8/18/2016  General
                 Giving   Evans                                  Operating
                 Tree     Road PO                                Support
                          Box 823                                with an
                          Gwynedd                                emphasis on
                          Valley,                                the Public
                          PA                                     Educational
                          19437                                  Giving
                                                                 Events
    ------------------------------------------------------------------------
    Monetary    The      2600             $10,000    3/24/2016  Hubert J.P.
                 Melmar   Wayland                                Schoemaker
                 k        Road                                   Classic
                 Charit   Berwyn,
                 able     PA
                 Founda   19312
                 tion
    ------------------------------------------------------------------------
    Monetary    The      400                 $600    9/19/2016  Costs
                 Pennsb   Pennsbu                                associated
                 ury      ry                                     with 2016
                 Societ   Memoria                                Janssen
                 y        l Road                                 Cares
                          Morrisv                                Volunteer
                          ille,                                  Activity
                          PA
                          19067
    ------------------------------------------------------------------------
    Monetary    The      775 E             $9,500     8/5/2016  Sarcoma
                 Sarcom   Blithed                                Alliance
                 a        ale                                    General
                 Allian   #334                                   Support
                 ce       Mill
                          Valley,
                          CA
                          94941
    ------------------------------------------------------------------------
    Monetary    Trustee  3025              $5,000   12/26/2016  WXPN
                 s Of     Walnut                                 Musicians
                 The      Street                                 On Call
                 Univer   Philade
                 sity     lphia,
                 Of       PA
                 Pennsy   19104
                 lvania
    ------------------------------------------------------------------------
    Monetary    Turning  415               $5,000    4/12/2016  Families and
                 Points   South                                  Schools
                 For      15th                                   Together
                 Childr   Street                                 (FAST)
                 en       Philade                                Program
                          lphia,
                          PA
                          19146
    ------------------------------------------------------------------------
    Monetary    United   1709            $245,879   12/19/2016  Impact Fund
                 Way of   Benjami                                Greater
                 Southe   n                                      Philadelphi
                 astern   Frankli                                a, PA and
                 Pennsy   n                                      Southern,
                 lvania   Parkway                                NJ
                          Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    Youth    949               $5,000    12/9/2016  The Youth
                 Rally    Chestnu                                Rally--a
                 Commit   t Oak                                  camp for
                 tee      Dr St.                                 kids/teens
                 Inc.     Charles                                living with
                          , MO                                   conditions
                          63303                                  affecting
                                                                 the bowel
                                                                 (Crohn's
                                                                 Disease and
                                                                 UC) and
                                                                 bladder
                                                                 systems.
    ------------------------------------------------------------------------
    Monetary    Zero     2000             $50,000    4/21/2016  ZERO
                 The      Joseph                                 Prostate
                 Projec   E                                      Cancer Run/
                 t To     Sanker                                 Walk
                 End      BLVD                                   National
                 Prosta   Norwood                                Series--Nat
                 te       , OH                                   ionwide
                 Cancer   45212
    ------------------------------------------------------------------------
    Janssen has also made financial donations to independent charitable
      foundations that assist patients who are underinsured and in financial
      need with treatment-related expenses. In keeping with our donor
      agreements and applicable regulatory guidance, we will only disclose
      aggregate data on our charitable giving and do not publicize
      information on donations to specific foundations and disease states.
      In 2016, we contributed $47 million in donations to independent
      charitable foundations, enabling them to provide assistance with
      medication-related copays to patients with cancer and autoimmune
      diseases.

    ----------------------------------------------------------------------------------------------------------------

    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $71,016,839    3/31/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $58,963,086    6/30/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08934
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $60,107,176    9/30/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08935
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &           99,129,337  $12/31/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08936
    ----------------------------------------------------------------------------------------------------------------
    Updated March 30, 2017

    Janssen Pharmaceuticals, Inc. Monetary and Product Contribution to U.S.-
                  based Charitable Organizations Full Year 2016
            (Payments made from January 1, 2016 to December 31, 2016)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)         Date      Description
    ------------------------------------------------------------------------
    Monetary    180      1                 $1,000   12/15/2016  2NDFLOOR
                 Turnin   Bethany                                Youth
                 g        Road,                                  Helpline
                 Lives    Buildin                                Hunterdon,
                 Around   g 3                                    Mercer, and
                 Inc.     Suite                                  Somerset
                          42                                     Operations
                          Hazlet,
                          NJ
                          07730
    ------------------------------------------------------------------------
    Monetary    Alzheim  225 N.            $5,000   12/15/2016  Comfort Zone
                 er's     Michiga                                Program
                 Associ   n                                      Support
                 ation    Avenue
                          Chicago
                          , IL
                          60601
    ------------------------------------------------------------------------
    Monetary    America  4100             $20,000    12/7/2016  General
                 n        Alpha                                  mission
                 Diabet   Road,                                  support
                 es       Suite
                 Associ   100
                 ation    Dallas,
                          TX
                          75244
    ------------------------------------------------------------------------
    Monetary    America  1160             $10,000    7/11/2016  What Can I
                 n        Route                                  Eat?
                 Diabet   22
                 es       East,
                 Associ   Suite
                 ation    103
                          Bridgew
                          ater,
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    America  PO Box           $30,000   12/23/2016  Atrial
                 n        541                                    Fibrillatio
                 Founda   Greenwo                                n Patient
                 tion     od, TX                                 Education
                 For      76246                                  and Support
                 Womens
                 Health
    ------------------------------------------------------------------------
    Monetary    America  1 Union           $5,000   12/23/2016  Garden State
                 n        Street                                 Go Red For
                 Heart    Suite                                  Women
                 Associ   301                                    Luncheon
                 ation-   Robbins
                 -New     ville,
                 Jersey   NJ
                          08691
    ------------------------------------------------------------------------
    Monetary    America  1000            $100,000   12/15/2016  Typical or
                 n        Wilson                                 Troubled?
                 Psychi   Blvd,                                  School-
                 atric    Suite                                  Based
                 Founda   1825                                   Mental
                 tion     Arlingt                                Health
                          on, VA                                 Education
                          22209                                  Program
    ------------------------------------------------------------------------
    Monetary    America  1000            $200,000   12/15/2016  Judges' and
                 n        Wilson                                 Psychiatris
                 Psychi   Blvd,                                  ts'
                 atric    Suite                                  Leadership
                 Founda   1825                                   Initiative
                 tion     Arlingt                                previously
                          on, VA                                 known as
                          22209                                  Judges'
                                                                 Leadership
                                                                 Initiative
                                                                 (JLI)
    ------------------------------------------------------------------------
    Monetary    America  1000             $35,000   12/15/2016  Partnership
                 n        Wilson                                 for
                 Psychi   Blvd,                                  Workplace
                 atric    Suite                                  Mental
                 Founda   1825                                   Health
                 tion     Arlingt
                          on, VA
                          22209
    ------------------------------------------------------------------------
    Monetary    America  150                 $300    9/27/2016  Costs
                 's       Pittsto                                associated
                 Grow-A-  wn Road                                with 2016
                 Row,     Pittsto                                Janssen
                 Inc.     wn, NJ                                 Cares
                          08867                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Anchor   482                 $743    1/19/2016  General
                 House,   Centre                                 Operating
                 Inc.     Street                                 Support
                          Trenton
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Anderso  PO Box           $20,000    12/7/2016  Integrated
                 n        134 532                                Care
                 House    Route                                  Management
                          523
                          Whiteho
                          use
                          Station
                          , NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    Ann      595 W.            $9,500   12/15/2016  Improving
                 Silver   State                                  Patient
                 man      Street                                 Self-Care
                 Commun   Doylest                                and
                 ity      own, PA                                Management
                 Health   18901                                  of Chronic
                 Clinic                                          Illnesses
                                                                 at a Free
                                                                 Clinic for
                                                                 the
                                                                 Uninsured.
    ------------------------------------------------------------------------
    Monetary    Arbor    211                  $75    5/17/2016  Employee
                 Day      North                                  directed
                 Founda   12th St                                donation in
                 tion     Lincoln                                lieu of
                          , NE                                   company
                          68508                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Arc of   141               $3,000    9/28/2016  Day Care
                 Somers   South                                  subsidies
                 et       Main                                   for at risk
                 County   Street                                 children
                          Manvill                                and
                          e, NJ                                  children
                          08835                                  with
                                                                 disabilitie
                                                                 s
    ------------------------------------------------------------------------
    Monetary    Asian    180 W             $2,000     4/6/2016  Cardiovascul
                 Health   Washing                                ar Health
                 Coalit   ton St                                 Screenings
                 ion      Suite                                  for Low-
                          1000                                   Income at-
                          Chicago                                risk Asians
                          , IL                                   Immigrants
                          60602                                  and
                                                                 Refugees in
                                                                 Chicago
    ------------------------------------------------------------------------
    Monetary    Bay      66 Canal          $5,000    6/24/2016  Bay Cove
                 Cove     Street                                 Wellness
                 Human    Boston,                                Center
                 Servic   MA
                 es,      02114
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Bear     1162                $750   12/15/2016  The Bear
                 Tavern   Bear                                   Tavern
                 Parent   Tavern                                 Science
                 s        Road                                   Fair
                 Associ   Titusvi
                 ation    lle, NJ
                          08560
    ------------------------------------------------------------------------
    Monetary    Bear     1162                $750     3/1/2016  Bear Tavern
                 Tavern   Bear                                   Elementary
                 Parent   Tavern                                 School
                 s        Road                                   Science
                 Associ   Titusvi                                Fair
                 ation    lle, NJ
                          08560
    ------------------------------------------------------------------------
    Monetary    Big      2875              $6,500   11/18/2016  STEM School
                 Brothe   York                                   Mentoring
                 rs Big   Road                                   Initiative
                 Sister   Jamison
                 s of     , PA
                 Bucks    18929
                 County
    ------------------------------------------------------------------------
    Monetary    Big      535 East          $7,500   11/18/2016  Youth
                 Brothe   Frankli                                Mentoring
                 rs Big   n                                      Programs
                 Sister   Street
                 s of     Trenton
                 Mercer   , NJ
                 County   08610
    ------------------------------------------------------------------------
    Monetary    Boys     212              $20,000   12/15/2016  Extended Day
                 and      Centre                                 Learning
                 Girls    Street
                 Club     Trenton
                 of       , NJ
                 Trento   08611
                 n and
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Bristol  120               $7,500   12/15/2016  ArtRageous
                 Rivers   Radclif                                Theatre
                 ide      fe                                     Arts
                 Theate   Street                                 Education
                 r Co     Bristol                                Program
                 Inc.     , PA
                          19007
    ------------------------------------------------------------------------
    Monetary    Broward  305 SE           $15,000     8/4/2016  Affordable
                 County   18th                                   Housing
                 Commun   Court                                  program
                 ity      Fort
                 Develo   Lauderd
                 pment    ale, FL
                 Corpor   33316
                 ation
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Bucks    1069              $5,000   12/15/2016  Veterans
                 County   Jackson                                Housing
                 Housin   ville                                  Assistance
                 g        Road                                   Program
                 Group    Ivyland
                          , PA
                          18974
    ------------------------------------------------------------------------
    Monetary    Califor  2015             $25,000    4/11/2016  Using
                 nia      Steiner                                Community
                 Pacifi   Street                                 Health
                 c        San                                    Workers to
                 Medica   Francis                                increase
                 l        co, CA                                 underserved
                 Center   94115                                  patients'
                 Founda                                          ability to
                 tion                                            manage type
                                                                 2 diabetes.
    ------------------------------------------------------------------------
    Monetary    Caminar  2600 S.           $7,500    4/12/2016  Bridges to
                          El                                     Wellness
                          Camino
                          Real,
                          Suite
                          200 San
                          Mateo,
                          CA
                          94403
    ------------------------------------------------------------------------
    Monetary    Cardiov  PO Box            $5,000    3/31/2016  25th Annual
                 ascula   54632                                  Lansdale
                 r        Philade                                Internation
                 Instit   lphia,                                 al Spring
                 ute of   PA                                     Festival
                 Philad   19148
                 elphia
    ------------------------------------------------------------------------
    Monetary    Catholi  25 Ikea           $4,000   12/22/2016  Catholic
                 c        Drive                                  Charities,
                 Charit   Westham                                Diocese of
                 ies      pton,                                  Trenton On
                          NJ                                     My Own--
                          08060                                  Supportive
                                                                 Housing
                                                                 Program
                                                                 Services
    ------------------------------------------------------------------------
    Monetary    Catholi  25 Ikea          $15,000   12/22/2016  Partners in
                 c        Drive                                  Recovery
                 Charit   Westham                                program
                 ies      pton,
                          NJ
                          08060
    ------------------------------------------------------------------------
    Monetary    Catholi  212                  $75    1/19/2016  Employee
                 c        Ninth                                  directed
                 Charit   Street                                 donation in
                 ies      Pittsbu                                lieu of
                 Dioces   rgh,                                   company
                 e of     Pennsyl                                holiday
                 Pittsb   vania                                  gift
                 urgh     15222
    ------------------------------------------------------------------------
    Monetary    Catholi  920               $4,000   11/18/2016  CYO's Broad
                 c        South                                  St. Trenton
                 Youth    Broad                                  Center
                 Organi   Street                                 After
                 zation   Trenton                                School
                 of       , NJ                                   Program
                 Mercer   08611                                  (ASP)
                 County                                          Tutoring
                                                                 Project
    ------------------------------------------------------------------------
    Monetary    Catholi  920                 $600   10/19/2016  Costs
                 c        South                                  associated
                 Youth    Broad                                  with 2016
                 Organi   Street                                 Janssen
                 zation   Trenton                                Cares
                 of       , NJ                                   Volunteer
                 Mercer   08611                                  Activity--(
                 County                                          2
                                                                 Activities)
    ------------------------------------------------------------------------
    Monetary    Center   11               $10,000   10/24/2016  Community
                 for      Minneak                                Based Work
                 Educat   oning                                  Assessments
                 ional    Road
                 Advanc   Fleming
                 ement    ton, NJ
                          08822
    ------------------------------------------------------------------------
    Monetary    Center   11                  $300    11/3/2016  Costs
                 for      Minneak                                associated
                 Educat   oning                                  with 2016
                 ional    Road                                   Janssen
                 Advanc   Fleming                                Cares
                 ement    ton, NJ                                Volunteer
                          08822                                  Activity
    ------------------------------------------------------------------------
    Monetary    Childre  635                 $300   11/19/2016  Costs
                 n's      South                                  associated
                 Home     Clinton                                with 2016
                 Societ   Avenue                                 Janssen
                 y of     Trenton                                Cares
                 New      , NJ                                   Volunteer
                 Jersey   08611                                  Activity
    ------------------------------------------------------------------------
    Monetary    Childre  635              $10,000   11/22/2016  CUNA and
                 n's      South                                  Body and
                 Home     Clinton                                Soul
                 Societ   Avenue                                 Prenatal
                 y of     Trenton                                Health
                 New      , NJ                                   Education
                 Jersey   08611                                  Program
    ------------------------------------------------------------------------
    Monetary    Clevela  9500             $25,000    8/19/2016  Diabetes
                 nd       Euclid                                 Center
                 Clinic   Ave.                                   Educational
                 Educat   Clevela                                Initiatives
                 ional    nd, OH                                 at
                 Founda   44195                                  Cleveland
                 tion                                            Clinic
                                                                 South
                                                                 Pointe
                                                                 Hospital
    ------------------------------------------------------------------------
    Monetary    College  50 Milk          $20,000   12/21/2016  Establishing
                 Diabet   St 16th                                Best
                 es       Floor                                  Practices,
                 Networ   Boston,                                Policies,
                 k Inc.   MA                                     and
                          02109                                  Interventio
                                                                 ns
    ------------------------------------------------------------------------
    Monetary    College  2000             $20,000   11/22/2016  Nursing
                 of New   Penning                                Merit
                 Jersey   ton                                    Scholarship
                          Road                                   s ($7,500)
                          P.O.                                   and
                          Box                                    Educational
                          7718                                   Opportunity
                          Ewing,                                 Fund
                          NJ                                     Promise
                          08628                                  Awards
                                                                 ($12,500)
    ------------------------------------------------------------------------
    Monetary    College  2000              $5,000   11/22/2016  TCNJ Stress
                 of New   Penning                                Management
                 Jersey   ton                                    and Mental
                          Road                                   Health Days
                          P.O.
                          Box
                          7718
                          Ewing,
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    Colorad  915 E.            $3,000     8/9/2016  Wellness
                 o        9th                                    Recovery
                 Mental   Avenue                                 Action
                 Wellne   Denver,                                Planning
                 ss       CO                                     Program
                 Networ   80218
                 k
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box            $5,000   12/15/2016  Rise Summer
                 ty       88 116                                 Healthy
                 Action   North                                  Food
                 Servic   Main                                   Initiative
                 e        Street                                 for low
                 Center   Hightst                                income
                 , Inc.   own, NJ                                youth.
                          08520
    ------------------------------------------------------------------------
    Monetary    Communi  4059              $5,000     3/1/2016  Arts for
                 ty       Skyron                                 Seniors
                 Conser   Drive                                  ($3,000)
                 vatory   Doylest                                and Music
                 of       own, PA                                Therapy
                 Music    18902                                  ($2,000)
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box          $250,000   12/21/2016  Janssen
                 ty       338                                    Pharmaceuti
                 Founda   Morrist                                cal
                 tion     own, NJ                                Companies
                 of New   07963                                  Contributio
                 Jersey                                          n Fund
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box           $60,000   12/21/2016  HealtheVoice
                 ty       338                                    s Impact
                 Founda   Morrist                                Fund
                 tion     own, NJ
                 of New   07963
                 Jersey
    ------------------------------------------------------------------------
    Monetary    Communi  PO Box          $125,000    12/7/2016  Healthcare
                 ty       338                                    and Basic
                 Founda   Morrist                                Needs Fund
                 tion     own, NJ
                 of New   07963
                 Jersey
    ------------------------------------------------------------------------
    Monetary    Communi  315                  $75    5/27/2016  Employee
                 ty       Losher                                 directed
                 Founda   Street                                 donation in
                 tion     Suite                                  lieu of
                 of       100                                    Company
                 Northw   Hernand                                Holiday
                 est      o, MS                                  gift
                 Missis   38632
                 sippi
    ------------------------------------------------------------------------
    Monetary    Communi  959               $2,000    3/10/2016  General
                 ty       Route                                  Operating
                 Hope,    46                                     Support
                 Inc.     East,
                          Suite
                          402
                          Parsipp
                          any, NJ
                          07054
    ------------------------------------------------------------------------
    Monetary    Communi  959              $15,000   11/15/2016  Hope for
                 ty       Route                                  Veterans
                 Hope,    46                                     and Valley
                 Inc.     East,                                  Brook
                          Suite                                  Village for
                          402                                    Veterans
                          Parsipp
                          any, NJ
                          07054
    ------------------------------------------------------------------------
    Monetary    Communi  959              $11,000    5/16/2016  Pathway to
                 ty       Route                                  Recovery
                 Hope,    46                                     Residential
                 Inc.     East,                                  Programs
                          Suite                                  ($10,000)
                          402                                    The Annual
                          Parsipp                                Forum and
                          any, NJ                                Wellness
                          07054                                  Fair
                                                                 ($1,000)
    ------------------------------------------------------------------------
    Monetary    Compeer  259               $2,500    5/30/2016  Youth and
                 Roches   Monroe                                 Family
                 ter,     Avenue                                 Mentoring--
                 Inc.     Rochest                                Family Peer
                          er, NY                                 Advocate
                          14607                                  Services
    ------------------------------------------------------------------------
    Monetary    Contact  60 South          $1,000   10/20/2016  Fundraising
                 of       Main                                   event
                 Mercer   Street                                 support to
                 County   Penning                                benefit
                 New      ton, NJ                                general
                 Jersey   08534                                  mission of
                 Inc.                                            organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Contact  60 South          $8,500   12/15/2016  Crisis and
                 Of       Main                                   Suicide
                 Mercer   Street                                 Prevention
                 County   Penning                                HOTLINES,
                 New      ton, NJ                                Telephone
                 Jersey   08534                                  and Online:
                 Inc.                                            Crisis Chat
                                                                 and
                                                                 TxtToday
    ------------------------------------------------------------------------
    Monetary    CONTACT  P.O. Box          $3,500    4/12/2016  Training
                 We       2376                                   Nonprofessi
                 Care,    Westfie                                onals in
                 Inc.     ld, NJ                                 Crisis
                          07091                                  Interventio
                                                                 n for
                                                                 People
                                                                 Experiencin
                                                                 g Psychosis
    ------------------------------------------------------------------------
    Monetary    Court    1450             $15,000   12/15/2016  CASA of
                 Appoin   Parksid                                Mercer
                 ted      e                                      County
                 Specia   Avenue,                                Child
                 l        Suite                                  Advocacy
                 Advoca   22                                     Program for
                 tes      Ewing,                                 Abused and
                          NJ                                     Neglected
                          08638-                                 Children
                          2946
    ------------------------------------------------------------------------
    Monetary    Curtain  1483              $5,000   12/19/2016  Deaf and
                 Up       Rte.                                   Hard of
                 Produc   179                                    Hearing
                 tions    Lambert                                Access for
                 Inc.     ville,                                 Curtain Up
                          NJ                                     Productions
                          08530
    ------------------------------------------------------------------------
    Monetary    Daytop   80 West           $2,000   11/15/2016  Work
                 Villag   Main St                                Readiness
                 e Of     Mendham
                 New      , NJ
                 Jersey   07945
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Deborah  212               $2,000   11/14/2016  2017 Women's
                 Hospit   Trenton                                Heart
                 al       Road                                   Health
                 Founda   Browns                                 Symposium
                 tion     Mills,
                          NJ
                          08015
    ------------------------------------------------------------------------
    Monetary    Delawar  14                  $300   10/19/2016  Costs
                 e        Michael                                associated
                 River    McCorri                                with 2016
                 Steamb   stin                                   Janssen
                 oat      Road                                   Cares
                 Floati   Hamilto                                Volunteer
                 ng       n, NJ                                  Activity
                 Classr   08690
                 oom,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Depress  C/O                 $750     3/1/2016  DBSA NJ
                 ion      David                                  Annual
                 and      Mizenko                                Conference
                 Bipola   5                                      for Support
                 r        Village                                Group
                 Suppor   Ct                                     Participant
                 t        Lawrenc                                s--July,
                 Allian   eville,                                2016
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Depress  C/O                 $750     3/1/2016  DBSA NJ
                 ion      David                                  Mutual Aid
                 and      Mizenko                                Support
                 Bipola   5                                      Group
                 r        Village                                Facilitator
                 Suppor   Ct                                     Training--M
                 t        Lawrenc                                arch, 2016
                 Allian   eville,
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Desert   1695 N.           $3,500    5/16/2016  Quality of
                 Aids     Sunrise                                Life and
                 Projec   Way                                    Wellness
                 t        Palm                                   Interventio
                          Springs                                ns for
                          , CA                                   Desert AIDS
                          92262                                  Project
                                                                 Clients
                                                                 Living with
                                                                 Schizophren
                                                                 ia or
                                                                 Schizoaffec
                                                                 tive
                                                                 Disorder
    ------------------------------------------------------------------------
    Monetary    Diabete  319 N.           $24,000   12/22/2016  Diabetes
                 s        Weber                                  Sisters'
                 Sister   Road,                                  Minority
                 s        pmb                                    Initiative
                          #163                                   Program
                          Bolingb
                          rook,
                          IL
                          60490
    ------------------------------------------------------------------------
    Monetary    Direct   27 S. La          $4,600    2/18/2016  Support to
                 Relief   Patera                                 improve the
                          Lane                                   lives of
                          Santa                                  people
                          Barbara                                affected by
                          , CA                                   poverty or
                          93117                                  emergency
                                                                 situations
                                                                 by
                                                                 mobilizing
                                                                 and
                                                                 providing
                                                                 essential
                                                                 medical
                                                                 resources
                                                                 needed for
                                                                 their care
    ------------------------------------------------------------------------
    Monetary    Dress    3131              $9,000   10/11/2016  Women's
                 for      Princet                                Empowerment
                 Succes   on Pike                                Programs
                 s        Bldg 4;
                          Suite
                          209
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Eden     2                 $9,500   12/15/2016  Adult
                 Autism   Merwick                                Employment
                 Servic   Road                                   Program
                 es       Princet
                 Founda   on, NJ
                 tion     08540
    ------------------------------------------------------------------------
    Monetary    Emory    49 Jesse         $25,000   10/24/2016  Emory Latino
                 Univer   Hill                                   Diabetes
                 sity     Jr. Dr                                 Education
                          Atlanta                                Program
                          , GA                                   (ELDEP)
                          30303
    ------------------------------------------------------------------------
    Monetary    Enable,  13                $3,000    9/12/2016  Fundraising
                 Inc.     Roszel                                 event
                          Road,                                  support to
                          Suite                                  benefit
                          B110                                   general
                          Princet                                mission of
                          on, NJ                                 organizatio
                          08540                                  n
    ------------------------------------------------------------------------
    Monetary    Enable,  13                $7,500   12/15/2016  Enable
                 Inc.     Roszel                                 Connect--Ca
                          Road,                                  mpus
                          Suite                                  Volunteer
                          B110                                   Program
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Every    Fred              $9,000   12/15/2016  Every Child
                 Child    Vereen,                                Valued
                 Valued   Jr.                                    (ECV) After
                 A NJ     Communi                                School
                 Nonpro   ty                                     Program
                 fit      Center
                 Corpor   175
                 ation    Johnson
                          Avenue
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Everybo  707               $7,500   12/15/2016  Coming Up
                 dy       Alexand                                for AIRTM
                 Loves    er
                 Kenny    Road,
                 Projec   Suite
                 t Inc.   208 PO
                          Box
                          3127
                          Princet
                          on, NJ
                          08543
    ------------------------------------------------------------------------
    Monetary    Family   1931             $10,000   12/21/2016  Family
                 Guidan   Notting                                Campus
                 ce       ham Way                                Project--Ho
                 Center   Hamilto                                meFront
                 Corpor   n, NJ                                  Collaborati
                 ation    08619                                  on
    ------------------------------------------------------------------------
    Monetary    Family   1931                $600   10/19/2016  Costs
                 Guidan   Notting                                associated
                 ce       ham Way                                with 2016
                 Center   Hamilto                                Janssen
                 Corpor   n, NJ                                  Cares
                 ation    08619                                  Volunteer
                                                                 Activities
    ------------------------------------------------------------------------
    Monetary    Family   1 AAA            $14,790   12/13/2016  Center on
                 Resour   Dr.                                    Nutrition
                 ce       Suite                                  and
                 Networ   203                                    Disability-
                 k        Trenton                                -Diabetes
                          , NJ                                   Prevention
                          08691                                  and Self
                                                                 Management
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    Family   4                $10,000   12/15/2016  Nurse
                 Servic   Corners                                Educator
                 e        tone                                   for
                 Associ   Drive                                  Homeless
                 ation    Langhor                                Shelter
                 of       ne, PA
                 Bucks    19047
                 County
    ------------------------------------------------------------------------
    Monetary    Federat  One               $2,000    4/11/2016  Big Nosh
                 ion of   Farming                                Vocational
                 Organi   dale                                   Services
                 zation   Road                                   Program
                 s        West
                          Babylon
                          , NY
                          11704
    ------------------------------------------------------------------------
    Monetary    Feed     Central              $75    1/19/2016  Employee
                 More,    Virgini                                directed
                 Inc.     a Food                                 donation in
                          Bank                                   lieu of
                          1415                                   company
                          Rhoadmi                                holiday
                          ller                                   gift
                          Street
                          Richmon
                          d, VA
                          23220
    ------------------------------------------------------------------------
    Monetary    Feeding  National         $32,200    2/18/2016  Domestic
                 Americ   Office                                 hunger
                 a        35 East                                relief
                          Wacker                                 efforts--me
                          Drive                                  al program
                          Suite
                          2000
                          Chicago
                          , IL
                          6618
    ------------------------------------------------------------------------
    Monetary    Fleming  110                 $300    9/15/2016  Costs
                 ton      Broad                                  associated
                 Area     Street                                 with 2016
                 Food     Box 783                                Janssen
                 Pantry   Fleming                                Cares
                          ton, NJ                                Volunteer
                          08822                                  Activity
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $2,500   12/15/2016  Funding
                 ion of   Lawrenc                                support for
                 Morris   eville                                 the 2017
                 Hall/    Road                                   Philly Pops
                 St.      Lawrenc                                Benefit
                 Lawren   eville,                                Concert
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $7,000   12/15/2016  Music and
                 ion of   Lawrenc                                Memory
                 Morris   eville
                 Hall/    Road
                 St.      Lawrenc
                 Lawren   eville,
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $6,000    9/13/2016  2016 Mad
                 n        47th                                   About Art
                 House    Street                                 Auction and
                          New                                    Benefit
                          York,
                          NY
                          10036
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $1,000    3/11/2016  Silver
                 n        47th                                   sponsor
                 House    Street                                 Fountain
                          New                                    House One-
                          York,                                  in-Four 5K--
                          NY                                     April 9,
                          10036                                  2016
    ------------------------------------------------------------------------
    Monetary    From     1455             $12,500     8/4/2016  N.O.S. Film
                 The      Mandala                                Project
                 Heart    y Beach
                 Produc   Road
                 tions    Oxnard
                 Inc.     Shores,
                          CA
                          93035
    ------------------------------------------------------------------------
    Monetary    Gateway  11901            $10,000    5/19/2016  Community
                 Homes,   Reedy                                  Reintegrati
                 Inc.     Branch                                 on:
                          Road PO                                Maximizing
                          Box 460                                Work
                          Chester                                Readiness
                          field,                                 and
                          VA                                     Independenc
                          23838                                  e for Those
                                                                 with
                                                                 Schizophren
                                                                 ia and
                                                                 Schizoaffec
                                                                 tive
                                                                 Disorder
    ------------------------------------------------------------------------
    Monetary    Georgia  246               $1,500     8/4/2016  Consumer
                 Mental   Sycamor                                Scholarship
                 Health   e St.                                  s to attend
                 Consum   Suite                                  the 25th
                 er       260                                    Annual
                 Networ   Decatur                                Statewide
                 k        , GA                                   Consumer
                          30030                                  Conference
    ------------------------------------------------------------------------
    Monetary    Girl     1171              $2,000   12/23/2016  Science,
                 Scouts   Route                                  Technology,
                 Heart    28                                     Engineering
                 of New   North                                  and Math
                 Jersey   Branch,                                (STEM)
                 , Inc.   NJ                                     Program
                          08876
    ------------------------------------------------------------------------
    Monetary    Grounds  80                $7,500   12/15/2016  Wellness
                 for      Sculpto                                Walks/
                 Sculpt   rs Way                                 Wellness
                 ure      Hamilto                                Talks for
                          n, NJ                                  Fixed
                          08619                                  Income
                                                                 Seniors
    ------------------------------------------------------------------------
    Monetary    Habitat  31 Oak            $5,000   12/15/2016  Women Build
                 for      Ave                                    and Repair
                 Humani   Chalfon                                Homes that
                 ty of    t, PA                                  Strengthen
                 Greate   18914                                  Families
                 r
                 Bucks
    ------------------------------------------------------------------------
    Monetary    Habitat  212 Yost            $500    11/3/2016  Costs
                 for      Bouleva                                associated
                 Humani   rd                                     with 2016
                 ty of    Suite A                                Janssen
                 Greate   Pittsbu                                Cares
                 r        rgh, PA                                Volunteer
                 Pittsb   15221                                  Activity
                 urgh
    ------------------------------------------------------------------------
    Monetary    HARK,    5                 $2,000   12/15/2016  Scholarships
                 Inc.     Pirozzi                                for low-
                          Lane                                   income
                          Hillsbo                                participant
                          rough,                                 s in Girls
                          NJ                                     on the Run
                          08844                                  of Central
                                                                 New Jersey
    ------------------------------------------------------------------------
    Monetary    Heartla  4750 N.           $7,500    5/30/2016  Pathways
                 nd       Sherida                                Home
                 Health   n Road
                 Outrea   Chicago
                 ch       , IL
                          60640
    ------------------------------------------------------------------------
    Monetary    Henders  4740              $7,500    4/12/2016  Helping
                 on       North                                  Individuals
                 Behavi   State                                  Live Longer
                 oral     Road 7                                 (HILL)
                 Health   Lauderd
                          ale
                          Lakes,
                          FL
                          33319
    ------------------------------------------------------------------------
    Monetary    Henry    321               $7,500   12/21/2016  Decreasing
                 J.       North                                  Opioid Use
                 Austin   Warren                                 through
                 Health   Street                                 Patient
                 Center   Trenton                                Empowerment
                 , Inc.   , NJ                                   and
                          08618                                  Chiropracto
                                                                 r Services
    ------------------------------------------------------------------------
    Monetary    His      20000 NW            $600    1/18/2016  Employee
                 House    47th                                   directed
                 Childr   Avenue                                 donation in
                 en's     Hector                                 lieu of
                 Home     Buildin                                company
                          g No. 2                                holiday
                          Develop                                gift
                          ment
                          Departm
                          ent
                          Miami
                          Gardens
                          , FL
                          33055
    ------------------------------------------------------------------------
    Monetary    HiTops,  21                $7,500    9/12/2016  HiTOPS'
                 Inc.     Wiggins                                Sexual
                          Street                                 Health
                          Princet                                Interventio
                          on, NJ                                 ns for
                          08540                                  Youth-at-
                                                                 Risk
    ------------------------------------------------------------------------
    Monetary    Holiday  968               $4,000    9/29/2016  Holiday
                 Expres   Shrewsb                                Express
                 s Inc.   ury                                    Central
                          Avenue                                 Jersey
                          Tinton                                 Charity
                          Falls,                                 Concert
                          NJ                                     Series
                          07724
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880              $2,500    9/12/2016  Fundraising
                 nt       Princet                                event
                          on                                     support to
                          Avenue                                 benefit
                          Lawrenc                                general
                          eville,                                mission of
                          NJ                                     organizatio
                          08648                                  n
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880             $10,000   10/26/2016  Breaking the
                 nt       Princet                                Cycle of
                          on                                     Poverty for
                          Avenue                                 Homeless
                          Lawrenc                                Families
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880                $300   10/20/2016  Costs
                 nt       Princet                                associated
                          on                                     with 2016
                          Avenue                                 Janssen
                          Lawrenc                                Cares event
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Hopewel  35                  $750   12/15/2016  Hopewell
                 l        Princet                                Elementary
                 Elemen   on                                     School
                 tary     Avenue                                 Science
                 School   Hopewel                                Fair
                 Parent   l, NJ
                 Teache   08525
                 r
                 Organi
                 zation
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Hopewel  PO Box            $6,500   12/15/2016  (1) College
                 l        553                                    Scholarship
                 Valley   Penning                                ($1,000)
                 Educat   ton, NJ                                (2)
                 ion      08534                                  Hopewell
                 Founda                                          Valley HOSA
                 tion                                            ($500) (3)
                                                                 Teaching
                                                                 the Stars--
                                                                 Using
                                                                 Starlab to
                                                                 enhance
                                                                 curricula
                                                                 in the
                                                                 HVRSD
                                                                 ($5,000)
    ------------------------------------------------------------------------
    Monetary    Hopewel  PO Box            $1,000     5/2/2016  Scholarship
                 l        553                                    support
                 Valley   Penning
                 Educat   ton, NJ
                 ion      08534
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Hopewel  48                $2,000   12/21/2016  Hopewell
                 l        Orchard                                Valley
                 Valley   Ave PO                                 Rides
                 Senior   Box 567
                 Founda   Penning
                 tion     ton, NJ
                          08534
    ------------------------------------------------------------------------
    Monetary    Hunterd  7 Lower           $7,500   12/21/2016  Artistic
                 on Art   Center                                 Expressions
                 Center   Street                                 Program
                          Clinton
                          , NJ
                          08809
    ------------------------------------------------------------------------
    Monetary    Hunterd  1410              $2,500    11/9/2016  YMCA Comedy
                 on       Route                                  Night
                 County   22 West
                 YMCA     Annanda
                          le, NJ
                          08801
    ------------------------------------------------------------------------
    Monetary    Hunterd  9100                $100    1/19/2016  Memorial
                 on       Wescott                                Donation
                 Health   Drive
                 care     Suite
                 Founda   202
                 tion     Fleming
                          ton, NJ
                          08822
    ------------------------------------------------------------------------
    Monetary    Hunterd  111 Mine          $2,000   12/15/2016  Dvoor Farm
                 on       Street                                 Public
                 Land     Fleming                                Access
                 Trust    ton, NJ                                Enhancement
                          08822
    ------------------------------------------------------------------------
    Monetary    HVRSD    C/O               $5,000   12/22/2016  Playground
                 Specia   Pupil                                  resurfacing
                 l        Service                                project
                 Educat   s 425                                  Stonybrook
                 ion      South                                  Elementary
                 PtO      Main
                          Street
                          Penning
                          ton, NJ
                          08534
    ------------------------------------------------------------------------
    Monetary    Interfa  3635             $15,000   10/26/2016  Neighbors
                 ith      Quakerb                                Helping
                 Caregi   ridege                                 Neighbors
                 vers     Road,                                  Program
                 Trento   Suite                                  (NHN)
                 n,       16
                 Inc.     Hamilto
                          n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    Isles,   10 Wood           $9,000   12/15/2016  Trenton
                 Inc.     Street                                 Healthy
                          Trenton                                Homes
                          , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Jewish   707               $7,500   11/22/2016  Mercer
                 Family   Alexand                                County
                 and      er                                     Caregiver
                 Childr   Road,                                  Support
                 en's     Suite                                  Initiative
                 Servic   102
                 e of     Princet
                 Greate   on, NJ
                 r        08540
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Jewish   707               $7,500   11/22/2016  Senior
                 Family   Alexand                                Outreach
                 and      er                                     Service
                 Childr   Road,
                 en's     Suite
                 Servic   102
                 e of     Princet
                 Greate   on, NJ
                 r        08540
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Jewish   707                 $600   10/19/2016  Costs
                 Family   Alexand                                associated
                 and      er                                     with 2016
                 Childr   Road,                                  Janssen
                 en's     Suite                                  Cares
                 Servic   102                                    Volunteer
                 e of     Princet                                Activities
                 Greate   on, NJ
                 r        08540
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Junior   360 Pear          $7,150   12/21/2016  Junior
                 Achiev   Blossom                                Achievement
                 ement    Drive                                  program in
                 of New   Edison,                                Trenton
                 Jersey   NJ                                     Schools
                          08837
    ------------------------------------------------------------------------
    Monetary    Lafayet  1214             $30,000     1/6/2016  The Healthy
                 te       Coolidg                                Heart
                 Genera   e                                      Fairs: EKG
                 l        Street                                 to
                 Medica   Lafayet                                Survivorshi
                 l        te, LA                                 p Program
                          70503
    ------------------------------------------------------------------------
    Monetary    Latin    669               $5,000   12/16/2016  Welcome
                 Americ   Chamber                                House
                 an       s St                                   Community
                 Legal    Suite B                                Center
                 Defens   Trenton
                 e And    , NJ
                 Educat   08611
                 ional
                 Fund
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Lawrenc  PO Box            $3,900   12/15/2016  Mobile
                 e        6531 17                                Makerspaces
                 Townsh   Philips                                to create,
                 ip       Ave.                                   build,
                 Educat   Lawrenc                                tinker,
                 ion      eville,                                fail and
                 Founda   NJ                                     think
                 tion     08648                                  critically
                 Inc.                                            from
                                                                 elementary
                                                                 classrooms
                                                                 in Lawrence
                                                                 Township,
                                                                 NJ.
    ------------------------------------------------------------------------
    Monetary    Leyden   10001 W           $8,500    5/16/2016  Affordable
                 Family   Grand                                  Supportive
                 Servic   Ave                                    Housing for
                 e and    Frankli                                Individuals
                 Mental   n Park,                                with
                 Health   IL                                     Serious
                 Center   60131                                  Mental
                                                                 Illness
    ------------------------------------------------------------------------
    Monetary    Literac  PO Box            $5,000   12/21/2016  Early
                 y And    55636                                  Childhood:
                 Life     Trenton                                Building
                 Inc.     , NJ                                   Blocks for
                          08638                                  the Future
    ------------------------------------------------------------------------
    Monetary    Literac  100               $5,000   12/22/2016  Women
                 y New    Menlo                                  Empowered
                 Jersey   Park
                 Inc.     Dr.
                          #314
                          Edison,
                          NJ
                          08837
    ------------------------------------------------------------------------
    Monetary    Literac  120               $4,000   12/15/2016  Let's Talk
                 y        Findern                                About
                 Volunt   e Ave--                                Health
                 eers     Box 7
                 of       Bridgew
                 Somers   ater,
                 et       NJ
                 County   08807
    ------------------------------------------------------------------------
    Monetary    Main     8                 $4,000    4/12/2016  Accessible
                 Street   Marcell                                Mental
                 Counse   a                                      Health Care
                 ling     Avenue                                 for
                 Center   West                                   Schizoaffec
                          Orange,                                tive
                          NJ                                     Disorder
                          07052
    ------------------------------------------------------------------------
    Monetary    Massach  15                $3,500     2/9/2016  Changing
                 usetts   Vernon                                 Minds and
                 Clubho   Street                                 Expanding
                 use      Waltham                                Employment
                 Coalit   , MA                                   Campaign
                 ion      02453
    ------------------------------------------------------------------------
    Monetary    McCarte  91               $10,000   11/22/2016  OnStage
                 r        Univers                                Seniors: A
                 Theatr   ity                                    Community
                 e        Place                                  Project of
                 Center   Princet                                McCarter
                          on, NJ                                 Theatre
                          08540
    ------------------------------------------------------------------------
    Monetary    Meals    5 Walter            $300    11/3/2016  Costs
                 On       Foran                                  associated
                 Wheels   Blvd                                   with 2016
                 In       Suite                                  Janssen
                 Hunter   2006                                   Cares
                 don      Fleming                                Volunteer
                 Inc.     ton, NJ                                Activity
                          08822
    ------------------------------------------------------------------------
    Monetary    Meals    1501                 $75    5/23/2016  Employee
                 On       Sunset                                 directed
                 Wheels   Ave                                    donation in
                 of       Rocky                                  lieu of
                 Rocky    Mount,                                 company
                 Mount    NC                                     holiday
                 Inc.     27804                                  gift
    ------------------------------------------------------------------------
    Monetary    Meals    320              $15,000   10/26/2016  Meals on
                 on       Hollowb                                Wheels
                 Wheels   rook                                   Program
                 of       Drive
                 Trento   Ewing,
                 n        NJ
                 Ewing    08638
    ------------------------------------------------------------------------
    Monetary    Mental   500              $90,000   12/15/2016  Social Self-
                 Health   Montgom                                Directed
                 Americ   ery St.                                Care (SSDC)
                 a        Suite
                          820
                          Alexand
                          ria, VA
                          22314
    ------------------------------------------------------------------------
    Monetary    Mental   2211              $7,500    6/21/2016  Mental
                 Health   Norfolk                                Health
                 Americ   , Suite                                Community
                 a of     810                                    and
                 Greate   Houston                                Legislative
                 r        , TX                                   Advocacy
                 Housto   77098
                 n
    ------------------------------------------------------------------------
    Monetary    Mental   2323 W           $10,000    5/27/2016  Get
                 Health   5th                                    Connected
                 Americ   Ave.                                   program
                 a of     Suite
                 Frankl   160
                 in       Columbu
                 County   s, OH
                          43204
    ------------------------------------------------------------------------
    Monetary    Mental   8280              $2,500    8/24/2016  2016 Florida
                 Health   Princet                                Mental
                 Americ   on                                     Health
                 a Of     Square                                 Summit
                 Northe   Blvd.
                 ast      W.
                 Florid   Suite 8
                 a Inc.   Jackson
                          ville,
                          FL
                          32256
    ------------------------------------------------------------------------
    Monetary    Mental   1210 San          $2,500    5/16/2016  Mental
                 Health   Antonio                                Health
                 Americ   , Suite                                Education
                 a of     200                                    and
                 Texas    Austin,                                Advocacy
                          TX                                     Campaign
                          78701
    ------------------------------------------------------------------------
    Monetary    Mental   100 W.            $1,000     8/9/2016  Bronze
                 Health   10th                                   sponsor
                 Associ   St.                                    2016 E-
                 ation    Ste.                                   Racing the
                 in       600                                    Blues for
                 Delawa   Wilming                                Mental
                 re       ton, DE                                Health--Oct
                          19801                                  ober 30,
                                                                 2016
    ------------------------------------------------------------------------
    Monetary    Mental   100 W.            $2,000   10/18/2016  Community
                 Health   10th                                   Mental
                 Associ   St.                                    Health
                 ation    Ste.                                   Conference
                 in       600                                    2016:
                 Delawa   Wilming                                Bridging
                 re       ton, DE                                the Gaps--
                          19801                                  Through
                                                                 Resources
                                                                 and
                                                                 Networking
    ------------------------------------------------------------------------
    Monetary    Mental   673              $10,000     8/4/2016  MHANJ Access
                 Health   Morris                                 to Mental
                 Associ   Avenue,                                Health Care
                 ation    Suite
                 in New   100
                 Jersey   Springf
                          ield,
                          NJ
                          07081
    ------------------------------------------------------------------------
    Monetary    Mental   617               $2,500    4/21/2016  Operating
                 Health   Garden                                 Support for
                 Associ   Street                                 the Mental
                 ation    Santa                                  Wellness
                 in       Barbara                                Center's
                 Santa    , CA                                   Fellowship
                 Barbar   93101                                  Club
                 a
                 County
    ------------------------------------------------------------------------
    Monetary    Mental   3701              $7,500    5/16/2016  ParentVOICE
                 Health   Latrobe
                 Associ   Drive,
                 ation    Suite
                 Of       140
                 Centra   Charlot
                 l        te, NC
                 Caroli   28211
                 nas
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Mental   1301             $10,000     8/4/2016  Citizens
                 Health   York                                   Action
                 Associ   Road,                                  Team:
                 ation    Suite                                  Engaging
                 of       505                                    Consumers
                 Maryla   Lutherv                                of
                 nd,      ille,                                  Behavioral
                 Inc.     MD                                     Health in
                          21093                                  Healthcare
                                                                 Reform
                                                                 Initiatives
    ------------------------------------------------------------------------
    Monetary    Mental   580               $1,000    3/15/2016  Bronze
                 Health   White                                  sponsor MHA
                 Associ   Plains                                 on the
                 ation    Road                                   Move: Run/
                 of       Suite                                  Walk--May
                 Westch   510                                    1, 2016
                 ester    Tarryto
                          wn, NY
                          10591
    ------------------------------------------------------------------------
    Monetary    Mental   555 N             $3,500    6/24/2016  Access to
                 Health   Woodlaw                                Care Fund
                 Associ   n, Ste.
                 ation    3105
                 Reside   Wichita
                 ntial    , KS
                 Care     67208
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Mental   3809             $12,500     8/4/2016  Outreach and
                 Illnes   Rosewoo                                Behavioral
                 s        d Drive                                Healthcare
                 Recove   PO Box                                 for
                 ry       4246                                   Homeless
                 Center   Columbi                                Individuals
                 , Inc.   a, SC                                  with Mental
                          29240                                  Illness
    ------------------------------------------------------------------------
    Monetary    Mercer   1001              $9,500   12/15/2016  Implementing
                 Allian   Spruce                                 a Plan to
                 ce to    Street,                                End Chronic
                 End      Suite                                  Homelessnes
                 Homele   205                                    s in the
                 ssness   Trenton                                Trenton/
                          , NJ                                   Mercer
                          08638                                  Community:
                                                                 Utilizing
                                                                 assertive
                                                                 engagement,
                                                                 permanent
                                                                 housing and
                                                                 healthcare
                                                                 access to
                                                                 achieve
                                                                 this goal
    ------------------------------------------------------------------------
    Monetary    Mercer   P.O. Box         $16,680   12/15/2016  Mercer
                 County   17202                                  Student
                 Commun   Trenton                                Competency
                 ity      , NJ                                   in Optical
                 Colleg   08690                                  Examination
                 e                                               (M-SCOPE)
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Mercer   151              $20,000   10/26/2016  Mercer
                 Street   Mercer                                 Street
                 Friend   Street                                 Friends
                 s        Trenton                                Food Bank
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Mercer   151                 $300   10/19/2016  Costs
                 Street   Mercer                                 associated
                 Friend   Street                                 with 2016
                 s        Trenton                                Janssen
                          , NJ                                   Cares
                          08611                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Metropo  945               $5,000    7/20/2016  Supported
                 litan    Fawcett                                Employment
                 Develo   Ave.
                 pment    Tacoma,
                 Counci   WA
                 l        98402
    ------------------------------------------------------------------------
    Monetary    Middle   P.O. Box         $15,000   11/15/2016  Outreach
                 Earth    8045                                   Program and
                          520                                    Community
                          North                                  Youth
                          Bridge                                 Centers
                          Street
                          Bridgew
                          ater,
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    MIDJers  423               $5,000   10/26/2016  Urban Youth
                 ey       Rivervi                                Employment
                 Center   ew                                     Program
                 for      Plaza
                 Econom   Trenton
                 ic       , NJ
                 Develo   08611
                 pment
    ------------------------------------------------------------------------
    Monetary    Midland  60                $6,500    9/28/2016  Midland
                 Adult    Industr                                Helping
                 Servic   ial                                    Hands
                 es       Parkway                                Employment
                 Inc.     PO Box                                 Training
                          5026                                   Program.
                          North
                          Branch,
                          NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Millhil  101               $5,000   10/26/2016  Trenton Area
                 l        Oakland                                Stakeholder
                 Child    Street                                 s
                 and      Trenton
                 Family   , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Millhil  101              $15,000   10/26/2016  Millhill
                 l        Oakland                                Trenton
                 Child    Street                                 PEERS
                 and      Trenton
                 Family   , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Minding  2083              $6,000   12/15/2016  Minding Our
                 Our      Lawrenc                                Business
                 Busine   eville                                 Summer
                 ss       Road                                   Program: A
                 Inc.     Lawrenc                                Bridge to
                          eville,                                the Future
                          NJ                                     for Mercer
                          08648                                  County Low-
                                                                 Income
                                                                 Youth
    ------------------------------------------------------------------------
    Monetary    Minding  2083              $6,000     5/2/2016  Minding Our
                 Our      Lawrenc                                Business
                 Busine   eville                                 Summer
                 ss       Road                                   Program: A
                 Inc.     Lawrenc                                Bridge to
                          eville,                                the Future
                          NJ                                     for Mercer
                          08648                                  County Low-
                                                                 Income
                                                                 Youth
    ------------------------------------------------------------------------
    Monetary    Morven   55                $5,000   12/15/2016  Internship
                 Museum   Stockto                                for At-Risk
                 and      n                                      Youth
                 Garden   Street
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Mount    73 North         $15,000    9/15/2016  In Home
                 Carmel   Clinton                                Health
                 Guild    Avenue                                 Nursing
                          Trenton                                Program
                          , NJ
                          08609
    ------------------------------------------------------------------------
    Monetary    NAMI     4161 NW           $1,000    4/18/2016  Bronze
                 Browar   5 St,                                  sponsor
                 d        Suite                                  NAMIWalks
                 County   203                                    Broward
                 , Inc.   Plantat                                County--Nov
                          ion, FL                                ember 12,
                          33317                                  2016
    ------------------------------------------------------------------------
    Monetary    NAMI     8324              $1,000    3/21/2016  Bronze
                 Cook     Skokie                                 sponsor
                 County   Blvd                                   NAMI CCNS
                 North    420                                    Walk--Septe
                 Suburb   Frontag                                mber 18,
                 an       e Road                                 2016
                          Northfi
                          eld
                          Skokie,
                          IL
                          60077
    ------------------------------------------------------------------------
    Monetary    NAMI     2400 W.           $1,000    3/15/2016  Bronze
                 Delawa   4th St.                                sponsor
                 re       Wilming                                NAMIWalks
                          ton, DE                                Delaware--M
                          19805                                  ay 7, 2016
    ------------------------------------------------------------------------
    Monetary    NAMI     3371              $2,500     3/1/2016  Silver
                 Mercer   Brunswi                                sponsor
                 NJ       ck                                     2016 NAMI
                          Pike,                                  Mercer
                          Suite                                  Walk--May
                          124                                    7, 2016
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    NAMI     3371             $10,000    9/15/2016  NAMI Mercer
                 Mercer   Brunswi                                Education
                 NJ       ck                                     and Support
                          Pike,                                  Programs
                          Suite
                          124
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    NAMI     85 N.             $1,000     9/7/2016  Bronze
                 New      State                                  sponsor
                 Hampsh   Street                                 2016
                 ire      Concord                                NAMIWalks
                          , NH                                   New
                          03301                                  Hampshire--
                                                                 October 2,
                                                                 2016
    ------------------------------------------------------------------------
    Monetary    NAMI of  115               $8,000     8/9/2016  Peer Support
                 DuPage   North                                  Specialist
                 County   County                                 Program
                 Illino   Farm
                 is       Road
                          Wheaton
                          , IL
                          60187
    ------------------------------------------------------------------------
    Monetary    NAMI of  2701              $4,000    8/24/2016  General
                 Johnso   Rochest                                Program
                 n        er                                     Support/
                 County   Avenue                                 Finds
                 dba      Iowa                                   Friends/
                 Compee   City,                                  Volunteer
                 r of     IA                                     Recruitment
                 Johnso   52245
                 n
                 County
    ------------------------------------------------------------------------
    Monetary    NAMI of  One               $1,500     8/4/2016  Start to
                 Lake     Victori                                Finish
                 County   a Sq.,                                 sponsor
                          Ste.                                   NAMI Lake
                          260                                    County
                          Painesv                                Strides for
                          ille,                                  Awareness
                          OH                                     NAMI Walk--
                          44077                                  August 20,
                                                                 2016
    ------------------------------------------------------------------------
    Monetary    NAMI of  100 W,            $1,000    3/15/2016  Bronze
                 PA       Main                                   sponsor
                 Montgo   St.                                    Greater
                 mery     Suite                                  Philadelphi
                 County   204                                    a
                          Lansdal                                NAMIWalks--
                          e, PA                                  May 14,
                          19446                                  2016
    ------------------------------------------------------------------------
    Monetary    NAMI of  4055              $2,500     5/4/2016  Hope for
                 Southw   Executi                                Recovery
                 est      ve Park                                Pilot
                 Ohio     Drive,
                          Suite
                          450
                          Cincinn
                          ati, OH
                          45241
    ------------------------------------------------------------------------
    Monetary    NAMI     1750 S.           $1,000    3/15/2016  Kilometer
                 St.      Brentwo                                sponsor
                 Louis    od                                     NAMIWalks
                          Blvd.                                  St. Louis--
                          Suite                                  May 28,
                          511 St.                                2016
                          Louis,
                          MO
                          63144
    ------------------------------------------------------------------------
    Monetary    NAMI     PO Box            $1,000    4/19/2016  Bronze
                 Summit   462                                    sponsor
                 County   Cuyahog                                2016
                          a                                      NAMIWalks
                          Falls,                                 Summit
                          OH                                     County--Oct
                          44222                                  ober 22,
                                                                 2016
    ------------------------------------------------------------------------
    Monetary    NAMI     217               $1,000    5/27/2016  Bronze
                 Waukes   Wiscons                                sponsor
                 ha       in Ave                                 2016
                          Suite                                  NAMIWalks
                          300                                    Waukesha--P
                          Waukesh                                9/17/16
                          a, WI
                          53186
    ------------------------------------------------------------------------
    Monetary    Nationa  90 Park           $2,500    5/16/2016  Meet the
                 l        Avenue                                 Scientist
                 Allian   16th                                   Monthly
                 ce for   Floor                                  Webinar
                 Resear   New                                    Series
                 ch on    York,
                 Schizo   NY
                 phreni   10016
                 a and
                 Depres
                 sion
    ------------------------------------------------------------------------
    Monetary    Nationa  90 Park           $2,500    5/16/2016  28th New
                 l        Avenue                                 York Mental
                 Allian   16th                                   Health
                 ce for   Floor                                  Research
                 Resear   New                                    Symposium
                 ch on    York,
                 Schizo   NY
                 phreni   10016
                 a and
                 Depres
                 sion
    ------------------------------------------------------------------------
    Monetary    Nationa  1851              $2,500     2/9/2016  Bronze
                 l        Heritag                                sponsor
                 Allian   e Lane,                                2016 NAMI
                 ce for   Suite                                  California
                 the      150                                    Annual
                 Mental   Sacrame                                Conference
                 ly Ill   nto, CA
                          95815
    ------------------------------------------------------------------------
    Monetary    Nationa  The               $1,000    3/15/2016  Bronze
                 l        Schraff                                sponsor
                 Allian   t's                                    NAMIWalks
                 ce for   Center                                 Mass--May
                 the      529                                    14, 2016
                 Mental   Main
                 ly Ill   Street,
                          Suite
                          1M17
                          Boston,
                          MA
                          02129
    ------------------------------------------------------------------------
    Monetary    Nationa  3250              $1,000    3/15/2016  Bronze
                 l        Wilshir                                sponsor
                 Allian   e                                      NAMIWalks
                 ce for   Blvd.,                                 Los Angeles
                 the      Suite                                  County--Oct
                 Mental   1501                                   ober 1,
                 ly Ill   Los                                    2016
                          Angeles
                          , CA
                          90010
    ------------------------------------------------------------------------
    Monetary    Nationa  2812              $1,000    5/16/2016  Bronze
                 l        Swiss                                  sponsor
                 Allian   Avenue                                 Dallas
                 ce for   Dallas,                                NAMIWalk--M
                 the      TX                                     ay 14, 2016
                 Mental   75204
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  1706              $1,000    3/15/2016  Bronze
                 l        Brady                                  sponsor
                 Allian   Street                                 NAMIWalks
                 ce for   Suite                                  Greater
                 the      101                                    Mississippi
                 Mental   Davenpo                                Valley--Sep
                 ly Ill   rt, IA                                 tember 24,
                          52803                                  2016
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000     8/4/2016  NAMIFest
                 l        4096                                   2016--2 Day
                 Allian   Alvin,                                 Educational
                 ce for   TX                                     Conference
                 the      77512
                 Mental
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  1225              $7,500     2/9/2016  The Year of
                 l        Dublin                                 the
                 Allian   Road,                                  Affiliate:
                 ce for   Suite                                  Strengtheni
                 the      125                                    ng NAMI's
                 Mental   Columbu                                Voice in
                 ly Ill   s, OH                                  Ohio's
                          43215                                  Local
                                                                 Communities
    ------------------------------------------------------------------------
    Monetary    Nationa  1562              $1,000     2/2/2016  Bronze
                 l        Route                                  sponsor
                 Allian   130                                    2016 NAMI
                 ce for   North                                  Walks New
                 the      Brunswi                                Jersey,
                 Mental   ck, NJ                                 ``Step
                 ly Ill   08902                                  Forward for
                                                                 Our
                                                                 Heroes''
    ------------------------------------------------------------------------
    Monetary    Nationa  5095              $1,000     2/2/2016  Bronze
                 l        Murphy                                 sponsor
                 Allian   Canyon                                 2016 NAMI
                 ce for   Road                                   Walk
                 the      Suite
                 Mental   320 San
                 ly Ill   Diego,
                          CA
                          92123
    ------------------------------------------------------------------------
    Monetary    Nationa  3200 S.           $1,000     2/9/2016  Bronze
                 l        3rd                                    sponsor
                 Allian   Street,                                2016
                 ce for   Unit 6                                 NAMIWalks
                 the      Milwauk                                Greater
                 Mental   ee, WI                                 Milwaukee
                 ly Ill   53207
    ------------------------------------------------------------------------
    Monetary    Nationa  2601              $2,500     2/9/2016  Supporting
                 l        Cold                                   sponsor
                 Allian   Spring                                 NAMI
                 ce for   Road                                   Indiana's
                 the      P.O.                                   13th Annual
                 Mental   Box                                    Mental
                 ly Ill   22697                                  Health and
                          Indiana                                Criminal
                          polis,                                 Justice
                          IN                                     Summit
                          46222
    ------------------------------------------------------------------------
    Monetary    Nationa  576               $1,500     2/9/2016  Bronze
                 l        Farming                                sponsor
                 Allian   ton                                    2016 NAMI
                 ce for   Avenue                                 Walk
                 the      Hartfor
                 Mental   d, CT
                 ly Ill   06105
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000    5/27/2016  Platinum
                 l        550039                                 sponsor
                 Allian   Birming                                2016 NAMI
                 ce for   ham, AL                                Birmingham
                 the      35255-                                 Walk for
                 Mental   0039                                   Mental
                 ly Ill                                          Health--9/
                                                                 17/16
    ------------------------------------------------------------------------
    Monetary    Nationa  1536              $8,000    6/24/2016  Honest,
                 l        West                                   Open, Proud
                 Allian   Chicago                                to erase
                 ce for   Ave                                    the stigma
                 the      Chicago                                of mental
                 Mental   , IL                                   illness
                 ly Ill   60642
    ------------------------------------------------------------------------
    Monetary    Nationa  1562              $2,500   11/18/2016  2016 NAMI NJ
                 l        Route                                  Conference:
                 Allian   130                                    ``Building
                 ce for   North                                  Better
                 the      Brunswi                                Lives''
                 Mental   ck, NJ
                 ly Ill   08902
    ------------------------------------------------------------------------
    Monetary    Nationa  3333              $1,000   12/14/2016  Pink Ribbon
                 l        West                                   Sponsor--20
                 Allian   Pensaco                                17
                 ce for   la                                     Blueberry
                 the      Street                                 Horseshoe
                 Mental   Suite                                  5k--Februar
                 ly Ill   250                                    y 19, 2017
                          Tallaha
                          ssee,
                          FL
                          32302-0
                          961
    ------------------------------------------------------------------------
    Monetary    Nationa  99 Pine           $4,000    12/1/2016  2016 NAMI-
                 l        St.                                    NYS
                 Allian   Suite                                  Education
                 ce for   302                                    Conference
                 the      Albany,
                 Mental   NY
                 ly Ill   12207
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $75,000   12/15/2016  Strengthenin
                 l        Fairfax                                g CIT
                 Allian   Drive
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $50,000   12/15/2016  NAMI
                 l        Fairfax                                Helpline
                 Allian   Drive
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $5,000    6/24/2016  Mental
                 l        West                                   Illness
                 Allian   25th                                   Education
                 ce for   Street,
                 the      #600
                 Mental   Clevela
                 ly       nd, OH
                 Ill--G   44113
                 reater
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $1,000    3/15/2016  Bronze
                 l        West                                   sponsor
                 Allian   25th                                   NAMIWalks--
                 ce for   Street,                                August 27,
                 the      #600                                   2016
                 Mental   Clevela
                 ly       nd, OH
                 Ill--G   44113
                 reater
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  3839              $1,000    3/15/2016  Bronze
                 l        Merle                                  sponsor
                 Allian   Hay                                    NAMIWalks
                 ce for   Road,                                  Iowa--Septe
                 the      Suite                                  mber 24,
                 Mental   226 Des                                2016
                 ly       Moines,
                 Ill--I   IA
                 owa      50310
    ------------------------------------------------------------------------
    Monetary    Nationa  505 8th           $1,000    3/15/2016  Bronze
                 l        Avenue,                                sponsor
                 Allian   Ste                                    NAMIWalks
                 ce for   1103                                   NYC--May 7,
                 the      New                                    2016
                 Mental   York,
                 ly Ill   NY
                 of New   10018
                 York
                 City
    ------------------------------------------------------------------------
    Monetary    Nationa  1981              $1,000   11/11/2016  Bronze
                 l        Marcus                                 sponsor
                 Allian   Ave                                    NAMIWalks
                 ce for   Suite                                  Long Island/
                 the      C117                                   Queens May
                 Mental   Lake                                   6, 2017
                 ly Ill   Success
                 Queens/  , NY
                 Nassau   11042
    ------------------------------------------------------------------------
    Monetary    Nationa  5963              $1,000    7/20/2016  Bronze
                 l        Boymel                                 sponsor
                 Allian   Dr.                                    NAMIWalks
                 ce on    Fairfie                                Butler
                 Mental   ld, OH                                 County--Oct
                 Illnes   45014                                  ober 8,
                 s                                               2016
    ------------------------------------------------------------------------
    Monetary    Nationa  324A              $1,000    3/15/2016  NAMI Walk--
                 l        Springf                                May 15,
                 Allian   ield                                   2016
                 ce on    Street
                 Mental   Agawam,
                 Illnes   MA
                 s        01001
                 Wester
                 n
                 Mass.,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  P O Box           $6,000     5/3/2016  29th Annual
                 l Art    350891                                 NAEMI Art
                 Exhibi   Miami,                                 Exhibition
                 tions    FL
                 of the   33135
                 Mental
                 ly
                 Ill,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $75,000   12/15/2016  Policy
                 l        St NW,                                 Action
                 Counci   #400                                   Center
                 l for    Washing
                 Behavi   ton, DC
                 oral     20005
                 Health
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $75,000   12/15/2016  Early Onset
                 l        St NW,                                 Psychosis
                 Counci   #400                                   Community
                 l for    Washing                                of Practice
                 Behavi   ton, DC
                 oral     20005
                 Health
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $75,000   12/15/2016  Health
                 l        St NW,                                 Justice
                 Counci   #400                                   Learning
                 l for    Washing                                Collaborati
                 Behavi   ton, DC                                ve
                 oral     20005
                 Health
    ------------------------------------------------------------------------
    Monetary    Nationa  949 W.            $7,500   12/15/2016  Academic
                 l        State                                  Creative
                 Junior   Street                                 Engagement
                 Tennis   Trenton                                (ACE)
                 and      , NJ                                   Program and
                 Learni   08618                                  Science
                 ng of                                           Technology
                 Trento                                          Engineering
                 n                                               Arts Math
                                                                 (STEAM)
                                                                 Pilot
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $20,000   12/22/2016  Stroke
                 l        Easter                                 Recovery
                 Stroke   Lane,                                  Navigator
                 Associ   Suite B
                 ation    Centenn
                          ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $30,000   12/22/2016  National
                 l        Easter                                 Stroke
                 Stroke   Lane,                                  Awareness
                 Associ   Suite B                                Month
                 ation    Centenn
                          ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    New      275 Rt.           $4,000    4/12/2016  NJPC NJ
                 Jersey   10 East                                Youth
                 Parent   Suite                                  Caucus
                 s        220-414                                (Formerly
                 Caucus   Succasu                                known as NJ
                          nna, NJ                                Youth
                          07876                                  Coalition)
    ------------------------------------------------------------------------
    Monetary    NewBrid  7                 $2,000    6/24/2016  NewBridge
                 ge       Industr                                Day
                 Servic   ial                                    Treatment
                 es,      Road                                   Progam for
                 Inc.     P.O.                                   Adults
                          Box 336
                          Pequann
                          ock, NJ
                          07440
    ------------------------------------------------------------------------
    Monetary    Northea  2900              $2,500    7/12/2016  Day of
                 st       Conner                                 Restoration
                 Guidan   Avenue,                                -assistance
                 ce       Buildin                                for
                 Center   g A                                    Detroit's
                          Detroit                                Homeless
                          , MI                                   with Mental
                          48215                                  Illness
    ------------------------------------------------------------------------
    Monetary    NorthSh  1033             $10,000   12/22/2016  Clot Aware
                 ore      Univers                                Support
                 Univer   ity                                    Group
                 sity     Place
                 Health   Suite
                 system   450
                          Evansto
                          n, IL
                          60201
    ------------------------------------------------------------------------
    Monetary    Ohio     33 N.             $2,500    3/21/2016  Ohio's 2016
                 Associ   High                                   Recovery
                 ation    Street,                                Conference:
                 of       Ste.                                   Recovery Is
                 County   500                                    Beautiful
                 Behavi   Columbu
                 oral     s, OH
                 Health   43215
                 Author
                 ities
    ------------------------------------------------------------------------
    Monetary    Pancrea  1500                $100    2/15/2016  Memorial
                 tic      Rosecra                                Donation
                 Cancer   ns Ave,
                 Action   Suite
                 Networ   200
                 k        Manhatt
                          an
                          Beach,
                          CA
                          90266
    ------------------------------------------------------------------------
    Monetary    Passage  PO Box            $7,500   12/15/2016  Support for
                 Theatr   967                                    the State
                 e        Trenton                                Street
                 Compan   , NJ                                   Project
                 y Inc.   08605
    ------------------------------------------------------------------------
    Monetary    PEI      231              $17,500   10/26/2016  Comprehensiv
                 Kids     Lawrenc                                e Juvenile
                          e Road                                 Offenders
                          Lawrenc                                Outreach
                          eville,                                Services
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    PEI      231                 $300   10/20/2016  Costs
                 Kids     Lawrenc                                associated
                          e Road                                 with 2016
                          Lawrenc                                Janssen
                          eville,                                Cares event
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    People   295               $2,500   11/18/2016  Reading
                 And      Eggerts                                Deeply in
                 Storie   Crossin                                Community:
                 s--Gen   g Road                                 A
                 te Y     Lawrenc                                Literature
                 Cuento   eville,                                Project for
                 s Inc.   NJ                                     Mercer
                          08648                                  County
                                                                 Youth and
                                                                 Seniors
    ------------------------------------------------------------------------
    Monetary    Places   4130                $100     3/3/2016  Memorial
                 for      Lindell                                Donation
                 People   Blvd.
                 , Inc.   St.
                          Louis,
                          MO
                          63108
    ------------------------------------------------------------------------
    Monetary    Planned  P.O. Box          $5,000    4/12/2016  Life
                 Living   4755                                   Planning
                 Assist   Austin,                                Program
                 ance     TX
                 Networ   78765
                 k of
                 Centra
                 l
                 Texas
    ------------------------------------------------------------------------
    Monetary    Positiv  1411 N.              $75     3/1/2016  Donation in
                 e        Westsho                                lieu of
                 Coachi   re                                     company
                 ng       Blvd.                                  holiday
                 Allian   Suite                                  gift
                 ce       205
                          Tampa
                          Bay, FL
                          33607
    ------------------------------------------------------------------------
    Monetary    Princet  15               $50,000   12/21/2016  Bridge to
                 on       Princes                                Employment
                 Area     s Road                                 program
                 Commun   Lawrenc
                 ity      eville,
                 Founda   NJ
                 tion,    08648
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Princet  P.O. Box          $2,500   12/15/2016  PGC
                 on       145 190                                Afterschool
                 Girl     Nassau                                 Music
                 Choir    Street,                                Outreach
                          Lower                                  Program
                          Level
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    Princet  123 E.           $10,000   12/15/2016  Hunger
                 on       Hanover                                Prevention
                 Outrea   St.                                    and
                 ch       Trenton                                Nutrition
                 Projec   , NJ                                   Education
                 ts /     08608                                  ($7,500.00)
                 Crisis                                          Healthy
                 Minist                                          Living and
                 ry of                                           Housing
                 Mercer                                          Stability
                 County                                          Services
                                                                 ($2,500.00)
    ------------------------------------------------------------------------
    Monetary    Princet  45                $4,000   12/15/2016  Family
                 on       Stockto                                Caregiver
                 Senior   n St                                   Conference:
                 Resour   Princet                                Family
                 ce       on, NJ                                 Caregiving:
                 Center   08540                                  Compassion
                                                                 for Self
                                                                 and Others
    ------------------------------------------------------------------------
    Monetary    Princet  575               $3,500   12/15/2016  BRAVO!
                 on       Ewing                                  Trenton
                 Sympho   Street                                 Initiative
                 ny       Princet
                 Orches   on, NJ
                 tra      08540
    ------------------------------------------------------------------------
    Monetary    Princet  13                $7,500   12/15/2016  Summer
                 on-      Roszel                                 Bridge
                 Blairs   Road,                                  2017--Trent
                 town     Suite                                  on
                 Center   C204A
                 Inc.     Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Printma  440               $5,000   12/22/2016  Roving Press
                 king     River
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Printma  440              $15,000    12/8/2016  Combat Paper
                 king     River                                  NJ
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Raritan  P. O.             $7,000   12/15/2016  WaterWays
                 Headwa   Box 273                                Environment
                 ters     Gladsto                                al
                 Associ   ne, NJ                                 Education
                 ation    07934                                  Program
    ------------------------------------------------------------------------
    Monetary    Raritan  118              $20,000   10/24/2016  Promoting
                 Valley   Lamingt                                Access to
                 Commun   on Rd                                  STEM and
                 ity      Branchb                                Nursing
                 Colleg   urg, NJ                                Education
                 e        08844                                  at Raritan
                                                                 Valley
                                                                 Community
                                                                 College
    ------------------------------------------------------------------------
    Monetary    Recover  3423             $15,000    5/16/2016  Healthy
                 y        Covingt                                Start Pilot
                 Consul   on                                     Program--(M
                 tants    Drive,                                 ental
                 Of       Suite B                                Health
                 Atlant   Decatur                                Portion of
                 a        , GA                                   Program)
                 Incorp   30032
                 orated
    ------------------------------------------------------------------------
    Monetary    Regions  640              $15,000    5/16/2016  Make It OK,
                 Hospit   Jackson                                the
                 al       Street,                                campaign to
                 Founda   MS                                     fight
                 tion     11202C                                 stigma
                          St.
                          Paul,
                          MN
                          55101
    ------------------------------------------------------------------------
    Monetary    Rescue   98               $25,000   12/16/2016  Emergency
                 Missio   Carroll                                Services
                 n of     St. PO                                 program
                 Trento   Box 790
                 n        Trenton
                          , NJ
                          08605
    ------------------------------------------------------------------------
    Monetary    Rider    2083             $19,500    12/6/2016  Summer STEM
                 Univer   Lawrenc                                ($12,000);
                 sity     eville                                 Scholarship
                          Road                                   Support
                          Lawrenc                                ($5,000);
                          eville,                                Shakesperia
                          NJ                                     n at Rider
                          08648                                  ($2,500)
    ------------------------------------------------------------------------
    Monetary    Riverbe  PO Box            $5,000    4/12/2016  InSHAPE
                 nd       2032                                   Program
                 Commun   Concord
                 ity      , NH
                 Mental   03302-
                 Health   2032
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Riversi  4 South          $10,000    12/7/2016  Riverside
                 de       Union                                  Symphonia
                 Sympho   Street                                 Senior
                 nia      P.O.                                   Outreach
                 Inc.     Box 650                                Program
                          Lambert
                          ville,
                          NJ
                          08530
    ------------------------------------------------------------------------
    Monetary    Rutgers  4               $124,863    9/19/2016  Corporate
                 Univer   Hunting                                Social
                 sity     ton                                    Responsibil
                 School   Street                                 ity
                 of       New                                    Fellowship
                 Commun   Brunswi
                 icatio   ck, NJ
                 n,       08901-
                 Inform   1071
                 ation
                 and
                 Librar
                 y
                 Studie
                 s
    ------------------------------------------------------------------------
    Monetary    SAFE in  47 East             $600    9/22/2016  Costs
                 Hunter   Main                                   associated
                 don      Street                                 with 2016
                          Fleming                                Janssen
                          ton, NJ                                Cares
                          08822                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    Saint    436 Port            $100    3/28/2016  Memorial
                 Anthon   Reading                                Donation
                 y of     Avenue
                 Padua    Port
                 Roman    Reading
                 Cathol   , NJ
                 ic       07064
                 Church
    ------------------------------------------------------------------------
    Monetary    San      2789-             $5,000    5/16/2016  MHRC Client
                 Franci   25th                                   Wellness
                 sco      Street,                                Enhancement
                 Genera   #2028                                  Project
                 l        San
                 Hospit   Francis
                 al       co, CA
                 Founda   94110
                 tion
    ------------------------------------------------------------------------
    Monetary    SAVE A   1010                $600    9/19/2016  Costs
                 Friend   Route                                  associated
                 to       601                                    with 2016
                 Homele   Cedar                                  Janssen
                 ss       Lodge                                  Cares
                 Animal   Road                                   Volunteer
                 s        Skillma                                Activity
                          n, NJ
                          08558
    ------------------------------------------------------------------------
    Monetary    Schizop  602 Pink          $5,000    5/23/2016  Platinum
                 hrenia   Azalea                                 sponsor
                 and      Trl PO                                 2016
                 Relate   Box                                    symposium
                 d        941222                                 and
                 Disord   Houston                                workshop,
                 ers      , TX                                   ``You are
                 Allian   77094-                                 NOT Alone''
                 ce Of    8222                                   Self-help/
                 Americ                                          peer
                 a                                               support
                                                                 Symposium
                                                                 and
                                                                 workshop
    ------------------------------------------------------------------------
    Monetary    Scripps  10140            $25,000   12/14/2016  Scripps
                 Founda   Campus                                 Community
                 tion     Point                                  Diabetes
                 for      Drive                                  Programs:
                 Medici   Suite                                  Dulce
                 ne and   200 San                                Transitions
                 Scienc   Diego,
                 e        CA
                          92121
    ------------------------------------------------------------------------
    Monetary    Scripps  10140            $30,000   12/14/2016  Scripps
                 Founda   Campus                                 Community
                 tion     Point                                  Diabetes
                 for      Drive                                  and
                 Medici   Suite                                  Prevention
                 ne and   200 San                                Programs:
                 Scienc   Diego,                                 Project
                 e        CA                                     Dulce
                          92121
    ------------------------------------------------------------------------
    Monetary    SERV     20                $5,000    9/15/2016  14th Annual
                 Founda   Scotch                                 SERV
                 tion,    Road,                                  Wellness
                 Inc.     3rd                                    and
                          Floor                                  Development
                          Ewing,                                 Conference
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    SERV     20                $7,500    9/15/2016  SERV
                 Founda   Scotch                                 Foundation
                 tion,    Road,                                  Scholarship
                 Inc.     3rd                                    Fund
                          Floor
                          Ewing,
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    Shannon  PO Box              $500   12/14/2016  Shannon
                 Daley    1271 36                                Daley
                 Memori   Indian                                 Memorial
                 al       Run                                    Fund
                 Fund     Whiteho                                Charity
                          use                                    Events
                          Station
                          , NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    Sharing  1920              $2,000    5/30/2016  1920 Club
                 Place    10th                                   Art Program
                 Inc.     Avenue
                          South
                          PO Box
                          59455
                          Birming
                          ham, AL
                          35255
    ------------------------------------------------------------------------
    Monetary    Shiloh   PO Box            $5,000    2/18/2016  Family
                 Commun   398                                    Wellness
                 ity      Trenton                                Club--Diabe
                 Develo   , NJ                                   tes and
                 pment    08603                                  Chronic
                 Corpor                                          Disease
                 ation                                           Self
                                                                 Management
    ------------------------------------------------------------------------
    Monetary    Shiloh   PO Box            $5,000   12/15/2016  Family
                 Commun   398                                    Wellness
                 ity      Trenton                                Club--Diabe
                 Develo   , NJ                                   tes and
                 pment    08603                                  Chronic
                 Corpor                                          Disease
                 ation                                           Self
                                                                 Management
    ------------------------------------------------------------------------
    Monetary    Sister   1201              $5,000    9/14/2016  Pearl Grace
                 Networ   Hamilto                                Breast
                 k of     n                                      Cancer
                 Centra   Street                                 Assistant
                 l New    Somerse                                Tournament
                 Jersey   t, NJ
                 , Inc.   08873
    ------------------------------------------------------------------------
    Monetary    Somerse  49                $7,500   12/23/2016  Street
                 t Home   Brahma                                 Smart--HIV/
                 for      Avenue                                 AIDS
                 Tempor   P.O.                                   Program
                 arily    Box
                 Displa   6871
                 ced      Bridgew
                 Childr   ater,
                 en       NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    Somerse  49                  $900    12/5/2016  Costs
                 t Home   Brahma                                 associated
                 for      Avenue                                 with 2016
                 Tempor   P.O.                                   Janssen
                 arily    Box                                    Cares
                 Displa   6871                                   Volunteer
                 ced      Bridgew                                Activity
                 Childr   ater,
                 en       NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    Somerse  One              $20,000   12/13/2016  El Poder
                 t        Rehill                                 Sobre La
                 Medica   Avenue                                 Diabetes--N
                 l        Somervi                                J Neighbor
                 Center   lle, NJ                                of Choice
                 Founda   08876                                  Program
                 tion
    ------------------------------------------------------------------------
    Monetary    Somervi  51 West           $2,000   10/19/2016  A Maker
                 lle      Cliff                                  Space for
                 Educat   Street                                 Every Child
                 ional    P.O.
                 Founda   Box
                 tion,    8721
                 Inc.     Somervi
                          lle, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    St.      1025                $100     3/3/2016  Memorial
                 Mark     Radclif                                Donation
                 Church   fe
                 and      Street
                 School   Bristol
                          , PA
                          19007
    ------------------------------------------------------------------------
    Monetary    St.      One              $15,000   12/21/2016  Providing
                 Mary     Summit                                 Food for
                 Medica   Square,                                Underserved
                 l        Suite                                  School-Age
                 Center   300                                    Children in
                 Founda   1717                                   Bucks
                 tion     Langhor                                County: The
                          ne-                                    St. Mary
                          Newtown                                Backpacks
                          Road                                   for Kids
                          Langhor                                Program
                          ne, PA
                          19047
    ------------------------------------------------------------------------
    Monetary    Stony    31 Titus         $15,000   10/26/2016  StreamWatch
                 Brook    Mill                                   Volunteer
                 Millst   Road                                   Water
                 one      Penning                                Quality
                 Waters   ton, NJ                                Monitoring
                 hed      08534                                  Program
                 Associ
                 ation
    ------------------------------------------------------------------------
    Monetary    T-1      8216             $35,000   10/25/2016  Friends for
                 Today    Princet                                Life
                 Inc.     on-                                    Orlando
                          Glendal                                2017
                          e Road,
                          PMB 200
                          West
                          Chester
                          , OH
                          45069
    ------------------------------------------------------------------------
    Monetary    Taking   1110             $35,000   10/25/2016  Taking
                 Contro   Camino                                 Control Of
                 l of     Del Mar                                Your
                 Your     Suite C                                Diabetes
                 Diabet   Del                                    (TCOYD)
                 es       Mar, CA                                Conference
                          92014                                  and Health
                                                                 Fair
    ------------------------------------------------------------------------
    Monetary    TASK,    72\1/2\          $25,000   10/26/2016  Trenton Area
                 Inc.     Escher                                 Soup
                          Street,                                Kitchen
                          P.O.                                   Meal
                          Box 872                                Service
                          Trenton                                Program
                          , NJ
                          08605
    ------------------------------------------------------------------------
    Monetary    The      Paul              $5,000    9/15/2016  Communiversi
                 Arts     Robeson                                ty ArtsFest
                 Counci   Center                                 2017
                 l of     for the
                 Prince   Arts
                 ton      102
                          Withers
                          poon
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      Paul             $10,000    9/15/2016  Arts Council
                 Arts     Robeson                                of
                 Counci   Center                                 Princeton
                 l of     for the                                Community
                 Prince   Arts                                   Outreach
                 ton      102                                    Programs
                          Withers
                          poon
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      2020              $2,000   12/23/2016  Art Classes
                 Center   Burnt                                  for
                 for      Mills                                  Children
                 Contem   Road                                   with Autism
                 porary   Bedmins                                Spectrum
                 Art      ter, NJ                                Disorder
                          07921                                  and Other
                                                                 Special
                                                                 Needs
    ------------------------------------------------------------------------
    Monetary    The      19               $12,000    9/14/2016  Support of
                 Center   Dellwoo                                Adult
                 For      d Lane                                 Women's
                 Great    Somerse                                Program
                 Expect   t, NJ                                  through a
                 ations   08873                                  Program
                                                                 Grant and
                                                                 2016 Gift
                                                                 of Hope
                                                                 Gala
                                                                 Sponsorship
    ------------------------------------------------------------------------
    Monetary    The      1040              $7,500     8/4/2016  Jail
                 Edinbu   Waltham                                Diversion
                 rg       Street                                 Program
                 Center   Lexingt
                          on, MA
                          02421
    ------------------------------------------------------------------------
    Monetary    The      222              $75,000   12/22/2016  Terracotta
                 Frankl   North                                  Warriors:
                 in       20th                                   Guards for
                 Instit   St.                                    Eternity
                 ute      Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    The      1289                $300    9/22/2016  Costs
                 Legacy   Route                                  associated
                 Treatm   38 West                                with 2016
                 ent      Suite                                  Janssen
                 Servic   203                                    Cares
                 es       Hainesp                                Volunteer
                 Founda   ort, NJ                                Activity
                 tion     08036
    ------------------------------------------------------------------------
    Monetary    The      8150 N.          $40,000   12/14/2016  HeartGuide--
                 Mended   Central                                Patient
                 Hearts   Express                                Resource
                 , Inc.   way                                    and
                          Suite                                  Visiting
                          M2248                                  Program: An
                          Dallas,                                Educational
                          TX                                     and Support
                          75206                                  Program for
                                                                 Patients,
                                                                 Caregivers
                                                                 and
                                                                 Families
                                                                 Affected by
                                                                 Heart
                                                                 Disease
    ------------------------------------------------------------------------
    Monetary    The      401               $1,000    4/11/2016  Head Lite
                 Mental   Cypress                                sponsor 7th
                 Health   Street                                 Annual Lite
                 Center   Manches                                up the Nite
                 Of       ter, NH                                Run/Walk
                 Greate   03103                                  for Mental
                 r                                               Health--Jun
                 Manche                                          e 23, 2016
                 ster
    ------------------------------------------------------------------------
    Monetary    The      P.O. Box          $7,500   11/18/2016  Opera for
                 Prince   2063                                   All
                 ton      Princet
                 Festiv   on, NJ
                 al       08543
    ------------------------------------------------------------------------
    Monetary    The      4101             $20,000    8/23/2016  MindStrong
                 Thresh   North                                  program
                 olds     Ravensw
                          ood
                          Avenue
                          Chicago
                          , IL
                          60613
    ------------------------------------------------------------------------
    Monetary    The      100              $10,000     8/4/2016  Farm Based
                 Willia   Gould                                  Psychiatric
                 m J.     Road PO                                Rehabilitat
                 Gould    Box 157                                ion and
                 Associ   Montere                                Recovery
                 ates,    y, MA
                 Inc.     01245
    ------------------------------------------------------------------------
    Monetary    Thomas   111 West         $12,000   12/15/2016  Scholarship
                 Edison   State                                  Support for
                 State    Street                                 Nursing
                 Colleg   Trenton                                Students
                 e        , NJ                                   Enrolled in
                 Founda   08608                                  the W. Cary
                 tion                                            Edwards
                                                                 School of
                                                                 Nursing's
                                                                 Accelerated
                                                                 Second
                                                                 Degree BSN
                                                                 Program at
                                                                 Thomas
                                                                 Edison
                                                                 State
                                                                 University
    ------------------------------------------------------------------------
    Monetary    Tpto     51 South          $1,000    9/12/2016  2017
                 Inc.--   Timberl                                Timberlane
                 Timber   ane                                    Science and
                 lane     Drive,                                 Engineering
                 Parent   Penning                                Fair
                 Teache   ton, NJ
                 r        08534
                 Organi
                 zation
    ------------------------------------------------------------------------
    Monetary    Trenton  439 S.            $7,000    9/12/2016  Second
                 Commun   Broad                                  Semester,
                 ity      Street,                                Trenton
                 Music    Ste. 90                                Community
                 School   Trenton                                Music
                          , NJ                                   School
                          08638
    ------------------------------------------------------------------------
    Monetary    Trenton  635               $5,000   12/15/2016  Trenton
                 Educat   South                                  Education
                 ion      Clinton                                Dance
                 Dance    Avenue                                 Institute
                 Instit   Trenton                                (TEDI)
                 ute      , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Trenton  218 N            $15,000   11/22/2016  Navigating
                 Health   Broad                                  for Health
                 Team     St
                 Inc.     Trenton
                          , NJ
                          08608
    ------------------------------------------------------------------------
    Monetary    Trinity  22                $7,500   12/15/2016  TCS Mental
                 Counse   Stockto                                Health and
                 ling     n                                      Wellness
                 Servic   Street                                 Program
                 es       Trinity
                          Counsel
                          ing
                          Service
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Tuscalo  PO Box            $1,000    3/30/2016  Supporting
                 osa      2322                                   sponsorship
                 Mental   Tuscalo                                -Hot
                 Health   osa, AL                                Hundred
                 Allian   35403                                  Bicycle
                 ce                                              Ride--July,
                                                                 30, 2016
    ------------------------------------------------------------------------
    Monetary    Twiligh  P.O. Box          $7,500    11/9/2016  Simple Needs
                 t Wish   1042 11                                Wish
                 Founda   Duane                                  Granting
                 tion     Road                                   Program
                          Doylest
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    UIH      4 North           $9,000   12/15/2016  Community of
                 Family   Broad                                  Health for
                 Partne   Street                                 Men, Year 3
                 rs       2nd
                          Floor
                          Trenton
                          , NJ
                          08618-
                          4408
    ------------------------------------------------------------------------
    Monetary    United   9-25              $7,500   11/18/2016  Janssen
                 Negro    Alling                                 Pharmaceuti
                 Colleg   Street                                 cals-
                 e Fund   2nd                                    Princeton
                          Floor                                  Committee
                          Newark,                                of UNCF
                          NJ                                     Scholarship
                          07102
    ------------------------------------------------------------------------
    Monetary    United   Crossroa        $530,664   12/19/2016  Company
                 Way of   ds                                     match to
                 Greate   Corpora                                employee
                 r        te                                     United Way
                 Mercer   Center                                 campaign
                 County   3150                                   for
                          Brunswi                                Titusville
                          ck                                     based
                          Pike,                                  companies
                          Suite
                          230
                          Lawrenc
                          eville,
                          NJ
                          08648-
                          2420
    ------------------------------------------------------------------------
    Monetary    United   4 Walter            $600   11/29/2016  Costs
                 Way of   Foran                                  associated
                 Hunter   Blvd.                                  with 2016
                 don      Fleming                                Janssen
                 County   ton, NJ                                Cares
                          08822                                  Volunteer
                                                                 Activity
    ------------------------------------------------------------------------
    Monetary    United   PO Box           $42,219   12/21/2016  Company
                 Way of   6835                                   match to
                 Northe   1011                                   employee
                 rn New   Route                                  United Way
                 Jersey   22                                     campaign
                          West,                                  less Truist
                          2nd                                    processing
                          Floor                                  fee for
                          Bridgew                                Raritan
                          ater,                                  campus
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    Urbanpr  801 West          $3,500   10/26/2016  StreetLeader
                 omise    State                                  Program
                 Intern   Street
                 ationa   Trenton
                 l Inc.   , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Valeo    5401 SW           $3,500    4/12/2016  Creations of
                 Behavi   7th                                    Hope: A
                 oral     Street                                 gallery by
                 Health   Topeka,                                artists
                 Care     KS                                     experiencin
                 Inc.     66606                                  g mental
                                                                 illness
                                                                 focused on
                                                                 advocacy
                                                                 through
                                                                 art.
    ------------------------------------------------------------------------
    Monetary    Volunte  12                $7,500   12/15/2016  SkillsConnec
                 er       Stockto                                t
                 Connec   n
                 t        Street
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Washing  P. O.               $750    9/12/2016  Educational
                 ton      Box 83                                 program
                 Crossi   Titusvi                                support:
                 ng       lle, NJ                                ``Digging
                 Park     08560                                  New Jersey:
                 Associ                                          Colonial
                 ation                                           and
                 Inc.                                            Revolutiona
                                                                 ry War
                                                                 Archeology'
                                                                 ' and ``The
                                                                 Occupation
                                                                 of Trenton:
                                                                 December 1-
                                                                 21, 1776''
    ------------------------------------------------------------------------
    Monetary    West     PO Box            $5,000    11/9/2016  Excellence
                 Windso   280                                    in
                 r        West                                   Education
                 Plains   Windsor                                Grant
                 boro     , NJ                                   Program
                 Educat   08550-
                 ion      0280
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Womansp  1530              $5,000   11/18/2016  Domestic
                 ace      Brunswi                                Violence
                          ck Ave.                                Shelter
                          Lawrenc                                (Safe
                          eville,                                House) and
                          NJ                                     Transitiona
                          08648                                  l Housing
                                                                 (Barbara's
                                                                 House)
    ------------------------------------------------------------------------
    Monetary    Women's  3200                 $75    1/19/2016  Employee
                 Commun   Hilltop                                directed
                 ity,     Avenue                                 donation in
                 Inc.     Wausau,                                lieu of
                          WI                                     company
                          54401                                  holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Woods    40                  $600   10/24/2016  2016 Janssen
                 Servic   Martin                                 Cares
                 es       Gross                                  Volunteer
                 Founda   Drive                                  Events
                 tion     PO box
                          36
                          Langhor
                          ne, PA
                          19047
    ------------------------------------------------------------------------
    Monetary    Woods    40                $4,000   12/15/2016  Yoga at
                 Servic   Martin                                 Maplewood:
                 es       Gross                                  A Program
                 Founda   Drive                                  for People
                 tion     PO box                                 with Prader-
                          36                                     Willi
                          Langhor                                Syndrome
                          ne, PA
                          19047
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 1,489,699    4/27/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Gaza,
                                                                 Tanzania,
                                                                 West Bank,
                                                                 Afghanistan
                                                                 , USA,
                                                                 Jamaica,
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 1,865,102    4/27/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Jamaica,
                                                                 Nicaragua,
                                                                 USA
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 2,283,779    4/27/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Armenia,
                                                                 Nicaragua,
                                                                 Peru, St.
                                                                 Lucia, West
                                                                 Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88             $ 189,778    4/27/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in USA
    ------------------------------------------------------------------------
    Product     AmeriCa  88             $ 871,464    5/10/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in USA
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 3,176,645    5/10/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , USA,
                                                                 Armenia,
                                                                 Nicaragua,
                                                                 Peru, St.
                                                                 Lucia, West
                                                                 Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 1,347,810    5/10/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Armenia,
                                                                 Nicaragua,
                                                                 Peru, St.
                                                                 Lucia, West
                                                                 Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 1,482,447    5/10/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Tanzania,
                                                                 Armenia,
                                                                 St. Lucia,
                                                                 Jamaica
    ------------------------------------------------------------------------
    Product     AmeriCa  88             $ 133,034    5/10/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia,
                                                                 Tanzania,
                                                                 Afghanistan
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $ 15,673     6/8/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Tanzania.
    ------------------------------------------------------------------------
    Product     AmeriCa  88             $ 518,523     6/9/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua,
                                                                 Tanzania,
                                                                 West Bank,
                                                                 and the US
    ------------------------------------------------------------------------
    Product     AmeriCa  88           $ 1,087,540     6/9/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Gaza,
                                                                 Sierra
                                                                 Leone,
                                                                 Tanzania,
                                                                 West Bank,
                                                                 Afghanistan
                                                                 , and US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $672,076     8/1/2016  Product
                 res      Hamilto                                Donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in:
                                                                 Dominican
                                                                 Republic,
                                                                 Lebanon,
                                                                 Palestine
                                                                 Territory,
                                                                 Senegal,
                                                                 St. Lucia,
                                                                 Guatemala,
                                                                 Nicaragua
                                                                 and US
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $15,291     8/1/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Guatemala,
                                                                 Nicaragua,
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $536,094     8/1/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in:
                                                                 Dominican
                                                                 Republic,
                                                                 Lebanon,
                                                                 Palestine
                                                                 Territory,
                                                                 Senegal,
                                                                 Guatemala,
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $2,923,869     8/1/2016  Product
                 res      Hamilto                                Donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in:
                                                                 Dominican
                                                                 Republic,
                                                                 Lebanon,
                                                                 Palestine
                                                                 Territory,
                                                                 Senegal,
                                                                 St. Lucia,
                                                                 Guatemala,
                                                                 Nicaragua,
                                                                 US
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $83,360     8/1/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in: Haiti,
                                                                 Palestine
                                                                 Territory,
                                                                 St. Lucia,
                                                                 Lebanon,
                                                                 Senegal,
                                                                 Jamaica
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $481,959     8/1/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in:
                                                                 Guatemala,
                                                                 Nicaragua,
                                                                 Palestine
                                                                 Territory,
                                                                 Senegal, US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $354,276    9/13/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Colombia,
                                                                 Lebanon,
                                                                 Tanzania
                                                                 and West
                                                                 Bank.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $589,968    9/13/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                Americares
                          d, CT                                  US Clinics
                          06902                                  Network.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $34,315    9/13/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Tanzania
                                                                 and West
                                                                 Bank.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $114,481    9/13/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Colombia,
                                                                 Tanzania,
                                                                 and West
                                                                 Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $613,250    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
                                                                 Clinics.
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $6,343,517    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Lebanon,
                                                                 St. Lucia,
                                                                 West Bank,
                                                                 Gaza,
                                                                 Afghanistan
                                                                 and the US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $807,284    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Colombia,
                                                                 West Bank,
                                                                 Afghanistan
                                                                 .
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $61,169    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,516,094    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in West
                                                                 Bank and
                                                                 the US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $252,240    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $292,992    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
                                                                 Clinics.
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,270,212    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
                                                                 Clinics
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $641,091    9/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in West
                                                                 Bank and
                                                                 the US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $113,318    9/13/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 , Colombia,
                                                                 Tanzania,
                                                                 West Bank.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $622,686   10/24/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $42,437   10/24/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Haiti,
                                                                 Sierra
                                                                 Leone,
                                                                 Ghana.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $555,202   10/24/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in West
                                                                 Bank, Gaza,
                                                                 US
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,321,288   11/17/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Puerto
                                                                 Rico
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $99,595   11/22/2016  Product
                 res      Hamilto                                Donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia and
                                                                 Colombia
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $25,655   11/29/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in West
                                                                 Bank, Gaza,
                                                                 Dominican
                                                                 Republic,
                                                                 St. Lucia,
                                                                 Colombia
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $151,578   11/29/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Colombia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $38,160   11/29/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Colombia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $119,132   11/29/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in West
                                                                 Bank and
                                                                 St. Lucia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $238,579   11/29/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Colombia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $381,064   11/30/2016  Produce
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $86,941   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua
                                                                 and West
                                                                 Bank.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $239,612   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua,
                                                                 St. Lucia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $46,647   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $10,987   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $145,709   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Nicaragua,
                                                                 West Bank
                                                                 and US
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $23,053   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $282,912   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $142,865   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 ,
                                                                 Nicaragua,
                                                                 St. Lucia,
                                                                 and West
                                                                 Bank.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $212,731   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $54,332   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua
                                                                 and
                                                                 Liberia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $25,485   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $183,120   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in the US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $179,712   12/19/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Romania.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $428,182   12/21/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $270,923   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Afghanistan
                                                                 and
                                                                 Tanzania.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $30,737   12/22/2016  Product
                 res      Hamilto                                donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $291,417   12/30/2016  Product
                 res      Hamilto                                Donation
                 Founda   n Ave                                  for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Nicaragua,
                                                                 West Bank,
                                                                 and US
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall      $1,167,782   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in D.R., El
                          10005                                  Salvador,
                                                                 Guatemala,
                                                                 Haiti,
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $30,737   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $30,737   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall     $12,212,928   12/21/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti,
                          10005                                  Honduras,
                                                                 Jamaica,
                                                                 Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $135,843   12/19/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance.
                 Board    NY
                          10005
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $43,471   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Jamaica.
                          10005
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $374,394   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $42,860   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $106,365   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $27,166   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Jamaica.
                          10005
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $101,942   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall      $2,140,908   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Haiti,
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $336,398   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $582,322   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Haiti,
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall      $2,723,631   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Guatemala,
                                                                 Haiti,
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $89,706   12/22/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $43,293    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti,
                          10005                                  Jamaica and
                                                                 El
                                                                 Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $223,922    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala,
                                                                 Haiti,
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $218,883    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala,
                                                                 Haiti,
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $41,696    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti.
                          10005
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall     $26,039,346    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala,
                                                                 Haiti,
                                                                 Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $248,988    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti.
                          10005
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $381,604    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Haiti
                          10005                                  and
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $361,008    12/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala
                                                                 and Haiti.
    ------------------------------------------------------------------------
    Product     Catholi  33-01            $76,321    9/13/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti.
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $622,686   10/25/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador,
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $482,784   10/25/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in El
                          10005                                  Salvador
                                                                 and
                                                                 Guatemala.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall     $16,848,000   10/25/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala.
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $822,943    9/22/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n relief in
                 n        Island                                 Honduras.
                 Board    City,
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $139,387    9/22/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Honduras.
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $732,675    9/22/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Honduras.
    ------------------------------------------------------------------------
    Product     Catholi  33-01            $76,696    9/13/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti.
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  33-01            $30,737    9/13/2016  Product
                 c        Elevent                                Donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti.
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  33-01            $75,546    9/13/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti.
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $270,923    9/13/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti.
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $151,003    9/13/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti.
                          NY
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $275,235     8/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $48,005     8/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $208,481     8/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall      $1,162,207     8/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall          $4,168     8/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in Jamaica.
                          10005
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $952,711     8/1/2016  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Guatemala
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Catholi  33-01            $15,673     6/8/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $884,080     6/9/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $294,990     6/9/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Nicaragua.
    ------------------------------------------------------------------------
    Product     Catholi  33-01            $97,026    5/10/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $137,045    5/10/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $561,881    5/10/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Armenia,
                          NY                                     Guatemala,
                                                                 Honduras,
                                                                 El Salvador
    ------------------------------------------------------------------------
    Product     Catholi  33-01         $3,165,318    5/10/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Dominican
                                                                 Republic,
                                                                 El
                                                                 Salvador,
                                                                 Haiti,
                                                                 Jamaica
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $439,527    4/27/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Dominican
                                                                 Republic,
                                                                 Haiti,
                                                                 Jamaica,
                                                                 Honduras
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $864,289    4/27/2016  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Dominican
                                                                 Republic,
                                                                 Armenia,
                                                                 Haiti,
                                                                 Jamaica, El
                                                                 Salvador
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,970,703    4/27/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ecuador,
                                                                 Guatemala,
                                                                 Honduras,
                                                                 Liberia,
                                                                 Paraguay,
                                                                 Peru,
                                                                 Dominican
                                                                 Republic,
                                                                 Ghana,
                                                                 Haiti
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $2,216,643    4/27/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana,
                                                                 Honduras,
                                                                 Jordan,
                                                                 Liberia,
                                                                 Malawi,
                                                                 Paraguay,
                                                                 Peru,
                                                                 Sierra
                                                                 Leone,
                                                                 Guatemala,
                                                                 Haiti
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $68,096     4/4/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  disaster
                          Barbara                                preparednes
                          , CA                                   s module
                          93117
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $571,913    4/27/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Nicaragua,
                                                                 Malawi,
                                                                 Ghana, US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,270,853    4/27/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Colombia,
                                                                 Ghana,
                                                                 Guatemala,
                                                                 Honduras,.
                                                                 Jordan,
                                                                 Paraguay
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $172,405     6/8/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic,
                                                                 Ghana,
                                                                 Pakistan,
                                                                 Paraguay.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $3,702,692    5/10/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Guyana,
                                                                 Armenia
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $114,204    5/10/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Guyana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $4,350,366     6/9/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic,
                                                                 Ghana,
                                                                 Jamaica,
                                                                 Pakistan,
                                                                 Paraguay,
                                                                 Liberia,
                                                                 and
                                                                 Honduras
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $2,620,434     6/9/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana,
                                                                 Haiti,
                                                                 Paraguay,
                                                                 Somaliland,
                                                                 Dominican
                                                                 Republic,
                                                                 Honduras,
                                                                 Jamaica,
                                                                 Malawi,
                                                                 Pakistan,
                                                                 Rwanda.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $20,006     8/2/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Haiti.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $91,508     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in the
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,368,726     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic,
                                                                 Guyana,
                                                                 Fiji.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $30,737     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $812,768     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $300,317     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic
                                                                 and Guyana.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $572,406     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic
                                                                 and Guyana.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $423,969     9/7/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Dominican
                                                                 Republic
                                                                 and
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $996,184   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $159,065   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $296,198   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $113,778   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $70,614   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $56,506   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $801,421   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $720,416   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $848,095   11/16/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $22,144    5/10/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in USA
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,151,659   10/24/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Haiti,
                                                                 Ghana,
                                                                 Sierra
                                                                 Leone.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,781,473   10/24/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Honduras
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $49,798   11/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Jamaica.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $18,947   11/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Peru and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $21,529   11/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Peru.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $152,642   11/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Jamaica
                                                                 and
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $244,221   11/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Jamaica,
                                                                 Guatemala,
                                                                 Colombia,
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $54,936   11/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Peru,
                                                                 Nicaragua
                                                                 and
                                                                 Colombia.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $86,941   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Honduras
                                                                 and
                                                                 Afghanistan
                                                                 .
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $381,882   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Haiti,
                                                                 Afghanistan
                                                                 , Honduras.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $64,354   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $145,709   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $57,146   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Lebanon
                                                                 and
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $53,183   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Afghanistan
                                                                 .
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $45,277   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Afghanistan
                                                                 and
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $203,883   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n relief in
                          , CA                                   Honduras
                          93117                                  and US.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $241,908   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Haiti
                                                                 and US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $102,180   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in the US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $126,300   12/22/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Haiti.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La          $8,017   11/28/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Peru.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $179,712   12/19/2016  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Malawi.
    ------------------------------------------------------------------------
    Product     Heart    13250 W           $8,017   11/28/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $199,190   11/28/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Haiti.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $190,802   11/28/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Honduras
    ------------------------------------------------------------------------
    Product     Heart    13250 W          $83,392   11/28/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $635,226    9/26/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Haiti.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $194,454    9/16/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Haiti
                                                                 and
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Heart    13250 W       $1,327,428    9/16/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Haiti,
                                                                 Guatemala
                                                                 and
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $114,481    9/16/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Haiti.
    ------------------------------------------------------------------------
    Product     Heart    13250 W          $61,475    9/16/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Guatemala
                                                                 and El
                                                                 Salvador.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $128,184    9/16/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in Haiti
                                                                 and
                                                                 Guatemala.
    ------------------------------------------------------------------------
    Product     Heart    1021            $148,499     6/9/2016  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in
                                                                 Dominican
                                                                 Republic,
                                                                 Guatemala,
                                                                 Jamaica
    ------------------------------------------------------------------------
    Product     Heart    1021             $31,346     6/8/2016  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in
                                                                 Guatemala,
                                                                 Jamaica.
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $963,188    5/10/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     Heart    13250 W         $808,425    5/10/2016  Product
                 To       98th                                   donation
                 Heart    Street                                 for
                 Intern   Lenexa,                                humanitaria
                 ationa   KS                                     n
                 l        66215                                  assistance
                                                                 in
                                                                 Swaziland
    ------------------------------------------------------------------------
    Product     Johnson  One          $84,928,778    3/31/2016  Patient
                 and      Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08933
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One          $86,415,842    6/31/2016  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08934
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One          $68,286,613    9/30/2016  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08935
                 tion
    ------------------------------------------------------------------------
    Product     Johnson  One          $77,655,085   12/31/2016  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        New
                 Assist   Brunswi
                 ance     ck, NJ
                 Founda   08936
                 tion
    ------------------------------------------------------------------------
    Product     MAP      4700            $168,361   10/21/2016  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                disaster
                          ck, GA                                 response in
                          31525                                  Haiti.
    ------------------------------------------------------------------------
    Product     MAP      4700             $35,275   11/28/2016  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 in Central
                                                                 America.
    ------------------------------------------------------------------------
    Product     MAP      4700          $1,600,598   12/14/2016  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                Humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     MAP      4700              $1,816   12/14/2016  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     MAP      50 Hurt       $1,471,357   12/16/2016  Product
                 Intern   Plaza                                  donation
                 ationa   Atlanta                                for
                 l        , GA                                   humanitaria
                          30303                                  n
                                                                 assistance
                                                                 in
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Updated March 30, 2017

      Janssen Therapeutics, Division of Janssen Products, LP, Monetary and
      Product Contribution to U.S.-based Charitable Organizations Full Year
                                      2016
            (Payments made from January 1, 2016 to December 31, 2016)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    Acercam  827               $7,500    4/25/2016  ContraSIDA
                 iento    Wildwoo                                (Against
                 Hispan   d Ave,                                 HIV/AIDS)
                 o de     Suite
                 Caroli   200
                 na del   Columbi
                 Sur      a, SC
                          29203
    ------------------------------------------------------------------------
    Monetary    ADAP     312 11th          $5,000     6/1/2016  Improving
                 Advoca   Avenue,                                Access to
                 cy       #21g                                   Care Among
                          New                                    Transgender
                          York,                                  Men and
                          NY                                     Women
                          10001                                  Living with
                                                                 HIV/AIDS
                                                                 under the
                                                                 AIDS Drug
                                                                 Assistance
                                                                 Program
                                                                 (ADAP)
    ------------------------------------------------------------------------
    Monetary    ADAP     312 11th          $5,000    2/29/2016  ADAP
                 Advoca   Avenue,                                Directory
                 cy       #21g
                          New
                          York,
                          NY
                          10001
    ------------------------------------------------------------------------
    Monetary    African- 1833 W.         $200,000    12/6/2016  Certificatio
                 Americ   8th                                    n of the
                 an       St.,                                   U.S. HIV
                 Aids     Suite                                  Workforce:
                 Policy   200 Los                                A Project
                 And      Angeles                                to Increase
                 Traini   , CA                                   HIV
                 ng       90057                                  Literacy
                 Instit                                          and
                 ute                                             Competency
    ------------------------------------------------------------------------
    Monetary    AIDS     600 St.          $26,700    8/24/2016  (RFA)--Healt
                 Action   Clair                                  hy Start
                 Coalit   Avenue
                 ion of   P.O.
                 Huntsv   Box
                 ille     2409
                          Huntsvi
                          lle, AL
                          35801
    ------------------------------------------------------------------------
    Monetary    AIDS     75 Amory         $30,000    12/6/2016  Getting to
                 Action   Street                                 Zero MA
                 Commit   Boston,
                 tee of   MA
                 Massac   02119
                 husett
                 s
    ------------------------------------------------------------------------
    Monetary    Aids     575 8th          $15,000    7/13/2016  HIV Health
                 Commun   Ave,                                   Literacy
                 ity      Suite                                  Education
                 Resear   502 New                                and
                 ch       York,                                  Training
                 Initia   NY                                     for Service
                 tive     10018                                  Providers
                 of                                              Working
                 Americ                                          with
                 a                                               Vulnerable
                 ACRIA                                           Populations
    ------------------------------------------------------------------------
    Monetary    AIDS     200 W.           $48,000    6/21/2016  Ensuring
                 Founda   Jackson                                Access to
                 tion     Blvd                                   HIV
                 of       Suite                                  Prevention
                 Chicag   2100                                   and Care in
                 o        Chicago                                Illinois
                          , IL                                   through
                          60606                                  Policy
                                                                 Monitoring
                                                                 and
                                                                 Advocacy
    ------------------------------------------------------------------------
    Monetary    AIDS     400 N             $5,000    2/29/2016  HIV Case
                 Outrea   Beach                                  Management
                 ch       Street                                 at AIDS
                 Center   Fort                                   Outreach
                          Worth,                                 Center
                          TX
                          76111
    ------------------------------------------------------------------------
    Monetary    AIDS     The               $7,500   12/14/2016  HIV Access
                 Projec   David                                  and Care
                 t Los    Geffen                                 Coordinatio
                 Angele   Center                                 n Program
                 s        611 S.
                          Kingsle
                          y Dr.
                          Los
                          Angeles
                          , CA
                          90005
    ------------------------------------------------------------------------
    Monetary    AIDS     64 West          $20,000    6/21/2016  Peer
                 Servic   35th                                   Education,
                 e        Street,                                Health
                 Center   3rd                                    Coaching,
                 NYC      Floor                                  and Access
                          New                                    to Care
                          York,                                  programs
                          NY
                          10001
    ------------------------------------------------------------------------
    Monetary    AIDS     P.O. Box         $30,000    8/24/2016  (RFA)--Posit
                 Servic   169 121                                ive Living
                 es       College
                 Coalit   Street
                 ion      Hatties
                          burg,
                          MS
                          39401
    ------------------------------------------------------------------------
    Monetary    AIDS     17982             $5,000   12/16/2016  HIV and
                 Servic   Sky                                    Hepatitis C
                 es       Park                                   Testing
                 Founda   Circle,                                Program
                 tion     Suite J
                 Orange   Irvine,
                 County   CA
                          92614
    ------------------------------------------------------------------------
    Monetary    AIDS     17982             $5,000    2/29/2016  HIV and
                 Servic   Sky                                    Hepatitis C
                 es       Park                                   Testing
                 Founda   Circle,                                Program
                 tion     Suite J
                 Orange   Irvine,
                 County   CA
                          92614
    ------------------------------------------------------------------------
    Monetary    AIDS     7215              $5,000    1/18/2016  HIV Case
                 Servic   Cameron                                Management
                 es of    Road
                 Austin   Austin,
                 Inc.     TX
                          78752
    ------------------------------------------------------------------------
    Monetary    AIDS     7215              $2,500   12/14/2016  Palateria
                 Servic   Cameron                                Cart
                 es of    Road
                 Austin   Austin,
                 Inc.     TX
                          78752
    ------------------------------------------------------------------------
    Monetary    AIDS     7215             $30,000     8/8/2016  (RFA)--Risin
                 Servic   Cameron                                g Star
                 es of    Road                                   University
                 Austin   Austin,
                 Inc.     TX
                          78752
    ------------------------------------------------------------------------
    Monetary    AIDS     1424 K          $300,000   12/19/2016  Transgender
                 United   Street,                                Leadership
                          NW                                     Demonstrati
                          Suite                                  on Project
                          200
                          Washing
                          ton, DC
                          20005-2
                          411
    ------------------------------------------------------------------------
    Monetary    Alexian  825 W.            $5,000    6/20/2016  Transitional
                 Brothe   Welling                                Living
                 rs       ton                                    Program for
                 Bonave   Chicago                                Homeless
                 nture    , IL                                   Adults with
                 House    60657                                  HIV/AIDS
    ------------------------------------------------------------------------
    Monetary    Allianc  825               $3,000   12/14/2016  Continuum-of-
                 e For    Colorad                                Care
                 Housin   o                                      Services
                 g And    Blvd.,                                 for Multi-
                 Healin   Suite                                  Diagnosed
                 g        100 Los                                Persons
                          Angeles                                with HIV/
                          , CA                                   AIDS
                          90041
    ------------------------------------------------------------------------
    Monetary    America  Greater           $3,000    8/25/2016  Ask the
                 n        New                                    Experts:
                 Liver    York                                   Hepatitis C/
                 Founda   Divisio                                HIV Co-
                 tion     n 39                                   infection
                          Broadwa                                Seminar
                          y Suite
                          2700
                          New
                          York,
                          NY
                          10006
    ------------------------------------------------------------------------
    Monetary    Atlanta  P.O. Box         $15,000    2/16/2016  Hepatitis C
                 Harm     92670                                  Prevention
                 Reduct   Atlanta                                Program
                 ion      , GA
                 Coalit   30314
                 ion
    ------------------------------------------------------------------------
    Monetary    Bienest  5326 E           $25,000    12/6/2016  Bienestar
                 ar       Beverly                                HIV
                          Blvd                                   Programs
                          Los                                    and
                          Angeles                                Services
                          , CA
                          90022
    ------------------------------------------------------------------------
    Monetary    Brother  2714             $28,500    8/24/2016  (RFA)--EMPOW
                 hood,    Canal                                  ER NOLA
                 Inc.     Street
                          Suite
                          503A
                          New
                          Orleans
                          , LA
                          70119
    ------------------------------------------------------------------------
    Monetary    Caring   PO Box           $40,000    3/24/2016  Hepatitis C
                 Ambass   1748                                   Program
                 adors    Oregon                                 Support--SH
                 Progra   City,                                  APE and
                 m Inc.   OR                                     CHOICES
                          97045
    ------------------------------------------------------------------------
    Monetary    Catholi  119               $5,000    3/14/2016  The Home
                 c        Dameron                                Place
                 Charit   Avenue
                 ies of   Knoxvil
                 East     le, TN
                 Tennes   37917
                 see
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Central  1785              $5,000    2/29/2016  Free On-Site
                 Louisi   Jackson                                Neighborhoo
                 ana      Street                                 d Testing,
                 Aids     Alexand                                Counseling,
                 Suppor   ria, LA                                and
                 t        71301                                  Prevention
                 Servic                                          Program
                 es
                 Inc.
                 (CLASS
                 )
    ------------------------------------------------------------------------
    Monetary    Christi  2440             $10,000    7/13/2016  Integrated
                 e's      Third                                  Services
                 Place    Ave San                                for Women,
                 Inc.     Diego,                                 Children
                          CA                                     and
                          92101                                  Families
    ------------------------------------------------------------------------
    Monetary    Christi  2440             $20,000    2/18/2016  CHANGE for
                 e's      Third                                  Women
                 Place    Ave San
                 Inc.     Diego,
                          CA
                          92101
    ------------------------------------------------------------------------
    Monetary    Coaliti  127 W            $50,000    12/6/2016  Strengthenin
                 on On    127th                                  g Patient
                 Positi   Street                                 Education
                 ve       Suite                                  through
                 Health   208 New                                Technology
                 Empowe   York,                                  and Social
                 rment    NY                                     Media
                 Inc.     10027
    ------------------------------------------------------------------------
    Monetary    Coastal  5633             $15,000    10/7/2016  HEP:
                 Bend     South                                  Hepatitis
                 Wellne   Staples                                Education
                 ss       , Suite                                Program
                 Founda   700
                 tion     Corpus
                          Christi
                          , TX
                          78411
    ------------------------------------------------------------------------
    Monetary    Communi  714 East          $5,000    6/24/2016  Patient
                 ty       Sahara                                 Wellness
                 Counse   Ave.                                   Education
                 ling     Suite
                 Center   103 Las
                          Vegas,
                          NV
                          89104
    ------------------------------------------------------------------------
    Monetary    Communi  2409             $29,633    8/24/2016  (RFA)--Safe
                 ty       Murchis                                Spaces
                 Health   on Rd                                  Ambassador
                 Interv   Fayette                                Program
                 ention   ville,
                 s and    NC
                 Sickle   28301
                 Cell
                 Agency
                 Incorp
                 orated
    ------------------------------------------------------------------------
    Monetary    Communi  60               $30,000    2/29/2016  Transgender
                 ty       Madison                                Linkage to
                 Health   Avenue,                                Care
                 care     5th
                 Networ   floor
                 k        New
                          York,
                          NY
                          10010
    ------------------------------------------------------------------------
    Monetary    Compreh  142 S.           $25,000    8/24/2016  (RFA)--Proje
                 ensive   Brunswi                                ct IRIS
                 Aids     ck                                     (Improving
                 Resour   Street                                 Retention
                 ce       Suite B                                In the
                 Encoun   P.O.                                   South)
                 ter      Box 552
                 Inc.     Jesup,
                          GA
                          31545
    ------------------------------------------------------------------------
    Monetary    Crisis   1218                 $75    7/12/2016  Employee
                 Shelte   West                                   directed
                 r of     State                                  donation in
                 Lawren   Street                                 lieu of
                 ce       New                                    company
                 County   Castle,                                holiday
                          PA                                     gift
                          16101-
                          2021
    ------------------------------------------------------------------------
    Monetary    Desert   1695 N.           $5,000     6/1/2016  Get Tested
                 AIDS     Sunrise                                Coachella
                 Projec   Way                                    Valley
                 t        Palm                                   Linkage to
                          Springs                                Care for
                          , CA                                   Newly
                          92262                                  Diagnosed
                                                                 HIV-
                                                                 Positive
                                                                 Persons
    ------------------------------------------------------------------------
    Monetary    Frannie  30                $5,000    9/13/2016  Integrated
                 Peabod   Danfort                                Access to
                 y        h St.                                  Care for
                 Center   Suite                                  People
                 Inc.     311                                    Living with
                          Portlan                                HIV/AIDS
                          d, ME
                          04101
    ------------------------------------------------------------------------
    Monetary    Harm     22 West          $25,000    7/13/2016  Hepatitis C
                 Reduct   27th                                   Project
                 ion      Street
                 Coalit   5th
                 ion      Floor
                          New
                          York,
                          NY
                          10001
    ------------------------------------------------------------------------
    Monetary    Health   1211              $5,000   12/14/2016  Pennsylvania
                 Federa   Chestnu                                Ryan White
                 tion     t                                      Part C/D
                 Of       Street,                                Collaborati
                 Philad   Suite                                  ve
                 elphia   801
                          Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    HealthH  2000 S           $30,000    2/18/2016  Do You Know
                 IV       Street                                 Me?:
                          NW                                     Engaging
                          Washing                                and
                          ton, DC                                Retaining
                          20009                                  Young MSM
                                                                 of Color in
                                                                 HIV Care
    ------------------------------------------------------------------------
    Monetary    Heart    3600              $5,000    3/16/2016  BROTHA--Brot
                 Health   Broadwa                                hers
                 and      y West                                 Responding
                 Healin   Palm                                   Openly to
                 g        Beach,                                 HIV/AIDS
                 Minist   FL                                     (Ujima
                 ries     33407                                  Men's
                 Inc.                                            Collective)
    ------------------------------------------------------------------------
    Monetary    Hepatit  35 East          $22,000    2/18/2016  The
                 is C     38th                                   Hepatitis C
                 Mentor   Street,                                Education
                 And      Suite                                  and Support
                 Suppor   #4G New                                Group
                 t        York,                                  Assistance
                 Group    NY                                     Program
                 Inc.     10016
    ------------------------------------------------------------------------
    Monetary    Hepatit  1261 S.          $35,000    3/14/2016  Case
                 is       Jackson                                management
                 Educat   St.                                    ($25,000);
                 ion      Suite                                  King County
                 Projec   201                                    Jail
                 t        Seattle                                Hepatitis
                          , WA                                   Education
                          98144                                  ($10,000)
    ------------------------------------------------------------------------
    Monetary    Hepatit  8121              $5,000     5/6/2016  Call To
                 is       Georgia                                Action: A
                 Founda   Avenue                                 National
                 tion     Suite                                  Response
                 Intern   350                                    for
                 ationa   Silver                                 Hepatitis C
                 l Inc.   Spring,                                Treatment
                          MD                                     among the
                          20910                                  Hard to
                                                                 Reach, Hard
                                                                 to Treat.
                                                                 Proposal
    ------------------------------------------------------------------------
    Monetary    Jackson  P.O. Box         $30,000     8/8/2016  (RFA)--#AIDS
                 ville    380103                                 FreeJax
                 Area     Jackson                                Linkage to
                 Sexual   ville,                                 Care (L2C)
                 Minori   FL                                     Program--a
                 ty       32205                                  Comprehensi
                 Youth                                           ve HIV/AIDS
                 Networ                                          Linkage to
                 k,                                              Care
                 Inc.                                            Program for
                 (JASMY                                          African
                 N)                                              American
                                                                 YMSM, ages
                                                                 13-23
    ------------------------------------------------------------------------
    Monetary    Legacy   4054              $5,000   12/14/2016  Legacy
                 Counse   McKinne                                Counseling
                 ling     y                                      Center
                 Center   Avenue                                 Counseling
                          Suite                                  and Walk-In
                          102                                    Crisis
                          Dallas,                                Clinic
                          TX                                     Program for
                          75204                                  People
                                                                 Living with
                                                                 HIV/AIDS
    ------------------------------------------------------------------------
    Monetary    Make-A-  2880                $450     2/8/2016  Employee
                 Wish     Slater                                 directed
                 Founda   Road,                                  donation in
                 tion     Suite                                  lieu of
                 of       108                                    company
                 Easter   Morrisv                                holiday
                 n        ille,                                  gift
                 North    NC
                 Caroli   27560
                 na
    ------------------------------------------------------------------------
    Monetary    MCCNY    446 West         $10,000    12/6/2016  Linkage to
                 Charit   36th                                   Care for
                 ies      Street                                 LGBTQI
                          New                                    Homeless
                          York,                                  Youth
                          NY
                          10018
    ------------------------------------------------------------------------
    Monetary    Minorit  5149 W.           $7,500    4/12/2016  The Missing
                 y AIDS   Jeffers                                Link
                 Projec   on Blvd                                ``G.L.A.M.O
                 t        Los                                    .R.''
                          Angeles                                (Getting
                          , CA                                   Linked And
                          90016                                  Managing
                                                                 Our
                                                                 Regimen)
    ------------------------------------------------------------------------
    Monetary    Missour  601               $9,650     8/9/2016  Hep C
                 i        Busines                                Education
                 Hepati   s Loop                                 and
                 tis C    70 West                                Testing--Th
                 Allian   Suite                                  e Texas
                 ce       138                                    Project
                          Columbi
                          a, MO
                          65203
    ------------------------------------------------------------------------
    Monetary    Nationa  580             $175,000     3/7/2016  NATAP HIV
                 l AIDS   Broadwa                                and HCV
                 Treatm   y Suite                                Information
                 ent      1010                                   and
                 Advoca   New                                    Education
                 cy       York,                                  Project
                 Projec   NY
                 t        10012
    ------------------------------------------------------------------------
    Monetary    Nationa  444 N.          $150,000   12/19/2016  Health
                 l        Capitol                                Systems
                 Allian   St., NW                                Integration
                 ce of    Suite                                  , Ryan
                 State    339                                    White/ADAP,
                 and      Washing                                and Viral
                 Territ   ton, DC                                Hepatitis
                 orial    20001                                  Public
                 AIDS                                            Policy and
                 Direct                                          Technical
                 ors                                             Assistance
                                                                 Programs
    ------------------------------------------------------------------------
    Monetary    Nationa  1000             $50,000   12/15/2016  Strong
                 l        Vermont                                Communities
                 Minori   Avenue                                 : Social
                 ty       NW                                     Drivers of
                 AIDS     Suite                                  HIV
                 Counci   200
                 l        Washing
                          ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Nationa  1000             $30,000    2/16/2016  Strong
                 l        Vermont                                Communities
                 Minori   Avenue                                 :
                 ty       NW                                     Strengtheni
                 AIDS     Suite                                  ng
                 Counci   200                                    connections
                 l        Washing                                between
                          ton, DC                                LGBT
                          20005                                  communities
                                                                 of color
                                                                 and the
                                                                 providers
                                                                 that serve
                                                                 them
    ------------------------------------------------------------------------
    Monetary    New      44 South          $5,000    2/29/2016  Community
                 Jersey   Street                                 Based
                 AIDS     Morrist                                Services
                 Servic   own, NJ
                 es       07960
    ------------------------------------------------------------------------
    Monetary    Next     99                $5,000    6/20/2016  Expansion of
                 Step     Bishop                                 Next Step's
                 Fund     Allen                                  Year-round
                 Inc.     Drive                                  Programming
                          Cambrid                                for teens
                          ge, MA                                 and young
                          02139                                  adults
                                                                 living with
                                                                 HIV.
    ------------------------------------------------------------------------
    Monetary    Our      2727 SE           $5,000    8/23/2016  Neighborhood
                 House    Alder                                  Housing and
                 of       St.                                    Care
                 Portla   Portlan                                Program
                 nd       d, OR                                  (NHCP)
                 Incorp   97214
                 orated
    ------------------------------------------------------------------------
    Monetary    Palmett  2638 Two          $7,500     5/6/2016  HIV Care
                 o AIDS   Notch                                  Coordinatio
                 Life     Road,                                  n Program
                 Suppor   Suite
                 t        108
                 Servic   Columbi
                 es       a, SC
                          29204
    ------------------------------------------------------------------------
    Monetary    Positiv  785               $2,500   12/16/2016  Employment
                 e        Market                                 and
                 Resour   Street,                                Benefits
                 ce       10th                                   Education
                 Center   Floor
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $60,000    10/6/2016  Policy
                 Inform   Ninth                                  Initiatives
                          Street                                 to Improve
                          San                                    Access to
                          Francis                                Care and
                          co, CA                                 Treatment
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $20,000    7/15/2016  Hepatitis C
                 Inform   Ninth                                  Education
                          Street                                 and Linkage
                          San                                    to Care
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $30,000   12/19/2016  The Support
                 Inform   Ninth                                  Partnership
                          Street
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $70,000    5/19/2016  Mission
                 Inform   Ninth                                  Support for
                          Street                                 Project
                          San                                    Inform
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $40,000    2/18/2016  The Support
                 Inform   Ninth                                  Partnership
                          Street
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    RAIN,    601 E.           $30,000     8/8/2016  (RFA)--Impro
                 Inc.     5th                                    ving
                          Street,                                Retention
                          Suite                                  in Care and
                          470                                    Access to
                          Charlot                                Treatment
                          te, NC                                 for African
                          28202                                  Americans
                                                                 Living with
                                                                 HIV in
                                                                 Charlotte
                                                                 Metropolita
                                                                 n area
    ------------------------------------------------------------------------
    Monetary    RAIN,    601 E.            $5,000    4/25/2016  Medical Case
                 Inc.     5th                                    Management
                          Street,                                for Youth,
                          Suite                                  Adults and
                          470                                    Seniors
                          Charlot                                with HIV/
                          te, NC                                 AIDS
                          28202
    ------------------------------------------------------------------------
    Monetary    Recover  3423             $75,000    4/15/2016  The Healthy
                 y        Covingt                                Start
                 Consul   on                                     Program
                 tants    Drive,
                 Of       Suite B
                 Atlant   Decatur
                 a        , GA
                 Incorp   30032
                 orated
    ------------------------------------------------------------------------
    Monetary    Resourc  5750              $3,000   12/14/2016  Valor Latino
                 e        Cedar                                  Project
                 Center   Springs
                 of       Road
                 Dallas   Dallas,
                 , Inc.   TX
                          75235-6
                          805
    ------------------------------------------------------------------------
    Monetary    Sero     PO Box           $15,000    2/29/2016  HIV is Not a
                 Projec   1233                                   Crime
                 t Inc.   Milford                                regional
                          , PA                                   and
                          18337                                  national
                                                                 conferences
                                                                 and webinar
                                                                 trainings
    ------------------------------------------------------------------------
    Monetary    Shanti   730 Polk         $10,000    7/13/2016  Shanti HIV
                 Projec   Street,                                Services
                 t Inc.   3rd                                    Program/HCV
                          Floor                                  Services
                          San
                          Francis
                          co, CA
                          94109
    ------------------------------------------------------------------------
    Monetary    South    601               $7,500    6/27/2016  West
                 Centra   Bland                                  Virginia
                 l        Street                                 Infection
                 Educat   P.O.                                   Disease
                 ional    Box                                    Coalition
                 Develo   4322
                 pment    Bluefie
                          ld, WV
                          24701
    ------------------------------------------------------------------------
    Monetary    Southwe  1101 N.           $5,000   12/14/2016  General
                 st       Central                                mission
                 Center   Avenue                                 support
                 For      Suite
                 HIV/     200
                 AIDS     Phoenix
                 Inc.     , AZ
                          85004
    ------------------------------------------------------------------------
    Monetary    Step-Up  850 N.            $5,000   12/16/2016  Indianapolis
                 Incorp   Meridia                                Men
                 orated   n                                      Advancing
                          Street                                 Prevention
                          First                                  (IMAP)
                          Floor
                          Indiana
                          polis,
                          IN
                          46204
    ------------------------------------------------------------------------
    Monetary    The      17 Davis         $65,000    12/6/2016  Ensuring
                 Aids     Blvd.                                  Adequate
                 Instit   Suite                                  Funding for
                 ute      403                                    Domestic
                          Tampa,                                 HIV/AIDS
                          FL                                     and
                          33606                                  Hepatitis
                                                                 Programs
    ------------------------------------------------------------------------
    Monetary    The      429 E.               $75     2/8/2016  Employee
                 Health   Vermont                                directed
                 Founda   Street,                                donation in
                 tion     Suite                                  lieu of
                 of       400                                    company
                 Greate   Indiana                                holiday
                 r        polis,                                 gift
                 Indian   IN
                 apolis   46202
    ------------------------------------------------------------------------
    Monetary    The Hep  1325 S.          $15,000    7/12/2016  HCV Patient
                 C        Colorad                                Linkage to
                 Connec   o                                      Care and
                 tion     Blvd.,                                 Navigation
                          B-302
                          Denver,
                          CO
                          80222
    ------------------------------------------------------------------------
    Monetary    The      PO Box           $30,000    8/24/2016  (RFA)--``Rep
                 Open     99243                                  ''
                 Door,    Pittsbu                                presenting
                 Inc.     rgh, PA                                the
                          15233                                  solution
                                                                 for optimal
                                                                 health
                                                                 outcomes
                                                                 and housing
                                                                 stability
                                                                 for African
                                                                 American
                                                                 ``payees''
                                                                 living with
                                                                 HIV/AIDS
    ------------------------------------------------------------------------
    Monetary    The San  3909              $5,000     3/7/2016  Latin@
                 Diego    Centre                                 Services
                 LGBT     St San                                 program
                 Commun   Diego,
                 ity      CA
                 Center   92103
    ------------------------------------------------------------------------
    Monetary    The      85               $30,000    3/24/2016  Support
                 Well     Norman                                 Information
                 Projec   Avenue,                                ,
                 t        Suite 1                                Community,
                          P.O.                                   Advocacy
                          Box                                    and
                          220410                                 Evaluation
                          Brookly
                          n, NY
                          11222
    ------------------------------------------------------------------------
    Monetary    The      1331             $30,000    8/24/2016  (RFA)--Enhan
                 Women'   Rhode                                  cements of
                 s        Island                                 Community
                 Collec   Avenue                                 Health
                 tive     NE                                     Worker
                          Washing                                Program
                          ton, DC
                          20018
    ------------------------------------------------------------------------
    Monetary    Tourett  4240                 $75     5/4/2016  Donation in
                 e        Bell                                   lieu of
                 Associ   Blvd.,                                 company
                 ation    Suite                                  holiday
                 of       205                                    gift
                 Americ   Bayside
                 a        , NY
                          11361
    ------------------------------------------------------------------------
    Monetary    TPA      5050 N.           $5,000     6/1/2016  Healthy
                 Networ   Broadwa                                Aging with
                 k        y Suite                                HIV
                 Incorp   300
                 orated   Chicago
                 Test     , IL
                 Positi   60640
                 ve
                 Aware
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    TPA      5050 N.          $25,000    10/6/2016  Total Care
                 Networ   Broadwa                                Portal
                 k        y Suite
                 Incorp   300
                 orated   Chicago
                 Test     , IL
                 Positi   60640
                 ve
                 Aware
                 Networ
                 k
    ------------------------------------------------------------------------
    Monetary    Treatme  261              $25,000    5/19/2016  Case Studies
                 nt       Fifth
                 Action   Ave
                 Group,   Suite
                 Inc.     2110
                          New
                          York,
                          NY
                          10016
    ------------------------------------------------------------------------
    Monetary    Univers  UCSF              $7,500    6/20/2016  Mission-
                 ity of   Allianc                                Based
                 Califo   e                                      Support of
                 rnia     Health                                 UCSF
                 San      Project                                Alliance
                 Franci   1855                                   Health
                 sco      Folsom                                 Project
                          Street,                                Services
                          Ste.                                   for People
                          670 Box                                Living With
                          0884                                   or at Risk
                          San                                    of HIV/AIDS
                          Francis
                          co, CA
                          94143
    ------------------------------------------------------------------------
    Monetary    Univers  5801 S.          $20,741     3/7/2016  4 Her by Her
                 ity of   Ellis
                 Chicag   Avenue
                 o        Chicago
                          , IL
                          60637
    ------------------------------------------------------------------------
    Monetary    US       1300 PA         $500,000     8/5/2016  Bedaquiline
                 Agency   Avenue.                                Donation
                 for      , NW SA-                               Program in
                 Intern   44 Rm                                  support of
                 ationa   475-J                                  World
                 l        Washing                                Health
                 Develo   ton, DC                                Organizatio
                 pment    20523                                  n's END TB
                                                                 Strategy
                                                                 for 2016-
                                                                 2035
    ------------------------------------------------------------------------
    Monetary    Venice   604 Rose          $5,000   12/16/2016  Venice
                 Family   Ave.                                   Family
                 Clinic   Venice,                                Clinic's
                          CA                                     Common
                          90291                                  Ground
    ------------------------------------------------------------------------
    Monetary    Vermont  187               $5,000     6/1/2016  Vermont HIV
                 Commit   Saint                                  Transportat
                 tee      Paul                                   ion Support
                 For      Street
                 Aids     Burling
                 Resour   ton, VT
                 ces      05401
                 Educat
                 ion
                 and
                 Servic
                 es
    ------------------------------------------------------------------------
    Monetary    Washing  566 West         $30,000    3/24/2016  Engaging
                 ton      181st                                  High Risk
                 Height   Street,                                Active
                 s        Floor 2                                Injection
                 CORNER   New                                    Drug Users
                 Projec   York,                                  in
                 t        NY                                     Hepatitis C
                          10033                                  Testing and
                                                                 Treatment
                                                                 in Northern
                                                                 Manhattan
    ------------------------------------------------------------------------
    Monetary    Women    417               $7,500    4/25/2016  SafetyPIN
                 On       Welshwo
                 Mainta   od
                 ining    Drive,
                 Educat   Suite
                 ion      303
                 And      Nashvil
                 Nutrit   le, TN
                 ion      37211-
                          4248
    ------------------------------------------------------------------------
    Monetary    Womens   4615              $2,500    3/23/2016  She's Still
                 Challe   Harrier                                Got It
                 nge      Way                                    educational
                 Inc.     Belcamp                                initiative
                          , MD
                          21017
    ------------------------------------------------------------------------
    Monetary    WORLD    389 30th         $15,000   12/14/2016  Community
                 Women    St                                     Researchers
                 Organi   Oakland                                Engaging
                 zed to   , CA                                   Women
                 Respon   94609                                  (CREW) III
                 d to
                 Life-
                 threat
                 ening
                 Diseas
                 es
    ------------------------------------------------------------------------

    ----------------------------------------------------------------------------------------------------------------

    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $ 3,700,026    3/31/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08933
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $ 3,459,402    6/30/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08934
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $ 2,280,117    9/30/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08935
    ----------------------------------------------------------------------------------------------------------------
    Product               Johnson & Johnson     One Johnson &          $ 3,874,808   12/31/2016  Patient Assistance
                           Patient Assistance    Johnson Plaza New                                Product Donation
                           Foundation            Brunswick, NJ 08936
    ----------------------------------------------------------------------------------------------------------------
    Product               Partnership for       1616 Fort Myer         $ 6,123,407    10/3/2016  Product donation
                           Supply Chain          Drive, 12th Floor                                for humanitarian
                           Management            Arlington, VA 22209-                             assistance.
                                                 3100
    ----------------------------------------------------------------------------------------------------------------
    Product               US Agency for         1300 PA Avenue., NW,  $ 44,580,000    12/1/2016  Bedaquiline product
                           International         SA-44 Rm 475-J                                   donation
                           Development           Washington, DC
                                                 20523
    ----------------------------------------------------------------------------------------------------------------
    Updated March 30, 2018

      Janssen Biotech, Inc. Monetary and Product Contribution to U.S.-based
                     Charitable Organizations Full Year 2017
            (Payments made from January 1, 2017 to December 31, 2017)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    AAUW     7511              $1,000   12/14/2017  Annual
                 Makefi   Germant                                Girl's
                 eld      own                                    Recognition
                 Area     Avenue                                 Reception
                 Branch   Philade                                and
                 PA       lphia,                                 Scholarship
                 Inc.     PA                                     Awards
                          19119                                  American
                                                                 Association
                                                                 of
                                                                 University
                                                                 Women--Make
                                                                 field
                                                                 Branch
    ------------------------------------------------------------------------
    Monetary    Aid For  12271               $300   11/16/2017  Costs
                 Friend   Townsen                                associated
                 s        d Rd.                                  with
                          Philade                                Janssen
                          lphia,                                 Cares
                          PA                                     Volunteer
                          19154                                  Activity--S
                                                                 eptember
                                                                 27, 2017
    ------------------------------------------------------------------------
    Monetary    Aid For  12271               $300   11/16/2017  Costs
                 Friend   Townsen                                associated
                 s        d Rd.                                  with
                          Philade                                Janssen
                          lphia,                                 Cares
                          PA                                     Volunteer
                          19154                                  Activity--O
                                                                 ctober 6,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    America  250               $9,500     2/2/2017  General
                 n        William                                Operating
                 Cancer   s                                      Support
                 Societ   Street
                 y        NW
                 (HDQTS   Atlanta
                 )        , GA
                          30303
    ------------------------------------------------------------------------
    Monetary    America  Atlanta             $300   10/25/2017  Costs
                 n        Hope                                   associated
                 Cancer   Lodge                                  with
                 Societ   1552                                   Janssen
                 y Inc.   Shoup                                  Cares
                          Ct                                     Volunteer
                          Decatur                                Activity
                          , GA
                          30033
    ------------------------------------------------------------------------
    Monetary    America  1626              $1,000    4/21/2017  Relay For
                 n        Locust                                 Life of the
                 Cancer   Street                                 Wissahickon
                 Societ   Philade                                Valley
                 y Inc,   lphia,
                 Philad   PA
                 elphia   19103
                 , PA
    ------------------------------------------------------------------------
    Monetary    Arthrit  1355            $200,000    5/24/2017  Walk To Cure
                 is       Peachtr                                Arthritis
                 Founda   ee                                     and Jingle
                 tion     Street,                                Bell Run
                          Suite
                          600
                          Atlanta
                          , GA
                          30309
    ------------------------------------------------------------------------
    Monetary    Arthrit  1355            $200,000   12/21/2017  Walk To Cure
                 is       Peachtr                                Arthritis
                 Founda   ee                                     and Jingle
                 tion     Street,                                Bell Run
                          Suite
                          600
                          Atlanta
                          , GA
                          30309
    ------------------------------------------------------------------------
    Monetary    Artz     1229              $7,500   11/30/2017  ``ARTZ in
                 Philad   Chestnu                                the
                 elphia   t                                      Neighborhoo
                          Street,                                d: A
                          #188                                   Community-
                          Philade                                Based
                          lphia,                                 Program''
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Breathi  600 West          $5,000   12/25/2017  Program and
                 ng       Avenue,                                Family
                 Room     P.O.                                   Services--B
                 Founda   Box 287                                reathing
                 tion     Jenkint                                Room
                          own, PA                                Foundation
                          19046-2
                          729
    ------------------------------------------------------------------------
    Monetary    Cancer   3                 $5,000    3/30/2017  Oncology
                 Suppor   Crossro                                Support
                 t        ads                                    Groups
                 Commun   Drive
                 ity      Bedmins
                 Centra   ter, NJ
                 l New    07921
                 Jersey
    ------------------------------------------------------------------------
    Monetary    Cancer   1200 Old          $5,000    5/19/2017  Voice of the
                 Suppor   Henders                                Patient:
                 t        on                                     Distress
                 Commun   Columbu                                Screening
                 ity      s, OH                                  and Support
                 Centra   43220                                  for Cancer
                 l Ohio                                          Patients
                                                                 and
                                                                 Survivors
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk          $2,000    7/31/2017  Paws 4 Life
                 Suppor   Road                                   Dog Walk
                 t        Warmins
                 Commun   ter, PA
                 ity of   18974
                 Philad
                 elphia
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk            $300   11/30/2017  Costs
                 Suppor   Road                                   associated
                 t        Warmins                                with
                 Commun   ter, PA                                Janssen
                 ity of   18974                                  Cares
                 Philad                                          Volunteer
                 elphia                                          Activity--S
                                                                 eptember 28
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Cancer   200 Kirk            $300   11/30/2017  Costs
                 Suppor   Road                                   associated
                 t        Warmins                                with
                 Commun   ter, PA                                Janssen
                 ity of   18974                                  Cares
                 Philad                                          Volunteer
                 elphia                                          Activity--S
                                                                 eptember 28
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Center   1617              $5,000     9/4/2017  Project for
                 for      John F.                                Medically
                 Child    Kennedy                                Needy
                 Advoca   Bouleva                                Children
                 tes      rd
                          Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    Central  2500                $300   11/30/2017  Costs
                 Bucks    Lower                                  associated
                 Family   State                                  with
                 YMCA     Road                                   Janssen
                          Doylest                                Cares
                          own, PA                                Volunteer
                          18901                                  Activity--O
                                                                 ctober 3
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Chester  100               $5,000    12/1/2017  Outreach
                 County   North                                  Programs
                 Art      Bradfor
                 Associ   d
                 ation    Avenue
                          West
                          Chester
                          , PA
                          19382
    ------------------------------------------------------------------------
    Monetary    Chester  790 East          $6,000   12/22/2017  Certified
                 County   Market                                 Nurse
                 Opport   Street,                                Assistant
                 unitie   Suite                                  (CNA)
                 s        100                                    Program
                 Indust   West
                 rializ   Chester
                 ation    , PA
                 Center   19382
    ------------------------------------------------------------------------
    Monetary    Chestnu  1710              $2,500   11/30/2017  General
                 t Hill   Bethleh                                Operating
                 Meals    em Pike                                Support
                 on       Flourto
                 Wheels   wn, PA
                          19031
    ------------------------------------------------------------------------
    Monetary    Childre  100 Penn         $12,000    6/28/2017  Family Care
                 n's      Square                                 Binder
                 Hospit   East                                   Program
                 al of    8th
                 Philad   Floor,
                 elphia   Suite
                 Founda   8050
                 tion     Philade
                          lphia,
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Childre  100 Penn          $6,000    4/13/2017  Walk for
                 n's      Square                                 Hope
                 Hospit   East                                   Benefiting
                 al of    8th                                    Pediatric
                 Philad   Floor,                                 Inflammator
                 elphia   Suite                                  y Bowel
                 Founda   8050                                   Disease
                 tion     Philade                                Research at
                          lphia,                                 CHOP
                          PA
                          19107
    ------------------------------------------------------------------------
    Monetary    Communi  300B             $25,000   12/21/2017  Provision of
                 ty       Lawrenc                                free
                 Volunt   e Drive                                medical and
                 eers     West                                   dental
                 in       Chester                                healthcare
                 Medici   , PA                                   to the
                 ne       19380                                  uninsured
                                                                 in Chester
                                                                 County
    ------------------------------------------------------------------------
    Monetary    Crohn's  733 3rd          $18,000    6/13/2017  Camp Oasis
                 and      Avenue
                 Coliti   Suite
                 s        510 New
                 Founda   York,
                 tion--   NY
                 NY       10017
                 Chapte
                 r
    ------------------------------------------------------------------------
    Monetary    Crohn's  733 3rd         $100,000   10/30/2017  Take Steps
                 and      Avenue                                 for Crohn's
                 Coliti   Suite                                  and Colitis
                 s        510 New                                Walks
                 Founda   York,
                 tion--   NY
                 NY       10017
                 Chapte
                 r
    ------------------------------------------------------------------------
    Monetary    Delawar  236               $5,000    5/22/2017  Teacher
                 e        Randell                                Development
                 Valley   Hall                                   Program
                 Scienc   3141
                 e        Chestnu
                 Fairs,   t
                 Inc.     Street
                          Philade
                          lphia,
                          PA
                          19104
    ------------------------------------------------------------------------
    Monetary    Emmanue  67                $3,500   12/21/2017  Pediatric
                 l        Walnut                                 Cancer
                 Cancer   Ave.                                   Family
                 Founda   Suite                                  Financial
                 tion     107                                    Assistance
                          Clark,                                 Fund
                          NJ
                          07040
    ------------------------------------------------------------------------
    Monetary    Family   142             $250,000   12/15/2017  Family Reach
                 Reach    Berkele                                Financial
                 Founda   y                                      Assistance
                 tion     Street;                                and
                          4th                                    Resource
                          Floor                                  Navigation
                          Boston,                                Programs
                          MA
                          02116
    ------------------------------------------------------------------------
    Monetary    For      620 West          $1,000    5/15/2017  7th Annual
                 Pete's   Germant                                For Pete's
                 Sake     own                                    Sake, Walk!
                 Cancer   Pike                                   at Citizens
                 Respit   Suite                                  Bank Park
                 e        250
                 Founda   Plymout
                 tion     h
                          Meeting
                          , PA
                          19462
    ------------------------------------------------------------------------
    Monetary    Friends  113 West          $5,000   12/14/2017  Outreach to
                 Associ   Chestnu                                Homeless
                 ation    t                                      Families
                 For      Street
                 Care     West
                 and      Chester
                 Protec   , PA
                 tion     19380
                 Of
                 Childr
                 en
    ------------------------------------------------------------------------
    Monetary    Georgia  560               $2,500    5/11/2017  Free
                 Prosta   Barnesl                                Prostate
                 te       ey Lane                                Cancer
                 Cancer   Alphare                                Screening
                 Coalit   tta, GA
                 ion      30022
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Girl     330               $4,000   11/21/2017  Science,
                 Scouts   Manor                                  Technology,
                 of       Road                                   Engineering
                 Southe   Miquon,                                , and Math
                 astern   PA                                     Outreach
                 Pennsy   19444-1                                Programming
                 lvania   741
    ------------------------------------------------------------------------
    Monetary    Global   515 N.           $25,000   12/21/2017  Puerto Rico
                 Health   Midland                                Rheumatolog
                 y        Ave                                    y Relief
                 Living   Upper
                 Founda   Nyack,
                 tion,    NY
                 Inc.     10960
    ------------------------------------------------------------------------
    Monetary    Habitat  1847 E            $2,500   12/18/2017  Cambria
                 for      Lincoln                                Housing
                 Humani   Hwy                                    Development
                 ty of    Coatesv                                -providing
                 Cheste   ille,                                  decent
                 r        PA                                     affordable
                 County   19320                                  housing
                 , Inc.                                          options in
                                                                 Chester
                                                                 County Pa.
    ------------------------------------------------------------------------
    Monetary    Habitat  1829 N.           $5,000   12/13/2017  Diamond Park
                 For      19th
                 Humani   Street
                 ty       Philade
                 Philad   lphia,
                 elphia   PA
                 Inc.     19121
    ------------------------------------------------------------------------
    Monetary    Hatboro- 229              $25,000    12/1/2017  STEM
                 Horsha   Meeting                                Programs
                 m        house                                  for Hatboro-
                 Educat   Road                                   Horsham
                 ional    Horsham                                Students
                 Founda   , PA
                 tion     19044
    ------------------------------------------------------------------------
    Monetary    Jack     3282             $25,000    5/31/2017  WOW!
                 And      Northsi                                Experience
                 Jill     de
                 Late     Parkway
                 Stage    , NW
                 Cancer   Suite
                 Founda   100
                 tion     Atlanta
                 Inc.     , GA
                          33327
    ------------------------------------------------------------------------
    Monetary    Joy of   580                 $525    4/11/2017  Employee
                 Sox      Lindsey                                directed
                          Dr.,                                   donation in
                          Ste 150                                lieu of
                          Radnor,                                company
                          PA                                     holiday
                          19087                                  gift
    ------------------------------------------------------------------------
    Monetary    Kids     26071             $3,000   11/21/2017  Support
                 Connec   Merit                                  Groups for
                 ted      Circle,                                the
                          #103                                   Children of
                          Laguna                                 Cancer
                          Hills,                                 Patients
                          CA
                          92653-7
                          016
    ------------------------------------------------------------------------
    Monetary    Lenape   500 N.             $ 300   11/30/2017  Costs
                 Valley   West                                   associated
                 Founda   Street                                 with
                 tion     Doylest                                Janssen
                          own, PA                                Cares
                          18901                                  Volunteer
                                                                 Activity--S
                                                                 eptember 29
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Metropo  420 N            $30,000    12/1/2017  Medical
                 litan    20th                                   Nutrition
                 Area     Street                                 for People
                 Neighb   Philade                                with Severe
                 orhood   lphia,                                 Illnesses
                 Nutrit   PA
                 ion      19103
                 Allian
                 ce
                 (MANNA
                 )
    ------------------------------------------------------------------------
    Monetary    Mitzvah  1561              $5,000   11/28/2017  Critical
                 Circle   Gehman                                 Needs for
                 Founda   Rd.                                    Families
                 tion     Harleys                                and
                          ville,                                 Individuals
                          PA
                          19438
    ------------------------------------------------------------------------
    Monetary    Montgom  340              $33,660   10/27/2017  Bridge to
                 ery      Dekalb                                 Employment
                 County   Pike                                   Extension--
                 Commun   Blue                                   Wissahickon
                 ity      Bell,                                  High School
                 Colleg   PA
                 e        19422
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    NAMI of  100 W,            $2,500    10/4/2017  Mental
                 PA       Main                                   health
                 Montgo   St.                                    education,
                 mery     Suite                                  support and
                 County   204                                    advocacy
                          Lansdal                                programs as
                          e, PA                                  well as
                          19446                                  support of
                                                                 Ending the
                                                                 Silence
                                                                 program
    ------------------------------------------------------------------------
    Monetary    NAMI of  100 W,            $1,000   12/25/2017  NAMIWalks
                 PA       Main                                   Greater
                 Montgo   St.                                    Philadelphi
                 mery     Suite                                  a
                 County   204
                          Lansdal
                          e, PA
                          19446
    ------------------------------------------------------------------------
    Monetary    Nationa  1107              $2,500    5/31/2017  National
                 l        Lakevie                                Cancer
                 Cancer   w Dr,                                  Survivors
                 Surviv   Suite                                  Day 2017
                 ors      C1
                 Day      Frankli
                 Founda   n, TN
                 tion     37067
    ------------------------------------------------------------------------
    Monetary    Nationa  4950              $2,500    7/31/2017  19th Annual
                 l        York                                   Break the
                 Ovaria   Rd,                                    Silence on
                 n        Unit                                   Ovarian
                 Cancer   631                                    Cancer Run/
                 Coalit   Holicon                                Walk
                 ion      g, PA
                 Inc.     18928
    ------------------------------------------------------------------------
    Monetary    Nationa  6600 SW          $50,000    3/16/2017  2017 Team
                 l        92nd                                   NPF Walk
                 Psoria   Ave.,
                 sis      #300
                 Founda   Portlan
                 tion     d, OR
                          97223
    ------------------------------------------------------------------------
    Monetary    Nationa  6600 SW          $20,000    12/5/2017  Patient
                 l        92nd                            2017   Education
                 Psoria   Ave.,                                  Initiative:
                 sis      #300                                   Phase Three
                 Founda   Portlan
                 tion     d, OR
                          97223
    ------------------------------------------------------------------------
    Monetary    North    P.O. Box          $5,000    12/4/2017  Project
                 Penn     103 16                                 Learn
                 Valley   Susqueh                                Homework
                 Boys     anna                                   Program
                 and      Avenue
                 Girls    Lansdal
                 Club     e, PA
                 Inc.     19446
    ------------------------------------------------------------------------
    Monetary    One      P.O. Box             $75    4/11/2017  Employee
                 Days     18071                                  directed
                 Wages    Seattle                                donation in
                          , WA                                   lieu of
                          98118                                  company
                                                                 holiday
                                                                 gift
    ------------------------------------------------------------------------
    Monetary    Patient  700 12TH          $5,000    3/31/2017  Patients
                 s        ST NW                                  Rising
                 Rising   Ste.                                   University:
                 Inc.     700                                    Spotlight
                          Washing                                Rheumatoid
                          ton, DC                                Arthritis
                          20005
    ------------------------------------------------------------------------
    Monetary    Philade  325               $5,000    1/24/2017  Summer READS
                 lphia    Chestnu
                 Reads    t
                          Street-
                          -Suite
                          903
                          Philade
                          lphia,
                          PA
                          19106
    ------------------------------------------------------------------------
    Monetary    Project  1515              $2,000   11/30/2017  Ending
                 Home     Fairmou                                Homelessnes
                          nt                                     s in
                          Avenue                                 Philadelphi
                          Philade                                a Through
                          lphia,                                 Supportive
                          PA                                     Housing
                          19130
    ------------------------------------------------------------------------
    Monetary    Prostat  7009 S.          $30,000     6/2/2017  Prostate
                 e        Potomac                                Cancer
                 Cancer   Street                                 Disparities
                 Educat   Suite                                  Outreach
                 ion      125                                    Program
                 Counci   Centenn
                 l        ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    Quest    461 Cann          $4,000    5/25/2017  Hippotherapy
                 Therap   Rd.                                    (Equine-
                 eutic    West                                   PAssisted
                 Servic   Chester                                Therapy)
                 es       , PA                                   Program
                 Inc.     19382                                  Support to
                                                                 Serve
                                                                 Children
                                                                 with
                                                                 Special
                                                                 Needs
    ------------------------------------------------------------------------
    Monetary    Rebuild  4355              $5,000    3/22/2017  Belmont
                 ing      Orchard                                Block Build
                 Togeth   Street                                 2017
                 er       Suite
                 Philad   2R
                 elphia   Philade
                          lphia,
                          PA
                          19124
    ------------------------------------------------------------------------
    Monetary    Retired  901 East          $7,000    5/31/2017  RSVP's
                 and      8th                                    America
                 Senior   Street                                 Reads/
                 Volunt   Suite                                  Writes and
                 eer      200                                    Protege
                 Progra   King of                                Programs
                 m of     Prussia
                 Montgo   , PA
                 mery     19406
                 County
    ------------------------------------------------------------------------
    Monetary    Retired  901 East         $10,000   12/13/2017  RSVP's My
                 and      8th                                    Free Tutor
                 Senior   Street                                 (MFT)
                 Volunt   Suite                                  Program and
                 eer      200                                    Family
                 Progra   King of                                Literacy
                 m of     Prussia                                Volunteer
                 Montgo   , PA                                   Program
                 mery     19406                                  (FLVP)
                 County
    ------------------------------------------------------------------------
    Monetary    Riverbe  1950              $6,000    7/31/2017  Philadelphia
                 nd       Spring                                 Children
                 Enviro   Mill                                   Access
                 nmenta   Road                                   Nature
                 l        Gladwyn                                Program
                 Educat   e, PA
                 ion      19035
                 Center
    ------------------------------------------------------------------------
    Monetary    Sandy    2010              $2,000   11/21/2017  Sandy Sprint
                 Rollma   West                                   Superhero
                 n        Chester                                5K or 10K
                 Ovaria   Pike,                                  Run/Walk
                 n        Suite                                  and Canine
                 Cancer   410                                    Sprint
                 Founda   Haverto
                 tion,    wn, PA
                 Inc.     19083
    ------------------------------------------------------------------------
    Monetary    Sarcoma  9899              $2,500   11/16/2017  Race to Cure
                 Founda   Main                                   SarcomaT 5K
                 tion     Street,                                Walk/Run
                 of       #204                                   Series
                 Americ   Damascu
                 a        s, MD
                          20872
    ------------------------------------------------------------------------
    Monetary    Special  2800              $4,000   11/21/2017  Special
                 Equest   Street                                 Equestrians
                 rians    Road                                   Equine-
                          P.O.                                   Assisted
                          Box                                    Learning
                          1001                                   and
                          Warring                                Therapeutic
                          ton, PA                                Riding
                          18976                                  Program
    ------------------------------------------------------------------------
    Monetary    Starfin  4015             $10,000    5/24/2017  Starfinder's
                 der      Main                                   Senior
                 Founda   Street                                 Leaders
                 tion     Philade                                Program
                          lphia,
                          PA
                          19127
    ------------------------------------------------------------------------
    Monetary    The      222              $10,000   12/22/2017  Corporate
                 Frankl   North                                  Membership
                 in       20th
                 Instit   Street
                 ute      Philade
                          lphia,
                          PA
                          19103
    ------------------------------------------------------------------------
    Monetary    The      PO Box            $2,000    7/31/2017  General
                 Giving   823                                    Operating
                 Tree,    Gwynedd                                Support
                 Gwyned   Valley,
                 d        PA
                 Valley   19437
                 , PA
    ------------------------------------------------------------------------
    Monetary    The      3               $250,000    4/12/2017  FY 2018
                 Leukem   Interna                                Light the
                 ia and   tional                                 Night
                 Lympho   Drive                                  National
                 ma       Suite                                  Sponsor
                 Societ   200 Rye
                 y        Brook,
                          NY
                          10573
    ------------------------------------------------------------------------
    Monetary    The      123               $7,500   12/14/2017  Master Class
                 Mann     South                                  Artist
                 Center   Broad                                  Residency
                 for      Street
                 the      Suite
                 Perfor   815
                 ming     Philade
                 Arts     lphia,
                          PA
                          19109
    ------------------------------------------------------------------------
    Monetary    The      2600             $10,000    4/25/2017  Hubert J.P.
                 Melmar   Wayland                                Schoemaker
                 k        Road                                   Classic
                 Charit   Berwyn,
                 able     PA
                 Founda   19312
                 tion
                 Berwyn
                 , PA
    ------------------------------------------------------------------------
    Monetary    Travis   164 E             $5,000   12/13/2017  Character
                 Manion   State                                  Does Matter
                 Founda   Street
                 tion     Doylest
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    Trustee  3025              $6,000   12/14/2017  WXPN
                 s of     Walnut                                 Musicians
                 the      Street                                 On Call
                 Univer   Philade
                 sity     lphia,
                 of       PA
                 Pennsy   19104
                 lvania
    ------------------------------------------------------------------------
    Monetary    Turning  415               $5,000    4/20/2017  Families and
                 Points   South                                  Schools
                 For      15th                                   Together
                 Childr   Street                                 (FAST)
                 en       Philade
                          lphia,
                          PA
                          19146
    ------------------------------------------------------------------------
    Monetary    United   8085              $2,017     8/8/2017  General
                 Mitoch   Saltsbu                                mission
                 ondria   rg Road                                support
                 l        Suite
                 Diseas   201
                 e        Pittsbu
                 Founda   rgh, PA
                 tion     15239
    ------------------------------------------------------------------------
    Monetary    Us Too   2720              $1,000    5/25/2017  13th Annual
                 Intern   South                                  SEA Blue
                 ationa   River                                  Prostate
                 l Inc.   Road                                   Cancer Walk
                          #112                                   & Run
                          Des
                          Plaines
                          , IL
                          60018
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Austin, TX
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Columbus,
                 Cancer   22314                                  OH
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Charleston,
                 Cancer   22314                                  SC
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Boston, MA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Cleveland,
                 Cancer   22314                                  OH
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Birmingham,
                 Cancer   22314                                  AL
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk San
                 te       ria, VA                                Diego, CA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk San
                 te       ria, VA                                Antonio, TX
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Sacramento,
                 Cancer   22314                                  CA
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Oklahoma
                 Cancer   22314                                  City, OK
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk East
                 te       ria, VA                                Lansing, MI
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Kansas
                 te       ria, VA                                City, KS
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Jacksonvill
                 Cancer   22314                                  e, FL
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Harrisburg,
                 Cancer   22314                                  PA
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Greensboro,
                 Cancer   22314                                  NC
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Des
                 te       ria, VA                                Moines, IA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Dayton, OH
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Dallas/
                 te       ria, VA                                Fort Worth,
                 Cancer   22314                                  TX
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Corpus
                 te       ria, VA                                Christi, TX
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Virginia
                 Cancer   22314                                  Beach, VA
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Tyler,
                 te       ria, VA                                TX
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk St.
                 te       ria, VA                                Louis, MO
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Puget
                 te       ria, VA                                Sound, WA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk San
                 te       ria, VA                                Francisco,
                 Cancer   22314                                  CA
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,000     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Napa
                 te       ria, VA                                Valley, CA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Minneapolis
                 Cancer   22314                                  , MN
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Hollywood,
                 Cancer   22314                                  FL
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Asheville,
                 Cancer   22314                                  NC
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Augusta, SC
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Towson/
                 te       ria, VA                                Baltimore,
                 Cancer   22314                                  MD
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk El
                 te       ria, VA                                Paso, TX
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Hartford,
                 Cancer   22314                                  CT
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Wichita, KS
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Capital
                 Cancer   22314                                  Area/
                                                                 Arlington,
                                                                 VA
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Syracuse,
                 Cancer   22314                                  NY
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Salt
                 te       ria, VA                                Lake City,
                 Cancer   22314                                  UT
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Raleigh, NC
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Portland,
                 Cancer   22314                                  OR
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Los
                 te       ria, VA                                Angeles, CA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk
                 te       ria, VA                                Lincoln, NE
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King          $1,250     8/1/2017  ZERO
                 he End   Street,                                Prostate
                 of       Ste 420                                Cancer Run/
                 Prosta   Alexand                                Walk Lehigh
                 te       ria, VA                                Valley, PA
                 Cancer   22314
    ------------------------------------------------------------------------
    Monetary    ZERO--T  515 King         $20,000    6/16/2017  Printed News
                 he End   Street,                                Resource
                 of       Ste 420                                for Men
                 Prosta   Alexand                                Living with
                 te       ria, VA                                Advanced
                 Cancer   22314                                  Disease
    ------------------------------------------------------------------------
    Product     Johnson  One         $497,856,557   12/31/2017  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        Kilmer
                 Assist   Square,
                 ance     Suite
                 Founda   130 New
                 tion     Brunswi
                          ck, NJ
                          08933
    ------------------------------------------------------------------------
    Janssen has also made financial donations to independent charitable
      foundations that assist patients who are underinsured and in financial
      need with treatment-related expenses. In keeping with our donor
      agreements and applicable regulatory guidance, we will only disclose
      aggregate data on our charitable giving and do not publicize
      information on donations to specific foundations and disease states.
      In 2017, we contributed approximately $61 million in donations to
      independent charitable foundations, enabling them to provide
      assistance with medication-related copays to patients with cancer and
      autoimmune diseases.Updated

    Updated March 30, 2018

    Janssen Pharmaceuticals, Inc. Monetary and Product Contribution to U.S.-
                  based Charitable Organizations Full Year 2017
            (Payments made from January 1, 2017 to December 31, 2017)
    ------------------------------------------------------------------------
                                                                   Project
     Donation    Payee     Payee   Payment Amount    Payment       Title/
       Type               Address       (USD)          Date      Description
    ------------------------------------------------------------------------
    Monetary    180      1                 $2,500    12/5/2017  2NDFLOOR
                 Turnin   Bethany                                Youth
                 g        Road,                                  Helpline--H
                 Lives    Buildin                                unterdon,
                 Around   g 3                                    Mercer,
                 , Inc.   Suite                                  Somerset
                          42                                     Operations
                          Hazlet,
                          NJ
                          07730
    ------------------------------------------------------------------------
    Monetary    Adult    872 E.              $300    11/6/2017  Costs
                 Day      Main                                   associated
                 Center   Street                                 with
                 of       Bridgew                                Janssen
                 Somers   ater,                                  Cares
                 et       NJ                                     Volunteer
                 County   08807                                  Activity--O
                                                                 ctober 4,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Allianc  2021 K           $20,000   12/28/2017  ``Living
                 e For    Street                                 with Atrial
                 Aging    N.W.                                   Fibrillatio
                 Resear   Suite                                  n'' Stroke
                 ch       305                                    Prevention
                          Washing                                PSA
                          ton, DC                                Campaign
                          20006
    ------------------------------------------------------------------------
    Monetary    Allies,  1262              $7,500    11/6/2017  Project Grow
                 Inc.     Whiteho
                          rse
                          Hamilto
                          n
                          Square
                          Rd.
                          Hamilto
                          n, NJ
                          08690
    ------------------------------------------------------------------------
    Monetary    Alterna  600                 $300    9/29/2017  Costs
                 tives    First                                  associated
                          Ave.                                   with
                          Raritan                                Janssen
                          , NJ                                   Cares
                          08869                                  Volunteer
                                                                 Activity
                                                                 #2--Septemb
                                                                 er 12, 2017
    ------------------------------------------------------------------------
    Monetary    Alterna  600                 $300    9/29/2017  Costs
                 tives    First                                  associated
                          Ave.                                   with
                          Raritan                                Janssen
                          , NJ                                   Cares
                          08869                                  Volunteer
                                                                 Activity
                                                                 #1--Septemb
                                                                 er 12, 2017
    ------------------------------------------------------------------------
    Monetary    Alterna  600               $7,500   12/13/2017  Fundraising
                 tives    First                                  event
                          Ave.                                   support to
                          Raritan                                benefit
                          , NJ                                   general
                          08869                                  mission of
                                                                 organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    America  900 Fort         $10,000     5/2/2017  Stop
                 n        Street                                 Diabetes @
                 Diabet   Mall,                                  Work
                 es       Suite
                 Associ   940
                 ation    Honolul
                          u, HI
                          96813
    ------------------------------------------------------------------------
    Monetary    America  PO Box           $30,000   12/22/2017  Atrial
                 n        541                                    Fibrillatio
                 Founda   Greenwo                                n Patient
                 tion     od, TX                                 Education
                 For      76246                                  Conference,
                 Women'                                          AF Patient
                 s                                               Treatment
                 Health                                          and Stroke
                                                                 Prevention
                                                                 Decision-
                                                                 Making
                                                                 Tool, and
                                                                 AF
                                                                 Community
                                                                 Screening
                                                                 Pilot
    ------------------------------------------------------------------------
    Monetary    America  7272             $30,000   12/28/2017  Raising
                 n        Greenvi                                Awareness
                 Heart    lle Ave                                on the
                          Dallas,                                Effects and
                          TX                                     Consequence
                          75231                                  s of
                                                                 Untreated
                                                                 Type 2
                                                                 Diabetes
    ------------------------------------------------------------------------
    Monetary    America  7272             $30,000   12/28/2017  Increasing
                 n        Greenvi                                Awareness
                 Heart    lle Ave                                of Deep
                          Dallas,                                Vein
                          TX                                     Thrombosis/
                          75231                                  Venous
                                                                 Thromboembo
                                                                 lism in
                                                                 General
                                                                 Population
                                                                 and At-Risk
                                                                 Patients
    ------------------------------------------------------------------------
    Monetary    America  One                 $300    9/29/2017  Costs
                 n        Union                                  associated
                 Heart    Street                                 with
                 Associ   Suite                                  Janssen
                 ation-   301                                    Cares
                 -New     Robbins                                Volunteer
                 Jersey   ville,                                 Activity--O
                          NJ                                     ctober 7,
                          08691                                  2017
    ------------------------------------------------------------------------
    Monetary    America  One               $5,000    12/4/2017  16th Annual
                 n        Union                                  Garden
                 Heart    Street                                 State Go
                 Associ   Suite                                  Red For
                 ation-   301                                    Women
                 -New     Robbins                                Luncheon
                 Jersey   ville,
                          NJ
                          08691
    ------------------------------------------------------------------------
    Monetary    America  1000            $200,000   12/12/2017  Judges and
                 n        Wilson                                 Psychiatris
                 Psychi   Blvd,                                  ts
                 atric    Suite                                  Leadership
                 Founda   1825                                   Initiative
                 tion     Arlingt                                (JPLI)
                          on, VA
                          22209
    ------------------------------------------------------------------------
    Monetary    America  1000            $100,000   12/12/2017  Typical or
                 n        Wilson                                 Troubled?
                 Psychi   Blvd,                                  School
                 atric    Suite                                  Mental
                 Founda   1825                                   Health
                 tion     Arlingt                                Education
                          on, VA                                 Program
                          22209
    ------------------------------------------------------------------------
    Monetary    America  1000             $35,000   12/12/2017  Center for
                 n        Wilson                                 Workplace
                 Psychi   Blvd,                                  Mental
                 atric    Suite                                  Health
                 Founda   1825                                   (formerly
                 tion     Arlingt                                the
                          on, VA                                 Partnership
                          22209                                  for
                                                                 Workplace
                                                                 Mental
                                                                 Health)
    ------------------------------------------------------------------------
    Monetary    America  88                  $600   11/28/2017  Donation In
                 res      Hamilto                                Lieu of
                 Founda   n Ave.                                 Gift
                 tion     Stamfor
                          d, CT
                          06902
    ------------------------------------------------------------------------
    Monetary    America  150                 $300    9/29/2017  Costs
                 's       Pittsto                                associated
                 Grow-A-  wn Road                                with
                 Row,     Pittsto                                Janssen
                 Inc.     wn, NJ                                 Cares
                          08867                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 27, 2017
    ------------------------------------------------------------------------
    Monetary    America  150                 $300    9/29/2017  Costs
                 's       Pittsto                                associated
                 Grow-A-  wn Road                                with
                 Row,     Pittsto                                Janssen
                 Inc.     wn, NJ                                 Cares
                          08867                                  Volunteer
                                                                 Activity--O
                                                                 ctober 6,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Anchor   482                 $300    9/29/2017  Costs
                 House,   Centre                                 associated
                 Inc.     Street                                 with
                          Trenton                                Janssen
                          , NJ                                   Cares
                          08611                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 28, 2017
    ------------------------------------------------------------------------
    Monetary    Anchor   482               $8,000   12/12/2017  Anchor House
                 House,   Centre                                 Shelter
                 Inc.     Street
                          Trenton
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Ann      595 W.            $9,500   12/12/2017  Increasing
                 Silver   State                                  Access to
                 man      Street                                 Comprehensi
                 Commun   Doylest                                ve
                 ity      own, PA                                Healthcare
                 Health   18901                                  for Low-
                 Clinic                                          Income,
                                                                 Uninsured
                                                                 Bucks
                                                                 County
                                                                 residents
    ------------------------------------------------------------------------
    Monetary    Arm In   123 E.           $15,000   10/30/2017  Improving
                 Arm,     Hanover                                Food
                 Inc.     St.                                    Security
                          Trenton                                and Housing
                          , NJ                                   Stability
                          08608
    ------------------------------------------------------------------------
    Monetary    Bear     1162                $750   12/12/2017  2018 Bear
                 Tavern   Bear                                   Tavern
                 Parent   Tavern                                 Elementary
                 s        Road                                   Science
                 Associ   Titusvi                                Fair
                 ation    lle, NJ
                          08560
    ------------------------------------------------------------------------
    Monetary    Big      2875              $6,500   10/30/2017  STEM School
                 Brothe   York                                   Mentoring
                 rs Big   Road                                   Initiative
                 Sister   Jamison
                 s of     , PA
                 Bucks    18929
                 County
    ------------------------------------------------------------------------
    Monetary    Big      535 East         $10,000    8/23/2017  Fundraising
                 Brothe   Frankli                                event
                 rs Big   n                                      support to
                 Sister   Street                                 benefit
                 s of     Trenton                                general
                 Mercer   , NJ                                   mission of
                 County   08610                                  organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Big      535 East          $7,500   10/16/2017  Youth
                 Brothe   Frankli                                Mentoring
                 rs Big   n                                      Programs
                 Sister   Street
                 s of     Trenton
                 Mercer   , NJ
                 County   08610
    ------------------------------------------------------------------------
    Monetary    Boys     212              $20,000   10/30/2017  Extended Day
                 and      Centre                                 Learning
                 Girls    Trenton
                 Club     , NJ
                 of       08611
                 Trento
                 n and
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Bristol  120               $7,500    11/6/2017  ArtRageous
                 Rivers   Radclif                                Theatre
                 ide      fe                                     Arts
                 Theate   Street                                 Education
                 r Co     P.O.                                   Program
                 Inc.     Box
                          1250
                          Bristol
                          , PA
                          19007
    ------------------------------------------------------------------------
    Monetary    Britesi  16 Sand             $300   11/15/2017  Costs
                 de       Hill                                   associated
                 Adult    Road                                   with
                 Day      Fleming                                Janssen
                 Center   ton, NJ                                Cares
                 s,       08822                                  Volunteer
                 Inc.                                            Activity--S
                                                                 eptember
                                                                 22, 2017
    ------------------------------------------------------------------------
    Monetary    Broward  305 SE           $15,000    6/28/2017  Affordable
                 County   18th                                   Housing
                 Commun   Court
                 ity      Fort
                 Develo   Lauderd
                 pment    ale, FL
                 Corpor   33316
                 ation,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Bucks    400                 $300    9/20/2017  Costs
                 County   Freedom                                associated
                 Associ   Drive                                  with
                 ation    Newtown                                Janssen
                 For      , PA                                   Cares
                 The      18940                                  Volunteer
                 Blind                                           Activity--S
                 And                                             eptember
                 Visual                                          26, 2017
                 ly
                 Impair
                 ed
    ------------------------------------------------------------------------
    Monetary    Bucks    626               $5,000   12/18/2017  Veterans
                 County   Jackson                                Housing
                 Housin   ville                                  Assistance
                 g        Road                                   Program
                 Group    Suite
                          140
                          Warmins
                          ter, PA
                          18974
    ------------------------------------------------------------------------
    Monetary    Bucks    100              $10,000   12/21/2017  Economic
                 County   Doyle                                  Self-
                 Opport   Street                                 Sufficiency
                 unity    Doylest                                Program
                 Counci   own, PA
                 l,       18901
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Caminar  2600 S.           $7,500    8/11/2017  Bridges to
                          El                                     Wellness
                          Camino                                 Program
                          Real,
                          Suite
                          200 San
                          Mateo,
                          CA
                          94403
    ------------------------------------------------------------------------
    Monetary    Capital  PO Box            $8,000     2/1/2017  ``I Am
                 City     1743                                   Trenton!'':
                 Commun   Trenton                                Positive
                 ity      , NJ                                   Images
                 Founda   08607-1                                Campaign
                 tion     743
    ------------------------------------------------------------------------
    Monetary    Catholi  920               $5,000    12/5/2017  CYO's Broad
                 c        South                                  St. Trenton
                 Youth    Broad                                  Center's
                 Organi   St.                                    After
                 zation   Trenton                                School
                 of       , NJ                                   Program
                 Mercer   08611                                  Tutoring
                 County                                          Project
    ------------------------------------------------------------------------
    Monetary    Center   151              $10,000   10/13/2017  Community-
                 for      Lawrenc                                Based
                 Altern   e                                      Health
                 ative    Street                                 Services
                 Senten   3rd                                    for Justice-
                 cing     Floor                                   Involved
                 and      Brookly                                Adults with
                 Employ   n, NY                                  Schizophren
                 ment     11201                                  ia
                 Servic
                 es
                 (CASES
                 )
    ------------------------------------------------------------------------
    Monetary    Central  2500              $5,000    10/3/2017  Diabetes
                 Bucks    Lower                                  Prevention
                 Family   State                                  Program
                 YMCA     Road
                          Doylest
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    Child    204 N.            $3,000     3/8/2017  Upper Bucks
                 Home     West                                   Area Young
                 and      Street                                 Parent
                 Commun   #101                                   Initiative
                 ity      Doylest
                          own, PA
                          18901
    ------------------------------------------------------------------------
    Monetary    Childre  635              $10,000   11/20/2017  CUNA and
                 n's      South                                  Body and
                 Home     Clinton                                Soul
                 Societ   Avenue                                 Prenatal
                 y of     Trenton                                Health
                 New      , NJ                                   Education
                 Jersey   08611                                  for Low-
                                                                 Income
                                                                 Women
    ------------------------------------------------------------------------
    Monetary    CIT      111 S.            $5,000    8/15/2017  CIT
                 Intern   Highlan                                Internation
                 ationa   d St.                                  al
                 l,       Box 71                                 Conference
                 Inc.     Memphis                                2017
                          , TN
                          38111
    ------------------------------------------------------------------------
    Monetary    Clevela  9500             $20,000   10/25/2017  Diabetes
                 nd       Euclid                                 Center
                 Clinic   Ave.,                                  Educational
                 Founda   DV4                                    Initiatives
                 tion     Clevela                                at
                          nd, OH                                 Cleveland
                          44195                                  Clinic
                                                                 South
                                                                 Pointe
                                                                 Hospital
    ------------------------------------------------------------------------
    Monetary    College  50 Milk          $20,000   12/28/2017  Campus
                 Diabet   St 16th                                Quality
                 es       Floor                                  Improvement
                 Networ   Boston,                                : Diabetes
                 k        MA                                     and Higher
                 (CDN)    02109                                  Education
    ------------------------------------------------------------------------
    Monetary    College  2000             $20,000   11/20/2017  Nursing
                 of New   Penning                                Merit
                 Jersey   ton                                    Scholarship
                          Road                                   s $7,500;
                          P.O.                                   and
                          Box                                    Educational
                          7718                                   Opportunity
                          Ewing,                                 Fund (EOF)
                          NJ                                     Promise
                          08628                                  Awards
                                                                 $12,500
    ------------------------------------------------------------------------
    Monetary    Communi  P.O. Box          $5,000    12/5/2017  Rise Summer
                 ty       88 116                                 Healthy
                 Action   North                                  Food
                 Servic   Main                                   Initiative
                 e        Street                                 for Low-
                 Center   Hightst                                Income
                 , Inc.   own, NJ                                Youth
                          08520-
                          9804
    ------------------------------------------------------------------------
    Monetary    Communi  4059              $5,000     3/8/2017  Arts for
                 ty       Skyron                                 Seniors
                 Conser   Drive                                  ($3,000)
                 vatory   Doylest                                and Music
                 of       own, PA                                Therapy
                 Music    18902                                  ($2,000)
    ------------------------------------------------------------------------
    Monetary    Communi  4059              $4,500    11/6/2017  Making the
                 ty       Skyron                                 Arts
                 Conser   Drive                                  Accessible
                 vatory   Doylest                                for Seniors
                 of       own, PA                                and Persons
                 Music    18902                                  with
                                                                 Disabilitie
                                                                 s: Music
                                                                 Therapy and
                                                                 Arts for
                                                                 Seniors
    ------------------------------------------------------------------------
    Monetary    Communi  P.O. Box         $60,000   12/18/2017  HealtheVoice
                 ty       338                                    sTM Impact
                 Founda   Morrist                                Fund
                 tion     own, NJ
                 of New   07963-
                 Jersey   0338
    ------------------------------------------------------------------------
    Monetary    Communi  P.O. Box         $75,000   12/18/2017  Healthcare
                 ty       338                                    and Basic
                 Founda   Morrist                                Needs Fund
                 tion     own, NJ
                 of New   07963-
                 Jersey   0338
    ------------------------------------------------------------------------
    Monetary    Communi  P.O. Box         $14,000    7/17/2017  ``Each One,
                 ty       15176                                  Teach
                 Health   407                                    One'':
                 Coalit   Crutchf                                Community
                 ion,     ield                                   Empowerment
                 Inc.     Street                                 Diabetes
                          Durham,                                Self-
                          NC                                     Management
                          27704                                  Education
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    Communi  959              $11,000    6/14/2017  Pathway to
                 ty       Route                                  Recovery
                 Hope,    46 East                                Residential
                 Inc.     Suite                                  Programs/
                          402                                    The Annual
                          Parsipp                                Forum and
                          any, NJ                                Wellness
                          07054                                  Fair
    ------------------------------------------------------------------------
    Monetary    Communi  959              $15,000   10/16/2017  Hope for
                 ty       Route                                  Veterans
                 Hope,    46 East                                and Valley
                 Inc.     Suite                                  Brook
                          402                                    Village for
                          Parsipp                                Veterans
                          any, NJ
                          07054
    ------------------------------------------------------------------------
    Monetary    Communi  310 W.            $5,000   12/18/2017  Basic Needs:
                 ty       State                                  Legal
                 Justic   Street,                                Services
                 e        3rd
                 Center   Floor
                 , Inc.   Trenton
                          , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Compeer  259               $2,500    5/31/2017  Caregiver
                 Roches   Monroe                                 Support
                 ter,     Avenue
                 Inc.     Rochest
                          er, NY
                          14607
    ------------------------------------------------------------------------
    Monetary    Contact  60 S.             $8,500    12/4/2017  Emotional
                 Of       Main                                   Support and
                 Mercer   St.                                    Crisis
                 County   Penning                                Services:
                 New      ton, NJ                                HOTLINE,
                 Jersey   08628                                  Crisis Chat
                 Inc.                                            and
                                                                 TxtToday
    ------------------------------------------------------------------------
    Monetary    CONTACT  P.O. Box          $4,000    10/4/2017  Training
                 We       2376                                   Nonprofessi
                 Care,    Westfie                                onals in
                 Inc.     ld, NJ                                 Crisis
                          07091                                  Interventio
                                                                 n for
                                                                 People
                                                                 Experiencin
                                                                 g Psychosis
    ------------------------------------------------------------------------
    Monetary    Court    1450                $300    8/29/2017  Costs
                 Appoin   Parksid                                associated
                 ted      e                                      with
                 Specia   Avenue,                                Janssen
                 l        Suite                                  Cares
                 Advoca   22                                     Volunteer
                 tes      Ewing,                                 Activity--S
                          NJ                                     eptember
                          08638-                                 12, 2017
                          2946
    ------------------------------------------------------------------------
    Monetary    Court    1450             $15,000   11/20/2017  General
                 Appoin   Parksid                                mission
                 ted      e                                      support
                 Specia   Avenue,
                 l        Suite
                 Advoca   22
                 tes      Ewing,
                          NJ
                          08638-
                          2946
    ------------------------------------------------------------------------
    Monetary    Deborah  212               $5,000   12/22/2017  2018 Women's
                 Hospit   Trenton                                Heart
                 al       Road                                   Health
                 Founda   Browns                                 Educational
                 tion     Mills,                                 Expo
                          NJ
                          08015
    ------------------------------------------------------------------------
    Monetary    Delawar  14                $4,500    11/6/2017  Environmenta
                 e        Michael                                l education
                 River    McCorri                                for
                 Steamb   stin                                   underfunded
                 oat      Road                                   and
                 Floati   Hamilto                                underserved
                 ng       n, NJ                                  schools and
                 Classr   08690                                  youth
                 oom,                                            groups
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Depress  5                 $1,000     3/8/2017  DBSA NJ
                 ion      Village                                Mutual Aid
                 and      Ct.                                    Support
                 Bipola   Lawrenc                                Group
                 r        eville,                                Facilitator
                 Suppor   NJ                                     Training
                 t        08648
                 Allian
                 ce
    ------------------------------------------------------------------------
    Monetary    Diabete  14652             $5,000    3/23/2017  The Diabetes
                 s        Corkwoo                                UnConferenc
                 Collec   d Drive                                e
                 tive,    Tampa,
                 Inc.     FL
                          33626
    ------------------------------------------------------------------------
    Monetary    Dress    3131             $10,000   10/16/2017  Women's
                 for      Princet                                Empowerment
                 Succes   on Pike                                Programs
                 s        Buildin
                          g 4,
                          Suite
                          209
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Eden     2                $10,000   10/16/2017  Adult
                 Autism   Merwick                                Employment
                 Servic   Road                                   Program
                 es       Princet
                 Founda   on, NJ
                 tion     08540
    ------------------------------------------------------------------------
    Monetary    Eden     2                $10,000   12/18/2017  Eden Dreams
                 Autism   Merwick                                Sponsorship
                 Servic   Road
                 es       Princet
                 Founda   on, NJ
                 tion     08540
    ------------------------------------------------------------------------
    Monetary    Emory    550               $3,500     7/3/2017  Atrial
                 Univer   Peachtr                                Fibrillatio
                 sity     ee                                     n Support
                          Street                                 Group
                          6th Fl,                                Meeting
                          Suite
                          4300
                          Atlanta
                          , GA
                          30308
    ------------------------------------------------------------------------
    Monetary    Enable,  13                $7,500   12/12/2017  Connect with
                 Inc.     Roszel                                 Enable--Div
                          Road,                                  ersity
                          Suite                                  Drive
                          B110
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Every    Fred              $9,000    12/4/2017  Every Child
                 Child    Vereen,                                Valued
                 Valued   Jr.                                    (ECV) After
                 A NJ     Communi                                School
                 Nonpro   ty                                     Program
                 fit      Center
                 Corpor   175
                 ation    Johnson
                          Avenue
                          Lawrenc
                          eville,
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Everybo  707               $7,500    12/4/2017  Coming Up
                 dy       Alexand                                for AIRTM
                 Loves    er
                 Kenny    Road,
                 Projec   Suite
                 t Inc.   208
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Familie  320 N.            $3,500    8/29/2017  DBT-Based
                 s and    Goodman                                Coping
                 Friend   St.,                                   Skills for
                 s of     Suite                                  Families
                 the      102
                 Mental   Rochest
                 ly Ill   er, NY
                 and      14607
                 Emotio
                 nally
                 Distur
                 bed,
                 Inc,
                 dba
                 NAMI-
                 Roches
                 ter
    ------------------------------------------------------------------------
    Monetary    Family   1931                $300    8/24/2017  Costs
                 Guidan   Notting                                associated
                 ce       ham Way                                with
                 Center   Hamilto                                Janssen
                 Corpor   n, NJ                                  Cares
                 ation    08619                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 28, 2017
    ------------------------------------------------------------------------
    Monetary    Family   1931             $10,000   10/27/2017  Outpatient
                 Guidan   Notting                                mental
                 ce       ham Way                                health
                 Center   Hamilto                                treatment
                 Corpor   n, NJ                                  for
                 ation    08619                                  homeless
                                                                 women and
                                                                 children.
    ------------------------------------------------------------------------
    Monetary    Family   1 AAA Dr         $12,500   11/20/2017  Caregiver
                 Resour   Suite                                  Wellness
                 ce       203                                    Series
                 Networ   Trenton
                 k        , NJ
                          08691
    ------------------------------------------------------------------------
    Monetary    Family   4                $14,000    12/4/2017  Nurse
                 Servic   Corners                                Educator at
                 e        tone                                   Bucks
                 Associ   Drive                                  County
                 ation    Langhor                                Emergency
                 of       ne, PA                                 Homeless
                 Bucks    19047                                  Shelter
                 County
    ------------------------------------------------------------------------
    Monetary    Federat  One               $2,500    5/31/2017  Big Nosh
                 ion of   Farming                                Vocational
                 Organi   dale                                   Services
                 zation   Road                                   Program
                 s        West
                          Babylon
                          , NY
                          11704
    ------------------------------------------------------------------------
    Monetary    Feed     Central              $75    2/24/2017  Employee
                 More,    Virgini                                directed
                 Inc.     a Food                                 donation in
                          Bank                                   lieu of
                          1415                                   company
                          Rhoadmi                                holiday
                          ller                                   gift
                          Street
                          Richmon
                          d, VA
                          23220
    ------------------------------------------------------------------------
    Monetary    Florida  2525              $1,500   10/13/2017  2017 Florida
                 Coalit   Saint                                  Institute
                 ion      Lucie                                  on
                 for      Avenue                                 Homelessnes
                 the      Vero                                   s and
                 Homele   Beach,                                 Supportive
                 ss,      FL                                     Housing
                 Inc.     32960
    ------------------------------------------------------------------------
    Monetary    Forsyth  4881                 $75    4/11/2017  Employee
                 Humane   Country                                directed
                 Societ   Club                                   donation in
                 y        Rd.                                    lieu of
                          Winston                                company
                          Salem,                                 holiday
                          NC                                     gift
                          27104
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $2,500    12/5/2017  Funding
                 ion of   Lawrenc                                support for
                 Morris   eville                                 the 2018
                 Hall/    Road                                   Philly Pops
                 St.      Lawrenc                                Benefit
                 Lawren   eville,                                Concert
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Foundat  2381              $7,000    12/5/2017  It's Never 2
                 ion of   Lawrenc                                Late
                 Morris   eville
                 Hall/    Road
                 St.      Lawrenc
                 Lawren   eville,
                 ce       NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $2,500   10/16/2017  Danny Zorn
                 n        47th                                   Scholarship
                 House    Street                                 Fund
                          New
                          York,
                          NY
                          10036
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $6,000   10/16/2017  Mad About
                 n        47th                                   Art Auction
                 House    Street                                 and Benefit
                          New
                          York,
                          NY
                          10036
    ------------------------------------------------------------------------
    Monetary    Fountai  425 West          $1,000    3/23/2017  Fountain
                 n        47th                                   House One-
                 House    Street                                 in-Four 5K
                          New
                          York,
                          NY
                          10036
    ------------------------------------------------------------------------
    Monetary    Friends  P.O. Box         $10,125   11/20/2017  Project
                 Of       395                                    Hopewell
                 Hopewe   Penning                                Healthy
                 ll       ton, NJ                                Habitats
                 Valley   08534
                 Open
                 Space
    ------------------------------------------------------------------------
    Monetary    Friends  P.O. Box          $2,500   10/27/2017  Fundraising
                 Of       395                                    event
                 Hopewe   Penning                                support to
                 ll       ton, NJ                                benefit
                 Valley   08534                                  general
                 Open                                            mission of
                 Space                                           organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Friends  6 Lilly           $3,600   12/18/2017  Giving Voice
                 of       Street                                 Through
                 Lamber   Lambert                                Film
                 tville   ville,
                 Librar   NJ
                 y,       08530
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Friends  57                  $300   10/16/2017  Costs
                 Of       Mountai                                associated
                 Prince   n                                      with
                 ton      Avenue                                 Janssen
                 Open     Princet                                Cares
                 Space    on, NJ                                 Volunteer
                          08540                                  Activity--S
                                                                 eptember
                                                                 13, 2017
    ------------------------------------------------------------------------
    Monetary    Gateway  4901             $10,000    8/29/2017  Outpatient
                 Homes,   Libbie                                 Clinical
                 Inc.     Mill                                   Services to
                          East                                   Support
                          Bouleva                                Individuals
                          rd                                     with
                          Suite                                  Schizophren
                          210                                    ia and
                          Richmon                                Schizoaffec
                          d, VA                                  tive
                          23230                                  Disorder
    ------------------------------------------------------------------------
    Monetary    Georgia  246               $2,000    8/21/2017  26th Annual
                 Mental   Sycamor                                Statewide
                 Health   e St.                                  Consumer
                 Consum   Suite                                  Conference
                 er       260
                 Networ   Decatur
                 k        , GA
                          30030
    ------------------------------------------------------------------------
    Monetary    Globalg  1110                $825   11/30/2017  Donation In
                 iving    Vermont                                Lieu of
                 Founda   Ave. NW                                Gift
                 tion,    Suite
                 Inc.     550
                          Washing
                          ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Good     38 Elm            $5,000   12/18/2017  Nights of
                 Grief,   Street                                 Support--Pr
                 Inc.     Morrist                                inceton
                          own, NJ                                Center
                          07960
    ------------------------------------------------------------------------
    Monetary    Greater  102             $150,000     2/2/2017  Greater
                 Trento   Barrack                                Trenton
                 n        Street                                 Initiative
                          Trenton
                          , NJ
                          08608
    ------------------------------------------------------------------------
    Monetary    Grounds  80                $7,500    12/4/2017  Wellness
                 for      Sculpto                                Walks
                 Sculpt   rs Way
                 ure      Hamilto
                          n, NJ
                          08534
    ------------------------------------------------------------------------
    Monetary    Habitat  530                 $300   12/18/2017  Costs
                 for      Route                                  associated
                 Humani   38 E                                   with
                 ty of    Maple                                  Janssen
                 Burlin   Shade,                                 Cares
                 gton     NJ                                     Volunteer
                 County   08052                                  Activity--O
                 and                                             ctober 6,
                 Greate                                          2017
                 r
                 Trento
                 n-
                 Prince
                 ton
    ------------------------------------------------------------------------
    Monetary    Habitat  530                 $300   12/18/2017  Costs
                 for      Route                                  associated
                 Humani   38 E                                   with
                 ty of    Maple                                  Janssen
                 Burlin   Shade,                                 Cares
                 gton     NJ                                     Volunteer
                 County   08052                                  Activity--O
                 and                                             ctober 4,
                 Greate                                          2017
                 r
                 Trento
                 n-
                 Prince
                 ton
    ------------------------------------------------------------------------
    Monetary    Habitat  530                 $300   12/18/2017  Costs
                 for      Route                                  associated
                 Humani   38 E                                   with
                 ty of    Maple                                  Janssen
                 Burlin   Shade,                                 Cares
                 gton     NJ                                     Volunteer
                 County   08052                                  Activity--S
                 and                                             eptember
                 Greate                                          29, 2017
                 r
                 Trento
                 n-
                 Prince
                 ton
    ------------------------------------------------------------------------
    Monetary    Habitat  530                 $300   12/18/2017  Costs
                 for      Route                                  associated
                 Humani   38 E                                   with
                 ty of    Maple                                  Janssen
                 Burlin   Shade,                                 Cares
                 gton     NJ                                     Volunteer
                 County   08052                                  Activity--S
                 and                                             eptember 8,
                 Greate                                          2017
                 r
                 Trento
                 n-
                 Prince
                 ton
    ------------------------------------------------------------------------
    Monetary    Habitat  530               $5,000   12/18/2017  Affordable
                 for      Route                                  Homeownersh
                 Humani   38 E                                   ip Program
                 ty of    Maple
                 Burlin   Shade,
                 gton     NJ
                 County   08052
                 and
                 Greate
                 r
                 Trento
                 n-
                 Prince
                 ton
    ------------------------------------------------------------------------
    Monetary    Habitat  31 Oak            $7,500    11/6/2017  Women Build
                 for      Avenue,                                and Safe at
                 Humani   Suite                                  Home Repair
                 ty of    100                                    Clinics
                 Greate   Chalfon
                 r        t, PA
                 Bucks    18914
    ------------------------------------------------------------------------
    Monetary    Heart    1325 G           $30,000   12/22/2017  HRS-WebMD:
                 Rhythm   Street                                 Atrial
                 Societ   NW,                                    Fibrillatio
                 y,       Suite                                  n and How
                 Inc.     400                                    to Reduce
                          Washing                                Your Risk
                          ton, DC                                of Stroke
                          20005
    ------------------------------------------------------------------------
    Monetary    Heartla  4750 N.           $7,500    8/11/2017  Pathways
                 nd       Sherida                                Home
                 Health   n Road
                 Outrea   Chicago
                 ch       , IL
                          60640
    ------------------------------------------------------------------------
    Monetary    Henders  4740              $7,500    5/31/2017  Helping
                 on       North                                  Individuals
                 Behavi   State                                  Live Longer
                 oral     Road 7                                 (HILL)
                 Health   Lauderd
                          ale
                          Lakes,
                          FL
                          33319
    ------------------------------------------------------------------------
    Monetary    HiTOPS,  21                $9,000   12/12/2017  HiTOPS
                 Inc.     Wiggins                                Comprehensi
                          Street                                 ve
                          Princet                                Sexuality
                          on, NJ                                 Interventio
                          08540                                  ns for
                                                                 Youth-at-
                                                                 Risk
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880                $300   10/30/2017  Costs
                 nt       Princet                                associated
                          on                                     with
                          Avenue                                 Janssen
                          Lawrenc                                Cares
                          eville,                                Volunteer
                          NJ                                     Activity--O
                          08648                                  ctober 20,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880                $300   10/30/2017  Costs
                 nt       Princet                                associated
                          on                                     with
                          Avenue                                 Janssen
                          Lawrenc                                Cares
                          eville,                                Volunteer
                          NJ                                     Activity--S
                          08648                                  eptember
                                                                 27, 2017
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880                $300   10/30/2017  Costs
                 nt       Princet                                associated
                          on                                     with
                          Avenue                                 Janssen
                          Lawrenc                                Cares
                          eville,                                Volunteer
                          NJ                                     Activity--S
                          08648                                  eptember
                                                                 20, 2017
    ------------------------------------------------------------------------
    Monetary    HomeFro  1880             $10,000   11/20/2017  Helping
                 nt       Princet                                Homeless
                          on                                     Families
                          Avenue                                 Break the
                          Lawrenc                                Cycle of
                          eville,                                Poverty
                          NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    Hopewel  35                  $750   12/12/2017  2018
                 l        Princet                                Hopewell
                 Elemen   on                                     Elementary
                 tary     Avenue                                 School
                 School   Hopewel                                Science
                 Parent   l, NJ                                  Fair
                 Teache   08525
                 r
                 Organi
                 zation
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Hopewel  PO Box            $6,446    12/4/2017  Scholarship
                 l        553                                    Support:
                 Valley   Penning                                $1,000;
                 Educat   ton, NJ                                STEM
                 ion      08534                                  Education
                 Founda                                          and
                 tion                                            Sustainabil
                                                                 ity
                                                                 Education
                                                                 at Hopewell
                                                                 Elementary
                                                                 and Stony
                                                                 Brook
                                                                 Elementary
                                                                 Schools :
                                                                 $5446
    ------------------------------------------------------------------------
    Monetary    Hopewel  48                $1,500    12/4/2017  Mobility for
                 l        Orchard                                Homebound
                 Valley   Ave PO                                 Residents
                 Senior   Box 567                                of the
                 Founda   Penning                                Hopewell
                 tion     ton, NJ                                Valley
                          08534
    ------------------------------------------------------------------------
    Monetary    Hopewel  P.O. Box          $2,525   12/18/2017  Scholarship
                 l        159 16                                 Fund
                 Valley   Seminar
                 Youth    y
                 Choral   Avenue,
                 e,       Suite C
                 Inc.     Hopewel
                          l, NJ
                          08525
    ------------------------------------------------------------------------
    Monetary    Hunterd  7 Lower           $7,500    12/4/2017  Open Studio/
                 on Art   Center                                 Open
                 Center   Street                                 Hearts:
                          Clinton                                Artistic
                          , NJ                                   Expressions
                          08809                                  and Art
                                                                 with Heart
    ------------------------------------------------------------------------
    Monetary    Hunterd  1410              $2,500    11/6/2017  Fundraising
                 on       Route                                  event
                 County   22 West                                sponsorship
                 YMCA     Annanda                                to benefit
                          le, NJ                                 general
                          08801                                  mission of
                                                                 organizatio
                                                                 n
    ------------------------------------------------------------------------
    Monetary    Hunterd  111 Mine            $300    9/29/2017  Costs
                 on       Street                                 associated
                 Land     Fleming                                with
                 Trust    ton, NJ                                Janssen
                          08822                                  Cares
                                                                 Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 14, 2017
    ------------------------------------------------------------------------
    Monetary    Hunterd  111 Mine          $2,500    12/4/2017  Promotion
                 on       Street                                 and
                 Land     Fleming                                Protection
                 Trust    ton, NJ                                of
                          08822                                  Preserves
    ------------------------------------------------------------------------
    Monetary    Interfa  3635             $15,000   10/30/2017  Neighbors
                 ith      Quakerb                                Helping
                 Caregi   ridge                                  Neighbors
                 vers     Road,
                 Trento   Suite
                 n,       #16
                 Inc.     Hamilto
                          n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    Isles,   10 Wood             $300    9/29/2017  Costs
                 Inc.     Street                                 associated
                          Trenton                                with
                          , NJ                                   Janssen
                          08618                                  Cares
                                                                 Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 20, 2017
    ------------------------------------------------------------------------
    Monetary    Isles,   10 Wood           $9,000   12/12/2017  Trenton
                 Inc.     Street                                 Healthy
                          Trenton                                Homes
                          , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Jewish   707                 $300    9/29/2017  Costs
                 Family   Alexand                                associated
                 and      er Road                                with
                 Childr   Suite                                  Janssen
                 en's     102                                    Cares
                 Servic   Princet                                Volunteer
                 e of     on, NJ                                 Activity--S
                 Greate   08540                                  eptember
                 r                                               28, 2017
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Jewish   707              $15,000   12/18/2017  Senior
                 Family   Alexand                                Outreach
                 and      er Road                                Service
                 Childr   Suite                                  (SOS) PLUS
                 en's     102                                    ($12,000);
                 Servic   Princet                                Caregiver
                 e of     on, NJ                                 Program
                 Greate   08540                                  ($3,000)
                 r
                 Mercer
                 County
    ------------------------------------------------------------------------
    Monetary    Jewish   150-A             $5,000   10/30/2017  Expanding
                 Family   West                                   Horizons
                 Servic   High
                 e of     St.
                 Somers   Somervi
                 et       lle, NJ
                 Hunter   08876
                 don
                 and
                 Warren
                 Counti
                 es
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Johnson  One           $5,500,000     7/3/2017  General
                 &        Johnson                                mission
                 Johnso   &                                      support
                 n        Johnson
                 Patien   Plaza
                 t        Kilmer
                 Assist   Square
                 ance     Suite
                 Founda   130 New
                 tion     Brunswi
                 Inc.     ck, NJ
                          08933
    ------------------------------------------------------------------------
    Monetary    Johnson  One          $15,500,000    9/28/2017  General
                 &        Johnson                                mission
                 Johnso   &                                      support
                 n        Johnson
                 Patien   Plaza
                 t        Kilmer
                 Assist   Square
                 ance     Suite
                 Founda   130 New
                 tion     Brunswi
                 Inc.     ck, NJ
                          08933
    ------------------------------------------------------------------------
    Monetary    Johnson  One           $2,400,000   12/18/2017  General
                 &        Johnson                                mission
                 Johnso   &                                      support
                 n        Johnson
                 Patien   Plaza
                 t        Kilmer
                 Assist   Square
                 ance     Suite
                 Founda   130 New
                 tion     Brunswi
                 Inc.     ck, NJ
                          08933
    ------------------------------------------------------------------------
    Monetary    Junior   360 Pear          $7,150   10/30/2017  STEMCivics
                 Achiev   Blossom                                High School
                 ement    Drive                                  Heroes JA
                 of New   Edison,                                Day
                 Jersey   NJ
                          08837
    ------------------------------------------------------------------------
    Monetary    Kidsbri  999              $10,000   10/16/2017  Bullying
                 dge,     Lower                                  Prevention
                 Inc.     Ferry                                  and
                          Rd                                     Diversity
                          Ewing,                                 Appreciatio
                          NJ                                     n Life
                          08628                                  Skills
                                                                 Program for
                                                                 At-Risk
                                                                 Middle
                                                                 School
                                                                 Students in
                                                                 Trenton
    ------------------------------------------------------------------------
    Monetary    Kidsbri  999               $9,500     2/1/2017  Bullying
                 dge,     Lower                                  Prevention
                 Inc.     Ferry                                  and
                          Rd                                     Diversity
                          Ewing,                                 Appreciatio
                          NJ                                     n Life
                          08628                                  Skills
                                                                 Program for
                                                                 At-Risk
                                                                 Elementary/
                                                                 Middle
                                                                 School
                                                                 Students in
                                                                 Trenton
    ------------------------------------------------------------------------
    Monetary    Latin    669               $5,000   12/12/2017  FUTURO
                 Americ   Chamber
                 an       s
                 Legal    Street,
                 Defens   Suite B
                 e and    Trenton
                 Educat   , NJ
                 ional    08611
                 Fund
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Leyden   10001 W          $25,000   12/12/2017  Transitional
                 Family   Grand                                  Living
                 Servic   Ave                                    Program
                 e and    Frankli                                Expansion
                 Mental   n Park,
                 Health   IL
                 Center   60131
    ------------------------------------------------------------------------
    Monetary    LifeTie  2205              $8,000   12/18/2017  Programs to
                 s,       Penning                                Serve
                 Inc.     ton                                    Chronically
                          Road                                   Ill and
                          Ewing,                                 Abused and
                          NJ                                     Neglected
                          08638                                  Older Youth
                                                                 Transitioni
                                                                 ng Into
                                                                 Adulthood.
    ------------------------------------------------------------------------
    Monetary    Literac  100               $5,000   12/12/2017  Women
                 y New    Menlo                                  Empowered
                 Jersey   Park                                   (WE)
                 , Inc.   Drive,
                          Suite
                          314
                          Edison,
                          NJ
                          08837
    ------------------------------------------------------------------------
    Monetary    Literac  120               $4,000   12/12/2017  Health
                 y        Findern                                Literacy
                 Volunt   e                                      for All
                 eers     Avenue
                 of       Box 7
                 Somers   Bridgew
                 et       ater,
                 County   NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    Main     8                 $1,000    5/31/2017  Crisis
                 Street   Marcell                                Interventio
                 Counse   a                                      n Team
                 ling     Avenue                                 Training
                 Center   West                                   for Essex
                          Orange,                                County Law
                          NJ                                     Enforcement
                          07052
    ------------------------------------------------------------------------
    Monetary    Main     8                 $5,000    6/12/2017  Accessible
                 Street   Marcell                                Mental
                 Counse   a                                      Health Care
                 ling     Avenue                                 for
                 Center   West                                   Individuals
                          Orange,                                Suffering
                          NJ                                     From
                          07052                                  Schizoaffec
                                                                 tive
                                                                 Disorder
    ------------------------------------------------------------------------
    Monetary    Massach  15                $3,500     2/6/2017  Changing
                 usetts   Vernon                                 Minds and
                 Clubho   Street                                 Expanding
                 use      Waltham                                Employment
                 Coalit   , MA                                   Campaign
                 ion      02453
    ------------------------------------------------------------------------
    Monetary    McCarte  91               $10,000   11/20/2017  OnStage
                 r        Univers                                Seniors: A
                 Theatr   ity                                    Community
                 e        Place                                  Project of
                 Center   Princet                                McCarter
                          on, NJ                                 Theatre
                          08540
    ------------------------------------------------------------------------
    Monetary    Meals    320                 $300    9/29/2017  Costs
                 on       Hollowb                                associated
                 Wheels   rook                                   with
                 of       Drive                                  Janssen
                 Trento   Ewing,                                 Cares
                 n        NJ                                     Volunteer
                 Ewing    08638                                  Activity--O
                                                                 ctober 4,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Meals    320              $15,000    11/6/2017  Subsidized
                 on       Hollowb                                Meal
                 Wheels   rook                                   Program
                 of       Drive                                  (SMP)
                 Trento   Ewing,
                 n        NJ
                 Ewing    08638
    ------------------------------------------------------------------------
    Monetary    Mental   500              $50,000    9/21/2017  General
                 Health   Montgom                                mission
                 Americ   ery St.                                support
                 a        Suite
                          820
                          Alexand
                          ria, VA
                          22314
    ------------------------------------------------------------------------
    Monetary    Mental   500             $100,000   12/12/2017  Social Self-
                 Health   Montgom                                Directed
                 Americ   ery St.                                Care (SSDC)
                 a        Suite
                          820
                          Alexand
                          ria, VA
                          22314
    ------------------------------------------------------------------------
    Monetary    Mental   2211              $7,500   10/20/2017  Mental
                 Health   Norfolk                                Health
                 Americ   , Suite                                Advocacy
                 a of     810
                 Greate   Houston
                 r        , TX
                 Housto   77098
                 n
    ------------------------------------------------------------------------
    Monetary    Mental   2323 W           $10,000    5/24/2017  Get
                 Health   5th                                    Connected
                 Americ   Ave.
                 a of     Suite
                 Frankl   160
                 in       Columbu
                 County   s, OH
                          43204
    ------------------------------------------------------------------------
    Monetary    Mental   1210 San          $2,500    4/24/2017  Mental
                 Health   Antonio                                Health
                 Americ   , Suite                                Education
                 a of     200                                    and
                 Texas    Austin,                                Advocacy
                          TX                                     Campaign
                          78701
    ------------------------------------------------------------------------
    Monetary    Mental   100 W.            $2,000   10/13/2017  Community
                 Health   10th                                   Mental
                 Associ   St.                                    Health
                 ation    Ste.                                   Conference
                 in       600                                    2017
                 Delawa   Wilming
                 re       ton, DE
                          19801
    ------------------------------------------------------------------------
    Monetary    Mental   100 W.            $1,000    10/3/2017  E-Racing the
                 Health   10th                                   Blues for
                 Associ   St.                                    Mental
                 ation    Ste.                                   Health Run/
                 in       600                                    Walk
                 Delawa   Wilming
                 re       ton, DE
                          19801
    ------------------------------------------------------------------------
    Monetary    Mental   617               $2,500    5/31/2017  Operating
                 Health   Garden                                 Support for
                 Associ   Street                                 the
                 ation    Santa                                  Fellowship
                 in       Barbara                                Club
                 Santa    , CA
                 Barbar   93101
                 a
                 County
    ------------------------------------------------------------------------
    Monetary    Mental   3701              $7,500    5/31/2017  ParentVOICE
                 Health   Latrobe
                 Associ   Drive,
                 ation    Suite
                 of       140
                 Centra   Charlot
                 l        te, NC
                 Caroli   28211
                 nas,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Mental   580               $1,000    5/31/2017  Get On Your
                 Health   White                                  Mat For
                 Associ   Plains                                 Mental
                 ation    Road                                   Health
                 of       Suite
                 Westch   510
                 ester    Tarryto
                          wn, NY
                          10591
    ------------------------------------------------------------------------
    Monetary    Mental   3809             $12,500    8/30/2017  Outreach and
                 Illnes   Rosewoo                                Behavioral
                 s        d Drive                                Healthcare
                 Recove   P.O.                                   for
                 ry       Box                                    Homeless
                 Center   4246                                   Individuals
                 , Inc.   Columbi                                with Mental
                          a, SC                                  Illness
                          29240
    ------------------------------------------------------------------------
    Monetary    Mercer   1001             $15,000   12/19/2017  Addressing
                 Allian   Spruce                                 Young Adult
                 ce to    Street                                 Homelessnes
                 End      Suite                                  s, through
                 Homele   205                                    planning,
                 ssness   Trenton                                assertive
                          , NJ                                   engagement,
                          08638                                  housing,
                                                                 and
                                                                 healthcare
                                                                 access
    ------------------------------------------------------------------------
    Monetary    Mercer   P.O. Box          $6,500    11/6/2017  Miscellaneou
                 County   17202                                  s medical
                 Commun   Trenton                                equipment
                 ity      , NJ                                   ($1,000),
                 Colleg   08690                                  and work
                 e                                               study
                 Founda                                          student
                 tion                                            mentors
                                                                 ($3,500) to
                                                                 provide
                                                                 academic
                                                                 enrichment
                                                                 for health
                                                                 profession
                                                                 students
                                                                 success
    ------------------------------------------------------------------------
    Monetary    Mercer   3 Creek           $1,000   11/20/2017  Mercer
                 Scienc   Rim                                    Science
                 e And    Drive                                  Fair 2018
                 Engine   Titusvi
                 ering    lle, NJ
                 Club     08560
    ------------------------------------------------------------------------
    Monetary    Mercer   151                 $300    8/24/2017  Costs
                 Street   Mercer                                 associated
                 Friend   Street                                 with
                 s        Trenton                                Janssen
                          , NJ                                   Cares
                          08611                                  Volunteer
                                                                 Activity--O
                                                                 ctober 4,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Mercer   151                 $300    8/24/2017  Costs
                 Street   Mercer                                 associated
                 Friend   Street                                 with
                 s        Trenton                                Janssen
                          , NJ                                   Cares
                          08611                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 14, 2017
    ------------------------------------------------------------------------
    Monetary    Mercer   151              $25,000   10/30/2017  Mercer
                 Street   Mercer                                 Street
                 Friend   Street                                 Friends
                 s        Trenton                                Food Bank
                          , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Middle   P.O. Bos         $15,000   10/16/2017  Outreach
                 Earth    8045                                   Program and
                          520                                    Community
                          North                                  Youth
                          Bridge                                 Center
                          Street
                          Bridgew
                          ater,
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    MIDJers  423               $5,000    8/16/2017  City of
                 ey       Rivervi                                Trenton--Su
                 Center   ew                                     mmer Youth
                 for      Plaza                                  Employment
                 Econom   Trenton                                Program
                 ic       , NJ
                 Develo   08611
                 pment
    ------------------------------------------------------------------------
    Monetary    Midland  60                $6,500    8/16/2017  Midland
                 Adult    Industr                                Meals on
                 Servic   ial                                    Wheels
                 es,      Parkway                                Employment
                 Inc.     P.O.                                   Training
                          Box                                    Program
                          5026
                          North
                          Branch,
                          NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Midland  94                  $300    9/13/2017  Costs
                 Founda   Reading                                associated
                 tion     ton                                    with
                          Road                                   Janssen
                          P.O.                                   Cares
                          Box                                    Volunteer
                          5026                                   Activity--O
                          North                                  ctober 3,
                          Branch,                                2017
                          NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Millhil  101               $5,000   10/30/2017  Trenton Area
                 l        Oakland                                Stakeholder
                 Child    Street                                 s
                 and      Trenton
                 Family   , NJ
                 Develo   08618
                 pment
    ------------------------------------------------------------------------
    Monetary    Millhil  101              $15,000   10/30/2017  Millhill
                 l        Oakland                                Trenton
                 Child    Street                                 PEERS
                 and      Trenton
                 Family   , NJ
                 Develo   08618
                 pment
    ------------------------------------------------------------------------
    Monetary    Morven   55                $5,000    11/6/2017  Internships
                 Museum   Stockto                                for At-Risk
                 and      n                                      Youth
                 Garden   Street
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Mount    73 North         $15,000   10/27/2017  In Home
                 Carmel   Clinton                                Nursing
                 Guild    Avenue                                 Services
                          Trenton
                          , NJ
                          08609
    ------------------------------------------------------------------------
    Monetary    NAMI     7500              $3,000    10/4/2017  Educational
                          Greenwo                                and
                          od Ave                                 Training
                          N                                      Programs
                          Seattle
                          , WA
                          98103
    ------------------------------------------------------------------------
    Monetary    NAMI--C  1904              $2,500    8/14/2017  Education
                 VA       Byrd                                   and support
                 Centra   Avenue                                 programs
                 l        Suite                                  and
                 Virgin   207                                    HelpLine
                 ias      (POB
                 Voice    18086)
                 On       Richmon
                 Mental   d, VA
                 Illnes   23230
                 s
    ------------------------------------------------------------------------
    Monetary    NAMI     107               $5,000    8/29/2017  NAMI Ending
                 Geauga   South                                  the Silence
                 County   Street;
                          # 5
                          Chardon
                          , OH
                          44024
    ------------------------------------------------------------------------
    Monetary    NAMI     107               $2,000    8/29/2017  NAMI
                 Geauga   South                                  Connection
                 County   Street;                                and Peer-to-
                          # 5                                    Peer
                          Chardon                                Collaborati
                          , OH                                   on A Peer-
                          44024                                  led Support
                                                                 and
                                                                 Education
                                                                 Program
    ------------------------------------------------------------------------
    Monetary    NAMI     4161 NW           $1,000    5/31/2017  NAMIWalks
                 Browar   5 St.                                  Broward
                 d        Suite                                  County
                 County   203
                 , Inc.   Plantat
                          ion, FL
                          33317
    ------------------------------------------------------------------------
    Monetary    NAMI     8324              $1,000    3/20/2017  NAMI CCNS 5k
                 Cook     Skokie                                 Run/Walk
                 County   Blvd                                   2017
                 North    Skokie,
                 Suburb   IL
                 an       60077
    ------------------------------------------------------------------------
    Monetary    NAMI     2400 W.           $1,000    3/20/2017  2017
                 Delawa   4th                                    NAMIWalks
                 re       Street                                 Delaware
                          Wilming
                          ton, DE
                          19805
    ------------------------------------------------------------------------
    Monetary    NAMI     P.O. Box          $2,500    10/4/2017  Support
                 Hernan   5613                                   Services
                 do       Spring                                 and CARE
                          Hill,                                  Line
                          FL
                          34609
    ------------------------------------------------------------------------
    Monetary    NAMI     1235             $10,000   10/16/2017  Education
                 Mercer   Whiteho                                and Support
                 NJ       rse                                    Programs
                          Mercerv                                for Mental
                          ille                                   Health
                          Road                                   Consumers
                          Bldg.                                  and Family
                          C,                                     Members
                          Suite
                          303
                          Hamilto
                          n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    NAMI     1235              $2,500     3/8/2017  Silver
                 Mercer   Whiteho                                sponsor
                 NJ       rse                                    2017
                          Mercerv                                NAMIWalks
                          ille                                   Mercer
                          Road                                   County, NJ
                          Bldg.                                  May 6, 2017
                          C,
                          Suite
                          303
                          Hamilto
                          n, NJ
                          08619
    ------------------------------------------------------------------------
    Monetary    NAMI     85 N.             $1,000    10/5/2017  NAMIWalks NH
                 New      State                                  2017
                 Hampsh   Street
                 ire      Concord
                          , NH
                          03301
    ------------------------------------------------------------------------
    Monetary    NAMI     1538              $7,500    8/29/2017  1-on-1
                 New      Louisia                                Education
                 Orlean   na Ave.                                for People
                 s        New                                    Living with
                          Orleans                                Schizoaffec
                          , LA                                   tive
                          70115                                  Disorder/
                                                                 Schizophren
                                                                 ia and
                                                                 Their Loved
                                                                 Ones/
                                                                 Caregivers
    ------------------------------------------------------------------------
    Monetary    NAMI of  115               $8,000    10/3/2017  Living Room
                 DuPage   North                                  Program
                 County   County
                 Illino   Farm
                 is       Road
                          Wheaton
                          , IL
                          60187
    ------------------------------------------------------------------------
    Monetary    NAMI of  2701              $3,000   10/13/2017  Compeer
                 Johnso   Rochest                                connects
                 n        er Ave.                                with Local
                 County   Iowa                                   Businesses
                 dba      City,                                  to Increase
                 Compee   IA                                     Volunteeris
                 r of     52245                                  m and
                 Johnso                                          Visibility
                 n
                 County
    ------------------------------------------------------------------------
    Monetary    NAMI of  One               $3,000    9/29/2017  NAMI Peer-to-
                 Lake     Victori                                Peer
                 County   a Sq.,                                 Recovery
                          Ste.                                   Education
                          260                                    Program
                          Painesv
                          ille,
                          OH
                          44077
    ------------------------------------------------------------------------
    Monetary    NAMI of  One               $1,500    8/11/2017  NAMI Lake
                 Lake     Victori                                County
                 County   a Sq.,                                 Strides for
                          Ste.                                   Awareness
                          260                                    NAMI Walk
                          Painesv
                          ille,
                          OH
                          44077
    ------------------------------------------------------------------------
    Monetary    NAMI of  100 W,            $1,000    1/31/2017  Bronze
                 PA       Main                                   sponsor
                 Montgo   St.                                    NAMIWalks
                 mery     Suite                                  Greater
                 County   204                                    Philadelphi
                          Lansdal                                a May 6,
                          e, PA                                  2017
                          19446
    ------------------------------------------------------------------------
    Monetary    NAMI of  4055              $3,500    9/29/2017  Hope for
                 Southw   Executi                                Recovery
                 est      ve Park
                 Ohio     Drive,
                          Suite
                          450
                          Cincinn
                          ati, OH
                          45241
    ------------------------------------------------------------------------
    Monetary    NAMI     3037 NW           $1,000     5/9/2017  NAMI Walks
                 Oklaho   63RD,                                  Oklahoma
                 ma       SUITE
                          104W
                          Oklahom
                          a City,
                          OK
                          73116
    ------------------------------------------------------------------------
    Monetary    NAMI     1750 S.           $1,000     5/4/2017  2017
                 St.      Brentwo                                NAMIWALKS
                 Louis    od                                     St. Louis
                          Blvd.
                          Suite
                          511 St.
                          Louis,
                          MO
                          63144
    ------------------------------------------------------------------------
    Monetary    NAMI     P.O. Box          $1,000     9/7/2017  13th Annual
                 Summit   462,                                   NAMIWalks
                 County   Cuyahog                                Summit
                          a Falls                                County 2017
                          OH
                          44222
                          Akron,
                          OH
                          44311
    ------------------------------------------------------------------------
    Monetary    NAMI     5251              $1,000    5/31/2017  NAMIWalks
                 Ventur   Verdugo                                event in
                 a        Way, #K                                Ventura
                 County   P.O.                                   County, CA
                          Box
                          1613
                          Camaril
                          lo, CA
                          93011
    ------------------------------------------------------------------------
    Monetary    NAMI     217               $1,000    8/30/2017  NAMIWalks
                 Waukes   Wiscons                                Waukesha
                 ha       in Ave
                          Suite
                          300
                          Waukesh
                          a, WI
                          53186
    ------------------------------------------------------------------------
    Monetary    NAMI     217               $1,000    8/11/2017  Crisis
                 Waukes   Wiscons                                Interventio
                 ha       in Ave                                 n Training
                          Suite                                  for Law
                          300                                    Enforcement
                          Waukesh
                          a, WI
                          53186
    ------------------------------------------------------------------------
    Monetary    Nationa  1851              $2,500    5/31/2017  2017 NAMI
                 l        Heritag                                California
                 Allian   e Way,                                 Annual
                 ce for   Suite                                  Conference
                 the      150
                 Mental   Sacrame
                 ly Ill   nto, CA
                          95815
    ------------------------------------------------------------------------
    Monetary    Nationa  576               $1,500    3/20/2017  2017 NAMI
                 l        Farming                                Connecticut
                 Allian   ton                                    Walk
                 ce for   Avenue
                 the      Hartfor
                 Mental   d, CT
                 ly Ill   06105
    ------------------------------------------------------------------------
    Monetary    Nationa  5095              $1,000    3/20/2017  NAMIWalks/
                 l        Murphy                                 Run San
                 Allian   Canyon                                 Diego
                 ce for   Road,                                  County
                 the      Suite
                 Mental   320 San
                 ly Ill   Diego,
                          CA
                          92123
    ------------------------------------------------------------------------
    Monetary    Nationa  1562              $1,000    1/31/2017  Bronze
                 l        Route                                  sponsor
                 Allian   130                                    2017
                 ce for   North                                  NAMIWalks
                 the      Brunswi                                New Jersey
                 Mental   ck, NJ                                 ``Building
                 ly Ill   08902                                  Better
                                                                 Lives''--Ma
                                                                 y 13, 2017
    ------------------------------------------------------------------------
    Monetary    Nationa  800               $3,500    8/29/2017  Project ADD
                 l        Transfe                                Advocating
                 Allian   r Road                                 for Dual
                 ce for   #31 St.                                Diagnosis
                 the      Paul,
                 Mental   MN
                 ly Ill   55114
    ------------------------------------------------------------------------
    Monetary    Nationa  3440              $1,000    4/21/2017  NAMIWalks
                 l        Viking                                 Northern
                 Allian   Drive,                                 California
                 ce for   Suite
                 the      104A
                 Mental   Sacrame
                 ly Ill   nto, CA
                          95827
    ------------------------------------------------------------------------
    Monetary    Nationa  PO Box            $1,000    8/29/2017  NAMI
                 l        550039                                 Birmingham
                 Allian   Birming                                2017 Walk
                 ce for   ham, AL                                for Mental
                 the      35255-                                 Health
                 Mental   0039
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $50,000    10/3/2017  General
                 l        Fairfax                                mission
                 Allian   Drive                                  support
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  1801 W            $8,000   11/16/2017  Honest,
                 l        Warner                                 Open,
                 Allian   Ave,                                   Proud:
                 ce for   Suite                                  Addressing
                 the      202                                    Stigma
                 Mental   Chicago                                Among the
                 ly Ill   , IL                                   Incarcerate
                          60613                                  d
                                                                 Population
    ------------------------------------------------------------------------
    Monetary    Nationa  1562,             $2,500   10/13/2017  Annual
                 l        Route                                  Conference-
                 Allian   130                                    -Honoring
                 ce for   North                                  The Past,
                 the      Brunswi                                Embracing
                 Mental   ck, NJ                                 The
                 ly Ill   08902                                  Present,
                                                                 Looking To
                                                                 The Future
    ------------------------------------------------------------------------
    Monetary    Nationa  3200 S.           $1,000    1/31/2017  Bronze
                 l        3rd                                    sponsor
                 Allian   Street,                                2017 NAMI
                 ce for   Unit 6                                 Walk of
                 the      Milwauk                                Greater
                 Mental   ee, WI                                 Milwaukee--
                 ly Ill   53207                                  May 20,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Nationa  218 West          $5,000   10/19/2017  NAMI
                 l        Lawrenc                                Illinois--G
                 Allian   e                                      rassroots
                 ce for   Springf                                Advocacy
                 the      ield,                                  Capacity
                 Mental   IL                                     Project
                 ly Ill   62704
    ------------------------------------------------------------------------
    Monetary    Nationa  P.O. Box          $1,000   10/11/2017  Mental
                 l        4096                                   Health
                 Allian   Alvin,                                 Education
                 ce for   TX                                     Conference-
                 the      77512                                  -May 2018
                 Mental
                 ly Ill
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $75,000   12/18/2017  NAMI 2018
                 l        Fairfax                                CIT/
                 Allian   Drive                                  Criminal
                 ce for   Suite                                  Justice
                 the      100                                    Enhancement
                 Mental   Arlingt                                Initiative
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  3803 N.          $50,000   12/18/2017  NAMI
                 l        Fairfax                                HelpLine
                 Allian   Drive                                  2018
                 ce for   Suite
                 the      100
                 Mental   Arlingt
                 ly Ill   on, VA
                          22203
    ------------------------------------------------------------------------
    Monetary    Nationa  99 Pine           $5,000   10/27/2017  Intervention
                 l        St.                                    ,
                 Allian   Suite                                  Engagement,
                 ce for   105                                    Implementat
                 the      Albany,                                ion: Three
                 Mental   NY                                     Pronged
                 ly Ill   12207                                  Approach to
                                                                 Sustainable
                                                                 Mental
                                                                 Health
                                                                 Recovery
    ------------------------------------------------------------------------
    Monetary    Nationa  P.O. Box          $1,000   10/19/2017  12th Annual
                 l        24128                                  NAMI
                 Allian   117                                    Lowcountry
                 ce for   William                                Walk
                 the      Hilton
                 Mental   Parkway
                 ly Ill   , Suite
                          K
                          Hilton
                          Head
                          Island,
                          SC
                          29925
    ------------------------------------------------------------------------
    Monetary    Nationa  4701 SE           $2,500    8/23/2017  NAMI Oregon
                 l        24th                                   Mental
                 Allian   Ave.,                                  Health
                 ce for   Suite E                                Education
                 the      Portlan                                and Support
                 Mental   d, OR                                  Programs
                 ly Ill   97202                                  for
                                                                 Recovery
                                                                 and
                                                                 Wellness
    ------------------------------------------------------------------------
    Monetary    Nationa  10630             $1,000     5/9/2017  2017 NAMI
                 l        Little                                 Walks
                 Allian   Patuxen                                Maryland
                 ce for   t
                 the      Parkway
                 Mental   Columbi
                 ly Ill   a, MD
                          21044
    ------------------------------------------------------------------------
    Monetary    Nationa  2059              $2,000    5/31/2017  Dane County
                 l        Atwood                                 Crisis
                 Allian   Ave,                                   Interventio
                 ce for   Floor 4                                n Team
                 the      Madison                                (CIT)
                 Mental   , WI                                   Program
                 ly Ill   53704
    ------------------------------------------------------------------------
    Monetary    Nationa  2059              $1,000    5/31/2017  NAMIWalks
                 l        Atwood                                 Dane County
                 Allian   Ave,                                   2017
                 ce for   Floor 4
                 the      Madison
                 Mental   , WI
                 ly Ill   53704
    ------------------------------------------------------------------------
    Monetary    Nationa  309 West          $1,000     5/5/2017  NAMI Walks
                 l        Millbro                                North
                 Allian   ok Rd,                                 Carolina
                 ce for   Suite
                 the      121
                 Mental   Raleigh
                 ly Ill   , NC
                          27609
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $5,000    8/29/2017  Mental
                 l        West                                   Illness
                 Allian   25th                                   Peer
                 ce for   Street,                                Support and
                 the      #600                                   Education
                 Mental   Clevela
                 ly       nd, OH
                 Ill--G   44113
                 reater
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  2012              $1,000    8/29/2017  NAMIWalks
                 l        West                                   2017
                 Allian   25th
                 ce for   Street,
                 the      #600
                 Mental   Clevela
                 ly       nd, OH
                 Ill--G   44113
                 reater
                 Clevel
                 and
    ------------------------------------------------------------------------
    Monetary    Nationa  505 8th           $1,000     5/4/2017  NAMIWalks
                 l        Avenue,                                NYC 2017
                 Allian   Ste.                                   Walk/Run
                 ce for   1103                                   for Mental
                 the      New                                    Health
                 Mental   York,
                 ly Ill   NY
                 of New   10018
                 York
                 City
    ------------------------------------------------------------------------
    Monetary    Nationa  154               $1,000    10/2/2017  NAMIWalks
                 l        Waterma                                Rhode
                 Allian   n St.,                                 Island 2017
                 ce of    Suite
                 Mental   5B
                 Illnes   Provide
                 s        nce, RI
                          02906
    ------------------------------------------------------------------------
    Monetary    Nationa  5963              $1,000    8/11/2017  NAMIWalks
                 l        Boymel                                 Butler
                 Allian   Dr.                                    County
                 ce on    Fairfie
                 Mental   ld, OH
                 Illnes   45014
                 s
    ------------------------------------------------------------------------
    Monetary    Nationa  P.O. Box          $6,000    4/21/2017  General
                 l Art    350891                                 mission
                 Exhibi   Miami,                                 support
                 tions    FL
                 of the   33135
                 Mental
                 ly
                 Ill,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  8321 Old         $30,000   12/28/2017  TakeIt2Heart
                 l        Courtho                                TM--An e-
                 Blood    use Rd.                                Health
                 Clot     Suite                                  Anticoagula
                 Allian   255 110                                tion
                 ce       N.                                     Management
                          Washing                                Education
                          ton                                    Program
                          St.,                                   Focused on
                          Suite                                  AFib
                          255                                    Awareness
                          Rockvil                                and
                          le, MD                                 Lifestyle
                          20850                                  Issues
                          Vienna,                                Encountered
                          VA                                     by AFib
                          22182                                  Patients
                                                                 and their
                                                                 Non-Medical
                                                                 Caregivers
    ------------------------------------------------------------------------
    Monetary    Nationa  1100             $10,000   10/25/2017  2017 Science
                 l        17th                                   and
                 Coalit   Street,                                Leadership
                 ion      NW                                     Symposium
                 for      Suite
                 Women    500
                 with     Washing
                 Heart    ton, DC
                 Diseas   20036
                 e,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $85,000   12/18/2017  Medication
                 l        Street                                 Adherence
                 Counci   NW                                     Learning
                 l for    Washing                                Community
                 Behavi   ton, DC
                 oral     20005
                 Health
    ------------------------------------------------------------------------
    Monetary    Nationa  1400 K           $85,000   12/18/2017  Policy
                 l        Street                                 Action
                 Counci   NW                                     Center
                 l for    Washing
                 Behavi   ton, DC
                 oral     20005
                 Health
    ------------------------------------------------------------------------
    Monetary    Nationa  949 West          $7,500    12/4/2017  ACE and STEM
                 l        State                                  Program,
                 Junior   St.                                    plus tennis
                 Tennis   Trenton
                 and      , NJ
                 Learni   08618
                 ng of
                 Trento
                 n
    ------------------------------------------------------------------------
    Monetary    Nationa  9707 E           $25,000   12/22/2017  National
                 l        Easter                                 Stroke
                 Stroke   Lane,                                  Awareness
                 Associ   Suite B                                Month
                 ation    Centenn
                          ial, CO
                          80112
    ------------------------------------------------------------------------
    Monetary    New      275 Rt.           $4,000    5/24/2017  NJPC
                 Jersey   10 East                                Professiona
                 Parent   Suite                                  l Parent
                 s        220-414                                Advocacy
                 Caucus   Succasu                                Training
                          nna, NJ
                          07876
    ------------------------------------------------------------------------
    Monetary    North    368              $10,000   12/22/2017  NATF Spring
                 Americ   Boylsto                                Patient
                 an       n St.                                  Program
                 Thromb   Brookli
                 osis     ne, MA
                 Forum    02445
    ------------------------------------------------------------------------
    Monetary    North    368              $20,000   12/22/2017  VTE Support
                 Americ   Boylsto                                Group
                 an       n St.                                  Project
                 Thromb   Brookli
                 osis     ne, MA
                 Forum    02445
    ------------------------------------------------------------------------
    Monetary    Northea  2900              $2,500     4/4/2017  Day of
                 st       Conner                                 Restoration
                 Guidan   Avenue,
                 ce       Buildin
                 Center   g A
                          Detroit
                          , MI
                          48215
    ------------------------------------------------------------------------
    Monetary    Passage  P.O. Box          $7,500    12/4/2017  Support for
                 Theatr   967                                    Passage
                 e        Trenton                                Theatre's
                 Compan   , NJ                                   Education
                 y,       08605                                  programming
                 Inc.                                            the State
                                                                 Street
                                                                 Project
    ------------------------------------------------------------------------
    Monetary    Peggie   93                   $75     3/9/2017  Employee
                 and      Patrici                                directed
                 Paul     a Place                                donation in
                 Shevli   Media,                                 lieu of
                 n        PA                                     company
                 Family   19063                                  holiday
                 Founda                                          gift
                 tion
    ------------------------------------------------------------------------
    Monetary    PEI      231              $17,500   10/16/2017  Comprehensiv
                 Kids     Lawrenc                                e Juvenile
                          e Road                                 Offenders
                          Lawrenc                                Outreach
                          eville,                                Services
                          NJ                                     (CJOOS)
                          08648                                  Program
    ------------------------------------------------------------------------
    Monetary    PEI      231                 $300    9/29/2017  Costs
                 Kids     Lawrenc                                associated
                          e Road                                 with
                          Lawrenc                                Janssen
                          eville,                                Cares
                          NJ                                     Volunteer
                          08648                                  Activity--O
                                                                 ctober 13,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    People   295               $2,500    12/5/2017  Reading
                 And      Eggerts                                Deeply in
                 Storie   Crossin                                Community:
                 s--Gen   g Road                                 A
                 te Y     Lawrenc                                Literature
                 Cuento   eville,                                Project for
                 s,       NJ                                     Mercer
                 Inc.     08648                                  County
                                                                 Youth and
                                                                 Seniors
    ------------------------------------------------------------------------
    Monetary    PlanSma  118 West          $3,500     3/8/2017  2017
                 rt NJ    State                                  Corporate
                          PlanSma                                membership
                          rt NJ                                  renewal
                          Trenton                                donation to
                          , NJ                                   support
                          08608                                  efforts
                                                                 around
                                                                 sound land
                                                                 use
                                                                 planning
    ------------------------------------------------------------------------
    Monetary    Princet  P.O. Box          $2,500    12/4/2017  Afterschool
                 on       134 190                                Music
                 Girl     Nassau                                 Outreach
                 Choir    Street                                 Program
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    Princet  45                $4,000   12/12/2017  Supporting
                 on       Stockto                                Family
                 Senior   n St                                   Caregivers
                 Resour   Princet
                 ce       on, NJ
                 Center   08540
    ------------------------------------------------------------------------
    Monetary    Princet  P.O. Box          $4,000   12/12/2017  PSO BRAVO!
                 on       250,                                   TRENTON
                 Sympho   575                                    Youth
                 ny       Ewing                                  Education
                 Orches   Street                                 Initiative
                 tra      Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Princet  13                $7,500    12/5/2017  Summer
                 on-      Roszel                                 Bridge
                 Blairs   Road                                   2018--Trent
                 town     Suite                                  on
                 Center   C204A
                 , Inc.   Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Printma  440              $15,000   12/18/2017  Combat Paper
                 king     River                                  NJ
                 Center   Road
                 of New   Branchb
                 Jersey   urg, NJ
                          08876
    ------------------------------------------------------------------------
    Monetary    Public   825               $7,500    7/25/2017  NJTV's In
                 Media    Eighth                                 Your
                 NJ,      Avenue                                 Neighborhoo
                 Inc.     New                                    d Trenton
                          York,
                          NY
                          10019
    ------------------------------------------------------------------------
    Monetary    Rainier  12020               $750    4/20/2017  Employee
                 Therap   123rd                                  directed
                 eutic    Ave. SE                                donation in
                 Riding   Rainier                                lieu of
                          Rainier                                company
                          , WA                                   holiday
                          98576                                  gift
    ------------------------------------------------------------------------
    Monetary    Raritan  P.O. Box          $7,000    12/5/2017  WaterWays
                 Headwa   273                                    Environment
                 ters     Gladsto                                al
                 Associ   ne, NJ                                 Education
                 ation    07934                                  Program
    ------------------------------------------------------------------------
    Monetary    Raritan  118              $20,000   10/30/2017  Nursing
                 Valley   Lamingt                                Scholarship
                 Commun   on Rd.                                 s
                 ity      Branchb                                ($12,500);
                 Colleg   urg, NJ                                Galileo
                 e        08876                                  Scholars
                                                                 Program
                                                                 ($5,000);
                                                                 Textbook
                                                                 Scholarship
                                                                 s ($2,500)
    ------------------------------------------------------------------------
    Monetary    Regions  640              $15,000    5/24/2017  Make It OK
                 Hospit   Jackson
                 al       Street,
                 Founda   MS
                 tion     11202C
                          St.
                          Paul,
                          MN
                          55101
    ------------------------------------------------------------------------
    Monetary    Rescue   98               $25,000   10/16/2017  Emergency
                 Missio   Carroll                                Services
                 n of     Street                                 Program
                 Trento   P.O.
                 n        Box 790
                          Trenton
                          , NJ
                          08605-
                          0790
    ------------------------------------------------------------------------
    Monetary    Rider    2083             $19,500   10/30/2017  Summer STEM
                 Univer   Lawrenc                                ($12,000);
                 sity     eville                                 Scholarship
                          Rd.                                    Support
                          Lawrenc                                ($5,000);
                          eville,                                Shakespeari
                          NJ                                     an at Rider
                          08648                                  ($2,500)
    ------------------------------------------------------------------------
    Monetary    Riverbe  P.O. Box          $5,000    8/14/2017  InSHAPE
                 nd       2032                                   Program
                 Commun   Concord
                 ity      , NH
                 Mental   03302-
                 Health   2032
                 , Inc.
    ------------------------------------------------------------------------
    Monetary    Riversi  P.O. Box         $10,000    12/4/2017  Riverside
                 de       650                                    Symphonia
                 Sympho   Lambert                                Senior
                 nia,     ville,                                 Outreach
                 Inc.     NJ                                     Program
                          08530
    ------------------------------------------------------------------------
    Monetary    Robert   One               $8,500   12/18/2017  Girls to
                 Wood     Hamilto                                Women: Myth
                 Johnso   n                                      vs. Reality
                 n        Health
                 Hamilt   Place
                 on       Hamilto
                 Founda   n, NJ
                 tion     08690
    ------------------------------------------------------------------------
    Monetary    Rush     2000              $2,500   10/16/2017  Fox Valley
                 Copley   Ogden                                  Heart Fund
                 Founda   Ave.
                 tion     Aurora,
                          IL
                          60504
    ------------------------------------------------------------------------
    Monetary    Rutgers  7                   $300    9/29/2017  Costs
                 Univer   College                                associated
                 sity     Avenue                                 with
                 Founda   Winants                                Janssen
                 tion     Hall                                   Cares
                          New                                    Volunteer
                          Brunswi                                Activity--S
                          ck, NJ                                 eptember
                          08901                                  20, 2017
    ------------------------------------------------------------------------
    Monetary    Rutgers  4                 $8,546   12/18/2017  Corporate
                 Univer   Hunting                                Social
                 sity     ton                                    Responsibil
                 School   Street                                 ity
                 of       New                                    Fellowship
                 Commun   Brunswi
                 icatio   ck, NJ
                 n,       08901-1
                 Inform   071
                 ation
                 and
                 Librar
                 y
                 Studie
                 s
    ------------------------------------------------------------------------
    Monetary    SAFE in  46 East             $300    9/29/2017  Costs
                 Hunter   Main                                   associated
                 don      Street                                 with
                          Fleming                                Janssen
                          ton, NJ                                Cares
                          08822                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 19, 2017
    ------------------------------------------------------------------------
    Monetary    SAFE in  46 East             $300    9/29/2017  Costs
                 Hunter   Main                                   associated
                 don      Street                                 with
                          Fleming                                Janssen
                          ton, NJ                                Cares
                          08822                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 18, 2017
    ------------------------------------------------------------------------
    Monetary    San      P.O. Box          $5,000    8/15/2017  Behavioral
                 Franci   410836                                 Health
                 sco      San                                    Court's
                 Genera   Francis                                Motivationa
                 l        co, CA                                 l
                 Hospit   94110                                  Incentives
                 al                                              Program
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    SAVE A   900                 $300    9/29/2017  Costs
                 Friend   Herront                                associated
                 to       own                                    with
                 Homele   Road                                   Janssen
                 ss       Princet                                Cares
                 Animal   on NJ                                  Volunteer
                 s        08540                                  Activity--S
                                                                 eptember
                                                                 22, 2017
    ------------------------------------------------------------------------
    Monetary    Schizop  P.O. Box         $15,000   12/12/2017  HVoS
                 hrenia   94122                                  (Hearing
                 And      Houston                                Voices of
                 Relate   , TX                                   Support)
                 d        77094                                  Perception
                 Disord                                          Changing
                 ers                                             Experientia
                 Allian                                          l
                 ce Of                                           Installatio
                 Americ                                          n and
                 a                                               Scientific
                                                                 Briefing
    ------------------------------------------------------------------------
    Monetary    SERV     20                $5,000   10/16/2017  SERV 15th
                 Founda   Scotch                                 Annual
                 tion,    Road                                   Wellness
                 Inc.     Ewing,                                 and
                          NJ                                     Development
                          08628                                  Conference
    ------------------------------------------------------------------------
    Monetary    SERV     20                $7,500   10/16/2017  SERV
                 Founda   Scotch                                 Foundation
                 tion,    Road                                   Scholarship
                 Inc.     Ewing,                                 Fund
                          NJ
                          08628
    ------------------------------------------------------------------------
    Monetary    SERV     20                  $300    8/24/2017  Costs
                 Founda   Scotch                                 associated
                 tion,    Road                                   with
                 Inc.     Ewing,                                 Janssen
                          NJ                                     Cares
                          08628                                  Volunteer
                                                                 Activity--A
                                                                 ugust 20,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Shannon  36                  $500    12/5/2017  Shannon
                 Daley    Indian                                 Daley
                 Memori   Run                                    Memorial
                 al       P.O.                                   Fund
                 Fund     Box                                    Charity
                          1271                                   Events
                          Whiteho
                          use
                          Station
                          , NJ
                          08889
    ------------------------------------------------------------------------
    Monetary    The      1920              $2,500    8/14/2017  1920 Club
                 Sharin   10th                                   Art Program
                 g        Avenue
                 Place,   South
                 Inc.     P.O.
                          Box
                          59455
                          Birming
                          ham, AL
                          35255
    ------------------------------------------------------------------------
    Monetary    Sisters  1201              $5,000   10/30/2017  Pearl Grace
                 Networ   Hamilto                                Memorial
                 k of     n                                      Golf
                 Centra   Street                                 Tournament
                 l New    Somerse
                 Jersey   t, NJ
                          08873
    ------------------------------------------------------------------------
    Monetary    Somerse  190 Lord            $300    8/24/2017  Costs
                 t        Stirlin                                associated
                 County   g Road                                 with
                 Park     Basking                                Janssen
                 Founda   Ridge,                                 Cares
                 tion     NJ                                     Volunteer
                          07920                                  Activity--S
                                                                 eptember
                                                                 15, 2017
    ------------------------------------------------------------------------
    Monetary    Special  1 Eunice          $7,500   12/12/2017  Special
                 Olympi   Kennedy                                Olympics
                 cs New   Shriver                                New Jersey--
                 Jersey   Way                                    Camp
                          Lawrenc                                Shriver
                          e
                          Townshi
                          p, NJ
                          08648
    ------------------------------------------------------------------------
    Monetary    St.      One              $20,000    12/4/2017  Providing
                 Mary     Summit                                 Food for
                 Medica   Square,                                Underserved
                 l        Suite                                  Children in
                 Center   300                                    Bucks
                 Founda   1717                                   County: The
                 tion     Langhor                                St. Mary
                          ne-                                    Backpacks
                          Newtown                                for Kids
                          Rd.                                    Program
                          Langhor
                          ne, PA
                          19047
    ------------------------------------------------------------------------
    Monetary    Stony    31 Titus         $15,000   12/18/2017  StreamWatch:
                 Brook    Mill                                   Citizen
                 Millst   Road                                   Scientists
                 one      Penning                                Monitoring
                 Waters   ton, NJ                                Water
                 hed      08534                                  Quality in
                 Associ                                          Central New
                 ation                                           Jersey
    ------------------------------------------------------------------------
    Monetary    TASK,    72\1/2\          $25,000   10/30/2017  Meal Service
                 Inc.     Escher                                 Program
                          Street
                          Trenton
                          , NJ
                          08609
    ------------------------------------------------------------------------
    Monetary    The Arc  180               $5,000   12/18/2017  The Arc
                 Mercer   Ewingvi                                Mercer and
                          lle                                    Medina
                          Road                                   Community
                          Ewing,                                 Clinic
                          NJ
                          08683
    ------------------------------------------------------------------------
    Monetary    The      Paul              $5,000   10/27/2017  Communiversi
                 Arts     Robeson                                ty ArtsFest
                 Counci   Center                                 2018
                 l of     for the
                 Prince   Arts
                 ton      102
                          Withers
                          poon
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      Paul             $10,000   10/27/2017  Arts Council
                 Arts     Robeson                                of
                 Counci   Center                                 Princeton
                 l of     for the                                Community
                 Prince   Arts                                   Outreach
                 ton      102                                    Programs
                          Withers
                          poon
                          Street
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      Paul                $300    9/29/2017  Costs
                 Arts     Robeson                                associated
                 Counci   Center                                 with
                 l of     for the                                Janssen
                 Prince   Arts                                   Cares
                 ton      102                                    Volunteer
                          Withers                                Activity--S
                          poon                                   eptember
                          Street                                 11, 2017
                          Princet
                          on, NJ
                          08542
    ------------------------------------------------------------------------
    Monetary    The      2020              $2,000    11/6/2017  Art Classes
                 Center   Burnt                                  for
                 for      Mills                                  Children
                 Contem   Road                                   with Autism
                 porary   Bedmins                                Spectrum
                 Art      ter, NJ                                Disorder
                          07882                                  and Other
                                                                 Special
                                                                 Needs
    ------------------------------------------------------------------------
    Monetary    The      19B                 $300    8/24/2017  Costs
                 Center   Dellwoo                                associated
                 For      d Lane                                 with
                 Great    Somerse                                Janssen
                 Expect   t, NJ                                  Cares
                 ations   08873                                  Volunteer
                                                                 Activity--S
                                                                 eptember
                                                                 19, 2017
    ------------------------------------------------------------------------
    Monetary    The      19B              $12,000    9/15/2017  Adult
                 Center   Dellwoo                                Women's
                 For      d Lane                                 Program
                 Great    Somerse
                 Expect   t, NJ
                 ations   08873
    ------------------------------------------------------------------------
    Monetary    The      205               $7,500   10/30/2017  The Edinburg
                 Edinbu   Burling                                Center Jail
                 rg       ton                                    Diversion
                 Center   Road                                   Program
                          Lexingt
                          on, MA
                          01730
    ------------------------------------------------------------------------
    Monetary    The      401               $1,000     5/4/2017  8th Annual
                 Mental   Cypress                                Run/Walk
                 Health   Street                                 for Mental
                 Center   Manches                                Health
                 Of       ter, NH
                 Greate   03103
                 r
                 Manche
                 ster
    ------------------------------------------------------------------------
    Monetary    The      400                 $300    9/29/2017  Costs
                 Pennsb   Pennsbu                                associated
                 ury      ry                                     with
                 Societ   Memoria                                Janssen
                 y        l Rd.                                  Cares
                          Morrisv                                Volunteer
                          ille,                                  Activity--S
                          PA                                     eptember
                          19067                                  25, 2017
    ------------------------------------------------------------------------
    Monetary    The      P.O. Box          $9,000    12/5/2017  Opera for
                 Prince   2063                                   All
                 ton      Princet
                 Festiv   on, NJ
                 al       08543
    ------------------------------------------------------------------------
    Monetary    The      243               $5,000   12/14/2017  Sensory
                 Roxey    North                                  Friendly
                 Ballet   Union                                  Performance
                 Compan   Street                                 s at
                 y,       Lambert                                Trenton
                 Inc.     ville,                                 Psychiatric
                          NJ                                     Hospital
                          08530                                  and The
                                                                 College of
                                                                 New Jersey
    ------------------------------------------------------------------------
    Monetary    The      4101             $20,000    9/26/2017  MindStrong
                 Thresh   North
                 olds     Ravensw
                          ood
                          Avenue
                          Chicago
                          , IL
                          60613
    ------------------------------------------------------------------------
    Monetary    The      100              $10,000    8/30/2017  Farm Based
                 Willia   Gould                                  Psychiatric
                 m J.     Road                                   Rehabilitat
                 Gould    P.O.                                   ion and
                 Associ   Box 157                                Recovery
                 ates,    Montere
                 Inc.     y, MA
                          01245
    ------------------------------------------------------------------------
    Monetary    Thomas   111 West         $15,000   12/18/2017  Scholarships
                 Edison   State                                  for Nursing
                 State    Street                                 Students
                 Colleg   Trenton                                Enrolled in
                 e        , NJ                                   the
                 Founda   08608                                  Accelerated
                 tion                                            Second
                                                                 Degree BSN
                                                                 Program at
                                                                 the W. Cary
                                                                 Edwards
                                                                 School of
                                                                 Nursing at
                                                                 Thomas
                                                                 Edison
                                                                 State
                                                                 University.
    ------------------------------------------------------------------------
    Monetary    TPTO     51 South          $1,500   10/30/2017  2018
                 Inc--T   Timberl                                Timberlane
                 imberl   ane                                    Science and
                 ane      Drive                                  Engineering
                 Parent   Penning                                Fair
                 Teache   ton, NJ
                 r        08534
                 Organi
                 zation
    ------------------------------------------------------------------------
    Monetary    Trenton  471               $7,500   12/18/2017  Trenton
                 Childr   Parkway                                Children's
                 en's     Avenue                                 Chorus
                 Chorus   Trenton
                 , Inc.   , NJ
                          08618
    ------------------------------------------------------------------------
    Monetary    Trenton  P.O. Box          $8,500    11/6/2017  Second
                 Commun   5206                                   Semester
                 ity      Trenton                                Programs,
                 Music    , NJ                                   Trenton
                 School   08638                                  Music
                                                                 Makers
    ------------------------------------------------------------------------
    Monetary    Trenton  635               $5,000    12/4/2017  Trenton
                 Educat   South                                  Education
                 ion      Clinton                                Dance
                 Dance    Avenue                                 Institute
                 Instit   Trenton                                (TEDI)
                 ute      , NJ
                          08611
    ------------------------------------------------------------------------
    Monetary    Trenton  218              $19,000   10/27/2017  Wheels to
                 Health   North                                  Wellness
                 Team     Broad
                 Inc.     Street
                          Trenton
                          , NJ
                          08608
    ------------------------------------------------------------------------
    Monetary    Trinity  22                $7,500   10/30/2017  TCS General
                 Counse   Stockto                                Counseling
                 ling     n                                      and
                 Servic   Street                                 Prevention
                 es       Princet                                Programming
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Tuscalo  P.O. Box          $1,000     5/4/2017  Hot Hundred
                 osa      2322                                   2017
                 Mental   Tuscalo
                 Health   osa, AL
                 Allian   35403
                 ce
    ------------------------------------------------------------------------
    Monetary    Twiligh  P.O. Box          $7,500   10/30/2017  Simple Needs
                 t Wish   1042                                   Wish
                 Founda   Doylest                                Granting
                 tion     own, PA                                Program
                          18901
    ------------------------------------------------------------------------
    Monetary    UIH      4 North          $10,000   12/18/2017  Healthy
                 Family   Broad                                  Relationshi
                 Partne   Street                                 ps, Healthy
                 rs       Suite                                  Choices
                          2R
                          Trenton
                          , NJ
                          08608
    ------------------------------------------------------------------------
    Monetary    UIH      4 North          $20,000   12/18/2017  Community of
                 Family   Broad                                  Health for
                 Partne   Street                                 Men, Year 4
                 rs       Suite
                          2R
                          Trenton
                          , NJ
                          08608
    ------------------------------------------------------------------------
    Monetary    United   60 Park           $7,500   10/30/2017  UNCF
                 Negro    Place                                  Scholarship
                 Colleg   Suite
                 e Fund   406
                          Newark,
                          NJ
                          07102
    ------------------------------------------------------------------------
    Monetary    United   413 Hood         $85,000    9/29/2017  Fresh
                 Way of   Blvd                                   Connect
                 Bucks    Fairles                                program
                 County   s
                          Hills,
                          PA
                          19030
    ------------------------------------------------------------------------
    Monetary    United   413 Hood         $42,500    9/29/2017  Emergency
                 Way of   Blvd                                   Needs
                 Bucks    Fairles                                program
                 County   s
                          Hills,
                          PA
                          19030
    ------------------------------------------------------------------------
    Monetary    United   3150             $85,000   10/30/2017  United Way
                 Way of   Brunswi                                of Greater
                 Greate   ck Pike                                Mercer
                 r        Suite                                  County
                 Mercer   230                                    Minority
                 County   Lawrenc                                and
                          eville,                                Multicultur
                          NJ                                     al Health
                          08648                                  Initiative
    ------------------------------------------------------------------------
    Monetary    United   3150                $920    12/4/2017  Costs
                 Way of   Brunswi                                associated
                 Greate   ck Pike                                with
                 r        Suite                                  Janssen
                 Mercer   230                                    Cares
                 County   Lawrenc                                Volunteer
                          eville,                                Activity--S
                          NJ                                     eptember
                          08648                                  26, 2017
    ------------------------------------------------------------------------
    Monetary    UrbanPr  801 West          $2,770   12/12/2017  Mindfulness
                 omise    State                                  Pilot
                 Intern   Street                                 Program
                 ationa   Trenton
                 l,       , NJ
                 Inc.     08618
    ------------------------------------------------------------------------
    Monetary    Valeo    5401 SW           $3,500    9/19/2017  Vocational
                 Behavi   7th                                    Empowerment
                 oral     Street                                 Photovoice
                 Health   Topeka,
                 Care,    KS
                 Inc.     66606
    ------------------------------------------------------------------------
    Monetary    Visions  49                $7,500   12/12/2017  Street-Smart
                 and      Brahma                                 HIV/AIDS
                 Pathwa   Ave.
                 ys       Bridgew
                          ater,
                          NJ
                          08807
    ------------------------------------------------------------------------
    Monetary    Visions  49                  $300    11/6/2017  Costs
                 and      Brahma                                 associated
                 Pathwa   Ave.                                   with
                 ys       Bridgew                                Janssen
                          ater,                                  Cares
                          NJ                                     Volunteer
                          08807                                  Activity
    ------------------------------------------------------------------------
    Monetary    Volunte  12                $9,000    12/1/2017  SkillsConnec
                 er       Stockto                                t
                 Connec   n
                 t        Street
                          Princet
                          on, NJ
                          08540
    ------------------------------------------------------------------------
    Monetary    Washing  P.O. Box            $750   10/16/2017  Revolutionar
                 ton      83                                     y War
                 Crossi   Titusvi                                Weekend
                 ng       lle, NJ
                 Park     08560
                 Associ
                 ation,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    We Care  3035              $1,500    5/31/2017  ArtWORK
                 Arts     Wilming
                          ton
                          Pike
                          Ketteri
                          ng, OH
                          45429
    ------------------------------------------------------------------------
    Monetary    West     P.O. Box          $5,000    12/5/2017  Excellence
                 Windso   280                                    in
                 r        West                                   Education,
                 Plains   Windsor                                and
                 boro     , NJ                                   Innovation
                 Educat   08550                                  Fair 2018
                 ion
                 Founda
                 tion
    ------------------------------------------------------------------------
    Monetary    Westmor  100                  $75    3/22/2017  Employee
                 eland    Devonsh                                directed
                 County   ire                                    donation in
                 Food     Drive                                  lieu of
                 Bank,    Delmont                                company
                 Inc.     , PA                                   holiday
                          15626-                                 gift
                          1607
    ------------------------------------------------------------------------
    Monetary    Womansp  1530              $7,500    12/5/2017  Safe House
                 ace      Brunswi                                (Emergency
                          ck Ave.                                Shelter)
                          Lawrenc                                and
                          eville,                                Barbara's
                          NJ                                     House
                          08648                                  (Transition
                                                                 al
                                                                 Housing):
                                                                 Supporting
                                                                 Women and
                                                                 Children
                                                                 Impacted by
                                                                 Domestic
                                                                 Violence
    ------------------------------------------------------------------------
    Monetary    Womansp  1530                $300    9/29/2017  Costs
                 ace      Brunswi                                associated
                          ck Ave.                                with
                          Lawrenc                                Janssen
                          eville,                                Cares
                          NJ                                     Volunteer
                          08648                                  Activity--O
                                                                 ctober 2,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Womansp  1530                $300    9/29/2017  Costs
                 ace      Brunswi                                associated
                          ck Ave.                                with
                          Lawrenc                                Janssen
                          eville,                                Cares
                          NJ                                     Volunteer
                          08648                                  Activity--O
                                                                 ctober 5,
                                                                 2017
    ------------------------------------------------------------------------
    Monetary    Woods    40                $4,000   12/12/2017  Yoga at
                 Servic   Martin                                 Woods
                 es       Gross                                  Services: A
                 Founda   Drive,                                 Recreationa
                 tion     P.O.                                   l Program
                          Box 36                                 for People
                          Langhor                                with
                          ne, PA                                 Special
                          19047                                  Needs
    ------------------------------------------------------------------------
    Monetary    Young    349 W.            $3,500   12/18/2017  Early
                 Schola   State                                  Literacy
                 rs'      St                                     Engagement
                 Instit   Trenton                                and
                 ute      , NJ                                   Development
                          08618
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $493,168     1/3/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 Nicaragua,
                                                                 West Bank,
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $145,709     1/6/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua,
                                                                 Dominican
                                                                 Republic,
                                                                 West Bank,
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $257,792     1/9/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua,
                                                                 Dominican
                                                                 Republic,
                                                                 West Bank,
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $100,065    2/16/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia,
                                                                 Nicaragua,
                                                                 Republic,
                                                                 and Lebanon
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,185,644    2/16/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in U.S.
                                                                 clinics
    ------------------------------------------------------------------------
    Product     AmeriCa  88                $4,640    3/13/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Puerto
                                                                 Rico
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,281,296    3/20/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Tanzania,
                                                                 West Bank,
                                                                 Gaza, St.
                                                                 Lucia,
                                                                 Lebanon,
                                                                 Dominican
                                                                 Republic,
                                                                 Colombia,
                                                                 Nicaragua,
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $91,239    3/20/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua
                                                                 and
                                                                 Colombia
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,077,988    4/11/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in Gaza,
                                                                 West Bank,
                                                                 Colombia,
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $181,140    4/11/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia,
                                                                 Afghanistan
                                                                 , and
                                                                 Colombia
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $191,031    5/23/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua,
                                                                 Dominican
                                                                 Republic,
                                                                 and St.
                                                                 Lucia
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $72,844    5/23/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Nicaragua.
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $871,110    6/22/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 St. Lucia,
                                                                 and West
                                                                 Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $185,347    6/22/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Dominican
                                                                 Republic,
                                                                 and West
                                                                 Bank
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $9,583,716    7/17/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in
                                                                 Kyrgyzstan
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $149,758    7/19/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in St.
                                                                 Lucia
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $91,601    8/21/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in United
                                                                 States
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $259,213    8/21/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in United
                                                                 States
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $383,085    9/27/2017  Pharmaceutic
                 res      Hamilto                                al product
                 Founda   n Ave.                                 Donation
                 tion     Stamfor                                for
                          d, CT                                  humanitaria
                          06902                                  n aid in
                                                                 Gaza, St.
                                                                 Lucia, and
                                                                 Peru
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $134,651    9/27/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n aid for
                          06902                                  El
                                                                 Salvador,
                                                                 Peru and
                                                                 St. Lucia
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $2,013,098   10/10/2017  Product for
                 res      Hamilto                                humanitaria
                 Founda   n Ave.                                 n and
                 tion     Stamfor                                disaster
                          d, CT                                  response in
                          06902                                  Houston,
                                                                 Florida and
                                                                 Puerto Rico
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $65,375   10/10/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n and
                          06902                                  disaster
                                                                 relief in
                                                                 Houston,
                                                                 Florida,
                                                                 and Puerto
                                                                 Rico
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $75,473   10/20/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n aid in
                          06902                                  Nicaragua
                                                                 and US
                                                                 Clinics
    ------------------------------------------------------------------------
    Product     AmeriCa  88               $82,469   11/15/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n aid in US
                          06902                                  Clinic
                                                                 Network
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $442,409   11/15/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n aid in
                          06902                                  Sierra
                                                                 Leone
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $816,348    8/31/2017  Product
                 res      Hamilto                                Donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                Disaster
                          d, CT                                  Response--H
                          06902                                  urricane
                                                                 Harvey
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $1,320,624   11/17/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in U.S
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $504,595    12/5/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in the
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     AmeriCa  88              $971,862    12/5/2017  Product for
                 res      Hamilto                                humanitaria
                 Founda   n Ave.                                 n
                 tion     Stamfor                                assistance
                          d, CT                                  in the
                          06902                                  Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     AmeriCa  88            $4,298,976    12/5/2017  Product
                 res      Hamilto                                donation
                 Founda   n Ave.                                 for
                 tion     Stamfor                                humanitaria
                          d, CT                                  n
                          06902                                  assistance
                                                                 in US
                                                                 Clinic
                                                                 Networks
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $432,510   11/16/2017  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in:
                          10005                                  Dominican
                                                                 Republic,
                                                                 Haiti and
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $566,919   11/16/2017  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in:
                          10005                                  Dominican
                                                                 Republic,
                                                                 Haiti, and
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $68,662   10/20/2017  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in the
                          10005                                  Dominican
                                                                 Republic,
                                                                 Guatemala
                                                                 and Haiti
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall         $47,020    9/27/2017  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n aid in
                 n        York,                                  the
                 Board    NY                                     Dominican
                          10005                                  Republic
    ------------------------------------------------------------------------
    Product     Catholi  33-01         $1,626,679    7/19/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Guatemala,
                                                                 Haiti,
                                                                 Dominican
                                                                 Republic,
                                                                 and
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01         $2,839,769    7/19/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Guatemala,
                                                                 Haiti,
                                                                 Dominican
                                                                 Republic,
                                                                 and
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall        $129,896    8/21/2017  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 and
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  100 Wall      $2,091,213    8/21/2017  Product
                 c        Street,                                donation
                 Medica   9th                                    for
                 l        Floor                                  humanitaria
                 Missio   New                                    n
                 n        York,                                  assistance
                 Board    NY                                     in
                          10005                                  Dominican
                                                                 Republic,
                                                                 Haiti, and
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $698,911    6/22/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Guatemala,
                                                                 El
                                                                 Salvador,
                                                                 Nicaragua,
                                                                 Haiti, and
                                                                 Jamaica
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $537,473    6/22/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Dominican
                                                                 Republic,
                                                                 Haiti,
                                                                 Guatemala,
                                                                 Jamaica,
                                                                 and El
                                                                 Salvador
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $597,003    4/10/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in El
                          NY                                     Salvador,
                                                                 Haiti, and
                                                                 Nicaragua
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $565,051    4/10/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in El
                          NY                                     Salvador,
                                                                 Haiti,
                                                                 Honduras,
                                                                 Nicaragua,
                                                                 and
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $610,715    5/23/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Tanzania,
                                                                 Guatemala,
                                                                 Jamaica,
                                                                 and
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $716,298    5/23/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Dominican
                                                                 Republic,
                                                                 Tanzania,
                                                                 and
                                                                 Guatemala
    ------------------------------------------------------------------------
    Product     Catholi  33-01         $1,336,614    3/20/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Guatemala,
                                                                 El
                                                                 Salvador,
                                                                 and Haiti
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $102,932    3/20/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in
                          NY                                     Guatemala
                                                                 and Haiti
    ------------------------------------------------------------------------
    Product     Catholi  33-01           $117,953    2/15/2017  Product
                 c        Elevent                                donation
                 Medica   h                                      for
                 l        Street                                 humanitaria
                 Missio   Long                                   n
                 n        Island                                 assistance
                 Board    City,                                  in Haiti,
                          NY                                     El Salvador
                                                                 and
                                                                 Honduras
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,051,504    3/20/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Honduras,
                                                                 Liberia,
                                                                 Haiti and
                                                                 El
                                                                 Salvador.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $91,239    3/20/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Haiti
                                                                 and
                                                                 Liberia.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $23,107    2/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $378,636    2/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $2,390,729    4/11/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Colombia,
                                                                 Sierra
                                                                 Leone,
                                                                 Vanuatu,
                                                                 Ghana,
                                                                 Malawi,
                                                                 Haiti,
                                                                 Nicaragua
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $249,548    4/11/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana,
                                                                 Malawi,
                                                                 Sierra
                                                                 Leone,
                                                                 Liberia,
                                                                 Pakistan
                                                                 and U.S.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $804,308    5/23/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Malawi
                                                                 and Sierra
                                                                 Leone
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $209,508    5/23/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Colombia,
                                                                 Pakistan,
                                                                 Ghana,
                                                                 Malawi,
                                                                 Sierra
                                                                 Leone and
                                                                 Liberia.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $500,169    6/22/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Jamaica,
                                                                 Nicaragua,
                                                                 Pakistan,
                                                                 and Liberia
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $710,949    6/22/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Jamaica
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,405,277    7/19/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Honduras,
                                                                 Colombia,
                                                                 and
                                                                 Pakistan
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $1,152,189    7/19/2017  Product
                 Relief   Patera                                 Donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in
                                                                 Honduras,
                                                                 Colombia,
                                                                 Pakistan,
                                                                 and USA.
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $271,063    9/27/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $61,205    9/27/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Ghana
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $373,326    8/21/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  Humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in the
                                                                 United
                                                                 States
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $259,561    8/21/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  Humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in the
                                                                 United
                                                                 States
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $239,304   10/23/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in US
                                                                 Clinics
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $571,784    12/5/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Syria
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $62,628    10/2/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Houston,
                                                                 Florida,
                                                                 and Puerto
                                                                 Rico
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $3,961,872   11/17/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Syria
    ------------------------------------------------------------------------
    Product     Direct   27 S. La      $3,482,171    12/1/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Syria
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $82,127     9/7/2017  Product
                 Relief   Patera                                 Donation
                          Lane                                   for
                          Santa                                  Disaster
                          Barbara                                response--H
                          , CA                                   urricane
                          93117                                  Harvey
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $494,813   11/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Syria
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $224,506   11/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Syria
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $161,977   11/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in Syria
    ------------------------------------------------------------------------
    Product     Direct   27 S. La         $31,448   11/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in US
    ------------------------------------------------------------------------
    Product     Direct   27 S. La        $505,634   11/16/2017  Product
                 Relief   Patera                                 donation
                          Lane                                   for
                          Santa                                  humanitaria
                          Barbara                                n
                          , CA                                   assistance
                          93117                                  in US
                                                                 Clinics
    ------------------------------------------------------------------------
    Product     Heart    1021             $61,205    9/27/2017  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in the
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     Heart    1021            $224,044    9/27/2017  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in the
                                                                 Dominican
                                                                 Republic
    ------------------------------------------------------------------------
    Product     Heart    1021            $979,095    6/22/2017  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Heart    1021            $126,867    6/22/2017  Product
                 to       Pacific                                Donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in
                                                                 Honduras.
    ------------------------------------------------------------------------
    Product     Heart    1021            $436,536    4/10/2017  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in
                                                                 Dominican
                                                                 Republic,
                                                                 Honduras
                                                                 and Papua
                                                                 New Guinea.
    ------------------------------------------------------------------------
    Product     Heart    1021             $62,476    4/10/2017  Product
                 to       Pacific                                donation
                 Heart    Avenue                                 for
                 Intern   Kansas                                 humanitaria
                 ationa   City,                                  n
                 l        KS                                     assistance
                          66102                                  in Honduras
                                                                 and
                                                                 Dominican
                                                                 Republic.
    ------------------------------------------------------------------------
    Product     Johnson  One         $338,315,809   12/31/2017  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        Kilmer
                 Assist   Square,
                 ance     Suite
                 Founda   130 New
                 tion     Brunswi
                          ck, NJ
                          08933
    ------------------------------------------------------------------------
    Product     MAP      4700             $13,197    2/15/2017  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 (Medical
                                                                 Mission
                                                                 Packs).
    ------------------------------------------------------------------------
    Product     MAP      4700            $125,592    2/14/2017  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 in Sierra
                                                                 Leone
    ------------------------------------------------------------------------
    Product     MAP      4700            $108,127   11/16/2017  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 in the
                                                                 Eastern
                                                                 Caribbean
    ------------------------------------------------------------------------
    Product     MAP      4700             $19,241    7/31/2017  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for medical
                 l        Brunswi                                mission
                          ck, GA                                 program
                          31525
    ------------------------------------------------------------------------
    Product     MAP      4700            $868,191    6/22/2017  Product
                 Intern   Glynco                                 donation
                 ationa   Parkway                                for
                 l        Brunswi                                humanitaria
                          ck, GA                                 n
                          31525                                  assistance
                                                                 in Haiti,
                                                                 Dominican
                                                                 Republic,
                                                                 and
                                                                 Guatemala.
    ------------------------------------------------------------------------
    Monetary    Acercam  P.O. Box          $5,000    4/26/2017  ContraSIDA
                 iento    3820
                 Hispan   Columbi
                 o de     a, SC
                 Caroli   29230
                 na del
                 Sur
    ------------------------------------------------------------------------
    Monetary    ADAP     P.O. Box          $5,000     4/4/2017  ADAP
                 Advoca   15275                                  Directory
                 cy       Washing
                          ton, DC
                          20003
    ------------------------------------------------------------------------
    Monetary    ADAP     P.O. Box          $5,000   10/16/2017  Improving
                 Advoca   15275                                  Access to
                 cy       Washing                                Care Among
                          ton, DC                                Formerly
                          20003                                  Incarcerate
                                                                 d
                                                                 Populations
                                                                 with HIV/
                                                                 AIDS under
                                                                 the AIDS
                                                                 Drug
                                                                 Assistance
                                                                 Program
                                                                 (ADAP)
    ------------------------------------------------------------------------
    Monetary    African- 1833             $75,000    7/20/2017  Black
                 Americ   West                                   Treatment
                 an       8th                                    Advocates
                 Aids     Street                                 Network
                 Policy   Suite                                  (BTAN)
                 And      200 Los                                Advanced
                 Traini   Angeles                                Development
                 ng       , CA                                   Program
                 Instit   90057
                 ute
    ------------------------------------------------------------------------
    Monetary    AIDS     6260              $3,000     4/4/2017  Linkage to
                 Founda   Westpar                                Care
                 tion     k Drive
                 Housto   Suite
                 n,       100
                 Inc.     Houston
                          , TX
                          77057
    ------------------------------------------------------------------------
    Monetary    AIDS     200 W.           $50,000     3/1/2017  Ensuring
                 Founda   Jackson                                Access to
                 tion     Blvd.,                                 HIV
                 of       Suite                                  Prevention
                 Chicag   2100                                   and Care in
                 o        Chicago                                Illinois
                          , IL                                   through
                          60606                                  Policy
                                                                 Monitoring
                                                                 and
                                                                 Advocacy
    ------------------------------------------------------------------------
    Monetary    AIDS     400               $5,000     4/4/2017  HIV Case
                 Outrea   North                                  Management
                 ch       Beach                                  at AIDS
                 Center   Street                                 Outreach
                          Fort                                   Center
                          Worth,
                          TX
                          76111
    ------------------------------------------------------------------------
    Monetary    AIDS     820 N.            $5,000    8/17/2017  Driving
                 Resour   Plankin                                Innovation
                 ce       ton                                    in HIV
                 Center   Ave.                                   Healthcare
                 of       Milwauk                                Via ARCW
                 Wiscon   ee, WI                                 HIV Medical
                 sin      53203                                  Centers
    ------------------------------------------------------------------------
    Monetary    AIDS     17982             $2,000     5/8/2017  HIV and
                 Servic   Sky                                    Hepatitis C
                 es       Park                                   Testing
                 Founda   Circle,                                Program
                 tion     Suite J
                 Orange   Irvine,
                 County   CA
                          92614
    ------------------------------------------------------------------------
    Monetary    AIDS     1101            $200,000   12/19/2017  Transgender
                 United   14th                                   Leadership
                          Street,                                Initiative
                          NW
                          Suite
                          300
                          Washing
                          ton, DC
                          20005
    ------------------------------------------------------------------------
    Monetary    Alexian  825 W.            $5,000    8/17/2017  Transitional
                 Brothe   Welling                                Living
                 rs       ton                                    Program for
                 Bonave   Chicago                                Homeless
                 nture    , IL                                   Adults with
                 House    60657                                  HIV/AIDS
    ------------------------------------------------------------------------
    Monetary    Alivene  3808              $1,000    7/31/2017  Integrative
                 ss       Nicolle                                Therapies
                 Projec   t Ave                                  for People
                 t,       Minneap                                Living with
                 Inc.     olis,                                  HIV
                          MN
                          55409
    ------------------------------------------------------------------------
    Monetary    Aunt     1101 N.           $2,500    7/11/2017  Project
                 Rita's   Central                                HIVAZ
                 Founda   Ave.
                 tion     Suite
                          212
                          Phoenix
                          , AZ
                          85004
    ------------------------------------------------------------------------
    Monetary    Caring   PO Box           $40,000    3/20/2017  General
                 Ambass   1748                                   Hepatitis C
                 adors    Oregon                                 Program
                 Progra   City,                                  Support
                 m, Inc   OR
                          97045
    ------------------------------------------------------------------------
    Monetary    Catholi  119               $5,000     4/4/2017  The Home
                 c        Dameron                                Place
                 Charit   Avenue
                 ies of   Knoxvil
                 East     le, TN
                 Tennes   37917
                 see,
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Center   1115 E.           $3,500   10/23/2017  HIV
                 For      12th                                   Prevention
                 Health   St.                                    Access and
                 Empowe   Austin,                                Linkage to
                 rment    TX                                     Care
                 (CHE)    78702
    ------------------------------------------------------------------------
    Monetary    Central  1785              $5,000   11/13/2017  HIV Testing,
                 Louisi   Jackson                                Counseling,
                 ana      Street                                 and
                 Aids     Alexand                                Prevention
                 Suppor   ria, LA                                for African
                 t        71301                                  American
                 Servic                                          Teens and
                 es Inc                                          Young
                 (CLASS                                          Adults
                 )
    ------------------------------------------------------------------------
    Monetary    Communi  1930             $20,000   12/18/2017  Equal Access
                 ty       Martin
                 Educat   Luther
                 ion      King Jr
                 Group    Avenue
                          SE
                          Washing
                          ton, DC
                          20020
    ------------------------------------------------------------------------
    Monetary    Communi  1930             $20,000    3/13/2017  Access Tools
                 ty       Martin                                 Linking All
                 Educat   Luther                                 to Services
                 ion      King Jr                                (ATLAS).
                 Group    Avenue
                          SE
                          Washing
                          ton, DC
                          20020
    ------------------------------------------------------------------------
    Monetary    Communi  575 8th          $15,000    7/20/2017  HIV Health
                 ty       Avenue,                                Literacy
                 Resear   Suite                                  Education
                 ch       502 New                                and
                 Initia   York,                                  Training
                 tive     NY                                     for Service
                 on       10018                                  Providers
                 AIDS,                                           Working
                 Inc.                                            with
                                                                 Vulnerable
                                                                 Populations
    ------------------------------------------------------------------------
    Monetary    Frannie  30                $5,000   11/13/2017  Supportive
                 Peabod   Danfort                                Pathways
                 y        h St.                                  Along the
                 Center   Suite                                  Care
                 Inc.     311                                    Continuum
                          Portlan                                (SPACC)
                          d, ME
                          04101
    ------------------------------------------------------------------------
    Monetary    Gay      446 W.           $30,000   12/19/2017  Peer
                 Men's    33rd                                   Navigation
                 Health   Street                                 for high-
                 Crisis   New                                    risk and
                          York,                                  HIV-
                          NY                                     positive
                          10001                                  transgender
                                                                 people
    ------------------------------------------------------------------------
    Monetary    Gay      446 W.           $30,000     3/1/2017  Peer
                 Men's    33rd                                   Navigation
                 Health   Street                                 for high-
                 Crisis   New                                    risk and
                          York,                                  HIV-
                          NY                                     positive
                          10001                                  transgender
                                                                 people
    ------------------------------------------------------------------------
    Monetary    Hepatit  35 East          $20,000     2/7/2017  The
                 is C     38th                                   Hepatitis C
                 Mentor   Street,                                Education
                 and      Suite                                  and Support
                 Suppor   #4G New                                Group
                 t        York,                                  Assistance
                 Group    NY                                     Program
                 Inc.     10016
    ------------------------------------------------------------------------
    Monetary    Hepatit  1261 S.          $35,000     2/8/2017  General
                 is       Jackson                                Program
                 Educat   St.,                                   Support
                 ion      Suite
                 Projec   201
                 t        Seattle
                          , WA
                          98144
    ------------------------------------------------------------------------
    Monetary    Howard   4025 N.          $25,000    9/29/2017  Patient
                 Brown    Sherida                                Assistance
                 Health   n                                      Clinic
                 Center   Chicago                                (PAC):
                          , IL                                   Medication
                          60613                                  Therapy
                                                                 Management
                                                                 for
                                                                 Underserved
                                                                 Patients
    ------------------------------------------------------------------------
    Monetary    Interna  2200             $75,000     3/1/2017  Conversation
                 tional   Pennsyl                                Maps:
                 Associ   vania                                  Patient
                 ation    Avenue,                                Empowerment
                 of       NW 4th                                 through HIV
                 Physic   Floor                                  Peer
                 ians     East                                   Dialogue in
                 in       Washing                                Five U.S.
                 AIDS     ton, DC                                Fast-Track
                 Care     20037                                  Cities
                 Inc.
    ------------------------------------------------------------------------
    Monetary    Legacy   4054              $5,000    4/26/2017  Grace
                 Counse   McKinne                                Project
                 ling     y Ave.,                                Program for
                 Center   Suite                                  Women
                          102                                    Living with
                          Dallas,                                HIV/AIDS
                          TX
                          75204
    ------------------------------------------------------------------------
    Monetary    Legal    17 N.             $5,000    8/23/2017  Communities
                 Counci   State                                  of Color
                 l for    Street,                                Outreach
                 Health   Suite                                  Program
                 Justic   900
                 e        Chicago
                          , IL
                          60602
    ------------------------------------------------------------------------
    Monetary    Lifelon  P.O. Box          $3,000    3/20/2017  Living
                 g Aids   80547                                  Positively
                 Allian   Seattle
                 ce       , WA
                          98108
    ------------------------------------------------------------------------
    Monetary    Minorit  5149 W.           $7,500     4/4/2017  S.T.E.P.
                 y AIDS   Jeffers                                Program
                 Projec   on Blvd                                Strengtheni
                 t        Los                                    ng
                          Angeles                                Treatment
                          , CA                                   Education
                          90016                                  for People
                                                                 Living with
                                                                 HIV/AIDS
    ------------------------------------------------------------------------
    Monetary    Nationa  580             $175,000    3/16/2017  NATAP HIV
                 l AIDS   Broadwa                                and HCV
                 Treatm   y Suite                                Information
                 ent      1010                                   and
                 Advoca   New                                    Education
                 cy       York,                                  Project
                 Projec   NY
                 t        10012
    ------------------------------------------------------------------------
    Monetary    Nationa  580             $175,000   12/18/2017  NATAP HIV
                 l AIDS   Broadwa                                and
                 Treatm   y Suite                                Hepatitis
                 ent      1010                                   Information
                 Advoca   New                                    and
                 cy       York,                                  Education
                 Projec   NY                                     Project
                 t        10012
    ------------------------------------------------------------------------
    Monetary    Nationa  444             $150,000   12/19/2017  Affordable
                 l        North                                  Care Act
                 Allian   Capitol                                (ACA), Ryan
                 ce of    Street                                 White/ADAP,
                 State    NW #339                                Public
                 and      Washing                                Policy and
                 Territ   ton, DC                                Technical
                 orial    20001                                  Assistance,
                 AIDS                                            and the
                 Direct                                          Minority
                 ors                                             Leadership
                                                                 Programs
    ------------------------------------------------------------------------
    Monetary    NovaSal  2946              $2,500   11/15/2017  ``Increasing
                 ud,      Sleepy                                 Testing and
                 Inc.     Hollow                                 Improving
                          Rd.                                    Retention
                          Falls                                  in Care and
                          Church,                                Access to
                          VA                                     Treatment
                          22044                                  for People
                                                                 at Risk or
                                                                 Currently
                                                                 Living with
                                                                 HIV''
    ------------------------------------------------------------------------
    Monetary    Palmett  2638 Two          $7,500    7/11/2017  HIV Care
                 o AIDS   Notch                                  Coordinatio
                 Life     Road,                                  n Program
                 Suppor   Suite
                 t        108
                 Servic   Columbi
                 es       a, SC
                          29204
    ------------------------------------------------------------------------
    Monetary    Positiv  785               $2,500   11/13/2017  Integrated
                 e        Market                                 Support
                 Resour   Street,                                Services
                 ce       10th
                 Center   Floor
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    PowerSo  P.O. Box          $2,500   10/23/2017  Bridging the
                 urce     12354                                  Gap
                 Tucson   Tucson,
                 , Inc.   AZ
                          85732
    ------------------------------------------------------------------------
    Monetary    Project  273              $10,000   12/18/2017  Mission
                 Inform   Ninth                                  Support
                          Street
                          San
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $10,000    6/26/2017  Mission
                 Inform   Ninth                                  Support for
                          Street                                 Project
                          San                                    Inform
                          Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $25,000    6/26/2017  HIV Care
                 Inform   Ninth                                  Linkage,
                          Street                                 Retention
                          San                                    and Re-
                          Francis                                engagement
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  273              $25,000    6/26/2017  Policy
                 Inform   Ninth                                  Advocacy to
                          Street                                 Protect HIV
                          San                                    Treatment
                          Francis                                and Care
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Project  2929 NE           $5,000   10/16/2017  ``Surviving
                 Link     6TH                                    and
                 of       Avenue                                 Thriving;
                 South    Wilton                                 Long-term
                 Florid   Manors,                                Survivors
                 a,       FL                                     workshops,
                 Inc.     33334                                  for Gay Men
                                                                 50 and Over
                                                                 Living with
                                                                 HIV,'' and
                                                                 for our
                                                                 ``Long-term
                                                                 Survivor''
                                                                 support
                                                                 group.
    ------------------------------------------------------------------------
    Monetary    RAIN,    601 E.           $20,000    9/29/2017  Free On-Site
                 Inc.     5th                                    Mental
                          Street,                                Health
                          Suite                                  Services
                          470 PO                                 for People
                          Box                                    Living with
                          37190                                  HIV
                          Charlot
                          te, NC
                          28202
    ------------------------------------------------------------------------
    Monetary    San      1035             $25,000    6/27/2017  TransLife
                 Franci   Market                                 HIV Care
                 sco      Street,                                and Support
                 AIDS     Suite
                 Founda   400 San
                 tion     Francis
                          co, CA
                          94103
    ------------------------------------------------------------------------
    Monetary    Service  305 7th           $5,000    4/21/2017  SAGEPositive
                 s and    Avenue,
                 Advoca   15th
                 cy For   Floor
                 Gay      New
                 Lesbia   York,
                 n        NY
                 Bisexu   10001
                 al and
                 Transg
                 ender
                 Elders
                 Inc.
    ------------------------------------------------------------------------
    Monetary    The      17 Davis         $65,000    7/20/2017  Ensuring
                 AIDS     Bouleva                                Adequate
                 Instit   rd,                                    Funding for
                 ute      Suite                                  Domestic
                          403                                    HIV/AIDS
                          Suite                                  Programs
                          403
                          Tampa,
                          FL
                          33606
    ------------------------------------------------------------------------
    Monetary    The      17 Davis         $65,000   12/19/2017  2018 Federal
                 AIDS     Bouleva                                and State
                 Instit   rd,                                    HIV/AIDS
                 ute      Suite                                  Policy
                          403                                    Issues
                          Suite
                          403
                          Tampa,
                          FL
                          33606
    ------------------------------------------------------------------------
    Monetary    The      64 West           $4,000    9/18/2017  ID Inspired
                 Allian   35th                                   Challenge
                 ce for   Street,
                 Positi   3rd
                 ve       Floor
                 Change   New
                          York,
                          NY
                          10001
    ------------------------------------------------------------------------
    Monetary    The      99                $5,000    7/11/2017  Expansion of
                 Next     Bishop                                 Next Step's
                 Step     Allen                                  Year-round
                 Fund,    Drive                                  Programming
                 Inc.     Cambrid                                for teens
                          ge, MA                                 and young
                          02138                                  adults
                                                                 living with
                                                                 HIV.
    ------------------------------------------------------------------------
    Monetary    The San  P.O. Box          $2,500    8/18/2017  Youth
                 Diego    3357                                   Services
                 LGBT     San
                 Commun   Diego,
                 ity      CA
                 Center   92163
    ------------------------------------------------------------------------
    Monetary    The San  P.O. Box          $5,000    7/19/2017  HIV services
                 Diego    3357
                 LGBT     San
                 Commun   Diego,
                 ity      CA
                 Center   92163
    ------------------------------------------------------------------------
    Monetary    The      85               $30,000   12/18/2017  Building
                 Well     Norman                                 H.O.P.E.
                 Projec   Avenue                                 (Hopeful
                 t        P.O.                                   Outreach
                          Box                                    and
                          220410                                 Positive
                          Brookly                                Engagement
                          n, NY                                  for Women
                          11222                                  Living with
                                                                 HIV)
    ------------------------------------------------------------------------
    Monetary    The      85               $30,000     3/1/2017  HIV Disease
                 Well     Norman                                 Awareness/
                 Projec   Avenue                                 Information
                 t        P.O.                                   , Community
                          Box                                    Support,
                          220410                                 Advocacy
                          Brookly                                and
                          n, NY                                  Capacity
                          11222                                  Building
    ------------------------------------------------------------------------
    Monetary    Treatme  90 Broad         $15,000    6/26/2017  Ending the
                 nt       Street,                                Epidemic
                 Action   Suite
                 Group,   2503
                 Inc.     New
                          York,
                          NY
                          10004
    ------------------------------------------------------------------------
    Monetary    Univers  UCSF             $15,000    9/29/2017  UCSF
                 ity Of   Allianc                                Alliance
                 Califo   e                                      Health
                 rnia     Health                                 Project
                 San      Project                                Mission-
                 Franci   1855                                   Based
                 sco      Folsom                                 Support--Co
                          Street,                                mmunity
                          Ste.                                   Based
                          670 Box                                Intensive
                          0884                                   Case
                          San                                    Management
                          Francis                                for People
                          co, CA                                 Living With
                          94143                                  HIV/AIDS
    ------------------------------------------------------------------------
    Monetary    Univers  620 W.            $2,500   11/13/2017  JACQUES
                 ity Of   Lexingt                                Initiative
                 Maryla   on St.                                 Community
                 nd       2nd                                    Outreach
                 Baltim   floor                                  Program
                 ore      Baltimo
                 Founda   re, MD
                 tion,    21201
                 Inc.
    ------------------------------------------------------------------------
    Monetary    US       1300 PA         $725,000   12/19/2017  Global
                 Agency   Avenue.                                Public
                 for      , NW SA-                               Health
                 Intern   44 Rm                                  Programs:
                 ationa   475-J                                  Infection
                 l        Washing                                Control
                 Develo   ton, DC                                ($250,000),
                 pment    20523                                  Anti-
                                                                 Microbial
                                                                 Resistance
                                                                 ($300,000),
                                                                 Pharmacovig
                                                                 ilance
                                                                 ($175,000)
    ------------------------------------------------------------------------
    Monetary    Wellnes  2929 NE           $2,000   10/16/2017  Prevention
                 s        6                                      for HIV
                 Center   Avenue,                                Positive
                 of       Suite B                                Heterosexua
                 South    Wilton                                 l/Minority
                 Florid   Manors,                                Outreach
                 a,       FL                                     Program
                 Inc.     33334
    ------------------------------------------------------------------------
    Monetary    Young    4164              $5,000    7/19/2017  TruEvolution
                 Schola   Brockto                                Community
                 rs For   n Ave                                  Wellness
                 Academ   Riversi                                Center
                 ic       de, CA
                 Empowe   92501
                 rment
    ------------------------------------------------------------------------
    Product     Johnson  One          $14,933,212   12/31/2017  Patient
                 &        Johnson                                Assistance
                 Johnso   &                                      Product
                 n        Johnson                                Donation
                 Patien   Plaza
                 t        Kilmer
                 Assist   Square,
                 ance     Suite
                 Founda   130 New
                 tion     Brunswi
                          ck, NJ
                          08933
    ------------------------------------------------------------------------
    Product     Partner  1616          $1,018,932    3/31/2017  Product
                 ship     Fort                                   Donation
                 for      Myer                                   for New
                 Supply   Drive,                                 Horizons
                 Chain    12th                                   global
                 Manage   Floor                                  public
                 ment     Arlingt                                health
                          on, VA                                 program
                          22209-
                          3100
    ------------------------------------------------------------------------
    Product     Partner  1616            $124,669     9/8/2017  Product
                 ship     Fort                                   donation
                 for      Myer                                   for New
                 Supply   Drive,                                 Horizons
                 Chain    12th                                   Global
                 Manage   Floor                                  Public
                 ment     Arlingt                                Health
                          on, VA                                 Program
                          22209-
                          3100
    ------------------------------------------------------------------------
    Product     US       1300        $302,250,000   12/18/2017  Product
                 Agency   Pennsyl                                donation
                 for      vania                                  for global
                 Intern   Avenue,                                public
                 ationa   N.W.                                   health
                 l        Washing                                programs
                 Develo   ton, DC
                 pment    20523
    ------------------------------------------------------------------------

      Actelion Pharmaceuticals US, Inc. Contribution Payments Made in 2018
    ------------------------------------------------------------------------
     Organization Information      Project Title      Paid Amount     Paid
    ------------------------------------------------------------------------
    Westchester Medical        Girls' Night Out         $2,000.00   20180326
     Center Foundation
    ------------------------------------------------------------------------
    Scleroderma Research       CONQUER Registry       $500,000.00   20180125
     Foundation                 Project
    ------------------------------------------------------------------------
    Multiple Sclerosis         The Latest MS           $12,000.00   20180424
     Association of America     Research Updates
    ------------------------------------------------------------------------
    Have a Ball Foundation     14th Annual ``Have a     $5,000.00   20180309
                                Ball'' Golf
                                Tournament
    ------------------------------------------------------------------------
    CMDAT Research Foundation  Free seminars on         $1,400.00   20180411
                                pulmonary arterial
                                hypertension and
                                Gaucher disease in
                                the Greater Denver
                                area
    ------------------------------------------------------------------------
    Echo Hill Outdoor School   Echo Hill Outdoor        $5,000.00   20180410
     Heart Camp 2018            School Heart Camp
                                2018
    ------------------------------------------------------------------------
    Pulmonary Hypertension     Chicago Area Trivia      $3,200.00   20180510
     Association                Night
    ------------------------------------------------------------------------
    American Lung Association  St. Louis Lung Force     $1,500.00   20180524
     in Missouri                Expo
    ------------------------------------------------------------------------
    Pulmonary Hypertension     Thirsting for a Cure     $6,000.00   20180725
     Association
    ------------------------------------------------------------------------
    UPHill Journeys            11th Annual Northern     $2,000.00   20180710
                                New England PH Forum
    ------------------------------------------------------------------------
    Pulmonary Hypertension     Steps for Stripes Fun    $1,500.00   20180925
     Association                Walk
    ------------------------------------------------------------------------
    American Heart             Ann Arbor-Jackson        $5,000.00   20181025
     Association                Heart Ball
    ------------------------------------------------------------------------
    phaware global             PHAWARE CHARITY         $2,500.00   20181116
     association                POKER TOURNAMENT
    ------------------------------------------------------------------------
    Pulmonary Hypertension     Georgia Fun Walk         $2,500.00   20181010
     Association
    ------------------------------------------------------------------------
    American Lung Association  St. Louis Lung Force     $1,500.00  20181010
     in Missouri                Expo
    ------------------------------------------------------------------------
    Actelion has also made financial donations to independent charitable
      foundations that assist patients who are underinsured and in financial
      need with treatment-related expenses. In keeping with our donor
      agreements and applicable regulatory guidance, we will only disclose
      aggregate data on our charitable giving and do not publicize
      information on donations to specific foundations and disease states.
      In 2018, we contributed approximately $50.2 million in donations to
      independent charitable foundations, enabling them to provide
      assistance with medication-related copays to patients with pulmonary
      hypertension.

                                     ______

         Submitted by Hon. John Thune, a U.S. Senator From South Dakota

                                  340B Health

                         1101 15th Street NW, Suite 910

                              Washington, DC 20005

                              Phone: 202-552-5850

                               FAX: 202-552-5868

                               www.340bhealth.org

                    340B is a Small Share of the Drug Market

                       and Does Not Increase Drug Prices

    New data show drug manufacturers provided $6.1 billion in total drug
    discounts in 2015 under the 340B Program. The 340B discount is less
    than 2 percent of the total U.S. drug market and is dwarfed by other
    segments of the drug industry.

    340B does not increase drug prices. 340B reduces costs for safety net
    providers, allowing them to provide affordable drugs and services to
    low-income patients.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    Compared to other segments of the market, the total 340B discount is:

          Less than 2 percent of total U.S. drug spending.
          3.6 percent of all discounts and rebates offered by
    manufacturers.
          4 percent of the specialty drug spending.
          89 percent less than the rebates manufacturers provide to health
    plans and PBMs.
          78 percent less than what manufacturers spend on advertising.
          57 percent less than what brand-name manufacturers have lost
    from patent expirations.

    Nearly one third of the total 340B discount is due a penalty enforced
    against drug manufacturers for raising the price of drugs higher than
    the rate of inflation or voluntarily providing a discount lower than
    the 340B price. Manufacturers could avoid this penalty by not
    increasing their drug prices at such high rates.

                        Total 340B Discount, $6.1 Billion
    ------------------------------------------------------------------------

    ------------------------------------------------------------------------
    Required by 340B Statute, $4.2 Billion             Inflationary Penalty,
                                                                $1.9 Billion
    ------------------------------------------------------------------------

    The full analysis by Dobson Davanzo is available here: http://
    www.340bhealth.org/files/340B_Financial_Impact_7_17.pdf.

                                     ______

                     Prepared Statement of Hon. Ron Wyden,
                           a U.S. Senator From Oregon
        Prescription drugs did not become outrageously expensive by
    accident. It's not the result of a system too complicated for Americans
    to comprehend. Drug prices are astronomically high because that's where
    pharmaceutical companies and their investors want them. The brakes have
    come off pharmaceutical pricing, and American families are hurtling
    along in the passenger seat terrified of what comes next.

        Today the committee will hear uplifting stories about miracle
    cures, but it is morally repugnant when patients can't afford them. It
    is morally repugnant when ailing patients are forced to choose between
    filling that next prescription or putting food on the table, because
    they can't afford both. It is morally repugnant when patients are
    forced to skip doses.

        You Pharma executives are here because the way you do business is
    unacceptable and unsustainable. Ten companies accounted for half of all
    profts in the health-care sector last fall. Nine of those ten were drug
    manufacturers. All but one of today's witnesses represent companies on
    that list. Drug makers behave as if patients and taxpayers are unlocked
    ATMs full of cash to be extracted, and their shareholders are the
    customers they value above all else.

        Let's look at concrete examples, starting with AbbVie. AbbVie
    manufactures the top-selling prescription drug in America, the
    arthritis medication Humira. Over 6 years, the company doubled the
    price of a 12-month supply from $19,000 to $38,000. Can patients opt
    for a less-expensive alternative? No they cannot, because AbbVie
    protects the exclusivity of Humira like Gollum with his ring: thick
    cobwebs of patents, legal tricks, and shadowy deals with other drug
    makers, all to keep the cash flowing.

        I also want to address troubling information the committee recently
    uncovered. I'm holding AbbVie's proxy statement, a document every
    publicly traded company must file with the SEC. Page 37 shows that in
    2017, a portion of CEO Richard Gonzalez's multi-million-dollar bonus
    was directly tied to sales of Humira. It appears the same incentive was
    in place in 2015 and 2016.

        In fact, the committee's review shows that all of AbbVie's top
    executives had the same arrangement. Mr. Gonzalez is welcome to
    respond, but the implication of that incentive ought to be clear. From
    top down, AbbVie's leadership had reason to keep pushing prices and
    sales upward.

        Now on to Pfizer. Pfizer gets first prize for emptiest gesture on
    pricing in 2018. After stern Trump tweets last year, Pfizer said it
    would temporarily freeze prices. But once the President got his splashy
    headlines, his gaze turned elsewhere, and Pfizer's former CEO told
    investors it was back to ``business as normal.'' Another round of price
    hikes in 2019, including on its pain medication Lyrica. Lyrica's price
    has increased 163 percent since 2012. With this one drug, Pfizer raked
    in $4.5 billion in 2017.

        Merck: Merck gets second prize for emptiest gesture on pricing in
    2018. It made sweet-sounding promises after coming under criticism, but
    it cut prices for drugs that provide essentially no revenue to the
    company. Left untouched were the cash cows Keytruda and Januvia, which
    account for more than a quarter of Merck's revenue. It's like promising
    car shoppers a great deal, except the only discounted model on the lot
    is an Edsel.

        Sanofi: A company wringing more and more cash out of people with an
    incurable disease. In 2010, a vial of Sanofi insulin cost less than
    $100. In 2018 it cost nearly $300, and the company raised prices again
    in 2019. Considering that the landmark breakthrough on insulin came
    early in the roaring twenties, nothing could justify that sudden price
    increase nearly a century later. Diabetics who can't afford the costs
    are self-rationing and endangering their lives, but at least the
    investors are happy.

        AstraZeneca: A lesson in saying the quiet part out loud. In an
    interview earlier this year, CEO Pascal Soriot complained that his $12-
    million salary made him ``the lowest-paid CEO in the whole industry.''
    He said it was ``annoying to some extent.'' His company, meanwhile,
    continues to raise the price of Symbicort, its $3-billion asthma drug.
    For some asthmatics, being able to breathe costs hundreds of dollars a
    month.

        Johnson & Johnson: A record-setting flip-flop. This January 7th, at
    the JP Morgan Healthcare Conference, CEO Alex Gorsky said that the
    pharmaceutical industry needed to self-police on pricing. Sounds good,
    but it didn't last long. Three days later, his company hiked the prices
    of hundreds of its drugs, including drugs that account for billions in
    Medicare spending.

        Bristol-Myers-Squibb: In 2017, the company spent roughly $11.5
    billion on dividends, stock buybacks, marketing, sales, and
    administrative costs. That's roughly triple the amount it spent on R&D.

        This is all a stark illustration of drug makers' profiteering and
    two-faced scheming. The central argument that the committee will hear
    in response is that the fault is everybody else's. The health plans are
    at fault. The PBMs are at fault. Regulators are at fault. They always
    point the finger elsewhere.

        We'll also hear that list prices don't matter; that the true costs
    are complicated. But companies don't set and raise list prices for fun.
    Those prices are directly tied to the amount patients pay out-of-pocket
    at the pharmacy window. They are directly tied to what taxpayers spend
    on health-care programs.

        Next, drug makers point fingers at the middlemen, pharmacy benefit
    managers. I've said for years that PBMs are wasteful and secretive,
    taking their cut without proving their worth to anybody. They will have
    their day before this committee. But PBMs don't set list prices;
    manufacturers do. Furthermore, manufacturers don't offer rebates for
    nearly 40 percent of Part D brand-name drugs. Those prices continue to
    rise. That's on the drug companies, not on PBMs.

        Next, drug makers say changes in the status quo will hurt R&D. A
    quick look at these companies' finances, on both sides of the balance
    sheet, shows that isn't the case. Revenue generated from American
    patients alone dwarfs what they spend on R&D worldwide. Drug makers
    also spend as much, if not more, on flashy TV ads and office-to-office
    salesmen as they spend on R&D. And if lower prices would diminish R&D,
    why don't costly dividends? Why don't stock buybacks? Is the stock
    price more important than inventing the next miracle cure?

        Even if you buy the specious argument that a drug's list price at
    launch is driven by the cost of R&D, what could justify arbitrary price
    increases year after year, long after the R&D spending is done?

        Finally, companies say they help patients afford drugs with
    ``coupons`` or patient assistance programs. But if these programs are
    so widely generous, why can't drug makers instead simply lower prices
    across the board? Because it's just more slick branding--ploys that
    allow companies to maintain the status quo.

        One final point. I was there when seven Big Tobacco CEOs testifed
    in a committee room like this one, and they lied. The chairman and I
    expect better this morning. Your profits are outsized compared to
    others in the industry, you receive a massive portion of your revenue
    from American taxpayers, and you bear none of the consequences of high
    drug prices. It's past time to get beyond the excuses and make
    prescription drugs affordable.

                                     ______

                                 Communications

                                  ----------

                                      AARP

                                601 E Street, NW

                              Washington, DC 20049

     202-434--2277 | 1-888-OUR-AARP | 1-888-687-2277 | TTY: 1-877-434-7598

      www.aarp.org | twitter: @aarp | facebook.com/aarp | youtube.com/aarp

    February 26, 2019

    The Honorable Chuck Grassley        The Honorable Ron Wyden
    Chairman                            Ranking Member
    Committee on Finance                Committee on Finance
    U.S. Senate                         U.S. Senate
    219 Dirksen Senate Office Building  219 Dirksen Senate Office Building
    Washington, DC 20510                Washington, DC 20510

    Dear Chairman Grassley and Ranking Member Wyden:

    AARP appreciates your focus on prescription drug prices and the
    challenges that increasing drug costs pose for seniors, and we thank
    you for holding the hearing on February 26, 2019, to highlight rising
    prescription drug prices. AARP, with its nearly 38 million members in
    all 50 states, the District of Columbia, and the U.S. territories is a
    nonpartisan, nonprofit, nationwide organization that helps people turn
    their goals and dreams into real possibilities, strengthens communities
    and fights for the issues that matter most to families such as
    healthcare, employment and income security, retirement planning,
    affordable utilities and protection from financial abuse.

    Prescription drug prices are a high priority for AARP and all older
    Americans, as older adults are particularly vulnerable to high
    prescription drug prices. Medicare Part D enrollees take an average of
    4.5 prescriptions per month, and over two-thirds have two or more
    concurrent chronic illnesses. When older Americans talk about the
    impact of high prescription drug prices, they are often talking about
    costs that they will face every year for the rest of their lives.

    Most Medicare beneficiaries live on modest incomes, with an annual
    median of just over $26,000. One-quarter have incomes of just over
    $15,000. One-quarter have less than $15,000 in savings. This is not a
    population that has the resources to absorb rapidly escalating
    prescription drug prices, and many are simply unable to afford the
    medications they need.

    Unfortunately, older Americans have seen their prescription drug prices
    skyrocket in recent years. About 30 years ago, the public was outraged
    over a drug that cost less than $10,000 per year. We now have drugs
    with prices approaching $1 million per year.

    In 2015, the average annual cost for a single specialty drug used on a
    chronic basis was $52,486--which is only slightly less than the median
    household income in the United States.\1\ We strongly support efforts
    to bring new treatments to market, but innovation is meaningless if
    patients cannot afford to use the treatment.
    ---------------------------------------------------------------------------
        \1\ https://www.aarp.org/content/dam/aarp/ppi/2017/11/full-report-
    trends-in-retail-prices-of-specialty-prescription-druqs-widely-used-by-
    older-americans.pdf.

    AARP has been tracking the prices of widely-used prescription drugs
    since 2004. Our most recent Rx Price Watch Report focused on brand-name
    drugs and found that their retail prices increased by an average of
    8.4% in 2017--four times the rate of inflation. AARP's report also
    examined how drug companies' relentless price increases add up over
    time and found that the average annual cost of one brand-name drug--now
    around $6,800--would have been just under $2,200 in 2017 if retail
    price changes had been limited to general inflation between 2006 and
    2017.\2\
    ---------------------------------------------------------------------------
        \2\ https://www.aarp.org/content/dam/aarp/ppi/2018/09/trends-in-
    retail-prices-of-brand-name-prescription-druqs-year-end-update.pdf

    The average annual price increases for brand name drugs have exceeded
    the corresponding rate of inflation every year since at least 2006.
    More importantly, this problem goes beyond a few bad actors: virtually
    ---------------------------------------------------------------------------
    all of the manufacturers we track raise their prices every single year.

    As a result, it is hardly surprising that our members consistently tell
    us they cannot afford the medications they need and are forced to make
    difficult choices as a result. Even less surprising is that they want
    this situation to change. Last year, in AARP's 2018 Mid-Term Voter
    Issues Survey, 92 percent of voters age 50 and older told us that
    candidates' positions on lowering drug costs was important to them,
    with 74 percent saying ``very important.''

    Moreover, in a Kaiser 2018 Health Tracking Poll, prescription drug
    prices topped the list of the public's priorities, with 90 percent
    calling it an important priority, and 52 percent listing it as a ``top
    priority.'' In that poll, a large majority (80 percent) of the public
    reported perceiving prescription drug costs as ``unreasonable,'' a
    share that has increased since 2015.

    Today it seems that prescription prices are in a never-ending race to
    the top. High priced specialty drug approvals have exceeded traditional
    drug approvals since 2010, and the number of people using such drugs is
    growing. Meanwhile, the research pipeline is full of products like
    orphan drugs, biologics, and personalized medicines that face little
    competition and will undoubtedly command even higher prices.

    We have also seen massive increases in Medicare spending on
    prescription drugs. Between 2005 and 2016, Medicare Part B drug
    spending more than doubled from $12 billion to $29 billion. Total
    Medicare Part D spending is approaching $150 billion. These escalating
    costs will eventually result in higher taxes, cuts to vitally important
    public programs, or both.

    Current prescription drug price trends are simply not sustainable. High
    and growing drug prices are affecting all Americans in some way. Their
    cost is passed along to everyone with health coverage through increased
    health care premiums, deductibles, and other forms of cost-sharing.
    They are also driving larger cost increases for a variety of taxpayer-
    funded programs. Meanwhile, drug companies are working very hard to try
    to shift the blame to others in the health care system, leaving them
    free to set incredibly high prices and increase them with little
    restraint.

    It is long past time for Congress to take action to rein in high drug
    prices. Thoughtful bipartisan efforts to help reduce prescription drug
    prices could save tens of billions of dollars for patients, taxpayers
    and the U.S. health care system. More importantly, they will help
    ensure that all Americans have affordable access to the drugs that they
    need to get and stay healthy.

    We look forward to working with this Committee to find solutions that
    will lower prescription drug prices and costs for older Americans. If
    you have any additional questions, feel free to contact me or have your
    staff contact Amy Kelbick on our Government Affairs staff at
    akelbick@aarp.org or 202-434-2648.

    Sincerely,

    Joyce A. Rogers
    Senior Vice President
    Government Affairs

                                     ______

              American Society of Health-System Pharmacists (ASHP)

                       4500 East West Highway, Suite 900

                               Bethesda, MD 20814

                              Email: gad@ashp.org

                              Phone: 301-664-8692

    ASHP (American Society of Health-System Pharmacists) respectfully
    submits the following statement for the record to the Senate Committee
    on Finance hearing on ``Drug Pricing in America: A Prescription for
    Change, Part II.''

    ASHP represents pharmacists who serve as patient care providers in
    acute and ambulatory settings. The organization's nearly 50,000 members
    include pharmacists, student pharmacists, and pharmacy technicians. For
    more than 75 years, ASHP has been at the forefront of efforts to
    improve medication use and enhance patient safety.

    ASHP's vision is that medication use will be optimal, safe, and
    effective for all people all of the time. A primary tenet of that
    vision includes access to affordable medications needed to save or
    sustain lives. Addressing the issue of skyrocketing drug prices,
    including excessive price increases on commonly used generic
    medications, is one of ASHP's highest and longstanding public policy
    priorities. According to a Kaiser Health Tracking Poll, 1 in 4
    Americans cannot afford their medications.\1\ Poor access to
    medications can lead to increased morbidity and mortality, and can
    cause healthcare costs to increase.
    ---------------------------------------------------------------------------
        \1\ DiJulio, Bianca, et al. ``Kaiser Health Tracking Poll: August
    2015.'' The Henry J. Kaiser Family Foundation, 20 Aug. 2015,
    www.kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-
    august-2015/. Accessed February 10, 2019.

    ASHP has been proactively addressing challenges related to the rapid
    increase of prescription drug pricing on several fronts, including
    working with like-minded stakeholders and educating members of Congress
    about the unsustainable burdens faced by patients, healthcare
    ---------------------------------------------------------------------------
    providers, and the entire healthcare system.

    ASHP is a lead member of the Steering Committee of the Campaign for
    Sustainable Rx Pricing (CSRxP), a coalition of prominent national
    organizations representing physicians, consumers, payers, hospitals,
    health systems, and patient advocacy groups. CSRxP has developed a
    policy platform promoting market based solutions supported by three
    pillars: competition, value, and transparency.

    The goal of the campaign is to identify policy options that have
    bipartisan support and, therefore, a greater likelihood of passage. To
    that end, CSRxP focuses on policies to incentivize a more competitive
    marketplace to help stimulate lower drug prices. The campaign has also
    expressed support for efforts to loosen restrictions that prevent
    generic drug companies from obtaining the samples necessary to
    manufacture a competing product.

    The price increases have placed enormous budgetary pressure on
    healthcare organizations, including hospitals and health systems. ASHP,
    along with the American Hospital Association (AHA) and the Federation
    of American Hospitals (FAH), recently released a report on the impact
    that the cost of and access to prescription drugs are having on
    hospital budgets and operations.

    Specifically, the report showed that:

          Average total drug spending per hospital admission increased by
    18.5% between fiscal years (FY) 2015 and FY2017.

          Outpatient drug spending per admission increased by 28.7%, while
    inpatient drug spending per admission increased by 9.6%, between FY2015
    and FY2017.

          Hospitals experienced price increases of over 80% across
    different classes of drugs, including those for anesthetics, parenteral
    solutions, and chemotherapy.

          Over 90% of surveyed hospitals reported having to identify
    alternative therapies to manage spending.

          One in 4 hospitals had to cut staff to mitigate budget
    pressures.\2\
    ---------------------------------------------------------------------------
        \2\ NORC at the University of Chicago. ``Recent Trends in Hospital
    Drug Spending and Manufacturer Shortages'' (2019), https://www.aha.org/
    system/files/2019-01/aha-drug-pricing-study-report-01152019_1.pdf.
    Accessed 25 Feb. 2019.

    ASHP does not collect, store, or report drug pricing information.
    However, we continually hear from pharmacy leaders in hospitals and
    health systems that sudden, inexplicable, and unpredictable price
    increases in connection with some of the most commonly used, long
    standing generic medications are becoming more prevalent--and are
    ---------------------------------------------------------------------------
    occurring on a nationwide basis.

    As there is no single solution to spikes in the prices of certain
    drugs, there is no single cause either. In this statement, we address
    four additional issues as they relate to drug pricing: competition,
    Risk Evaluation and Mitigation Strategies (REMS), Direct and Indirect
    Remuneration (DIR Fees), and the 340B Drug Pricing Program.

    COMPETITION

    In particular, ASHP would like to learn more about the marketplace
    dynamics that could contribute to this issue, as we have worked
    diligently to address the issue of drug shortages for nearly 15 years.
    Although drug shortages are caused by a number of factors, we have
    observed that drugs in short supply made by only one or two
    manufacturers often result in higher-than-normal prices. If, for
    example, there is a lack of competition in the generic market place, we
    urge the committee to look at ways to stimulate more marketplace
    presence. ASHP supports bills such as S. 64, the ``Preserve Access to
    Affordable Generics and Biosimilars Act.'' This bipartisan bill would
    potentially increase competition by prohibiting companies from engaging
    in ``pay-to-delay'' tactics to stifle generic and biosimilar entry into
    the market.

    RISK EVALUATION AND MITIGATION STRATEGY (REMS)

    ASHP recognizes that there may be limited circumstances in which
    constraints on the traditional drug supply system may be appropriate
    for reasons of patient safety, including through the use of
    manufacturer-driven REMS. However, we believe that REMS should never be
    used to artificially inflate drug prices, nor should REMS interfere
    with the professional practice of pharmacists, physicians, nurses, and
    other providers. We believe that there may be current cases in which a
    manufacturer-
    driven REMS using restricted distribution is causing higher prices for
    those drugs, having adverse effects on patient access, and delaying
    treatment. In some cases, there may be evidence to suggest that the use
    of restricted or limited distribution channels has resulted in the
    inability of a potential competitor to acquire enough of a drug to
    conduct the required testing to bring a generic competitor to market.
    For this reason, ASHP thanks Chairman Grassley for introducing S. 340,
    the ``Creating and Restoring Equal Access to Equivalent Samples
    (CREATES) Act of 2019.'' The CREATES Act will help ensure that brand-
    name pharmaceutical companies cannot manipulate regulatory rules to
    prevent competition, which is essential for patient access to
    affordable medications. Additionally, we recommend that Congress
    require the Food and Drug Administration (FDA) to investigate
    restricted distribution under a REMS as a means to artificially
    increase drug prices and limit access to critical medications.
    Restricting distribution of medications is often a means to push
    patients to a specific purchasing channel, which in some cases
    increases not only their out-of-pocket costs, but also systemic costs.
    Further, restricted distribution networks can complicate patient access
    to critical medications, potentially disrupting care.

    DIRECT AND INDIRECT REMUNERATION FEES (DIR FEES)

    Many factors contribute to high drug product costs; addressing the
    problem is made difficult by lack of transparency about the marketplace
    for those products. For example, DIR fees and other rebates negotiated
    by pharmacy benefit managers (PBMs) make it difficult to determine the
    actual cost of a drug. DIR fees are a growing nationwide concern among
    pharmacies that dispense medications in a community pharmacy or
    outpatient clinic setting. Created under the Medicare Part D Program,
    DIR fees were originally intended as a way for CMS to account for the
    true cost of the drug dispensed, including any manufacturer rebates.
    Often these rebates were unknown until the drug was dispensed and the
    claim adjudicated. Moreover, the fees themselves, which are often
    arbitrary in nature, have mushroomed over the past decade, to the point
    that pharmacies regularly see annual DIR totals in the tens of
    thousands of dollars.

    Recently, a concerning trend has emerged in which pharmacy benefit
    managers (PBMs) have begun to charge DIR fees to their pharmacy
    providers. Under this scenario, PBMs are inappropriately applying their
    own plan performance measures as a way to assess fees on pharmacies.
    This is problematic for the following reasons:

          It is an arbitrary and unintended application of quality
    measures meant for total plan performance as opposed to pharmacy-level
    metrics.

          The quality measures applied tend to be based on maintenance
    medications such as blood pressure medications or medications used to
    treat diabetes. These measures were never intended to be applied to
    specialty medications or to other specialized disease states such as
    oncology, yet PBMs assess DIR fees against the gross reimbursement for
    all prescriptions received by pharmacy providers, not just maintenance
    medication s.

          Pharmacy providers are essentially being penalized with backdoor
    fees without any requirement that PBMs define, justify, or explain
    these charges to providers and to CMS.

    DIR fees assessed on pharmacies providing specialty medications have
    been especially hard-hit, due to the fee structure. Fees could be a
    flat rate of per dollar per claim or a percentage (typically 3-9%) of
    the total reimbursement per claim. Using the percentage-based
    structure, the fees would increase markedly for specialty drugs, which
    are typically much more expensive than maintenance medications,
    sometimes resulting in thousands of dollars. A 9% fee on a drug costing
    $100,000 is $9,000. Additionally, these fees are assessed
    retroactively, sometimes months after the claim has been adjudicated,
    providing no recourse for the pharmacy impacted by the assessment.

    The result of imposing DIR fees has led to higher cost-sharing
    responsibilities for Medicare beneficiaries, which have, in turn,
    caused more of these beneficiaries to enter the Part D donut hole,
    where the patient is solely responsible for the cost of the drug. Along
    with the higher costs absorbed by patients, adherence rates tend to be
    lower among Medicare beneficiaries who are in the donut hole and may
    not have the financial resources to pay for their medications. This is
    in stark contrast to the very reason DIR fees targeting manufacturer
    rebates were created--so that savings could be passed on to patients.

    Pharmacies are not alone in their concern. In January 2017, CMS
    published a fact sheet expressing concern over DIR fees and cited those
    fees as contributing to increased drug costs, which, in turn, increased
    patients' out-of-pocket spending and Medicare spending overall.\3\
    Additionally, questions remain as to whether Part D plan sponsors have
    the authority to assess these fees on pharmacies. There are no
    references to DIR fees collected on pharmacies in either the Part D
    statute or corresponding CMS regulations.
    ---------------------------------------------------------------------------
        \3\ Fact sheet, ``Medicare Part D--Direct and Indirect Remuneration
    (DIR).'' Centers for Medicare and Medicaid Services, 19 January. 2017,
    https://www.cms.gov/newsroom/fact-sheets/medicare-part-d-direct-and-
    indirect-remuneration-dir. Accessed February 10, 2019

    ---------------------------------------------------------------------------
    ASHP's professional policy on DIR fees is as follows:

            To advocate that payers and pharmacy benefit managers be
            prohibited from recovering direct and indirect remuneration
            fees from pharmacies on adjudicated dispensing claims; further,

            To oppose the application of plan-level quality measures on
            specific providers, such as participating pharmacies.\4\
    ---------------------------------------------------------------------------
        \4\ ASHP Policy 1814, ``Direct and Indirect Remuneration Fees.''
    ---------------------------------------------------------------------------

    THE 340B DRUG PRICING PROGRAM

    For 25 years, the federal 340B program has allowed safety-net hospitals
    ``to stretch scarce Federal resources as far as possible, reaching more
    eligible patients and providing more comprehensive services.'' This
    program has been essential to expanding access to lifesaving
    prescription drugs and comprehensive healthcare services to low-income
    and uninsured individuals, at no cost to the federal government. The
    federal 340B program is not causing high drug prices. The program
    accounts for less than 5% of annual drug purchases in the United
    States, while safety-net providers give 30% of the care. There are many
    contributing factors to higher drug costs, but there is no objective
    evidence that the program has increased overall drug pricing. In fact,
    the 340B program is revenue-neutral, benefiting patients without
    increasing costs for federal payors.

    The federal 340B program enables these hospitals to serve their
    communities by providing vital care such as:

          Free or lower-cost medications to patients.
          Programs to increase medication adherence, including clinical
    pharmacy services to high-risk patients who are on multiple and/or
    complex medications.
          Increased access to primary care.
          Screenings and preventive care services to detect health
    problems early and decrease morbidity and mortality, as well as to
    decrease healthcare costs and hospital admissions.

    The federal 340B program is at risk because of a recent change in
    Medicare payment policy that reduces payment from average sales price
    plus 6 percent to average sales price minus 22.5 percent. Cuts of this
    magnitude undermine the intent of the program, reducing resources that
    hospitals use to expand access to care and services to vulnerable
    communities. Given the increasingly high cost of pharmaceuticals, the
    federal 340B program provides critical support to the entities eligible
    to participate in the program.

    CONCLUSION

    ASHP thanks the Committee on Finance for holding this important
    hearing. ASHP remains committed to working with Congress and industry
    stakeholders to ensure that patients have affordable access to
    lifesaving and life-sustaining medications.

                                     ______

                  Coalition for Affordable Prescription Drugs
    U.S. Senate
    Committee on Finance
    Dirksen Senate Office Bldg.
    Washington, DC 20510-6200

    Tuesday, February 26, 2019

    The Coalition for Affordable Prescription Drugs (CAPD) appreciates the
    opportunity to submit the following statement for the record.

    Overview

    CAPD is a diverse group of employers, unions, public sector employees
    and retirees and the pharmacy benefit managers (PBMs) they partner with
    to provide more affordable prescription drug coverage for millions of
    Americans.

    Today, too many patients and families are struggling to pay for the
    medications they need. It's no surprise that a recent Politico/Harvard
    Chan School of Public Health poll showed that 80 percent of Americans
    see high prescription drug prices as a top priority for the new
    Congress and the Administration.

    The Role of PBMs in Lowering Costs

    In the face of rising drug prices, PBMs partner with employers, unions,
    public sector retirees and other organizations who purchase health care
    to help manage prescription drug coverage for millions of Americans. By
    negotiating with drug companies and providing patient-centered tools to
    improve care and help lower out-of-pocket costs, PBMs save over $900
    per person each year.

    In addition, PBMs are expanding visibility into drug prices by enabling
    doctors and patients to see the price of various medicines at the point
    of prescribing, based on the individual's specific drug benefits. With
    this information, physicians switch to a more affordable medicine
    nearly 20 percent of the time when clinically equivalent alternatives
    are offered through UnitedHealth Group's RTBT, PreCheck MyScript. In
    another example, CVS Health's Real Time Benefits tool has saved
    patients an average of $120 to $130 per fill.

    Drug Company Prices Are the Problem

    Although there have been many ideas proffered about how to address the
    rising prices of medicines, CAPD believes that we first need to address
    the root problem: prices set by drug makers. Drug companies alone set
    their prices and they are rising at an unsustainable rate. In fact,
    drug companies have raised prices already in 2019 on hundreds of
    medicines. And, what's worse is that this is repeat behavior. Drug
    companies often raise those prices multiple times a year for the exact
    same product. Over the last five years, prices increased on the top 20
    most prescribed brand-name drugs for seniors by an average of 12
    percent each year, which is significantly above the annual rate of
    inflation. The truth is simple: Drug companies hike their prices
    because they can. When they do so, millions of patients pay more at the
    counter.

    Drug companies, hoping to avoid scrutiny and sustain high profits, are
    pointing the finger at every other industry except themselves.
    According to drug companies, the reason why drug prices are so high
    isn't because they keep raising prices, or abuse the patent system, or
    make by far the highest profits in health care--it's everyone else's
    problem, not theirs.

    In today's testimony, we will likely hear a common refrain from drug
    companies: part of the reason that drug prices are so high are because
    of the rebates that they are forced to give to PBMs. But the problem
    with this argument is that, according to a recent study, there is
    little correlation between prices drug companies set for their drugs
    and the rebates negotiated by PBMs across 23 major drug categories.
    What's more, in Medicare Part D, even after accounting for rebates, the
    costs of brand name drugs still increased 62% from 2011 to 2015.

    All parties need to come to the table to make prescriptions more
    affordable and accessible to the patients who need them--but nothing
    will be done if pharma refuses to even pull up a chair and address the
    problem where it starts: their high prices. We hope Congress will use
    this hearing as an opportunity to ask the pharmaceutical industry to
    answer for these increases.

    Pharma's Gamesmanship Reducing Competition to Keep Prices High

    One way to meaningfully lower drug prices for patients is to stop the
    gamesmanship of the patent and regulatory systems that drug companies
    use to maintain their monopoly pricing power and keep lower-cost
    generic alternatives from entering the market.

    Brand drug manufacturers exploit the FDA Risk Evaluation and Mitigation
    Strategies (REMS) program to prevent generic drug makers from accessing
    needed samples, costing the U.S. health care system $5.4B each year.
    The CREATES Act, which passed out of the Senate Judiciary Committee
    last year, is a targeted, market-based, bipartisan solution to the
    longstanding problem of brand name pharmaceutical companies denying
    generic manufacturers access to the samples they require to conduct
    necessary equivalence testing to bring their product to market.

    Another way brand drug manufacturers game the patent and regulatory
    system is through ``pay-for-delay'' deals, in which drug makers engage
    in anticompetitive patent settlements with potential generic
    competitors, resulting in $3.58 in higher drug costs each year. In the
    most high-profile example of these abuses, drug maker AbbVie last year
    reached agreements with Amgen, Samsung Bioepis and Mylan to delay entry
    of a lower-cost biosimilar version of the drug to 2023 in the United
    States.

    A third example of gamesmanship by brand drug manufacturers is
    evergreening, in which generic competition is delayed by additional
    patents on minor variations of the original drug for the clear purpose
    of extending monopoly protection. While these tweaks often do not
    convey enhanced clinical benefits to the patient, they do extend the
    time period during which drug manufacturers can continue to control
    pricing by preventing competition. For example, best selling drug
    Humira to treat rheumatoid arthritis and psoriasis is protected by over
    100 patents and the product may not face any competition until as late
    as 2034.

    We encourage Congress to explore proposals that target patent and
    regulatory abuses by drug companies in order to lower drug prices for
    patients.

    Conclusion

    Simply put, a patient cannot be helped by a drug they cannot afford. We
    ask today that Congress once and for all refuse to accept drug
    manufacturers' excuses for high prices and take steps to put an end to
    the patent and regulatory abuses that keep prices artificially high.

    We believe the time to act is now. CAPD is committed to working with
    Congress and other stakeholders on this and other solutions to
    meaningfully lower prescription drug prices for all Americans. We look
    forward to supporting this critical effort.

    Debra Barrett
    Executive Director, Coalition for Affordable Prescription Drugs

    Contact:
    Meghan Scott
    Spokesperson, Coalition for Affordable Prescription Drugs
    mscott@affordableprescriptiondrugs.org
    (202) 341-2060

               What They're Saying: Don't Let Pharma Off the Hook

    On January 29, the Senate Finance Committee held a hearing, ``Drug
    Pricing in America: A Prescription for Change.'' During the hearing,
    both Senators and witnesses discussed drug companies' high prices and
    their anti-competitive actions.

    DRUG COMPANIES' HIGH PRICES

          Chairman Chuck Grassley (R-Iowa): ``I've also heard from seniors
    who have seen their prescriptions increase month after month for no
    apparent reason. And I've heard stories about people reducing their
    life-saving medicines...to save money. This is unacceptable. . . . But
    other drugs are creating problems as well, that is why tackling high
    prescription drug costs is one of Senator Wyden's and my first priority
    on this committee.''
          Ranking Member Ron Wyden (D-Oregon): ``So there's no shortage of
    evidence about what the problems are. The companies have unchecked
    powers to set prices on their own, and often it's to meet Wall Street's
    expectations rather than meet demand in the market.''
          Mark Miller, The Arnold Foundation: ``The revenues that come out
    of the United States exceed R&D by something like 70, 75 percent. . . .
    So the first point is when people say R&D is driving these prices,
    there is a big disconnect in there. . . . We found many companies in
    which they're spending much more on advertising, marketing and other
    administrative expenses than they are on R&D.''
          Peter Bach, Memorial Sloan Kettering: ``Prices for monopoly
    goods such as these are determined by the market in which they are
    sold, not the other way around. . . . Please realize that these drugs
    do not inherently cost $1 million any more than they inherently cost
    $1.''
          Kathy Sego, mother of a child with diabetes: ``As a mother, I
    would probably say to them--I hope you know that there are people who
    are going without their medication, and because they're going without
    their medication they're at risk of dying. And how can you be OK with
    that? . . . That should never be a decision that a person needs to
    make. And unfortunately, it is.''

    GAMESMANSHIP AND ANTICOMPETITIVE PRACTICES

          Douglas Holtz-Eakin, American Action Forum: ``We have some very
    isolated instances of cost associated with off-patent sole-source
    drugs. And in those circumstances, it appears that firms are able to
    take advantage of their market power and raise the prices of drugs
    sharply. This strikes me as a fundamental anti-competitive act that
    ought to be investigated.''
          Senator Robert Menendez (D-New Jersey): ``Manufacturer coupons,
    many suggest, distort spending. . . . Who's winning with these
    coupons?'' Peter Bach: ``I can assure you we know who's winning and
    it's the people who are printing the coupons . . . the reality is
    they're artificial price supports.''
          Senator Maggie Hassan (D-New Hampshire): ``We've seen a lot of
    bad actors gaming the system over the years, really to pad their
    pockets. There are countless ways drug companies take advantage of
    loopholes and taxpayers end up footing the bill.''
          Mark Miller: ``We need to curb the anticompetitive behaviors of
    manufacturers and inject competition back into the marketplace.
    Manufacturers benefit from taxpayer-funded NIH research and from
    government granted monopolies. And naturally, they devote resources to
    protecting those monopolies.''

                        AffordablePrescriptionDrugs.org

                                     ______

                        Letter Submitted by Linda George
    March 4, 2019

    U.S. Senate
    Committee on Finance
    Dirksen Senate Office Bldg.
    Washington, DC 20510-6200

    RE: ``Drug Pricing in America,'' Senate hearing held on February 26,
    2019

        Dear Finance Committee:

        On Wednesday January 23, 2019, I gave myself my last weekly
    injection of Humira, which had helped my mobility due to psoriatic
    arthritis. I have done very well for the past two years with this
    drug--one typically requiring a biweekly 40mg syringe injection. But I
    just started a new medication, an infusion administered in my doctor's
    office by an outsourced nurse who's not part of the practice.

        I needed to switch to the infused medication because on March 1st--
    when I became eligible for Medicare--Humira would increase from $5/
    monthly under our previous private insurer, Anthem Blue Cross, to a
    prohibitive $800+ per injection with Medicare Part D coverage. Bottom
    line: Medicare does not cover self-injections. Because an infusion
    would be administered in my rheumatologist's office, it is 100% covered
    as a medical procedure through Part B via Medicare. Now, I understand
    why Humira's advertisements, invading my television screen no matter
    what time or what channel I watch, always feature younger people
    engaged in various physical activities.

        When I needed information about how to navigate this insurance
    morass, I called my Humira ambassador, an AbbVie employee who serves as
    a liaison between the consumer and the company. She assured me that I
    may be covered if I submitted my tax returns to the company's
    foundation. Evidently if I make less than $65,000, through the
    company's assistance program, the parent company's foundation pays a
    portion of the thousands needed to offset consumers' exorbitant cost of
    this drug; however, regardless of my income, I have a huge problem
    submitting my tax statements to anyone--except to my trusted accountant
    and the IRS.

        It seems AbbVie puts some big money into tiers of bureaucracy
    through advertising, marketing, and supporting a foundation based on
    employees forced to donate a percentage of their income. In addition,
    whenever a consumer needs to have the simplest question answered by the
    company, instead of AbbVie offering an 800 phone number, that consumer
    must first enroll in the ``Ambassador Program,'' then wait for their
    designated ambassador to return the call. I've had two ambassadors so
    far, and each seems more than willing to keep me on the phone for an
    extended time, asking all kinds of questions, as if padding their own
    positions by calling consumers on a monthly basis. I'd much prefer that
    these ambassadors work to figure out ways to reduce the drug's cost, so
    consumers like me can afford it.

        Switching to new medication certainly had caused me some angst. I
    had no sense of how I will respond to the new infusion. Based on
    history, I've had my share of side effects during the 38 years I've
    been dealing with arthritis. I have trouble with drugs that are
    ingested through the GI tract. I also have had two different cancers, a
    risk accompanying many of the biologic arthritis medications. In
    addition, I've had some serious adverse reactions to medications,
    requiring hospitalization. Lucky for me, the new infusion, 100% covered
    by Medicare Part B, seems to be working well.

        Despite having this ailment, I consider myself to be healthy, doing
    whatever possible to maintain whatever I can do to stay well to
    overcome arthritis' swelling, fatigue, and pain that has challenged me
    physically and mentally. I probably have had more knee aspirations and
    steroid injections than some Olympic athletes. My Fitbit gets a daily
    workout. Even after trying many alternative treatments in search of a
    solution, Humira seemed to help me resume a normal life. And for that,
    I was grateful.

        AbbVie Chairman and CEO Richard A Gonzalez stated at the U.S.
    Senate Finance Committee on February 26, 2019, ``We believe it is
    important that discussions about access and affordability include a
    focus on how to alleviate Medicare Part D out-of-pocket burdens above
    and beyond just lowering list prices.'' I must raise the question to
    AbbVie: What is the company doing internally to cut costs for
    consumers?

        I am hoping that you will help address the mounting bureaucratic
    issues surrounding health care in America that make it challenging for
    consumers to afford and navigate. Please feel free to reach out to me
    if you need more information or assistance in any way.

        Yours,

    Linda George

    cc: Senator Patrick Toomey
      Senator Bob Casey
      Attorney General Josh Shapiro

                                     ______

                         Statement of Robin K. Huszagh
    February 26, 2019

    After listening to the hearing today on C-SPAN, I wanted to share my
    situation with you as a patient being forced to pay the full
    ``negotiated'' price for Humira and Enbrel. My husband and I are self-
    employed and self-insured. We must purchase health insurance through
    the independent ``retail'' market. I specifically renewed a
    grandfathered ``retail'' PPO health insurance policy we've had since
    2010 for our family of 3, now priced at $2,166.00/month, so that could
    get the specialty formulary I needed to treat my Rheumatoid Arthritis
    at an affordable price and continue to see my doctors. To my distress,
    the Insurer (BCBS) and Pharmacy Benefit Manager (Prime Therapeutics)
    altered the PPO plan's pharmacy benefits (cost sharing details) after
    the plan commenced, leaving me with an expensive policy that no longer
    covers my expensive specialty formulary at an affordable price. Unlike
    typical commercial employer-based group policies, once I needed the
    expensive specialty formulary, my independent retail PPO policy was
    switched into a restricted pharmacy network with only one mail-order
    supplier and an ``Accumulator Adjustment Program.'' The Insurer/PBM
    also blocked the use of drug manufacturer's discount coupons and
    programs completely (worth $12,000 to $16,000 per year in my case) so
    that a drug that used to cost me $5.00 to $10.00 per month with a
    manufacturer's coupon now costs between $5356 to $6652 per month, the
    negotiated contract rate between the insurer and the drug manufacturer.
    My deductible was raised from $2600 to $5200 for a 20% coinsurance
    responsibility and $11,200 out-of-pocket max for full benefits. The
    insurer added a second review process in 2019 for any drug with a
    contract rate of $5000/month or higher, in addition to the one put in
    place in 2018 as part of a ``step therapy'' restriction/review. In 2019
    the price for both Humira and Enbrel jumped to over $5000 per month and
    the insurer has stated their ``secondary review'' would allow them to
    deny benefits for these drugs even though the policy states they are
    approved formularies.

    At the current premium rate, paying for insurance and an expensive
    formulary has been financially challenging to say the least and has
    caused us to take an early withdrawal from our IRA. I contacted the
    Illinois Department of Insurance and asked why insurers can change
    pharmacy benefits mid-year and weren't required to document the
    specific cost-sharing and pharmacy details on all insurance policy
    documents, so benefits are locked in for the year. I was told those
    details are NOT a requirement for retail plans, and pharmacy benefit
    changes are allowed to occur throughout the life of the contract which
    also includes medication price changes. So, if a consumer buys a policy
    based on access and pricing for a particular drug, there is no
    guarantee the terms will remain in effect for the full contract year. I
    was never notified of the changes even after contacting the insurer. I
    hadn't realized any changes until I went to the pharmacy to pick up a
    prescription and hit the payment ``brick wall''!

    The Network Transparency Act of 2019 was passed in Illinois, however
    that only set policy guidelines for ``notification requirements'' to
    the policy holder if a particular provider pulls out of a network but
    doesn't address the insurer's ability to change a policy's pharmacy
    benefits mid-year, leaving the policy holder with a shocking bill. The
    contract price for Humira went up 9% in January, the cost of my PPO
    policy went up 9% in 2019, and now I'm required to pay a higher
    premium, higher out-of-pocket max, and the full price for Humira
    without the use of manufacturer's discount programs. Patients with
    employer-based group plans who are already benefiting from employer
    cost-sharing perks are allowed the use of discount programs and coupons
    at the point of sale (the pharmacy) because the insurer and the
    employer never know the coupon is being used as a form of payment at
    the retail pharmacy location. The coupon value pays for the drug and
    that hidden payment is applied to the user's deductible. Those who
    benefit from these programs do not care what the list price or the
    negotiated price is for a high-priced drug because they never have to
    actually pay it, the insurer pays for it because deductibles and out-
    of-pocket limits are met early in the year. Those with commercial group
    plans obtain specialty formularies for $5 to $10 per month. I have to
    pay the full price. The change in my PPO policy was intentionally made
    by the insurer to ensure I personally pay the full cost of the drug for
    as long as possible. They do not want me to get assistance from Pharma
    to reach my deductible or maximum. There is no relief in sight for the
    independently insured who have no employer or government subsidies and
    actually pay the full high price for each medication and monthly
    insurance premiums. With the majority of Americans getting health
    insurance perks from their employer and using drug coupons, there is no
    incentive for drug manufacturers to ever lower list prices.

                                     ______

              Interfaith Center on Corporate Responsibility (ICCR)

                        475 Riverside Drive, Suite 1842

                               New York, NY 10115

                                 (212) 870-2295

                                  www.iccr.org

    March 12, 2019

    Mr. Chairman, Ranking Member and Members of the Committee:

    ICCR is a coalition of over 300 global institutional investors
    representing more than $400 billion in managed assets. Leveraging our
    equity ownership in some of the world's largest and most powerful
    companies, ICCR members regularly engage management to identify and
    mitigate social and environmental risks resulting from corporate
    operations and policies. While ICCR members never shy away from making
    the moral case for action, our fundamental proposition as investors is
    that responsible and sustainable business practices--and a strong
    corporate culture of ethics--are in the long-term interest of
    companies, investors and communities.

    ICCR members have a long-standing history of engagement with
    pharmaceutical companies on issues of price restraint, equitable
    pricing strategies, anti-competitive practices, marketing policies and
    practice, as well as disclosure of R&D expenditures (e.g., report on
    the number of products in the R&D pipeline that are new versus enhanced
    versions of existing products) and lobbying/political activities with
    agendas that may restrict the access and affordability of medicines.

    For decades, ICCR members have pressed drug companies for greater
    disclosures on pricing structures as a way to promote greater access to
    medicines. A lack of transparency around how drug prices are determined
    has led to an industry-wide ethos of ``whatever the market will bear,''
    which can lead to predatory pricing. We have asked companies to
    disclose the rates of price increases year-to-year of their top selling
    branded prescriptions drugs and to disclose the rationale and criteria
    used for these price increases. We have also asked the companies to
    assess the legislative, reputational and financial risks these
    increases represent for the companies. However, that lack of
    transparency still prevails.

    Most recently, we have become increasingly concerned about
    pharmaceutical companies' governance structures and their Boards'
    ability to proactively mitigate risk related to high drug prices. A
    2017 Credit Suisse analyst report stated that ``US drug price rises
    contributed 100% of industry EPS growth in 2016'' and characterized
    that fact as ``the most important issue for a Pharma investor today.''
    In response to this, in 2018 ICCR members filed resolutions at the
    companies highlighted in the 2017 Credit Suisse report asking ``the
    Compensation Committee (the `Committee') to report annually to
    shareholders on the extent to which risks related to public concern
    over drug pricing strategies are integrated into [company's] incentive
    compensation policies, plans and programs (`arrangements') for senior
    executives. The report should include, but need not be limited to,
    discussion of whether (i) incentive compensation arrangements reward,
    or not penalize, senior executives for adopting pricing strategies, or
    making and honoring commitments about pricing, that incorporate public
    concern regarding prescription drug prices; and (ii) such concern is
    taken into account when setting financial targets for incentive
    compensation arrangements.'' In other words, are executives
    incentivized to simply increase the price of drugs with no added
    benefit in clinical efficacy simply to meet short-term revenue targets?

    In particular, we are seeking better articulation of the goal-setting
    process and the translation of those goals into incentive pay targets.
    We would strongly encourage you, as members of the Senate Finance
    Committee, to also seek written answers to the following questions:

          How assumptions about price changes are incorporated when
    revenue goals are set;
          Whether any policy or guideline exists regarding the preferred
    proportion of revenue growth derived from price increases;
          Whether any policy exists regarding unplanned price increases
    that would enable revenue goals or compensation revenue targets to be
    met and whether the board has to approve such increases; and
          How the compensation committee uses revenue goals or estimates
    to produce the various target levels (e.g., minimum, target and
    maximum) used to determine incentive payouts.

    Mirroring Senator Wyden's concern that AbbVie's CEO's bonus is directly
    tied to the sales of Humira, we have also been asking why Humira sales
    are an appropriate measure for AbbVie's short-term incentive plan
    (STIP), and whether the company considers pricing increases when
    awarding STIP? AbbVie uses net revenue, income before taxes and Humira
    sales as metrics for the annual bonus and earnings per share (EPS) as a
    metric for certain long-term incentive awards to senior executives. For
    Pfizer, it is concerning to investors that the company publicly states
    that ``innovation in medicine has been and continues to be the
    cornerstone of the company,'' yet no pipeline metrics are included in
    the executive incentive agreements.

    In addition to increased disclosure on incentive structures, we have
    also asked companies to formalize board oversight of prescription drug
    pricing risk. For example, what is Pfizer's board oversight of drug
    pricing, or lack thereof, which may have led to the settlement of the
    co-pay kickback investigation and drug shortages due to manufacturing
    or market issues. A 2018 Credit Suisse report highlighted AbbVie as
    among the companies most at risk from specialty pricing pressures in
    commercial insurance. Humira, which accounted for 65% of AbbVie's
    revenues in 2017 now faces competition in Europe from biosimilars,
    which are expected to cost less. Therefore, robust board oversight of
    risks related to drug pricing would provide a valuable outside
    perspective and help ensure that those risks are being managed for the
    long term.

    Lastly, we also recognize that the strategy to expand monopolies
    without any meaningful new science is an unsustainable business model
    that exacts a heavy cost on patients and on the systems in which they
    seek care, and therefore, encourage companies to refrain from engaging
    in anti-competitive practices.

    As investors, we want the companies in which we invest to be successful
    in the long term, with sustainable business models that deliver value
    to customers and stakeholders. Because pharmaceutical companies derive
    their social license to operate from their contribution to public
    health, it is critical that their businesses--including their executive
    incentives structures--reinforce, not undermine, that social contract.
    After many years of investor engagement in an effort to promote greater
    access and affordability of medicines, today we seriously question the
    value pharmaceutical companies are delivering to their shareholders and
    to the greater public.

    If you have any questions, please contact, Meg Jones-Monteiro, Program
    Director--Health Equity, at mjonesmonteiro@iccr.org or (212) 870-2984.

                 APPENDIX: 2019 ICCR EXECUTIVE INCENTIVES AND
                         DRUG PRICING RISK RESOLUTIONS

    2018 Companies: AbbVie, Amgen, Biogen, Bristol-Meyers Squibb, Eli Lilly
    2019 Companies: AbbVie, Biogen, Bristol-Meyers Squibb, Celgene, Johnson
    & Johnson, Merck & Co, Pfizer, Vertex

    Example 2019 Resolutions:

    AbbVie (ABBV)

    _______________________________________________________________________

    RESOLVED, that shareholders of AbbVie Inc. (``AbbVie'') urge the
    Compensation Committee (the ``Committee'') to report annually to
    shareholders on the extent to which risks related to public concern
    over drug pricing strategies are integrated into AbbVie's incentive
    compensation policies, plans and programs (together, ``arrangements'')
    for senior executives. The report should include, but need not be
    limited to, discussion of whether (i) incentive compensation
    arrangements reward, or not penalize, senior executives for adopting
    pricing strategies, or making and honoring commitments about pricing,
    that incorporate public concern regarding the level or rate of increase
    in prescription drug prices; and (ii) such concern is considered when
    setting financial targets for incentive compensation arrangements.

    Supporting Statement: As long-term investors, we believe that senior
    executive incentive compensation arrangements should reward the
    creation of sustainable long-term value. To that end, it is important
    that those arrangements align with company strategy and encourage
    responsible risk management.

    A key risk facing pharmaceutical companies is potential backlash
    against high drug prices. Societal anger over exorbitant prices and
    pressure over limited patients' access due to unaffordability may force
    price rollbacks and harm corporate reputation.

    We applaud AbbVie for committing not to increase prices by more than
    10% for 2018, yet we are unaware of a like commitment for 2019 or
    beyond. Moreover, we are concerned that the incentive compensation
    arrangements applicable to AbbVie's senior executives may undermine any
    such commitment.

    AbbVie uses net revenue, income before taxes and Humira sales as
    metrics for the annual bonus and earnings per share (EPS) as a metric
    for certain long-term incentive awards to senior executives (2018 Proxy
    Statement, at 31). A 2017 Credit Suisse analyst report stated that ``US
    drug price rises contributed 100% of industry EPS growth in 2016'' and
    characterized that fact as ``the most important issue for a Pharma
    investor today.'' The report identified AbbVie as a company where price
    increases accounted for at least 100% of EPS growth in 2016 (Global
    Pharma and Biotech Sector Review: Exploring Future US Pricing Pressure,
    Apr. 18, 2017, at 1). It has been noted that the company's 2018 9.7%
    price increase for Humira could add $1.2 billion to the U.S. healthcare
    system (https://www.fiercepharma.com/pharma/drug-price-hikes-a-few-bad-
    actors-or-widespread-pharma?mkt_tok=eyJpljoiWWpZeFlt
    RTBOMIZoTkRJNSlslnQiOiJhckk2UONqNXBxNOx2UCtvdVdldzZVZXRIUHIrSOx
    ZOVRBNXdTV1FOeVNBSDMxb3NWUGJsRWtNcFROZmlPYmM5d2hXd3VuVOkld
    GICelBTYmk2).

    In our view, excessive dependence on drug price increases is a risky
    and unsustainable strategy, especially when price hikes drive large
    senior executive payouts. We believe that the company's strategy to use
    ``nursing support,'' which the California Department of Insurance
    claims in its suit against the company to be largely a kickback scheme
    to boost Humira sales, may have been better managed by leadership if
    Humira sales were not an explicit part of the payment incentive plan
    (https://www.law360.com/articles/1084008).

    The disclosure we request would allow shareholders to better assess the
    extent to which compensation arrangements encourage senior executives
    to responsibly manage risks relating to drug pricing and contribute to
    long-term value creation. We urge shareholders to vote for this
    Proposal.

    Merck & Co. (MRK)

    _______________________________________________________________________

    RESOLVED, that shareholders of Merck & Co., Inc. (``Merck'') urge the
    Compensation and Benefits Committee to report annually to shareholders
    on the extent to which risks related to public concern over drug
    pricing strategies are integrated into Merck's incentive compensation
    policies, plans and programs (``arrangements'') for senior executives.
    The report should include, but need not be limited to, discussion of
    whether (i) incentive compensation arrangements reward, or not
    penalize, senior executives for adopting pricing strategies, or making
    and honoring commitments about pricing, that incorporate public concern
    regarding prescription drug prices; and (ii) such concern is considered
    when setting financial targets for incentive compensation arrangements.

    Supporting Statement: As long-term investors, we believe that senior
    executive incentive compensation arrangements should reward the
    creation of sustainable value. To that end, it is important that those
    arrangements align with company strategy and encourage responsible risk
    management.

    We are concerned that the incentive compensation arrangements
    applicable to Merck's senior executives may discourage them from taking
    actions that result in lower short-term financial performance even when
    those actions may be in Merck's best long-term interests. Merck has
    committed to limit average price increases of its drugs to no more than
    the rate of inflation (https://www.marketwatch.com/story/merck-to-
    lower-price-of-hep-c-treatment-zepatier-by-60-commits-to-responsible-
    pricing-2018-07-19), but incentive compensation arrangements may be
    inconsistent with that commitment.

    Merck uses revenue and pre-tax income as metrics for the annual bonus,
    and earnings per share (EPS) is a metric for performance share units
    granted after January 1, 2017 (2018 Proxy Statement, at 51, 61). A 2017
    Credit Suisse analyst report identified Merck as a company where U.S.
    net price increases accounted for at least 100% of 2016 net income
    growth (Global Pharma and Biotech Sector Review: Exploring Future US
    Pricing Pressure, Apr. 18, 2017, at 22).

    In our view, risks to long-term value arise when large senior executive
    payouts can be driven by price hikes. Attention may focus on both high
    senior executive payouts and drug pricing, fueling public outrage. Ovid
    Therapeutics CEO Jeremy Levin has argued that incentives to boost
    short-term performance, such as EPS, lead executives to raise prices
    (and rebates to middlemen), starve research and development and buy
    back shares (https://www.biocentury.com/biocentury/strategy/2016-09-19/
    why-jeremy-levin-says-executive-compensation-and-drug-pricing-must-).

    Incentives may have societal implications, as one critic of high pay
    for healthcare executives has noted: ``[I]f the most influential
    executives of these companies are being paid to keep that [cost]
    trajectory up, that's money that's being taken away from education or
    infrastructure or other parts of the economy that may not be growing as
    quickly, and maybe that we'd want to grow more quickly'' (https://
    www.npr.org/sections/health-shots/2017/07/26/539518682/as-cost-of-u-s-
    heaIth-care-skyrockets-so-does-pay-of-heaIth-care-ceos).

    The disclosure we request would allow shareholders to better assess the
    extent to which compensation arrangements encourage senior executives
    to responsibly manage risks relating to drug pricing and contribute to
    long-term value creation. For example, it would be useful for investors
    to know whether incentive compensation target amounts reflect
    consideration of pricing pressures. We urge shareholders to vote for
    this Proposal.

    Pfizer (PFE)

    _______________________________________________________________________

    RESOLVED, that shareholders of Pfizer Inc. (``Pfizer'') urge the
    Compensation Committee (the ``Committee'') to report annually to
    shareholders on the extent to which risks related to public concern
    over drug pricing strategies are integrated into Pfizer's incentive
    compensation policies, plans and programs (``arrangements'') for senior
    executives. The report should include, but need not be limited to,
    discussion of whether (i) incentive compensation arrangements reward,
    or not penalize, senior executives for adopting pricing strategies, or
    making and honoring commitments about pricing, that incorporate public
    concern regarding prescription drug prices; and (ii) such concern is
    considered when setting financial targets for incentive compensation
    arrangements.

    Supporting Statement: As long-term investors, we believe that senior
    executive incentive compensation arrangements should reward the
    creation of sustainable value. To that end, it is important that those
    arrangements align with company strategy and encourage responsible risk
    management.

    A key risk facing pharmaceutical companies is potential backlash
    against high drug prices. Pfizer has been criticized for repeated price
    increases, and in July 2018 President Trump called out ``Pfizer and
    others'' in a tweet, saying they ``should be ashamed that they have
    raised drug prices for no reason''; Pfizer then postponed planned
    increases.

    We are concerned that the incentive compensation arrangements
    applicable to Pfizer's senior executives may discourage them from
    taking actions, like foregoing price increases that result in lower
    short-term financial performance even when those actions may be in
    Pfizer's best long-term interests.

    Pfizer uses revenue and earnings per share (EPS) as metrics for the
    annual bonus and operating income as a metric for performance share
    awards (2018 Proxy Statement, at 66, 68). A 2017 Credit Suisse analyst
    report identified Pfizer as a company where U.S. net price increases
    accounted for at least 100% of 2016 net income growth (Global Pharma
    and Biotech Sector Review: Exploring Future US Pricing Pressure, Apr.
    18, 2017, at 22). In its 2018 report, Credit Suisse characterized
    Pfizer's 2017 10% net price increase as above average for the industry
    and noted that its list price increases were the second highest (Global
    Pharmaceuticals: Scoring Sensitivity to Trump's Reforms, May 25, 2018,
    at 15, 20).

    In our view, excessive dependence on drug price increases is a risky
    and unsustainable strategy, especially when price hikes appear to drive
    large senior executive payouts. Highlighting this connection, a March
    2018 article carried the headline, ``Pfizer CEO Gets 61% Pay Raise--to
    $27.9 Million--As Drug Prices Continue to Climb'' (https://
    arstechnica.com/science/2018/03/amid-drug-price-increases-pfizer-ceo-
    gets-61-pay-raise-to-27-9-million/; see also https://www.usnews.com/
    opinion/articles/2017-08-30/bernie-sanders-take-on-big-pharma-and-
    lower-prescription-drug-prices). We are concerned that large payouts
    based on financial metrics that can be affected by pricing create risks
    for Pfizer.

    The disclosure we request would allow shareholders to better assess the
    extent to which compensation arrangements encourage senior executives
    to responsibly manage risks relating to drug pricing and contribute to
    long-term value creation. For example, it would be useful for investors
    to know whether incentive compensation target amounts reflect
    consideration of pricing pressures. We urge shareholders to vote for
    this Proposal.

                                     ______

              National Association of Free and Charitable Clinics

                          1800 Diagonal Road, Suite 600

                              Alexandria, VA 22314

            Nicole Lamoureux, President and Chief Executive Officer

    Chairman Grassley, Ranking Member Wyden and Members of the Committee,
    my name is Nicole Lamoureux and I am the President and Chief Executive
    Officer of the National Association of Free and Charitable Clinics.
    Last month, I was sitting in the hearing room as the pharma executives
    testified. While I applaud Congress for finally getting these
    executives to speak, I noticed some important gaps in the conversation.

    During the hearing, both Congress and the pharmaceutical executives
    focused on a specific group of Americans: those with health insurance.
    Senate Finance Committee Chairman Grassley opened the hearing by
    describing how high list prices hurt ``those with high deductibles''
    and ``taxpayers,'' but did not mention the uninsured. While we
    understand that the committee's focus remains largely on health
    programs within your jurisdiction that require significant federal
    investments, we believe that by not addressing the high cost of
    medication for the uninsured as well as the insured, the overall cost
    of health care will continue to increase.

    When medication costs are too high, uninsured individuals must forgo
    their medication or split doses, and often end up needing the emergency
    department for both the repercussions of missed prescriptions and for
    primary care. Research shows that 75 percent of all emergency
    department visits not resulting in admission are for non-emergencies
    that should be treated outside of the emergency room (Hwang et al.
    2012). Patients who lack insurance and access to primary care are often
    forced to use the emergency room for routine medical needs. These
    emergency room visits are expensive, contribute to overcrowding, and
    drive up healthcare costs for everyone.

    Currently, there are 27 million Americans without insurance--about 1 in
    12 people--and that number is growing. I know this group well. These
    are the people who receive access to health care and medication from
    the 1,400 free and charitable clinics in our country. Free and
    Charitable Clinics are safety-net health care organizations that
    utilize a volunteer/staff model to provide a range of medical, dental,
    pharmacy, vision and/or behavioral health services to economically
    disadvantaged individuals. Such clinics are 501(c)(3) tax-exempt
    organizations or operate as a program component or affiliate of a
    501(c)(3) organization. Free or Charitable Clinics restrict eligibility
    for their services to individuals who are uninsured, underinsured and/
    or have limited or no access to primary, specialty or prescription
    health care. Additionally, Free and Charitable Clinics receive little
    to no state funding and no federal funding, do not receive HRSA 330
    funds, and are not Federally Qualified Health Centers or Rural Health
    Centers. Therefore, these clinics rely heavily on the generosity of
    individual donors, foundations and grants as funding sources.

    Even though our organizations do not receive federal funding, we are
    impacted by every decision that is made at the federal level,
    especially when it comes to medication affordability. In 2018, the
    1,400 free and charitable clinics served 2 million Americans, with a
    total of 6.3 million patient visits. In the most recent data reported
    by our members, the number one concern for both our patient population
    and their providers is the high cost of medication.

    I understand why Medicaid and Medicare patients were the main focus of
    the testimony, but the needs of millions of uninsured Americans are
    also critical to the conversation about solving the pricing issues and
    inequities of the current healthcare system. When Congress asked the
    seven executives, ``Who pays list price?'' Merck CEO Ken Frazier
    responded by saying, ``There's a small percentage of people who have no
    insurance who could actually be charged the list price.'' He also said
    that in our current system, ``The poorest and the sickest are
    subsidizing others.'' Senator Daines summarized the issue this way: "So
    the people who can afford it the least, arguably, are paying the list
    price?''

    Those who are paying the list price are our patients, the uninsured and
    underinsured in this country. The current minimum price of $150 for a
    vial of insulin is not affordable for a mother making the choice
    between putting food on her table or paying for her prescription. Our
    patients have no choice but to ration medications, taking lower doses
    of them or stopping them altogether. We have no shortage of these
    stories, from young adults eating less than they should to reduce the
    amount of insulin they need to parents starving themselves to afford
    insulin for their children. In our network of clinics, this is a lived
    reality.

    In a time when few issues are truly bipartisan, and health care
    continues to become ever more divisive, the exponential growth of drug
    prices is a rare issue that crosses the aisle. Needing insulin isn't
    red or blue, nor is using an EpiPen or depending on an inhaler to
    breathe. We need to harness this rare moment of unity and push for true
    progress.

    I know that Congress realizes how important it is to have the
    conversation to make medication more affordable once and for all, so we
    can fix this broken system. I want to make sure we get it right this
    time around. America's free and charitable clinics try to catch the
    people who slip through the cracks. If we don't stop this unchecked
    rise in the cost of medications, these cracks will widen until they
    threaten the foundation of our health care system.

    I appreciate the opportunity to submit my comments to the hearing
    record on behalf of the 2 million Americans who receive care at free
    and charitable clinics and look forward to answering any questions that
    the committee might have.

    Works Cited:

    Hwang, Liao, Griffin, and Foley. ``Do Free Clinics Reduce Unnecessary
    Emergency Department Visits?'' The Virginian Experience Journal of
    Health Care for the Poor and Underserved 23 (2012): 1189-1204.

                                     ______

                       National Business Group on Health

                           20 F Street, NW, Suite 200

                              Washington, DC 20001

                        202-558-3000  Fax 202-628-9244

                          www.businessgrouphealth.org

    Chairman Grassley, Ranking Member Wyden and members of the Senate
    Committee on Finance, thank you for the opportunity to submit a
    statement for the record on the large employers' perspective on drug
    pricing.

    The National Business Group on Health (NBGH or the ``Business Group''),
    whose members include 437 of the nation's largest employers, commend
    the Committee's effort to take a holistic look at the root causes of
    high and escalating drug prices. In addition to these, we anticipate
    submitting comments on subsequent hearings within the Committee's
    series on drug pricing.

    Along with the government, taxpayers and families, employers have a
    vested interest in improving the efficiency and effectiveness of health
    care delivery, which includes the delivery of pharmaceuticals.
    According to NBGH's 2019 Large Employers' Health Care Strategy and Plan
    Design Survey, almost half, 49% of respondents are taking an activist
    role in driving delivery system change.\1\ As part of this, more
    employers are scrutinizing the role of the pharmaceutical supply chain,
    as specialty pharmacy costs remain one of the top drivers of overall
    health care trend. Particularly as the growth of high-deductible plans
    over the past decade has put a spotlight on drug prices, employers have
    become increasingly frustrated by complexity within the supply chain,
    which could be described as a ``rebate-driven'' contracting model.
    ---------------------------------------------------------------------------
        \1\ 2019 Large Employers' Health Care Strategy and Plan Design
    Survey, National Business Group on Health.

    Nearly all employers believe the pharmaceutical supply chain model
    needs to change:
          14% believe it needs to be more transparent.
          35% believe rebates need to be reduced.
          49% believe the model needs to be overhauled and simplified.

    Regarding the use of rebates as a mechanism to control drug costs:
          75% do not believe drug manufacturer rebates are an effective
    tool for helping to drive down pharmaceutical costs.
          91% would welcome an alternative to the rebate-driven approach
    to managing drug costs.

    The rapid pace at which reforms are being considered within the
    marketplace and by both legislative and regulatory bodies at the
    federal and state levels is encouraging. A focus of the hearing, the
    Administration's proposals to implement changes to how pharmaceutical
    reimbursement and contracting is administered within Medicare Part Band
    Part D illuminates the need and possibility that there are likely to be
    multiple solutions that improve upon the current model within the
    private and public sector. NBGH supports a model marked by
    transparency, and one that removes incentives to consistently increase
    prescription drug prices. However, we also urge cautious, thoughtful,
    and analytical approaches that comprehensively evaluate the impact to
    market dynamics for all supply chain stakeholders.

    Below, we highlight NBGH's perspectives on two of the widely discussed
    proposals. Our full comments on the International Pricing Index (IPI)
    model can be found online. Additionally, we intend to provide full
    comments on the rebate proposal by the April 8th deadline.
    International Pricing Index (IPI) Model \2\
    ---------------------------------------------------------------------------
        \2\ ``International Pricing Index (IPI) Model,'' Center for
    Medicare and Medicaid Innovation, accessed March 11, 2019.
    ---------------------------------------------------------------------------
          We must take a broad perspective to assure that public policy
    decisions contribute to overall cost control and quality improvement
    for all Americans. We commend the Administration's commitment to
    lowering the cost of prescription drugs and encourage it to seek
    solutions. However, we strongly recommend that whatever CMS adopts,
    part of the consideration and criteria for evaluating the results must
    be the impact on the private market and the 170 plus million people
    covered by employers and insurers and not limited to the impact on
    Medicare alone. If we as a nation are to succeed in controlling health
    care costs, we must ensure that public policy decisions do not merely
    ``squeeze the cost balloon'' in one area only for it to expand and
    exacerbate the problem in another area.
          Our chief concern centers on the ANPRM's proposal to link
    reimbursement rates to other nations' prices. Apart from the fact that
    these nations determine prices differently, have different patent and
    exclusivity models, and often vastly different incentives for
    biosimilar utilization, we are concerned that the impact on prices for
    the same pharmaceuticals in the US may rise in the private sector and
    the market for biosimilars may be adversely impacted if Medicare adopts
    this approach.
    Rebate Reform Proposal \3\
    ---------------------------------------------------------------------------
        \3\ ``Fraud and Abuse; Removal of Safe Harbor Protection for
    Rebates Involving Prescription Pharmaceuticals and Creation of New Safe
    Harbor Protection for Certain Point-of-Sale Reductions in Price on
    Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager
    Service Fees'' (Federal Register, February 6, 2019).
    ---------------------------------------------------------------------------
    Many large employers have already begun evaluating the utility of
    point-of-sale rebates as part of their benefit design and a subset (29
    percent) have them in place today. Thus, HHS's proposal picks up on the
    momentum from large employers and, more importantly, underscores the
    inefficiency of the pharmaceutical supply chain. Given the market
    momentum on this issue, to both lower out-of-pocket costs for patients
    and evaluate ways to simplify a complex system, the Business Group is
    in favor of market-based solutions relative to point-of-sale rebates.
    NBGH has the following serious concerns about proposals around rebates.

    While the stated goal of these proposals is to lower prescription drug
    prices and out-of-pocket costs for consumers by encouraging PBMs to
    pass discounts from drug manufacturers directly on to consumers and
    bring transparency to prescription drug market, we have various
    concerns with the proposals including but not limited to the following:

          The proposals focus on out-of-pocket costs only. The intent of
    the proposed rule and companion legislation is to lower out-of-pocket
    costs at the pharmacy counter and add needed pricing transparency to
    the market. While we support the proposed increased transparency and
    pricing relief for patients, we urge policy makers to avoid ``quick
    fixes'' that focus only on out-of-pocket costs, as opposed to total
    cost to the system. Focusing on out-of-pocket costs only has the
    potential to mask root causes of price increases, potentially lead to
    even higher increases over time, and drive the escalating trend on drug
    expenditures.

          Any changes in supply-chain contracting should not result in a
    net increase in drug costs to any payor, nor windfall to any supply
    chain stakeholder. Medicaid and CHIP Payment and Access, the
    Congressional Budget Office Commission (MACPAC) staff have noted that
    the CMS Office of the Actuary (OACT) estimated a net increase in
    Medicaid drug spending of $200 million over 10 years if the proposed
    rebate rule is finalized. A large chunk, if not the largest chunk, of
    this expected increase would come from the decline in inflation-based
    rebates.\4\ Further, manufacturer claim liabilities through the
    coverage gap discount program (CGDP) would be lower, which would
    produce an overall substantial savings for
    manufacturers.\5\, \6\ While savings is expected, that
    savings should be realized comprehensively across both the supply and
    demand sides of the pharmaceutical supply chain.
    ---------------------------------------------------------------------------
        \4\ ``Proposed Safe Harbor Regulation Impact'' (Office of the
    Actuary, August 30, 2018).
        \5\ Manufacturer payments through the CGDP are expected to be about
    $2 billion per year lower on average. When POS costs are lower, it
    takes longer for he costs to accumulate toward the initial coverage
    limit (ICL) and the TrOOP threshold. CGDP payments would be lower as
    fewer members would be calculated as a percentage of a lower POS cost,
    but the impact would vary by manufacturer and by plan sponsor.
        \6\ ``Impact of Potential Changes to the Treatment of Manufacturer
    Rebates'' (Milliman, Inc., January 31, 2019).

          The proposals do nothing to address list prices. The proposed
    rule ``intends'' and speculates that manufacturers might lower list
    prices, but there is little assurance that manufacturers will offset
    rebates with price reductions. In fact, at the hearing, not all CEOs in
    attendance would affirmatively state this would be the case at all, due
    to antitrust case law.\7\
    ---------------------------------------------------------------------------
        \7\ ``Foley Hoag LLP white paper, ``Antitrust Implications of a
    Proposed HHS Rule to Limit Manufacturer Rebates,'' accessed March 11,
    2019.

          The proposed timeline within the HHS proposal is arguably too
    aggressive. PBMs have largely already concluded negotiations on price
    concessions for plan year 2020 and are in the middle of actuarial
    analysis to prepare bids. There is no way to renegotiate in time to
    know the associated costs in order to bid properly, and it would be
    ---------------------------------------------------------------------------
    impossible to retool the supply chain in such a short period of time.

          Premiums will increase. The proposals are projected to increase
    the cost of healthcare for those who don't use drugs having rebates,
    through premium increases, while disproportionately decreasing costs
    for those who do use drugs with discounts.

    Thus, while we agree that the rebate-driven model is ripe for reform
    and ineffective at controlling drug prices, we are concerned about the
    unintended consequences associated with the proposals as written.

    In addition to contracting concerns within the rebate-driven model,
    there remains substantial opportunity for policy change relative to
    prescription drug prices, most of which would encourage a more
    competitive and dynamic market with correspondingly more affordable
    prices.
    Advance Policies to Promote More Affordable, Financially Sustainable
            Prescription Drug Pricing
    While many of the recommendations below are directed toward various
    agencies in the Administration, several of them require Congressional
    action. All of these policy recommendations are highlighted in the
    National Business Group on Health's Issue Brief on Policy
    Recommendations to Promote Sustainable, Affordable Pricing for
    Specialty Pharmaceuticals.

          Remove Uncertainties Surrounding Risk-based and Value-Oriented
    Contracting and Implement Indication Specific Pricing and Reference
    Pricing in Public Programs:
            -  Consider exemptions for value-based contracts from Medicaid
    best price requirements and clarify how drug makers and payers can
    conceive of value-based contracts without triggering broader Medicaid
    best price program implications.
            -  Allow for variable pricing, where the price better reflects
    the evidence for benefit.
            -  Evaluate the usefulness and application of the existing
    developed value frameworks and their potential to impact drug pricing
    in public programs, as well as their overall utility to the health care
    system.
            -  Directly link reimbursement and improved patient outcomes.
            -  Consider how drug makers and payers can enter into other
    types of innovative VBP arrangements, such as indication-specific
    pricing.
            -  Implement reference pricing policies supported by clinical
    evidence consistently across public programs, where possible.

          Limit Reach of Medicare Part D Protected Classes:
            -  Following the MedPAC's recommendations, the Congress and CMS
    should limit legislative and regulatory restrictions on formulary
    design within protected classes by modifying the Medicare Part D rules
    to remove those protected classes where enough generic competition
    exists, a change that would give private plans more freedom to control
    their formularies and negotiate for expanded manufacturer rebates.
            -  Specifically, CMS should resubmit its proposal to remove
    antidepressants, antipsychotics, and immunosuppressants for transplant
    rejection from the list of protected classes because, in these classes,
    price reductions have been more closely linked with the availability of
    generics than to their status as ``protected'' and stand firm against
    industry-funded campaigns that seek to undermine the agency's data-
    driven proposal to increase competitive pricing.
            -  At a minimum, policy makers should evaluate the potential
    anticompetitive influence of protected classes on the commercial
    market, and specifically, evaluate the limitations imposed on private
    payers' ability to negotiate competitive prices for drugs in the
    protected classes due to market spillover.

          Eliminate Perverse Payment Incentives Under Medicare Part B:
            -  Eliminate financial incentives for prescribing more
    expensive medicines, in more expensive settings.
            -  Establish direct links between reimbursement and improved
    patient outcomes.
            -  Encourage manufacturers to assume some financial risk for
    use of high-priced drugs.

          Encourage the Uptake of Biosimilars:
            -  Consider the utility of having an ``interchangeability''
    distinction and potential alignment with the European biosimilars
    model, which has no such distinction.
            -  Work with stakeholders to disseminate provider and patient
    education to firmly establish the safety and efficacy of biosimilar
    drugs to their reference products, recognizing that key successes to
    the uptake of biosimilar medicines in other countries was predicated on
    the creation of trust and confidence among all the stakeholders
    involved, such as prescribers, pharmacists, and patients.
            -  Maintain payer autonomy to implement utilization management
    tools for specialty pharmaceuticals, including tools that pertain to
    biosimilar products.

          Reform Permissive Patent and Exclusivity Protocols:
            -  Reduce the market exclusivity period for biologics from 12
    years to 7 years.
            -  Eliminate or limit additive patent extensions and
    exclusivity periods that serve only to extend monopoly power,
    especially where there is limited, or no additional company investment
    or patient value produced.
            -  Develop sound policy that would discourage patent abuses
    such as ``evergreening'' and ``product hopping.'' These policies may
    include financial penalties, loss of exclusivity periods and/or reduced
    patent terms for other products.
            -  Refine the biosimilars patent dance to effectively
    incentivize the use of the section 351(1) patent dispute resolution
    provisions.

          Reject anticompetitive ``quick fixes'':
            -  As consumers find themselves paying more of their drug
    costs, it's tempting to be lured into new policies which may only
    further contribute to an anticompetitive climate. These policies may
    include specialty drug price caps, out-of-pocket payment caps,
    limitations on utilization management tools and mandated disclosure of
    propriety information.
            -  Additionally, a federal law permitting importation
    nationwide could lead to some price reductions for both payors and
    patients in the short-term but, as markets adapt, it is unclear what
    the long-term effect on prices would be. It would also likely require a
    significant boost in resources for the Food and Drug Administration
    (FDA) to monitor imports and assure safety.

    The National Business Group on Health, representing 437, primarily
    large, employers (including 70 of the Fortune 100) who voluntarily
    provide valued health benefits and other health programs to over 55
    million American employees, retirees, and their families, looks forward
    to working with you on our shared goals for health care: lower costs,
    improved access, and higher quality--umbrella goals we consider
    inclusive of prescription drugs. Please contact Steven Wojcik, the
    National Business Group on Health's Vice President of Public Policy, at
    (202) 558-3012, if you would like to discuss our comments in more
    detail or if we can provide additional information as the Committee
    continues its evaluation of drug pricing.

    Sincerely,

    Brian J. Marcotte
    President and CEO

                                     ______

            National Coordinating Committee for Multiemployer Plans

                              815 16th Street, NW

                              Washington, DC 20006

                           Telephone: (202) 737-5315

                       Michael Scott, Executive Director

    The National Coordinating Committee for Multiemployer Plans (the
    ``NCCMP'') appreciates the opportunity to provide comments to the
    Committee on the issue of prescription drug pricing and the challenges
    that multiemployer group health plans face in today's environment. We
    also appreciate the efforts of the Committee to promote discussion of
    solutions to America's problem of the high cost of prescription
    medications.

    Background on the Multiemployer Plans and the NCCMP

    Multiemployer plans are a product of the collective bargaining process,
    where at least one labor organization and two or more employers provide
    health, pension and a variety of other employee benefits through
    negotiated contributions to trust funds that are required by law to be
    maintained for the ``sole and exclusive benefit'' of plan participants.
    Multiemployer plans are jointly trusted by both labor and management
    and are subject to applicable provisions of the Taft-Hartley Act,
    ERISA, and the Internal Revenue Code. The NCCMP is the only national
    organization devoted exclusively to protecting the interests of the
    over 20 million active and retired American workers and their families
    who rely on multiemployer plans for retirement, health, and other
    benefits. The NCCMP is a nonprofit, non-partisan organization with
    members, plans, and contributing employers in a broad range of
    industries, including agriculture, building and construction, bakery
    and confectionary, entertainment, health care, hospitality, longshore,
    maritime, mining, retail food, service, steel, and trucking. The
    NCCMP's purpose is to assure an environment in which multiemployer
    plans continue their vital role in providing benefits to working men
    and women.

    Multiemployer health plans are often self-insured and plan sponsors
    contract with both medical and pharmacy benefit managers to provide
    administrative services. These plans provide benefits to both active
    workers and their families, and to retirees. Consequently,
    multiemployer plans will often contract with a Medicare Part D
    Prescription Drug Plan or Medicare Advantage plan to provide
    prescription drug and other benefits to retired participants.

    Prescription Drug Prices Continue to Rise

    Most multiemployer health plans provide prescription drug coverage to
    active employees, dependents, and retirees. Prescription drug costs are
    a significant part of health plan expenses. Multiemployer plan sponsors
    have looked to a variety of means to lower drug prices. Strategies
    include increased use of step therapy, prior authorization, quantity
    limits, formularies (which exclude certain drugs) and other utilization
    management techniques. However, prescription drug cost increases are
    primarily driven by price increases, not increased utilization.\1\ Drug
    price inflation is a significantly greater component of projected
    prescription drug price trend than utilization. In addition, specialty
    drug price increases are projected to be in the double digits for 2019,
    a significant and concerning pattern because specialty drugs now
    account for as much as 35 percent of total pharmacy spending.\2\ New
    specialty brand drugs to treat serious illnesses contribute to the cost
    increase, and there are limited opportunities to substitute generic
    drugs in therapeutic classes dominated by single-source specialty brand
    drugs. Consequently, plan sponsors cannot effectively control prices
    through utilization controls alone.
    ---------------------------------------------------------------------------
        \1\ 2019 Segal Health Plan Cost Trend Survey, available at http://
    www2.segalco.com/me-trend-survey-20l9.pdf.
        \2\ Id.
    ---------------------------------------------------------------------------

    Areas for Congressional and/or Regulatory Inquiry and Action

    The NCCMP recommends that the Committee take action to promote
    transparency in the rebate system while ensuring that action taken on
    the rebate side of the pricing equation results in lower--not higher--
    drug prices paid by plan sponsors and consumers. In addition, we
    emphasize the NCCMP's commitment to eliminating the tax that penalizes
    plan sponsors and workers for the high costs of health care (including
    drug costs) beyond their control.
    Rebates and Transparency
    Rebates account for a substantial portion of the drug pricing equation.
    Rebate offsets that are passed through to multiemployer plan sponsors
    from pharmacy benefit managers (PBMs) help to lower net plan cost
    trends. However, multiemployer plans must aggressively monitor PBMs to
    assure that rebates are actually passed through to the plan, and in
    many cases, the rebate structure is opaque and impenetrable. Pricing
    structures also change frequently, as can be seen by some of the PBMs
    ``market pricing'' strategies, which adjust prices, rebates, and
    participant cost sharing based on market price variations for certain
    drugs.

    State legislators are increasingly attempting to rein in drug costs by
    passing laws requiring greater transparency. However, those laws may
    not be effective, either because the states cannot tackle the problem
    alone, or the laws will be subject to multiple challenges by
    pharmaceutical manufacturers and PBMs.

    As a core principle of ERISA, employee benefit plan fiduciaries need
    information concerning all compensation to be received by a service
    provider and any conflicts of interest that may adversely affect the
    service provider's performance under the contract or arrangement. In
    2014, the NCCMP provided supporting testimony to the ERISA Advisory
    Council, which was studying PBM Compensation and Fee Disclosure.\3\ At
    that time, we suggested that plan fiduciaries would be well served if
    PBMs were required to disclose all instances in which they receive
    financial remuneration from drug manufacturers, retail pharmacy
    providers, and data managers. The disclosures need to be sufficient to
    allow trustees to assess whether, and to what extent, the services
    offered by the PBMs are in the best interest of plan participants,
    rather than simply furthering the financial interests of the PBM.
    Transparency continues to be a concern to plan sponsors and efforts of
    the Committee to increase transparency for rebates and financial
    arrangements between PBMs and pharmaceutical manufacturers would assist
    multiemployer plans in efforts to control prescription drug prices.
    ---------------------------------------------------------------------------
        \3\ https://www.dol.gov/sites/default/files/ebsa/about-ebsa/about-
    us/erisa-advisory-council/2014-pbm-compensation-and-fee-disclosure.pdf.

    More attention is being paid of late to the rebate system and the
    important role that it plays in determining the prices that plan
    sponsors and consumers pay for prescription drugs. But rebates are only
    part of the equation. The list price that drug manufacturers set for
    their prescription drugs is the starting point for the negotiation
    between manufacturers and PBMs over rebates. More transparency in the
    setting of list prices could help to put some downward pressure on
    those prices. But if list prices continue to go up while rebates go
    down, plan sponsors and consumers will end up paying more. As a result,
    it is essential that any action taken to address the rebate structure
    not have the unintended consequence of actually increasing what plan
    sponsors and consumers pay for prescription drugs.
    Eliminating the Unfair Tax on Health Plan Coverage
    For decades before the enactment of the Patient Protection and
    Affordable Care Act (ACA), the majority of Americans with health
    coverage received their coverage through employment. This has remained
    the case well after the ACA first went into effect. Today, over 181
    million Americans have employment-based health coverage, which includes
    coverage under multiemployer plans. The 40 percent excise tax under
    Internal Revenue Code section 49801, enacted as part of the ACA,
    threatens these hard-working Americans with a steep and unfair tax on
    their health coverage. Sometimes popularly (although inappropriately)
    referred to as the ``Cadillac plan'' tax, the original intent of the
    tax was to impact plans with ``gold-plated coverage.'' In actuality,
    however, the tax will have a much broader impact on even modest plans
    as a result of underlying medical inflation.

    Employers understand that quality health care is an investment in
    employees and not simply a monetary benefit. At the same time, both
    employers and employees recognize that the cost of health care cannot
    become so great that it makes employers non-competitive. This
    marketplace reality is the reason that the vast majority of private
    plan sponsors have utilized cost containment strategies for decades to
    manage and stretch finite compensation dollars as much as possible.

    Unfortunately, the high and ever-increasing health care costs faced by
    the private sector are directly amplified by the U.S. Government
    through its own health care programs, statutes, and regulatory
    requirements. As the largest provider and purchaser of health care in
    the U.S. through Medicare and Medicaid, programs that collectively
    spend more than $1.2 trillion annually,\4\ the U.S. Government's
    longstanding policy of significantly under-compensating health care
    providers results in these providers charging more to their private
    sector clients in order to recoup their uncompensated federal expenses.
    In this way, the private sector subsidizes Medicare, Medicaid, and the
    U.S. Government by absorbing these uncompensated expenses through
    higher costs and premiums.
    ---------------------------------------------------------------------------
        \4\ In 2017, Medicare spending grew 4.2% to $705.9 billion in 2017
    and Medicaid spending grew 2.9% to $581.9; https://www.cms.gov/
    research-statistics-data-and-systems/statistics-trends-and-reports/
    nationalhealthexpenddata/nhe-fact-sheet.html.

    The simple fact is that the high costs of employment-based health plans
    and medical inflation are not driven by employment based health plans
    themselves, but by other factors, including the actions (and inactions)
    of the U.S. Government. Congress should continue to work to address
    medical care inflation, including rising drug costs, while maintaining
    good health care outcomes and quality of care. Congress should not
    penalize employers, health plans, or employees and their families
    through unfair taxes. If the excise tax is imposed, the end result will
    not be an overall reduction in health care costs, lower medical
    inflation or higher federal tax revenue; rather it will be borne by
    hardworking Americans through cost-shifting and foregoing needed care.
    Additionally, as employment based healthcare is penalized, it will
    become increasingly unavailable to those currently covered, which will
    increase federal spending on subsidies and Medicare as a significant
    portion of the currently covered workforce is eligible for these
    ---------------------------------------------------------------------------
    programs.

    NCCMP appreciates the actions Congress has taken in the past to help
    prevent the imposition of the 40 percent excise tax by delaying it
    twice, so that the effective date is now pushed back to 2022. Delays,
    however, are not sufficient to prevent the harmful impact of this tax.
    In calling for repeal, NCCMP joins the voices of a large, diverse
    group, as evidenced by a recent letter to Congress signed by over 550
    organizations representing such interests as public and private sector
    employers across a wide range of industries, non-profit organizations,
    chambers of commerce, unions, and patient groups. We support the bi-
    partisan Middle Class Health Benefits Tax Repeal Act of 2019, recently
    introduced in the Senate by Senators Heinrich (D-NM) and Rounds (R-SD)
    and co-sponsored by many others, including members of this Committee.
    We also support the House version of the bill, which was introduced in
    January and which as of this writing has 229 co-sponsors, with growing
    numbers.

    The NCCMP recommends fully and immediately repealing the 40% excise tax
    on employer sponsored health coverage and also opposes any efforts to
    tax employees on their health care benefits.

                                     ______

                                 Oxfam America

                        1101 17th Street, NW, Suite 1300

                              Washington, DC 20036

      Tel +1 (202) 496-1180 | Fax +1 (202) 496-1190 | www.oxfamamerica.org

                               February 26, 2019

    Mr. Chairman, Ranking Member and Members of the Committee,

    Oxfam appreciates the Committee's sincere intention to ensure
    affordable and accessible medicines for all who need them. We would
    like to take this opportunity to bring the Committee's attention to our
    recent investigation, Prescription for Poverty,\1\ illustrating how
    four major pharmaceutical firms (three of whom are testifying before
    the Committee at this hearing) may well be underpaying their US taxes
    to the tune of $2.3 billion annually by systematically stashing their
    profits in overseas tax havens. On top of these tax losses from
    offshore tax avoidance, these companies likely benefitted significantly
    from the Tax Cuts and Jobs Act (TCJA).\2\
    ---------------------------------------------------------------------------
        \1\ Oxfam, ``Prescription for Poverty: Drug companies as tax
    dodgers, price gougers, and influence peddlers,'' Sept. 2018 at https:/
    /www.oxfamamerica.org/explore/research-publications/prescription-for-
    poverty/.
        \2\ Report of the Senate Finance Committee Democratic Staff,
    ``Trump Tax Law and the Health Care Industry: A $100 Billion Bonanza,''
    April 17, 2018.

    Here in the US and around the world, in rich and poor countries alike,
    high drug prices are causing too many people to sacrifice their savings
    or worse--their lives--to enrich executives at highly profitable and
    ---------------------------------------------------------------------------
    influential drug companies.

    As is well known, these drug companies' very business model depends to
    a large degree on American taxpayer dollars: to pay for essential
    front-end drug research, to protect patents and intellectual property,
    and to purchase their drugs through Medicare, and the Veteran's
    Administration.

    Yet, these same companies are undermining public trust (and their very
    own business model) by steadily under-paying their taxes, in the US and
    around the world. Scouring the companies' financials, we've found that
    four major pharmaceutical firms--Abbott, Johnson & Johnson (JNJ), Merck
    (MRK), and Pfizer (PFE)--alone appear to have deprived rich and poor
    countries alike of around $3.7 billion of vital revenue that could have
    been spent on vaccines, midwives, or health clinics. Because the
    companies reveal little financial information about their subsidiaries,
    Oxfam's investigation barely scratches the surface. Yet even a small
    sampling reveals a striking degree of tax avoidance through profit-
    shifting.

    As the largest market for the four pharmaceutical companies, the United
    States is the biggest loser from tax avoidance by these companies, to
    the tune of an estimated $2.3 billion a year: $1 billion by JNJ, $589
    million by Pfizer, $533 million by Merck, and $143 million by Abbott.
    Together, this is enough to pay for health insurance for nearly a
    million low-income children in the US.

    How are companies avoiding their tax responsibilities?

    Oxfam examined publicly available data on subsidiaries of four of the
    largest US drug companies and found a striking pattern. In the
    countries analyzed with standard corporate tax rates, the companies
    reported low pre-tax profits--7 percent profits on average in high-
    income countries, and 5 percent on average in seven low- and middle-
    income countries. In contrast, these corporations reported annual
    global profits of up to 30 percent. So, where were these companies
    reporting such sky-high profits? Tax havens. In four countries which
    charge very low or no corporate tax rates, these companies posted 31
    percent profit margins--suggesting that the companies are artificially
    shifting their profits to avoid paying taxes in countries with higher
    tax rates.

    In the case of the pharmaceutical giants, the ploy may involve
    ``domiciling'' their patent, not in the corporation's home country
    where the drug was actually developed, but in a tax haven-where a
    company's presence may be as little as a mailbox. That subsidiary then
    charges hefty licensing fees to subsidiaries in other countries. The
    fees are a tax deductible expense in the normal jurisdictions, meaning
    that they can be used to offset any earnings and thereby lower the
    reported profits. At the same time, the fee income accrues to the
    subsidiary in the tax haven, where it is taxed lightly or not at all.
    The company's overall tax payment then is lowered, sometimes
    significantly.

    Another technique many companies have used is to sell their production
    or services not directly to the countries where they will be consumed,
    but to ``pivot'' companies in low tax jurisdictions that then resell
    them at a profit to affiliated distributors. This practice creates an
    artificial profit that remains in the tax haven. Most of the time,
    these are only paper transactions--the goods are shipped straight from
    the factory in the production country to the warehouse in the
    consumption country--but the transactions allow profits to move from
    one country to another almost tax-free.

    Because companies refuse to release their full country-by-country
    financial reports to the public, and many governments have yet to make
    these reports public, the information on tax dodging is far from
    complete. Yet, the pattern of Big Pharma's tax practices is consistent:
    this is either an astounding coincidence or the result of using
    accounting tricks to deliberately shift profits from where they are
    actually earned to tax havens. Pfizer, Merck, and Abbott are among the
    20 US corporations with the greatest number of subsidiaries in tax
    havens; Johnson & Johnson is not far behind. While profits can vary
    from country to country for any number of legitimate reasons, it is
    highly unlikely that these explanations can fully account for the
    consistent pattern of much higher profits being posted in countries
    with very low tax rates where these corporations do not sell the
    majority of their medicines.

    Tax injustice and price gouging are two sides of the same coin

    Tax avoidance and price gouging are not, in fact, completely
    independent phenomena. Today's hearing provides a timely opportunity to
    connect the dots between high drug prices and unjust tax avoidance
    practices which deprive the US Treasury of precious public revenue
    needed to fund essential public health programs in the US. Every tax
    dollar avoided means a tax dollar less for new drug research at the
    National Institutes of Health, and for essential health insurance
    programs like Medicaid, Medicare and the Child's Health Insurance
    Program.

    What's more, as we detail in our report cited above, a cornerstone of
    these companies' business model--the intellectual property rules
    protecting many of these pharmaceutical companies' most profitable
    products--is a central factor in allowing these companies to drive up
    drug prices, while driving down their tax payments. And conversely, our
    tax system at present incentivizes price hikes in a variety of ways.

    While the specific solutions to drug pricing and tax avoidance are
    distinct, there are some essential common approaches in our view.
    Global companies should be transparent about where they earn and spend
    their money, they should pay tax in alignment with actual economic
    activity rather than abuse our tax system in a variety of ways, and
    they should use their political influence responsibly, rather than
    undermining governments' efforts to provide essential medicines and
    healthcare for us all.

    ------------------------------------------------------------------------

    -------------------------------------------------------------------------
    In this context, we would encourage the Senate Committee to raise the
     following questions to JNJ, PFE and MRK during the February 26th
     hearing:

    1. According to evidence received, your companies systematically report
     low pre-tax profits in high-tax countries, and high pre-tax profits in
     low-tax countries: reportedly resulting in billions of dollars of lost
     revenue in the US which could have been spent on new drug research or
     to fund essential healthcare. Can you explain why these aggressive tax
     planning practices serve the public interest?

    2. Is your company involved in offshore tax avoidance? If so, please
     explain why you believe this is acceptable practice. Can you commit to
     publicly releasing your company's country-by-country financial reports
     to show and prove your tax practices meet social expectations?

    3. How has your company invested the fresh cash resulting from the
     passage of the TCJA? Very concretely, can you explain how these
     expenditures are working to drive down drug prices? If they are not
     doing so, why not?
    ------------------------------------------------------------------------

    For any questions, please contact Nicholas J. Lusiani, Senior Advisor
    at nicholas.lusiani@oifam.org, or (202) 777-2912.

                                     ______

                       Patients for Affordable Drugs Now

                      Statement by David Mitchell, Founder

    Chairman Grassley, Ranking Member Wyden, and members of the Senate
    Finance Committee,

    Thank you for your leadership to address the problem of high drug
    prices in America. U.S. patients and taxpayers spend more than $450
    billion \1\ each year on prescription drugs. By some estimates, nearly
    one-fifth \2\ of all health care costs go toward prescription drugs.
    The main driver of prescription drug spending is patent-protected
    brand-name drugs, which make up only about 10 percent \3\ of
    prescriptions but account for three-quarters of drug spending.\4\
    ---------------------------------------------------------------------------
        \1\ https://www.finance.senate.gov/imo/media/doc/
    29JAN2019MILLERSTMNT.pdf
        \2\ https://www.ncbi.nlm.nih.gov/pubmed/27552619.
        \3\ https://docs.house.gov/meetings/GO/G000/20190129/108817/HHRG-
    116-GOOO-Wstate-KesselheimA-20190129.pdf.
        \4\ https://docs.house.gov/meetings/GO/G000/20190129/108817/HHRG-
    116-GOOO-Wstate-KesselheimA-20190129.pdf.

    That's why today's hearing is so important. You have called CEOs of
    seven major drug corporations before the Senate Finance Committee to
    explain their pricing practices, patent thickets and the fact that
    American patients and taxpayers pay anywhere from two to six times \5\
    more than the rest of the world for brand name prescription drugs.
    ---------------------------------------------------------------------------
        \5\ https://www.cnn.com/2015/09/28/health/us-pays-more-for-drugs/
    index.html.

    We hear every day from patients suffering under the high cost of
    prescription drugs--cutting pills in half, choosing between groceries
    ---------------------------------------------------------------------------
    and medication, and simply going without.

    Patients have questions for the CEOs in front of you today, and we hope
    Congress will ask them.

    AbbVie Inc,

    About AbbVie: AbbVie's anti-inflammatory drug Humira is the top-selling
    \6\ drug in the world. The drug company doubled the price \7\ from
    about $19,000 per year in 2012 to $38,000 per year in 2018. AbbVie
    secured over 100 patents \8\ on Humira, ensuring that patent thickets
    will keep competition off the U.S. market, while the company cut the
    price in Europe by 80 percent \9\ for the exact same drug.
    ---------------------------------------------------------------------------
        \6\ https://www.nytimes.com/2018/01/06/business/humira-drug-
    prices.html.
        \7\ https://www.nytimes.com/2018/01/06/business/humira-drug-
    prices.html.
        \8\ https://www.bloomberg.com/news/articles/2017-09-07/this-shield-
    of-patents-protects-the-world-s-best-selling-drug.
        \9\ https://www.axios.com/abbvie-cuts-humira-price-europe-
    biosimilars-cc2d3d61-5782-4042-8c24-b322ea8285b4.html.

    Questions:
          Is it fair that Europeans have access to a less expensive
    biosimilar competitor for Humira, but your company bragged \10\ about
    blocking that competition in the U.S.?
    ---------------------------------------------------------------------------
        \10\ https://www.nbcnews.com/nightly-news/video/world-s-best-
    selling-drug-costs-five-times-more-in-u-s-than-europe-1445064259924.
    ---------------------------------------------------------------------------
          Do you partake in pay for delay or deals for delay? Do you
    support the Preserve Access to Affordable Generics and Biosimilars Act
    (S. 64)?
          Since Humira has already been very successful with more sales
    than the revenue of eBay,\11\ will you commit to holding the price of
    Humira steady until a biosimilar comes to market?
    ---------------------------------------------------------------------------
        \11\ https://www.axios.com/humira-2018-revenues-drug-prices-
    eb637e1f-09ae-479a-91ca-870edf7f5b4a.htm.

    Patient Stories:
          James Baer from Aurora, CO: ``I have seropositive degenerative
    rheumatoid arthritis, and am on a regimen of high cost drugs. Humira is
    the most expensive, at $4,500-$6,500 a month. My insurance, Humana, is
    refusing to pay for it starting next month. My doctor says I need it to
    win my fight against this genetic defect.''
          Jacquie from Iowa: ``Since my Crohn's diagnosis, I've taken
    Lialda and Humira. Both drugs would have been astronomical if I hadn't
    been for my good insurance and eligibility for the pharmacy savings
    programs for each. I have been lucky. But I am always constantly
    worried about no longer being able to work due to my health, or losing
    my health insurance, making these essential drugs unaffordable.''
          Sherry from North Carolina: ``I am unable to afford the biologic
    Humira even on Medicare. My monthly copay went from $5/month to $1,200/
    month.''

    Pfizer

    About Pfizer: Pfizer's history of price hikes is as staggering as it is
    long. Here's a look at the last three years: In 2017,\12\ Pfizer raised
    the price of 91 drugs by 20 percent--that was nearly 10 times the rate
    of inflation. In mid-2018,\13\ Pfizer announced price hikes on about
    100 prescription drugs. After temporary freezes, Pfizer raised the
    raised the price of 40 drugs in January 2019.\14\
    ---------------------------------------------------------------------------
        \12\ https://www.ft.com/contenUb2eOdd80-47ab-11e7-8519-
    9f94ee97d996.
        \13\ https://medcitynews.com/2018/07/pfizer-increases-prices-on-
    100-drugs/.
        \14\ https://www.cnn.com/2018/11/16/business/pfizer-drug-prices/
    index.html.
    ---------------------------------------------------------------------------
    Questions:
          Will you commit to limiting the increase in list price of your
    drugs to the rate of inflation?
          Will you commit to submitting to this committee at the end of
    this year (2019) a report of the ways you have utilized the $10 billion
    stock buyback \15\ to serve patients?
    ---------------------------------------------------------------------------
        \15\ https://www.axios.com/pharma-share-buyback-tax-reform-
    40a30b93-6149-4c67-bd6cd50-5ee814215.htm.
    ---------------------------------------------------------------------------
    Patient Stories:
          Helen Sgarlat from Kingston, PA: ``Because of the $600 price
    tag, I had to switch medications. I switched from Spiriva to one that's
    not working as well, Singulair. This is outrageous.''
          Sharon from Iowa: ``I can't eat any more! My Keppra costs $460,
    Pradaxa $400, Lyrica $360. If drug prices came down, I would be able to
    eat again.''
          Susan from Nevada: ``My sister has metastatic breast cancer
    taking Ibrance. Her co-pay is $2,290/month! Without this [drug] her
    cancer will spread! She received a short term grant to help but has to
    reapply to keep receiving. This is a lifesaving drug . . . must be more
    affordable!''

    Sanofi

    About Sanofi: Almost 30 million\16\ Americans live with diabetes and 6
    million need insulin to survive. From 2010 to 2015, Sanofi raised the
    price of the lifesaving diabetes drug Lantus by 168 percent.\17\
    ---------------------------------------------------------------------------
        \16\ https://www.cbsnews.com/news/insulin-prices-rise-yet-again-
    causing-diabetics-to-cry-foul/.
        \17\ https://www.nytimes.com/2016/02/21/opinion/sunday/break-up-
    the-insulin-racket.html.
    ---------------------------------------------------------------------------
    Questions:
          If PBM rebates were eliminated, would you lower your list
    prices?
          Will you commit to undoing the dozens of times you've raised the
    price of Lantus and lower the list price this year?
          As the Chairman of the lobbying group, PhRMA, your organization
    spent $27.5 million on lobbying in 2018.\18\ Next year, will you agree
    to take half that money and use it to lower drug prices across the
    board for patients?
    ---------------------------------------------------------------------------
        \18\ https://www.statnews.com/2019/01/22/phrma-spent-a-record-
    breaking-27-5-million-on-lobbying-in-2018-new-filings-show/.
    ---------------------------------------------------------------------------
    Patient Stories:
          Jerraline Krawetzki from Berlin Heights, OH: ``Because of
    diabetes type 2, Lantus and Humalog are required. Because of the
    increased costs of these medications, after filling the first
    prescriptions, already IN the donut hole. This means a one month
    prescription of these 2 drugs, will cost over $600 per month. Senior
    citizens on a fixed income cannot afford this.''
          David from Nevada: ``I have to take Lantus and Januvia for my
    Diabetes and Xeralto for my AFIB and many other medications for my
    heart, blood pressure, cholesterol, and BPH. These medications are very
    expensive and I can't afford them after I reach the Medicare Part D
    donut hole. Medicare prohibits free medications or discounts so living
    on social security means I will eventually die from lack of medicine.''
          Jeannie from Kansas: ``I am a type 2 diabetic. I take Lantus
    insulin. One month supply is $128 with insurance. I am single and on
    Social Security of $942 a month. How am I to pay for the insulin that
    keeps me alive?''

    Merck & Co. Inc.

    About Merck: Merck is no stranger to drug price increases. From January
    2017 to mid-2018, Merck raised the price of Januvia by nearly 20
    percent.\19\ In November 2018, the corporation raised the price on five
    drugs,\20\ including top-selling Gardasil and Keytruda.
    ---------------------------------------------------------------------------
        \19\ https://www.latimes.com/business/hiltzik/la-fi-hiltzik-drug-
    prices-20181206-story.html.
        \20\ https://www.reuters.com/article/us-merck-co-drugprices/merck-
    raised-prices-five-drugs-including-keytruda-in-november-idUSKCN1NX2ZN.
    ---------------------------------------------------------------------------
    Questions:
          Will you submit, for the record, the cost of research and
    development for the drug Keytruda, which reaped \21\ a total of $1.89
    billion the third quarter of 2018 alone--an increase of 80% since 2017?
    ---------------------------------------------------------------------------
        \21\ https://www.bloomberg.com/news/articles/2018-10-25/merck-
    plans-10-billion-buyback-as-cancer-drug-tops-estimates.
    ---------------------------------------------------------------------------
          Your company recently spent $10 billion on stock buybacks.\22\
    This year, will you commit to decreasing drug prices by that same
    amount?
    ---------------------------------------------------------------------------
        \22\ https://www.bloomberg.com/news/articles/2018-10-25/merck-
    plans-10-billion-buyback-as-cancer-drug-tops-estimates.
    ---------------------------------------------------------------------------
    Patient Stories:
          Stephen Hadfield from Charlotte, NC: ``I am on very expensive
    insulin for my diabetes. My Januvia is $400 a month and my Lantus is
    $350 every three weeks. If it was not for insurance, I would not be
    able to afford these drugs.''
          Yvonne from Georgia: ``I can't afford the medicines I need to
    treat my diabetes. Januvia costs over $200, and with my other
    medications too I am in the donut hole, making it hard to manage my
    disease.''
          Mark from Louisiana: ``I have extremely high cholesterol and I
    am allergic to statins. The only medication that I can take would be
    Zetia which costs $800 for 3 month supply after insurance coverage. The
    same drug is available in Canada for $150 for a 3 month supply and no
    insurance coverage!''

    Johnson & Johnson

    About Johnson & Johnson: Since 2012, Johnson & Johnson has raised the
    price of its blockbuster drug Xarelto by 87 percent.\23\ In January of
    2019, the company raised the price on about two dozen drugs.\24\
    ---------------------------------------------------------------------------
        \23\ https://www.i-mak.org/wp-content/uploads/2018/08/I-MAK-
    Overpatented-Overpriced-Report.pdf.
        \24\ https://www.reuters.com/article/us-johnson-johnson-
    drugpricing/jj-raises-u-s-prices-on-around-two-dozen drugs-
    idUSKCN1P42VY.
    ---------------------------------------------------------------------------
    Questions:
          Will you commit to holding your price increases to inflation
    each year?
          Will you commit to striking a deal with the New York Drug
    Utilization Review Board if they deem it necessary to decrease the cost
    of Remicade for state taxpayers?
    Patient Stories:
          Sarah Pekarske from Texas: ``I have Lupus and I have had 3 blood
    clot episodes. I take Xarelto. In August of last year it was suddenly
    $100/month. It has cost $150/month since September! This is too
    expensive for me.''
          Diane from Georgia: ``I have been on Remicade since 2013, but
    when I retire I won't be able to take it anymore because of change in
    insurance and higher co-pays. I don't know what I'll do.''
          Patricia from Texas: ``I am on fixed income because I am
    disabled with rheumatoid arthritis. I need infusions for Simponi Aria I
    cannot afford. Even with help to pay for the infusion, my part is going
    to be over $500 per month. That is half of my income every month.''

    Bristol-Myers Squibb Co.

    About Bristol-Myers Squibb: Over the last eight years, Bristol-Myers
    Squibb has spent over $25 million \25\ in lobbying expenditures and
    $1.75 million \26\ in campaign contributions, according to Open
    Secrets. The company raised the price of its blockbuster drug Eliquis
    by 6 percent \27\ in January 2019. Last year alone, U.S. Patients' paid
    Bristol-Myers Squibb $3.8 billion \28\ for Eliquis, a 30 percent \29\
    year-over-year increase.
    ---------------------------------------------------------------------------
        \25\ https://www.opensecrets.org/orgs/
    summary.php?id=D000000149&cycle=2018.
        \26\ https://www.opensecrets.org/orgs/
    summary.php?id=D000000149&cycle=2018.
        \27\ https://www.foxbusiness.com/healthcare/meet-the-big-pharma-
    ceos-who-will-testify-in-the-senate.
        \28\ https://www.foxbusiness.com/healthcare/meet-the-big-pharma-
    ceos-who-will-testify-in-the-senate.
        \29\ https://www.foxbusiness.com/healthcare/meet-the-big-pharma-
    ceos-who-will-testify-in-the-senate.
    ---------------------------------------------------------------------------
    Questions:
          Will you commit to donating 50% less to candidates for public
    office in 2020 and investing that money toward research and development
    or decreasing price for patients?
          With your recent acquisition of Celgene, will you commit to
    ending Celgene's use of the REMS program to prevent a generic from
    coming to market for its blockbuster drug, Revlimid?
          Do you support the CREATES Act?
    Patient Stories:
          Elizabeth from New Jersey: ``The greed of Bristol-Myers-Squibb
    is horrible. Now I have to decide if I should just take asprin each day
    and hope I don't have a stroke or pay the high cost each month for
    Eliquis for $145 per month.''
          Gail from Michigan: ``I didn't have coverage for a year and the
    Eliquis I need costs $400 per month. It's a crying shame that these
    drugs are so expensive. I had to stretch the script out by taking them
    every other day.''
          Tara from Kansas: ``Drug prices are killing me faster than the
    disease. When I first started taking my blood thinner a few years ago,
    I thought $400 a month was terrible. Now, I wonder how I can possibly
    afford the next dose of Opdivo. I can't. Without it I die. With it I go
    broke. What kind of choice is that? No one should ever be put in this
    position. No one should make this choice ever.''

    AstraZeneca

    About AstraZeneca: AstraZeneca has a history of charging cancer
    patients high prices. Here are three examples: Imfinzi costs $180,000
    per year \30\ for lung cancer, Lynparza costs around $15,000 for 112
    pills \31\ for ovarian cancer, and Iressa costs $8,000for 30 pills \32\
    lung cancer. And before AstraZeneca faced a generic competitor for its
    high cholesterol drug, Crestor, the company raised prices multiple
    times, including by about 15 percent \33\ right before a generic
    competitor came to market.
    ---------------------------------------------------------------------------
        \30\ https://professionals.optumrx.com/content/dam/optum3/
    professional-optumrx/news/rxnews/drug-approvals/
    drugapprovals_imfinzi_2017-0502.pdf.
        \31\ https://www.goodrx.com/lynparza/medicare-coverage.
        \32\ https://www.goodrx.com/iressa.
        \33\ https://www.marketwatch.com/story/big-pharma-games-the-system-
    to-make-generic-drugs-more-expensive-2018-07-27.
    ---------------------------------------------------------------------------
    Question:
          Will you submit for the record the following information: the
    amount you have spent on research and development vs. AstraZeneca's
    yearly budget for marketing and advertising?
    Patient Stories:
          Teresa Bianco from Elyria, OH said: ``We have a family history
    of dangerously high cholesterol levels. My sister and I have been on
    every medicine out there. The only one that lowers us into the high
    200's is Crestor. It is not covered by our insurances and thus is out
    of our reach. Sadly, we are both RNs and see others also go through
    this. We are college educated, helping people, always gainfully
    employed full time, but we are apparently disposable.''
          Linda Schoene from Pikesville, MD said: ``I have GERD and am
    prescribed Nexium. On Medicare Part D, my copay is a little over $100
    per month. I can't afford that. So I go without which causes me sharp
    pains in my stomach when I have a flair. I sometimes buy the over the
    counter version, but it is half the strength of what I am prescribed
    and doesn't treat my symptoms.''
          Silvio from Pennsylvania: ``I was taking Crestor but the prices
    kept rising and because I am on Medicare I was not eligible for a
    discount. So I had to stop taking it. Next time I got a blood test my
    bad cholesterol skyrocketed.''

                                     ______

                   Pharmaceutical Care Management Association

                         325 7th Street, NW, Suite 900

                             Washington, DC, 20004

    Introduction

    The Pharmaceutical Care Management Association (PCMA) is the national
    association representing America's pharmacy benefit managers (PBMs),
    which administer prescription drug plans for more than 266 million
    Americans with health coverage provided through Fortune 500 employers,
    health insurers, labor unions, Medicare, Medicaid, and the Federal
    Employees Health Benefits Program (FEHBP).

    PBMs are the primary advocate for consumers and health plans in the
    fight to keep prescription drugs accessible and affordable. PBMs
    negotiate on behalf of consumers, and work to keep a lid on overall
    costs for prescription drugs with market-based tools that encourage
    competition among drug manufacturers and pharmacies, and incentivize
    consumers to take the most cost effective and clinically appropriate
    medication.

    By leveraging competition among manufacturers, PBMs save patients and
    health plans $123 per prescription, and will negotiate prescription
    drug costs down $654 billion over the ten years ending 2025.\1\
    ---------------------------------------------------------------------------
        \1\ Visante, ``Pharmacy Benefit Managers (PBMs): Generating Savings
    for Plan Sponsors and Consumers,'' February 2016, https://
    www.pcmanet.org/wp-content/uploads/2016/08/visante-pbm-savings-feb-
    2016.pdf.

    PBMs manage Medicare Part D drug benefits through insurers, either as
    contractual service providers to stand-alone Prescription Drug Plans
    (PDPs) or Medicare Advantage plans that offer prescription drug
    ---------------------------------------------------------------------------
    coverage (MA-PDs).

    PBMs are proud of their performance in Part D. PBMs and Part D sponsors
    have kept overall program costs 30 percent below original government
    projections, offered beneficiaries lower-than-expected premiums, and
    generated high levels of generic utilization while providing broad
    choice of drugs and access to over 60,000 pharmacies, all while
    attaining a continually high rate of beneficiary satisfaction.

    PBMs Negotiate to Keep Drug Spending Manageable

    The most recent available data, which is for years 2016 and 2017, show
    that the overall growth in spending for all prescription drugs has been
    low.\2\ tallying 1.4% and -0.3% for 2016 and 2017, respectively. Drug
    industry stakeholders rightly trumpet such figures to show the success
    of private-sector negotiation in bringing spending discipline to the
    prescription drug market.
    ---------------------------------------------------------------------------
        \2\ KFF, ``What Are the Recent and Forecasted Trends in
    Prescription Drug Spending?'', February 20, 2019, https://
    www.healthsystemtracker.org/chart-collection/recent-forecasted-trends-
    prescription-drug-spending/#item-start.

    However, the totals mask the dynamics at work in different sectors of
    the prescription drug market. Spending on generic drugs has actually
    been declining, while spending on brands has been increasing. According
    to a November 2018 analysis, for the previous year, spending on brands
    increased 4% while spending on generics decreased 3%.\3\
    ---------------------------------------------------------------------------
        \3\ Blue Cross Blue Shield Association, ``Prescription Drug Cost
    Trend Update,'' November 14, 2018, https://www.bcbs.com/the-health-of-
    america/reports/prescription-drug-costs-trend-update.

    Further, the report indicates that while brand drugs made up only 17%
    of total prescriptions, they accounted for 79% of overall drug spending
    in the previous year.\4\
    ---------------------------------------------------------------------------
        \4\ BCBSA, Op. Cit.

    Data underlying the overall spending figures shows that manufacturers
    have been increasing the prices they set for their drugs rapidly.
    According to IQVIA data, for the 5-year period ending 2017, brand
    invoice price grew at an average annual rate of 10.5%, while overall
    inflation in the economy, as measured by CPI-U, grew at an average
    annual rate of 1.3%.\5\ These trends are mirrored in a study conducted
    on drugs most used by the elderly. A 2018 AARP analysis found retail
    prices for 113 chronic-use brand name drugs on the market since at
    least 2006 increased cumulatively over 12 years by an average of 214
    percent, compared with the cumulative general inflation rate of 25
    percent from 2006 to 2017.\6\
    ---------------------------------------------------------------------------
        \5\ https://www.iqvia.com/institute/reports/medicine-use-and-
    spending-in-the-us-review-of-2017-outlook-to-2022.
        \6\ AARP, ``No End in Sight for Skyrocketing Prescription Drug
    Prices,'' September 26, 2018.

    The near-flat overall trend for spending on all drugs, despite rising
    prices and spending for brands, illustrates the work that PBMs do as
    advocates for patients and their client health plans to hold the line
    on prescription drug costs.

    Drug Manufacturers Alone Set and Raise Prescription Drug Prices

    As the Committee continues its work with respect to prescription drug
    costs, one thing is clear: only manufacturers have the power to set or
    change prices. In recent years, brand manufacturers and their allies
    have attempted to deflect blame for the prices they set by blaming
    other parties in the drug supply chain,\7\ including pharmacies, PBMs,
    and wholesalers. While much has been said and written, research studies
    show that there is no correlation between the prices manufacturers set
    and the rebates PBMs negotiate with manufacturers.
    ---------------------------------------------------------------------------
        \7\ See, e.g., https://www.phrma.org/press-release/new-report-
    shows-how-supply-chain-shapes-brand-name-medicine-prices.

    A 2018 study found no correlation between the prices that brand drug
    manufacturers set for individual drugs and the rebates that they
    negotiate with PBMs on those products (see chart below).\8\ The data in
    the scatter plot below show that increasing list prices over a 5-year
    period were not correlated with changes in rebates (R\2\=0.016), as
    shown with the horizontal blue line. Additionally, there are prominent
    cases of higher-than-average price increases on brand drugs where
    rebates stayed the same or declined (e.g., Humulin).
    ---------------------------------------------------------------------------
        \8\ Visante, ``Increasing Prices Set by Drugmakers Not Correlated
    With Rebates: An Analysis Prepared by Visante on Behalf of PCMA,'' June
    2017.

    [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

    At the same time, separate research confirmed that negotiated rebates
    are correlated with competition-that the size of drug rebates is
    positively correlated with the extent to which a given brand drug faces
    competition in the market.\9\
    ---------------------------------------------------------------------------
        \9\ Credit Suisse Equity Research, ``Global Pharma and Biotech,''
    April 18, 2017.

    Other research sponsored in part by a multinational brand drug
    manufacturing firm reports that, for every $100 spent in the drug
    supply chain on branded drugs, manufacturers capture $58. This
    contrasts sharply with the amounts captured by pharmacies ($3), PBMs
    ($2), and wholesalers ($1).\10\ These results show that it is the
    manufacturers who benefit far more than any other party in the drug
    supply chain, and any rhetoric to the contrary is a smokescreen.
    ---------------------------------------------------------------------------
        \10\ Sood, N. et al. ``The Flow of Money Through the Pharmaceutical
    Distribution System,'' University of Southern California, Leonard D.
    Schaeffer Center for Health Policy and Economics, June 2017, https://
    healthpolicy.usc.edu/wp-content/uploads/2017/06/USC_Flow-of-Money
    WhitePaper_Final_Spreads.pdf.

    Further illustrating the lack of any connection of manufacturer list
    prices to negotiated rebates is the chart below containing Part B
    pricing data. Drugs under Medicare Part B typically carry no rebates.
    The chart shows that several unrebated branded drugs have posted price
    increases vastly outpacing the rate of inflation, as well as the rate
    of price increases among most drugs. Moreover, unrebated drugs in
    Medicare are not unique to Part B--HHS's Office of the Inspector
    General finds a full 39% of branded drugs in Part D carry no
    rebatex.\11\
    ---------------------------------------------------------------------------
        \11\ HHS Office of the Inspector General, ``Increases in
    Reimbursement for Brand-Name Drugs in Part D,'' June 2018.

                            Selected Part B Drugs With High Price Increases From 2017 to 2018
    ----------------------------------------------------------------------------------------------------------------
                                                                 Estimated                  Estimatied
                                                  2012 Price     2017 Price     % Price     2018 Price     % Price
                     Brand Name                   per Part B     per Part B     Increase    per Part B     Increase
                                                 Prescription  Prescription*    2012-17    Prescription    2012-17
    ----------------------------------------------------------------------------------------------------------------
    Miacalcin                                            $461        $16,375       3,449%       $19,266          18%
    Krystexxa                                          $2,717        $19,163         605%       $21,127          10%
    Teflaro                                              $110           $399         263%          $439          10%
    Bicillin                                              $41           $106         159%          $120          13%
    Rituxan                                            $5,125         $6,890          34%        $7,416           8%
    Orencia                                            $1,636         $2,849          74%        $3,020           6%
    ----------------------------------------------------------------------------------------------------------------
    * Estimated inflation adjusted price = 2012 price * weighted average manufacturer increase in list price per
      unit. Not affected by changes in numbers of units per claim, or mix of doses/dosage forms. Estimated 2018
      price through Q3 2018. During study years PBMs were not involved in Medicare Part B program, so no PBM rebates
      were involved. Analysis included drugs with Part B spending data for full period 2012-16.
    Source: Visante and PCMA analysis of data from CMS and SSR Health, 2019.

    In sum, the research record is clear: drug manufacturers alone are
    responsible for the prices they set and neither PBM-negotiated rebates,
    nor any other party nor factor in the supply chain affects the list
    price of a brand drug.

    Managing Drug Cost Growth Is Challenging, but Policy Changes Could
                        Improve Competition

    PBMs have an established record of negotiating with manufacturers and
    pharmacies to reduce costs for patients, either in the form of lower
    premiums for all participants in a plan, or through lower costs at the
    pharmacy, and usually both.

    The key to reducing prescription drug costs is increasing and
    encouraging competition. PBMs are best able to negotiate when
    competition exists, and PCMA's member companies support a number of
    ideas for increasing competition and building upon market-based tools
    to improve the Part D program. These include:

          Remove Part D's protected classes. Designating ``classes of
    clinical concern'' where all or substantially all drugs in a class must
    be covered allows drug manufacturers to virtually name their price.
    Indeed, a recent Milliman analysis showed that the average brand rebate
    (for drugs that had any rebate) in Part D was 30%, while the average
    rebate for brand drugs in protected classes was 14%.\12\ CMS already
    applies careful plan formulary coverage checks to assure proper
    coverage. A pending CMS plan only to lessen the effect of protected
    classes-not eliminate them-would save $2 billion over 10 years.
    ---------------------------------------------------------------------------
        \12\ Milliman, ``Prescription Drug Rebates and Part D Drug Costs:
    Analysis of Historical Medicare Part D Drug Prices and Manufacturer
    Rebates,'' July 16, 2018, https://www.ahip.org/wp-content/uploads/2018/
    07/AHIP-Part-D-Rebates-20180716.pdf.

          Encourage greater use of generics for Part D LIS enrollees.
    MedPAC recommended allowing the Secretary to lower cost-sharing on
    generics and raise it for brands that have generic competition.
    Allowing plans to lower generic cost-sharing for these beneficiaries
    would save money for beneficiaries, taxpayers, and the Medicare
    ---------------------------------------------------------------------------
    program.

          Modify the requirement for two drugs per class. The requirement
    that Part D plans cover two drugs per class is outmoded. It has
    encouraged manufacturers to argue for ever more granular classes and
    reduced competition, increasing Part D costs. Modifying the requirement
    by requiring plans to ensure access to therapies based on conditions or
    disease states instead would reduce costs without reducing access to
    needed drugs.

          Build on existing efforts to apply Part D management tools to
    Part B drugs. PBM tools such as value-based formularies, manufacturer
    negotiation, and prior authorization have proven indispensable for
    improving patient safety and lowering costs in outpatient prescription
    drug plans like Part D. Adding Part D management tools to the Medicare
    fee-for-service program and building on efforts in Medicare Advantage
    for Part B drugs would make drugs more affordable on Medicare's medical
    side.

          Encourage use of mail-order pharmacy in Part D. Mail-order
    pharmacy: vastly reduces errors in dispensing; increases convenience
    for beneficiaries on maintenance medications; improves adherence; and
    offers a lower cost-sharing option to beneficiaries in most cases. With
    much of the public using home-
    delivery for a wide range of goods and with many Medicare beneficiaries
    home-bound, CMS should take further steps to encourage home delivery of
    maintenance medications.

          Repeal any willing pharmacy provisions. Requirements that all
    pharmacies be included in Part D networks drives up costs and are
    unnecessary, given the network adequacy requirements. Congress should
    repeal the provision. One study showed that greater use of limited
    network pharmacies in Part D could generate $35 billion in savings over
    10 years.\13\
    ---------------------------------------------------------------------------
        \13\ Visante, ``How Pharmacy Networks Could Save Medicare,
    Medicaid, and Commercial Payers $115 Billion,'' January 2013, https://
    www.pcmanet.org/wp-content/uploads/2016/10/visante-pcma-pharmacy-
    networks-study-1-13.pdf.

          Give Part D plans meaningful access to Part A and B claims data.
    To coordinate care and make the best coverage decisions for
    beneficiaries, plans need to be able to use medical data as well as Rx
    data. Existing prohibitions on using A and B data to inform coverage
    design and decisions are misguided and keep plans from using claims
    data to improve care coordination and coverage. Researchers suggest
    combined data sets of Parts A, B, and D claims can be a ``rich
    ---------------------------------------------------------------------------
    resource'' for comparative effectiveness data.

    The following list of additional solutions would further increase
    competition in the marketplace. While these proposals are outside the
    Finance Committee's jurisdiction, they should help to bring balance
    back to the drug marketplace and enhance competition.

          Eliminate use of Risk Evaluation and Mitigation Strategies
    (REMS) to delay competition. Some manufacturers have used REMS to
    prevent generic or biosimilar developers from getting sufficient
    quantities of a drug or biologic to develop a competitor to the
    innovator product. REMS were never intended for this purpose; this
    practice should be prohibited. S. 340, ``Creating and Restoring Equal
    Access to Equivalent Samples Act of 2019'' or the ``CREATES Act of
    2019'' would address these abuses.

          Stop anticompetitive product adjustments, i.e.,
    ``evergreening.'' Drug manufacturers sometimes use tactics such as
    ``product hopping'' or ``evergreening,'' submitting applications to the
    FDA for approval of a ``new'' product that is essentially the same as
    the original product. These product lifecycle management tactics
    artificially extend drug exclusivity periods and delay the take-up of
    lower-cost generics.

          End orphan drug exclusivity abuses. Orphan drug exclusivities
    are meant to encourage research on rare diseases, but manufacturers
    have gamed the policy to apply it to blockbuster drugs with script
    volume in the tens of millions. Orphan exclusivity periods should only
    apply to those drugs originally approved by FDA under an orphan
    indication and only for the orphan indication itself.

          Eliminate ``pay-for-delay'' agreements. Patent settlements, or
    ``pay-for- delay'' agreements, allow drug patent holders to pay off
    potential competitors who would otherwise produce a competing generic
    or biosimilar drug. These anticompetitive agreements should be
    eliminated. S. 64, The Preserve Access to Affordable Generics and
    Biosimilars Act, would greatly ameliorate these concerns.

          Allow for FDA accelerated approval of brand drugs based on
    increasing competition. Accelerated review is granted to new drug
    applications that address ``unmet need.'' The economic need for
    competition to lower prices, or what some call ``financial toxicity,''
    should be a criterion of unmet need.

          Revisit and improve biosimilar labeling and naming.
    Substitutable biosimilars should bear identical names and labels to
    their innovator analogs. Use of different names will confuse patients
    and providers and inhibit prescribing of biosimilars.

          Reduce innovator biologic exclusivity to 7 years. Seven years of
    data exclusivity would still provide a sufficient return to
    manufacturers, while also speeding more affordable biosimilars to
    market.

    These policies and some of the specific bills that contain them can
    help lower costs in Part D and the wider prescription drug market.

    Part D Should Work for All Enrollees, but the Administration's Proposed
                        Rule Ending Drug Rebates Is Counterproductive

    In addition to the suggested policy changes above, specific
    interventions to help Part D beneficiaries who have high out-of-pocket
    spending are needed. Fourteen years into the program, it remains a
    great success with high enrollee satisfaction, however, policymakers
    should consider how best to balance the needs of all Part D enrollees.

    With respect to the Administration's recently proposed rule to end the
    drug rebate safe harbor, there is grave concern that this proposed rule
    would increase premiums for Medicare beneficiaries and costs for
    taxpayers.

    While the Administration's goals are well intentioned, the proposed
    rule does nothing to reduce the prices drug manufacturers set. To the
    contrary, it would cause substantial increases in seniors' Part D
    premiums, as well as the cost to taxpayers.

    The Administration's proposal also includes an unprecedented six
    different cost impact estimates by three different actuarial groups,
    including the independent HHS Office of the Actuary (OACT). The range
    of impact for cost to the federal government across the six estimates
    is an immense $300 billion. The great uncertainty surrounding the
    proposal should give the Committee pause. Americans deserve clarity on
    how such a proposal will affect those who rely on Medicare and
    Medicaid, and commercial coverage. Given OACT's skill and institutional
    independence from the agency, it is likely they have the most accurate
    estimates.

    Under the Administration's proposal, according to OACT, Part D premiums
    could rise by as much as 25 percent for 2020 to reach $47.66, marking
    the largest average premium increase in the program's history. Such a
    large increase could cause many seniors and disabled Americans to drop
    the prescription drug coverage they need to protect their health and
    financial security, or never sign up in the first place. Healthier
    beneficiaries (i.e., those who need fewer drugs) would drop coverage
    first, causing premiums to increase further and potentially
    destabilizing the Part D program, as increasingly those eligible for
    enrollment would find Part D coverage unaffordable.

    Additionally, OACT estimates that the proposal would cost the federal
    government an extra $196 billion over the next 10 years. If finalized,
    this could make the proposed rule among the costliest in U.S.
    history.\14\
    ---------------------------------------------------------------------------
        \14\ American Action Forum, ``Mandating Talking Cars: Costliest and
    Most Beneficial?'', December 16, 2016. This article describes what were
    at the time, the two costliest proposed regulations in U.S. history.
    The OACT cost estimate for the Administration's proposal is in excess
    of these two, https://www.americanactionforum.org/regulation-review/
    mandating-talking-cars-costliest-beneficial/.

    PCMA urges the Committee to encourage the Administration to withdraw,
    or at the very least significantly delay the implementation of, the
    proposed rule until its impact on beneficiaries and on Part D can be
    better understood and managed.

    Conclusion

    In the search for solutions to address high drug costs, the Committee
    and Congress would be best served in pursuing policies that foster and
    encourage competition to keep prescription drug costs and pharmacy
    benefits more affordable for employers, enrollees, taxpayers, and
    government programs. Unfortunately, the rule recently proposed by the
    Administration will not accomplish this goal, since it does nothing to
    encourage manufacturers to bring down the drug prices they alone set.

    PCMA member companies welcome continuing discussion among all
    stakeholders to create a robust, sustainable market that will continue
    to deliver needed cures and treatments for patients who suffer through
    disease and chronic illness.

                                     ______

                      Letter Submitted by Debra L. Raffle
    February 27, 2019

    U.S. Senate
    Committee on Finance
    Dirksen Senate Office Bldg.
    Washington, DC 20510-6200

    RE: The Escalating and Unsustainable Rising Cost of Insulin for
    Insulin-Dependent Diabetics

    Chairman Grassley and the Committee:

    I hope I am not too late and will be read at least. I only received
    this notification a few days ago from the American Diabetes
    Association, but I see you continue to have hearings, so I am revising
    and resending my letter.

    I have type 1 diabetes. I am an insulin-dependent diabetic, which means
    there's not one hour of every single day of my life that I MUST have
    insulin, or I will die. It's that simple. I was diagnosed around 9-11,
    sadly that it makes it easy to remember. I was an adult diagnosed with
    a mostly childhood disease and had a lot to learn! The cost of insulin
    that I need to stay alive 24 hours a day has escalated from $70 per
    1000 ml vial to nearly $300 a bottle. The same bottle of Novolog sells
    for $47.99 in Canada. I just had to pay $2300 out of pocket for 3
    months of insulin (and that was with a supposed discount)! The
    insurance I have through my employer has an extremely high deductible
    and high copays and some items are not covered at all. If my insulin
    pump supplies are not covered, I simply cannot afford them. If I can't
    afford to manage my diabetes the way my doctor and I have been doing
    successfully through pump therapy all these years, I will likely get
    sick, get a complication or two and then die. And no one seems to care!
    Certainly not the insurance companies or the pharmacies. People need to
    care. It will cost far more with the complications that will arise if I
    don't get my insulin and if I can't afford to pay it, other tax payers
    will ultimately bear those costs when all of this can be avoided.
    Again, I feel that most insurance companies and certainly the
    pharmacies prefer their profits over actual health care and effective
    management and if we can't afford the astronomical prices they are
    putting on once affordable drugs and supplies, then they would prefer
    we die and let someone else pay. This is insane to me! I should be able
    to afford my insulin and pump supplies, as in the past, but due to
    escalating prices of medications, insulin and insurance costs (so they
    can all make their profits) it is becoming unsustainable. I can't
    afford it and am very healthy and have a good paying job.

    I would like to join in the battle to fight insurance companies who
    seem to think we can do without these drugs--insulin is not even a
    drug, it's something my body quit making almost 20 years ago and that
    most of you all take for granted, but without it, I will, in fact, die
    within a few days/possibly lingering a few weeks in a coma. I didn't
    ask for this, however, if I am able to get what I need, what my doctor
    prescribes for me and have that covered by my insurance, I remain
    healthy. I am a working, productive, tax paying citizen and if you
    allow me to get insulin and medical supplies at a sustainable price, I
    can continue to be a productive tax paying citizen. If you don't I
    become unable to work, pay taxes and get sicker and die. Diabetes is a
    completely manageable disease and it's disheartening that the insurance
    companies, the pharmacies and the United States Government seem to have
    such low regard for those of us who were unfortunate to contract a
    disease where we have NO OPTION but to buy insulin at escalating
    prices. They keep raising the price of insulin higher and higher and
    higher, because they have a captive audience they are holding hostage.
    I really wish someone would take a stand on this and I would be willing
    to help, testify, or whatever it takes to help this situation.

    In addition, I also take a medication called Symlin that allows me to
    utilize my insulin more efficiently. It decreases my insulin intake
    about 30%. This helps me maintain a healthy weight. More insulin means
    more weight and more weight means taking more insulin. It's a vicious
    circle. I am a type 1 so I have never been over weight and I struggle
    to maintain my weight for the reasons I have listed above. If I can
    maintain my weight, not only will I be healthier, but I can take
    slightly less insulin to help combat the astronomical cost of something
    that I MUST HAVE EVERY SINGLE DAY OF MY LIFE. By reducing my intake by
    10 units a day, I may get another day or two out each vial and that's a
    lot! It certainly will NOT help my overall health to put on extra
    pounds! Anyhow, my new insurance will not cover Symlin at all and they
    tell me it will cost $5800 for a 3 month's supply that I used to pay
    $70 co-pay when I had Premera. I have been on this drug about 10 years.
    This is ridiculous and clearly, I cannot afford this, so I get to go
    off it cold turkey, increase my insulin intake and pay more than I ever
    have for the same insulin!

    I don't think they understand how this all works nor do insurance
    companies and administrators care, but if you give us the tools
    (medications and supplies) to manage our diseases with, we will not
    have as many costly complications. So, it is cost-effective to give us
    what we need now to avoid higher costs of complications later! To date,
    since I was diagnosed as a type 1 in 2001 and having been on an insulin
    pump for 17-18 years, I have never had any complications due to my
    diabetes and would like to keep it that way.

    I am so disgusted with insurance companies and I want to know what we
    can do to get things changed. Can I go up to Canada and purchase my
    insulin? Can I testify and be a witness? I am willing to do whatever I
    can to help! What can I do to lower my medication and durable medical
    equipment costs? The insurance company cannot even tell me what things
    cost until I purchase them, which is ridiculous since I don't want to
    pay for things I clearly cannot afford. I'm lost and feeling desperate.
    I look to your committee to make this manageable disease financially
    manageable. It is manageable if we can afford what we need to survive
    and there's NO reason for the price to quadruple in the last 10 years,
    NONE except for greed and profits.

    I spent over $6.5K last year on out pocket medical costs, mostly
    insulin and pump supplies. I had no surgeries, I had no illnesses, I
    had no procedures. This is becoming very difficult to afford.

    I don't think I should have to struggle to afford groceries and lose my
    home or just make simple choices because I can't afford my insulin and
    supplies. Please do something about the escalating cost of health care,
    specifically common insulin, Novolog in my case, and do what you have
    promised for many years! This is unsustainable as it currently is!

    Thank you for listening.

    Debra L. Raffle

                                     ______

                       Letter Submitted by Laura T. Ricci
    March 4, 2019

    U.S. Senate
    Committee on Finance
    Dirksen Senate Office Building
    Washington, DC 20510-6200

    RE: February 26, 2019, ``Drug Pricing in America: A Prescription for
    Change, Part II''

    To the Senate Committee on Finance,

    Thank you for beginning to tackle the outrageous prices of prescription
    drugs in America. I've watched many of the meetings and also the
    Congressional Oversight meeting with Congressman Cummings. I watched
    this meeting again and took notes. What I find interesting is several
    of the ``Magnificent Seven'' are foreigners. These are CEOs that have
    come to America to use Americans and the American healthcare system as
    pawns for their profits. I do think that it is a multi-layered problem
    and the American healthcare system is to blame for a lot of it. The
    first thing that the senate and congress need to do is regulate this
    industry so these people have to abide by stricter laws. All of the
    levels need to abide by stricter laws.

    I come to you as a mother of a type 1 diabetic, 20 years old, who will
    soon be on his own. What will happen to him if he has to enter a high
    deductible healthcare plan one day? Will he be the next Alec Smith or
    Antavia Worsham? I would like to see this system fixed before he has to
    cross that road. I am lucky enough to live in the Commonwealth of
    Massachusetts, where he is eligible for Masshealth benefits so I am not
    taxed in my wallet for his insulin. But one day, under the current
    system, he may be. What if he ever wants to move out of Massachusetts?
    What kind of healthcare plan will he be forced into? The current system
    is designed for failure for a T1 diabetic. The only way T1s can get
    their insulin for free or cheap is to make less than $16,000 or just
    work a part-time job so you will qualify financially. What kind of
    contribution to society is that? Will he ever be able to use the
    college degree he will earn? He might end up living at home for the
    rest of his life to be able to afford insulin because he will never be
    able to afford $324.00 for a bottle of insulin or the ridiculous copays
    assessed and high deductibles. High deductible healthcare plans need to
    be abolished. High deductible healthcare plans are only for the really
    healthy, they're not for anyone who needs to use the system, the only
    system in place. T1s are forced to use the system because insulin is
    not available over the counter like a loaf of bread is. My son can't
    buy and eat the bread if he doesn't have the insulin to go with it.

    Why does America not allow insulin to be purchased over the counter
    without a prescription? Why does America not trust Americans to use
    insulin correctly? I want insulin to be able to be purchased over the
    counter, maybe with a prescription, but no insurance attached to it.
    When you look at the supply chain of food, there's a manufacturer, a
    warehouse and distributor, the supermarket and then the consumer. When
    you look at the supply chain of medicine, there's the manufacturer, the
    warehouse and distributor, the pharmacy (supermarket), the consumer and
    then the PBMS and insurance companies. If the PBMS and insurance
    companies were eliminated from this chain, then the prices would come
    down because there would be no clawbacks and rebates involved. Is there
    a rebate for bread? No.

    My son was diagnosed with T1 diabetes in 2007. I was looking at some of
    my old receipts. I looked at one from 2010. The price that Blue Cross
    paid was $390.13 for 6 bottles of humalog. I had a $60 copay. That was
    $75.00 a bottle, but I only paid $10.00 a bottle with the copay. The
    lantus insulin was $152.48 that the insurance paid, and I paid $60.00.
    I got 3 bottles. So that was $212.48 divided by 3 is $70.82. I paid
    $20.00 for each bottle with the $60.00 copay. Today, I see the receipt
    from Walgreen's, and the cash price is $974.89 for 3 bottles of
    humalog. That's $324.96 each. That is what the Commonwealth of
    Massachusetts must pay because he is covered under Masshealth. Does
    Massachusetts pay that much? I have a feeling they do because Medicaid
    is not allowed to negotiate prices with drug companies. The budget for
    Massachusetts is 40% healthcare. Former Gov. Mitt Romney put this
    mandatory healthcare in place. This should have been used as the
    template for the ACA. Did the ACA cause these high deductible
    healthcare plans? Some people think it did. That's a question I have
    for you. Did the ACA cause high deductible plans? High deductible plans
    are bankrupting Americans. They're causing people to have to pay
    upwards to $25,000.00 sometimes for drug coverage before insurance will
    pay anything. It's unaffordable. People are selling their houses,
    taking out second and third mortgages, moving back home with mom and
    dad, and even living on the streets.

    You've heard the stories about people rationing insulin and dying. I
    don't want that to happen to my son. T1 diabetes will never go away.
    There is no cure. The pharmaceutical companies know there is no cure
    and know we are at their mercy. The American lawmakers allow them to
    carry on. You need to regulate this industry and put the brakes on
    their practices. Utilities, food, tobacco, guns, are all regulated.
    It's time for pharmaceutical companies to be held accountable so they
    will stop using Americans as pawns for profit. As said in the hearing,
    they make money on their drugs in Germany. If they didn't, they would
    say goodbye to Germany.

    When people can go to Mexico and buy the insulin for $30.00 a bottle,
    Canada for $35-45.00 a bottle, then that tells you that the price to
    produce it is low. I read an article that showed a study that said it
    only costs $3-6.00 to produce a bottle of insulin. It's just like the
    EpiPen. Heather Bresch, the CEO of Mylan, she told the Senate that it
    costs Mylan $1.00 to make it, they sell it for $60.00 and it retailed
    for $300.00! That's nuts. A lot of EpiPens never even get used. They're
    there for an emergency. Insulin is used anywhere from 4-10 times a day
    because you need to take it every time you eat. You don't need an
    EpiPen every time you eat. The equivalent to an EpiPen for a diabetic
    is a device called a glucagon injection. It is also very expensive and
    is often never used. It's an injection that will revive you from a low
    blood sugar if you pass out and may have a seizure. According to GoodRX
    website, the glucagon retails for $292.81 which is 19% off the retail
    price of $364.50. This is another device that often goes unused, but
    people pay for it because they want it in case of emergency. There are
    no coupons available to get it for free. I would like to know how much
    it really costs to manufacture a glucagon kit.

    The other thing that people are doing to get insulin is they're taking
    out gofundme accounts. They try to raise money to pay for the copays.
    They don't always succeed in raising the money and still end up dead,
    which is the case with a man named Shane Patrick Boyle. People then
    have to take out gofundme accounts to bury their loved ones because
    once you are diagnosed with T1 diabetes, you have a lot of difficulty
    in getting life insurance. You're a threat to insurance companies. They
    only want to bring money in, they don't want to pay it out. But they
    pay it out to CEOs in the form of huge salaries.

    All of the CEOs at every level of the supply chain make a lot of money.
    David Ricks, CEO of Eli Lilly, he makes $40,000.00 a day in salary.
    $5,000.00 an hour. Some people don't make $40K in two years. The CEOs
    of CVS, Walgreen's, Rite Aid, Kroger and all the insurance companies,
    like United Healthcare and Blue Cross, they also make millions. Why?
    Why is that allowed? They've all created monopolies. I've watched their
    stocks and they've all skyrocketed and I see a new CVS store in many
    towns around where I live. They've closed the old stores and built
    these fancy new buildings that are full of expensive products. I only
    get my son's insulin at Walgreen's because I am forced to get it
    locally, Medicaid will not allow you to use a 90 day pharmacy service.
    And insulin isn't the only thing that diabetics need to use for daily
    management of diabetes. They need test strips, meters, pump supplies,
    Dexcom supplies, glucose tablet s, ketone test strips, alcohol wipes,
    and sometimes they have to eat special food if they also end up with
    Celiac Disease.

    There are at least 80 autoimmune diseases. There is no cure for any of
    them. Do you think the pharmaceutical companies think there is a cure
    on the horizon, a vaccine? Is that why they're raping American's to get
    their profits before people don't need insulin anymore?

    Nicole Smith-Holt, the mother from Minnesota that lost her son Alec to
    rationing insulin said this in a Minnesota Roundtable: ``Before insulin
    was invented, diabetes was a death sentence. Now diabetes is a death
    sentence again because insulin is no longer affordable.'' Let that sit
    with you.

    I have a change.org petition going around asking Congress to subpoena
    the CEOs of the insulin companies. One of the signers of the petition
    posted that this is the new AMERICAN GENOCIDE. Let that sit with you.

    I like what Senator Wyden said about these CEOs using patients and
    taxpayers as ``unlocked ATMS.'' It's the truth. I also like what he
    said when he said ``drug prices are astronomically high because that's
    where pharmaceutical companies and investors want them, and diabetics
    who can't afford the costs self-ration and endanger their lives but the
    investor s are happy.'' It's the truth.

    The CEOs were asked `'What keeps you up at night?'' None of them
    answered that they were concerned about anyone dying because they can't
    afford their medicines. They all answered that they were more concerned
    about their drugs being put on formularies. That brings me to another
    problem. The formularies. The PBMS play games all the time with the
    switching in and out of the type of insulin that the insurance company
    will pay for. This means that people often end up getting a physician's
    override to be able to continue using the insulin of their choice. The
    formulary dictates to the diabetic what they can and cannot use. They
    limit your choices or make you fight for the kind of insulin you want
    to use. Do you have the choice to buy Pepperidge Farm bread or store
    brand bread? Yes. So why doesn't the diabetic or person in need of
    medication, have the ability to choose the one that works right for
    them and not have to argue and fight for it? If the industry was
    regulated, we may have the ability to choose what is right for us, the
    patient and consumer.

    Another problem I see and have stated this before, is that Congress has
    to pass legislation stopping these pharmaceutical companies from
    advertising on TV. They did it with tobacco. The last advertisement for
    tobacco was for a Virginia Slims ad on December 31, 1970 on the Johnny
    Carson show. Congress did that. So they need to do it again for
    pharmaceutical. American and New Zealand are the only countries that
    allow them to spend their profits on advertising. If they want to
    advertise, they should only be able to advertise for medicines that
    don't require a prescription. And I'm also tired of seeing
    advertisements on TV for erectile dysfunction.

    Doctors: Doctors need to inform patients of alternatives to getting
    insulin and not having to use insurance. People are already buying
    insulin from Canadian Pharmacies and going to Mexico if they can. The
    State of Utah will actually pay their state employees $500.00 to cross
    the Mexican border and get their medicines there instead of having to
    put the burden on the state's budget to pay for expensive medicines in
    the U.S. Isn't that crazy? Why should that happen? If medicines were
    affordable, the drug companies wouldn't have to give so much away for
    free. The burden would be shared equally and the money would stay in
    America. And I don't buy the insulin companies' stories about the fact
    that the insulin supply chain is not protected in Mexico like it is in
    the U.S. If the insulin in Mexico were tainted, people would be dying
    from it and it would be in the news that people are dying from it
    there, and dying in foreign countries from it. So that is just a scare
    tactic to get you to continue to pay high prices to support the high
    CEO salaries.

    Soriot--He said he was annoyed that he was the lowest paid CEO. Give me
    a break. That is all part of the GREED before NEED and PROFITS before
    PATIENTS.

    The FDA--Mr. Gottlieb, the commissioner, he is a part of the problem
    behind insulin as well. Insulin was classified as a DRUG. He went and
    changed the classification to a BIOLOGIC. That's just a term for a
    liquid medicine. So then that created the new biosimilar insulins.
    After thinking about this, I figured out that the biosimilars didn't
    make insulin a generic, all it did was allow these insulin companies to
    take out new patents, patents that will have maybe a 20 year life span
    under the Hatch-Waxman Act. So what does that do? It creates even more
    of a monopoly. Why, after almost 100 years, is there no generic insulin
    available? No one has an answer to that. The patent for humalog is long
    since expired. All these insulin companies have to do is tweak an amino
    acid in the insulin and they get a new patent. That's ridiculous to me.

    Today, March 4, 2019, there was a news article issued about Eli Lilly:
    https://investor.lilly.com/news-releases/news-release-details/lilly-
    introduce-lower-priced-insulin. In this article, Eli Lilly said they
    were going to make a ``generic'' humalog and the list price of it would
    be $137.35 for a vial and $265.20 for a box of 5 pens. That is
    ridiculous to me. First, how do we know that Eli Lilly won't just use
    the humalog as it is now and just put it in a new bottle with a
    different color and change the name on it? Are they only doing this to
    appease the senate and Ms. DeGette's investigation into these high
    prices? Plus, they already have their BLINK HEALTH system, which is
    like a GoodRX, that allows you to get a vial of insulin at $178.90 and
    if you don't have insurance, you can get insulin from GoodRX for
    $177.87. These prices are lower than the $324.00, but they still aren't
    the $30.00 or $45.00 that Mexicans and Canadians reap the benefits
    from. Canada would never allow insulin to be price gouged because it
    was invented there by Sir Frederick Banting who has probably rolled
    over in his grave a million times by now. I told my congressman, James
    McGovern, that insulin wasn't supposed to be a FOR-PROFIT business. He
    turned around to me, looked me in the eyes, and said: ``Well, it is''!

    The other thing about the financial aid that Eli Lilly offers, is you
    have to be really poor to be able to qualify for it. So only the poor,
    nonworking people in America can get it for free. They wouldn't have to
    give it out for free if it was affordable and accessible over the
    counter at the pharmacy. They also give a lot of insulin way to camps.
    Another thing that doctors don't tell people about is the 340B program.
    That's like a big secret, just like the other secrets that revolve
    around this industry. Many state attorney general's already have their
    own investigations going on to find out what is going on behind closed
    doors.

    What I heard from some of these CEOs, especially Caforio, was that they
    ``need America's help and support'' to fix this problem. I heard that
    from several of them. So they are asking YOU, the congress and the
    senate, those that write the laws, to help them figure it out because
    they know the system is unsustainable as it is and they will only
    continue to do what they are doing because there are no laws saying
    they can't do it. That's where my new hashtag comes into play--
    #thepowerofthepen. Lawmakers are voted in with the power of the pen and
    lawmakers can pick up the pen and write laws to protect Americans from
    the greed of this industry.

    I write to my congressman, James McGovern, and my senator, Elizabeth
    Warren, and share with them what I am sharing with you. I share that
    they need to take action and write better laws and regulate this
    industry. They also have to stop taking money from the pharmaceutical
    companies and lobbyists and don't fall for their antics. These people
    are crooked and have the thief mentality.

    Mr. Frazier stated that he couldn't walk away from the U.K. even though
    they give lower prices because he believes it is immoral. But it's
    okay. that he price gouges Americans and that's not immoral?

    I read in a recent article about Mr. Brandicourt, that he fought to
    keep any generic insulins out of the market and actually took out more
    patents to prevent it. So why is that allowed? That's crookedness. That
    is another case of Greed before Need. Companies like his, Sanofi, they
    give out coupons for their lantus insulin. They wouldn't have to give
    out coupons for people to get it for cheap or free if they just lowered
    the prices and made them affordable.

    NovoNordisk also gives out coupons and the same applies to them. Why
    can they let you have insulin for $25.00 with the coupon, but you can't
    go to the pharmacy and get the insulin for $25.00 without the coupon?
    So you know the price to make insulin is cheap if they are able to give
    out coupons for you to get it for free or cheap.

    Senator Isakson, he had quite the story. He has Parkinson's disease and
    takes 8 medicines. His story about all the ways he could get his
    medicines for cheaper were right on target. The options: Don't use
    insurance, use coupons, get rebates or just pay CASH. People could just
    pay cash if they didn't have to pay and arm and a leg for medicines
    that are supposed to keep you alive, not kill you because you can't
    afford them. And his story about his staff member's 2nd child being
    diagnosed with T1 diabetes was heartbreaking. T1 diabetes is an
    epidemic. There is never anything shared on TV about the signs and
    symptoms of T1 diabetes. Kids die from it after being misdiagnosed with
    strep throat or the flu. T1 diabetes mimics the flu. My son had strep
    throat when he was diagnosed. And it's not caused by vaccines. T1
    diabetes has been around for over 4500 years and no vaccines were
    invented then. People just died from it before insulin was invented in
    1921.

    My personal story is this: I have epilepsy. I take 3 medications for
    it. One of them was invented in 1914. It's older than insulin. When my
    husband had a great job with great insurance, I paid $3.96 for a 90 day
    supply. When my husband lost his job, I was eligible to get on Medicare
    because I am on disability. When I went to get my medicine at the
    pharmacy, I was hit with a $114.41 bill. YIKES! This stuff is cheaper
    than aspirin and here I am paying $114.41. The Medicare system, the
    Part D, they put the medicine on the most expensive tier. So what am I
    supposed to do? I have to pay it or my head goes nuts. Another medicine
    I take, the patent doesn't expire until 2022, so there is no generic
    for it. I just had to pay $1,200.00 for this medicine at the beginning
    of the year. Ouch! My disability benefits are $1,600.00 a month. Do the
    math. I wish I had never started to take it. The next time I get the
    prescription filled, it will be $800.00 for it. I will never meet the
    deductible set on my Part D plan because it is set so high that I never
    reach it. So I pay over $300/year for my Part D plan, over 1,200.00/
    year for my Part B, and even though the deductibles are lower than a
    high deductible plan like a Blue Cross plan, it still hurts the wallet
    every time I need to refill these prescriptions.

    I'd like to share with you some stories of people that have children
    with T1 diabetes.

    1. This lady had a child die from T1 diabetes after the girl was kicked
    off of BCMH at the age of 21. The girl rationed her insulin and was
    found dead at home. The lady also has a second daughter that has T1
    diabetes. She started a foundation and is on the warpath to make sure
    people don't die from insulin rationing and get kicked off of health
    plans. She just shared a story about her daughter being denied the
    Dexcom continuous glucose monitor. People like her are always fighting
    with insurance and distributors, especially Edgepark Medical Supply, to
    get their supplies. This is a problem created by insurance companies
    that ``don't want to pay.'' They will do everything in their power to
    deny you and now people are turning to Costco to get this Dexcom device
    and get out of the insurance loop to get it, and get it cheaper than it
    costs to use their insurance. Yet, these people are still paying their
    premiums and they can't use the insurance.

    2. This lady and her son, they live in Tennessee. Tennessee, as I found
    out, is one of the states that did not adopt the Medicaid expansion.
    The son is 24 years old. He is a T1 diabetic as well. He was working at
    a Hardee's burger place. He lost his job after getting sick with
    diabeticketoacidosis (OKA). He was in the hospital and couldn't work so
    they fired him. He had no access to insulin and started taking the
    ``WALMART'' insulin. This isn't the right kind of insulin for a T1
    diabetic to take. He ended up with a big sore on his arm from injecting
    the insulin in the same spot all the time. He ended up with a bad MRSA
    infection. He went to the hospital and was not taken care of very well
    and he checked himself out. He wanted something to drink and was denied
    water. The mother didn't know how to navigate the politics to get help
    in the state. She tried to get a social worker to get her son on
    Medicaid. She was told NO, that he didn't qualify because he wasn't
    pregnant, wasn't a single parent, and was over the age of 21.

    So the message from the state of Tennessee is ``JUST GO DIE'' if you
    can't work and get private insurance and you're over the age of 21.
    ``We don't want to take care of you anymore even though you have a life
    threatening disease.'' So I contacted the governor there and got his
    office to contact TennCare, the Medicaid office, and was able to at
    least get him set up to get insulin, but he still has no doctor to
    report to because he was denied care at a medical center there because
    he missed three appointments and they won't take him because of a long
    wait list. The option of moving out of the state is out of the question
    I was told. So here is a man that will end up living with his mother
    the rest of his life because he can't hold a job due to his diabetes.

    3. A family from Texas. The father has a decent job but they live
    paycheck to paycheck. They also have a T1 diabetic child. The father
    was offered a TWENTY CENT raise. That means he would make $416.00 more
    per year. Guess what? The twenty cent raise put his family over the
    income qualifications to be able to continue to get CHIP benefits so
    they can afford the insulin for the diabetic. The family would be
    forced to take the insurance from the place of work. The insurance
    would cost them $400.00 per month out of their paycheck. That means
    they would lose $2.50 an hour if they took the twenty cent raise. Does
    that make sense to you? The father ended up signing a waiver and not
    accept the raise so he won't lose the CHIP benefits so he can keep his
    child alive and not have to go get another job or try to come up with
    the money for insulin one way or another? If insulin was affordable and
    accessible over the counter, the $416.00 a year raise might pay for it.
    But that's not the case. So much for a raise. I told the mother to tell
    the company to give him a gift card for $400.00 that she can use on
    groceries.

    4. A United States citizen moved to the U.K. so she could get her
    insulin to stay alive. What in the world? Are you kidding me? Cases
    like this are what take money out of the U.S. economy.

    5. A mother was on vacation, she only took one bottle of insulin with
    her. The insulin got dropped on the floor. She came running to Facebook
    to see if anyone could supply her with insulin because she couldn't get
    a hold of her doctor to see if she could get her prescription filled
    where she was. She couldn't just walk into any pharmacy and say she
    wanted to buy the insulin her child used. She could do that if she
    needed a bottle of water, but she can't do that with insulin. She was
    frantic, thinking, how am I going to keep my child alive? The
    pharmacist was not allowed to give her insulin without a prescription.
    There was no emergency system in place. The pharmacist had no
    authorization to give an emergency supply of insulin to this desperate
    mother. In the end, she was finally able to get her doctor to call her
    back and call in a prescription to the pharmacy to get a bottle of
    insulin. That should never happen in America.

    So I see people pay for premiums out of their paychecks, they pay for
    copays at the doctor's office, they pay outrageous amounts of money in
    high deductibles, and what do they end up with? They end up in debt,
    end up with their own health problems because they are going crazy
    wondering where in the world they are going to get this money from and
    not have to lose everything they have.

    Senator Stabenow was in a hearing that I watched and she actually said
    she took people over the border to Canada herself to get cheaper
    medicines. What does that tell you? That tells you that she's a great
    person that will do whatever she has to do to make sure people don't
    die at the hands of the current system. Our system is broken, it's old,
    it out of date, and I am not 100% sure if this is all because of the
    Affordable (Unaffordable) Care Act. I find that the people that make
    these laws are not the people that actually have children with life-
    threatening diseases and they have no idea what the cost of managing
    the diseases consists of. If America is going to allow the
    pharmaceutical industry to dictate to them how the system should be
    run, then that is the wrong way of doing business.

    I do think that the Senate Finance Committee and congress have to
    subpoena these other pharmaceutical CEOs and get them to answer and be
    transparent about how much it costs them to make their products. I have
    a change.org petition going around getting signatures to ask congress
    to subpoena them. You can't just invite them. An invitation can be
    ignored and turned down, but not a subpoena. Heather Bresch had to come
    to Washington to be transparent, so don't let the rest of them off the
    hook.

    Another thing about Eli Lilly: I read in the news that they were going
    to buy an $8Billion oncology company. If they have $8B to buy an
    oncology company, then why are they killing people with the high costs
    of insulin, literally killing people because they just can't afford
    their outrageous prices? They should not be able to buy a company like
    that until insulin is affordable and accessible to everyone, not just
    in America, but even in Africa. Why isn't insulin available in Africa?
    People die from having no access to insulin there as well. Diabetes is
    a global disease. You can't eradicate it. There is a genetic component
    to it. People are living longer now with the invention of insulin so
    they are passing the genes along to their offspring who ultimately pass
    it on to the next generation.

    March 5, 2019: This morning, as I continue to write and finish this, I
    see a news article about Senator Durbin's response to Eli Lilly's
    announcement yesterday. He acknowledges in there that insulin is as low
    as $38.00 in Canada, but charging Americans four times the amount of
    what Canadians pay it not an outpouring of gratitude. Canadians pay
    less because their government negotiates the prices with these insulin
    companies (http://www.kfvs12.com/2019/03/05/lawmaker-weighs-
    annoucement-by-drug-maker-sell-lower-cost-insulin/). When will the
    United States do the same thing? Why do you have to have a National
    Health Care system to do it? Just regulate the industry, like gas and
    electric, and start setting limits on the prices they can charge. And
    the article says that Senator Durbin is urging the FDA to approve lower
    cost drugs. There is no generic insulin. Why, after almost 100 years,
    is there no generic insulin? Generic insulin is not the solution to
    this dilemma. Just lower the cost. They've made their money over the
    years, the patent for humalog is long since expired.

    Like I said, Eli Lilly can just take humalog, stick it in a different
    bottle, relabel it, and tell you it's a generic. The FDA can't regulate
    prices. Let them be in charge of making sure drugs are safe, but don't
    leave them in charge of this. Mr. Gottlieb went and changed the
    category from a drug to a biologic--that didn't lower the price, it
    only created new patent s. If there was a regulated industry, the price
    would still be controlled on new patents.

    Recap:

          The drug industry needs to be regulated. These companies need to
    be saved from themselves. They don't know how to do it on their own.

          Insulin needs to be available over the counter without a
    prescription. (Kevin's Law has been passed in many states to authorize
    pharmacies to give an emergency, up to 30 day, supply of insulin and
    the pharmacy and insurance can catch up with paperwork afterwards.)

          The United States needs to trust citizens to use insulin
    correctly. It's available over the counter in Mexico.

          The United States needs to find out exactly how much it costs to
    make insulin. The U.S. found out how much it costs to make an epipen.

          PBMs need to be abolished.

          High deductible healthcare plans need to be abolished.

          If insulin is not accessible over the counter without a
    prescription, then it should be exempt from any and all deductibles on
    healthcare plans, as should any prescription medications.

          No diabetic in America should be denied healthcare
    (#medicare4all).

          People shouldn't have to take out gofundme accounts to raise
    money for their medicines.

          People shouldn't have to take out home equity loans and second
    mortgages to pay for their medicines.

          People shouldn't have to turn to the black market and Facebook
    to find insulin.

          People shouldn't have to go out of the country to get affordable
    insulin (#insulin4all).

          People shouldn't have to share insulin with family members.

          People shouldn't have to revert to using the ``WALMART'' insulin
    which is going to kill them if not used correctly.

          People shouldn't have to rely on coupons and scrounge around for
    ways to get discounts on insulin and other drugs.

          People shouldn't have to feel they are a burden to their family
    and ration insulin.

          Companies that price gouge should be held accountable, fined and
    sued so they will stop being so greedy.

          CEOs shouldn't be making so much money while people are dying.

          Insurance companies shouldn't be able to dictate which medicines
    and insulin they want us to use. We should be able to choose the one
    that works for us. That's how the PBMs work. They tell us which insulin
    they will pay for. If insulin was available over the counter, the PBMs
    wouldn't be able to dictate which kind of insulin I want to use, just
    like they can't decide what kind of bread I want to eat or if I want to
    buy Mobil or Shell gasoline for my car.

          The Hatch-Waxman Act is being abused.

          The V.A. can negotiate prices for drugs and medical care, but
    only Medicare Parts A and B can negotiate prices. Medicare part D needs
    to be able to negotiate prices in an unregulated industry. You have the
    power, use it.

          Insulin doesn't need new R&D. Using that as a reason for high
    prices is a bad excuse for high prices.

          Television ads for prescription drugs has to stop, just as
    tobacco ads stopped.

          Politicians have to stop taking money from big pharmaceuticals.
    The pharmaceutical companies are like the mafia.

          If financial aid is going to remain available, the income
    requirements need to be adjusted to keep up with inflation and keep up
    with the times. People that make a decent, living wage, should be able
    to get some relief if these high deductible plans continue to exist. If
    you just got rid of high deductibles and the prices got lowered, we
    wouldn't be talking about this.

          Be proactive, not reactive. Right now we are in a reactive
    position.

          A sick person will always use the system since most want to
    live. Those that don't want to live will commit suicide.

          More teaching needs to take place in our country on what Type 1
    Diabetes really is. It is often mixed up with Type 2 diabetes. They are
    not the same disease.

          The PBMs need to be hired by the U.S. government to do the
    negotiating for lower prices, not be employees of the insurance
    companies. That creates a racket and secrets.

          Listen to more REAL stories of the burdens placed on Americans.
    Let the Americans tell you what they need and want, not allow the
    pharmaceutical companies to run their own agenda. Without sick people,
    they wouldn't even be in business.

          Put the brakes on big pharma.

          List prices work against the patient. Either set lower list
    prices or pass on the discounts to the patient.

          Patients don't care about pharmaceutical's position on the
    formularies, they care about being well.

          Stop the ``Happy Talk''; get down to business and pick up the
    pen (#thepowerofthepen).

          Lawmakers work for the citizens of the United States and get
    paid by our tax dollars. It's time for lawmakers to listen to citizens
    and not big pharma.

          Soriot's wise words: VBP--It used to be a system that was fit
    for purpose. Now it's no longer fit for purpose. No one in the system
    can fix it for themselves. The government has to step up and change the
    rules.

          #painpassionpurpose: Three words uttered to Nette Worsham by
    Congressman Cummings on January 29, 2019.

          CEOs from the two other insulin manufacturers, Eli Lilly and
    NovoNordisk need to be subpoenaed. They have been invited too many
    times and never accept the invite.

          Don't send letters asking for CEOs to tell you how much it costs
    them to make their drugs, make them come to Washington to tell you so
    the public can hear their lame excuses as well.

    Thank you, and I look forward to the next showdown with the PBMs and
    insurance companies. They are part of the problem, not part of the
    solution. The United States government is the entity that is part of
    the solution.

    Sincerely,

    Laura T. Ricci
                          Statement of Rhonda Rowland

                             R2 Communications, LLC

                                  Atlanta, GA

    March 5, 2019

    U.S. Senate
    Committee on Finance
    Dirksen Senate Office Bldg.
    Washington, DC 20510-6200

    To whom it may concern:

    This is in reference to the ``Drug Pricing in America: A Prescription
    for Change, Part II'' hearing held on February 26, 2019.

    As a person living with a rare disease and an advocate, I'm submitting
    the attached articles that provide background on the discovery/
    development of two old, cheap drugs that pharma has raised prices on,
    and the impact on patients.

    Best regards,

    Rhonda Rowland
    R2 Communications, LLC
    Rhonda@RhondaRowland.com
    RhondaRowland.com
    404-680-9053

    High drug costs: the tale of 4 women

    In 2016, Berna Heyman testified before a U.S. Senate committee about
    her personal experience with sudden and dramatic increases in drug
    prices. She was forced to switch drugs to treat her chronic genetic
    disease, which was not the ideal option for her.

    ``The only reason I changed was the cost,'' Berna testified. Her health
    had been stable while taking the drug Syprine, which removes excess
    copper in people with Wilson disease (WD) to prevent potentially fatal
    poisoning. ``My doctor and I made the change only under duress.''

    Valeant Pharmaceuticals (now Bausch Health) acquired the rights to
    Syprine in 2010 and began increasing the price. It's an old drug that
    was developed in the 1960s by British physician Dr. John Walshe, who
    made it in his laboratory and distributed it for free for many years.
    ``It was cheap to make,'' he told me. The generic name for it is
    trientine.

    As a librarian at the College of William and Mary in Virginia for 34
    years, Berna had good health insurance and drug coverage. Her WD went
    undiagnosed for 60 years, making her one of the oldest patients to be
    diagnosed. The first sign of her disease was cirrhosis of the liver
    that was picked up incidentally by a radiologist.

    Upon retirement, she was insured through Medicare and supplementary
    insurance.

    ``By 2014 my projected co-pay exceeded $10,000 per year with my
    insurance paying over $260,000,'' Berna testified. ``That is untenable.
    Something has to be done.''

    At the hearing, Valeant executives expressed regret and admitted to
    being too aggressive with their pricing strategies. When questioned by
    Senators, they said they'd lower their prices.

    For 3 years, Berna has waited. But Bausch Health has yet to lower
    prices.

    ``I left the hearing feeling hopeful, and anticipated changes by
    Valeant,'' Berna told me. ``It's very disappointing. It's the same old,
    same old.''

    Therapist kept patients out of the system, but drug company put her in
                        it

    Rose was completing her college degree in mechanical engineering when
    she noticed that she drooled while reading. Then she began forgetting
    math formulas, so she'd write them on her arm. As a straight-A student,
    she was bewildered that she had to re-read book chapters because she
    forgot what she'd read. She was on the crew team, but her fatigue got
    so bad that she couldn't keep up.

    ``I left college and went home,'' said Rose, who asked that her name be
    changed for privacy. After seeing more than a dozen doctors in New York
    and not getting a diagnosis, she went to an ophthalmologist who told
    her that some diseases can be diagnosed through the eye. He was right;
    an exam revealed Rose had rust-colored rings in her eyes, known as
    Kayser-Fleischer rings which are commonly seen in WD patients.

    Once diagnosed, Rose began taking the de-coppering drug, penicillamine.
    Her condition improved and she returned to college. But her WD left her
    with some memory loss and she couldn't remember her calculus formulas.
    She switched majors and got a degree in occupational therapy.

    Rose moved to Arizona and worked full-time as an occupational therapist
    for 20 years.

    ``Then one day I went to the pharmacy to pick up my WD drugs and was
    told my co-pay was $12,000! I was a single mom raising two kids and I
    couldn't afford it,'' said Rose. ``I felt totally screwed.''

    She had been prescribed Cuprimine, the brand name version of
    penicillamine--also made by Bausch Health. Penicillamine was discovered
    in 1955, also by Dr. John Walshe. ``It's easy to make if you're a good
    chemist,'' Dr. Walshe told me.

    Rose tried zinc supplements, an inexpensive, alternate treatment for
    WD, but they made her violently ill. Without her daily dose of
    Cuprimine, her fatigue returned and depression set in. She could only
    work part-time, so she lost her health insurance. Her WD symptoms
    worsened, so she could no longer work and applied for disability
    benefits.

    ``As an occupational therapist I was contributing to the system, and
    keeping others out of the system,'' said Rose. ``Then the drug company
    put me into the system.''

    Importing drugs from Canada and overseas

    After going without medication for months, Rose's uncle found a way for
    her to get affordable penicillamine through a Canadian pharmaceutical
    broker. At first, her supply came from England. ``The medicine looked
    and smelled like what I had taken for years, although the brands were
    different,'' said Rose. ``But then a shipment came from India that
    didn't smell right.''

    She looked for another option and found Duane, a prescription drug
    broker in the Midwest who could get her drugs shipped directly from
    Australia. She needed a doctor's prescription and paid about $200 for a
    3-month supply.

    ``We operate in a loophole,'' Duane said. ``Individuals are allowed to
    bring in a three-month supply of prescription drugs from other
    countries.''

    What Duane told me is partly true: It's illegal for individuals to
    import prescription drugs in most circumstances, because the FDA can't
    ensure the drugs' safety. And anyone who facilitates the importation is
    also liable. But in reality, the FDA looks the other way.

    So, it's tempting to take the risk. Duane imports an AIDS medication
    for a client who had a $25,000 co-pay. ``I can get it for him for
    $1,200 a month.''

    With exorbitant drug prices and patients' growing inability to pay
    them, there's momentum to make such drug imports legal. Five bills are
    before Congress that would allow prescription drug imports, primarily
    from Canada.

    Staying at poverty level to get prescription drugs

    Ashley Williams was about to start classes at Kansas State when she was
    diagnosed with WD and had to quit school to go to work instead. She was
    grateful to have a diagnosis for the hospitalizations and unnecessary
    surgeries she experienced the previous 2 years.

    ``I needed health insurance, so I took a full-time job with a
    technology company,'' said Ashley. ``I worked my way up from `coffee
    girl' to project manager and was working 70-80 hours a week.'' Even
    though she was taking Syprine, her health deteriorated. She thinks it
    was due to working too hard, to prove she wasn't sick.

    For medical reasons she got laid off and applied for disability
    benefits. Now with Medicare and supplemental insurance to cover her
    health care, she can't afford her Syprine co-pays.

    ``This year, I was told that the funds for Wilson disease were already
    gone!'' said Ashley. ``The $1,200 co-pay for my 30 days of trientine
    took my entire Social Security check.''

    ``A health insurance broker advised me to look into the PAN
    Foundation,'' said Ashley. ``I qualified and get $10,000 a year to
    cover the cost of my co-pay.'' The Patient Access Network Foundation
    relies on donations to help people who are underinsured with medication
    costs.

    Patients have to reapply every January for the PAN Foundation's drug
    benefit. ``But this year, I was told that the funds for Wilson disease
    were already gone!'' said Ashley. ``The $1,200 co-pay for my 30 days of
    trientine took my entire Social Security check.''

    Teva Pharmaceuticals introduced the first generic trientine in 2018 to
    compete with Bausch's Syprine.

    Generic competition hasn't lowered the drug cost . . . yet

    Dawn, who was diagnosed with WD at age 37 after her liver failed, was
    shocked when she picked up her prescription for trientine in January.
    The list price was $38,365.09. Her insurance co-pay was only $15.

    Still, she's not taking her good fortune for granted, and is
    stockpiling her drugs.

    ``I'm scared to take them all,'' said Dawn, who asked that her real
    name not be used. ``I went without my drugs for 3 years because we
    couldn't pay for them when the costs spiked.''

    Ultimately, the drug saved her life. But they went bankrupt in the
    process.

    Her husband had taken a new job just before she was diagnosed with WD.
    And then, just as their new insurance was coming through, ``the suckers
    fired him,'' Dawn says. ``They knew I needed a liver transplant and was
    really sick.''

    She had no choice but to take Syprine, and ultimately, the drug saved
    her life. But they went bankrupt in the process.

    Bausch currently offers patient assistance programs to insured and
    uninsured WD patients in the US who need Syprine or Cuprimine. ``Our
    first priority is that every patient has access to the medicines they
    need,'' a Bausch Health spokesperson said in a statement.

    Dawn tried to get help from the drug company previously, but couldn't.
    The inexpensive alternative, zinc therapy, made her sick.

    Her husband eventually found a job that provided health insurance--700
    miles from their home, in another state. ``He works 70 hours a week
    hauling chemicals in extreme weather on treacherous roads. It aged him
    so much.''

    Dawn's liver healed enough so she could be taken off the transplant
    list. Still, she's furious with the drug company for making the drug's
    cost out of reach for 3 years. And, she's fearful it could happen
    again.

    How does the tale end for the 4 women?

    Berna Heyman is encouraged that the problem of high drugs costs is
    still a major discussion. ``That's the bright side,'' she said.

    However, since she was forced to switch her WD medication, tests show
    copper has reaccumulated in her liver. Her doctor advised a low-copper
    diet for several months, but that didn't help. ``I may have to start
    taking trientine again.''

    Rose credits Duane for saving her life with the drug imports. But fear
    of her supply line drying up led her to enroll in a clinical trial
    testing a new drug for Wilson disease so she can get her life-saving
    medication at no cost for the next five years. ``I hope the new drug
    works,'' she said.

    Fear over the uncertainty of being able to pay for her drugs also led
    Ashley Williams to enroll in the new WD drug trial. By chance, she was
    put in the ``standard of care'' arm of the trial. That means she
    continued on trientine for a year and paid the drug's cost. ``Starting
    in April, I will be taking the new study drug,'' she said. That means
    she pays the $1,200 co-pay for her trientine for another month.

    ``It's scary to think that I have to stay in a drug trial to get my
    medication paid for,'' Ashley said.

    Even though Syprine saved Dawn's life, she's fearful that the drug's
    cost could make it out of reach for her again. Her solution: Rationing
    her drugs.

    Perhaps this will be the year that the Wilson disease drugs Dr. John
    Walshe discovered and developed more than 50 years ago will be
    affordable again. But, the human toll and cost to society that the
    drugs' price spikes caused, remains.

                                     ______

    98-year-old drug inventor chastises pharma for ``behaving badly''

    I've spent my career reporting medical news. It's an important topic to
    me because I live with my own health challenge: A rare, genetic
    condition called Wilson disease that allows copper--an essential
    dietary mineral--to build up in the liver and brain, leading to copper
    poisoning that can be fatal. It caused my liver to fail when I was a
    college student. But I was lucky--I was diagnosed, there was a
    treatment, and it worked.

    Before 1955, my disease was fatal. Then, through a series of chance
    events and serendipities, an English physician, Dr. John Walshe,
    discovered a drug that turned Wilson disease (WD) into one that could
    be treated and managed. The drug is known by its generic name,
    penicillamine, and the brand names, Cuprimine and Depen.

    While doing research for a book I'm writing on WD, I discovered that
    Dr. Walshe is still very much alive and well at age 98. So I traveled
    to Cambridge, England to thank him for saving my life and talk to him
    about his drug discovery.

    He invited me to his home, which is a William and Mary style house
    built in the late 1600s, in the riverside village of Hemingford Grey,
    near Cambridge. Talking in Dr. Walshe's quintessential English garden,
    it didn't take him long to attack the pharmaceutical industry that now
    sells the drug that he discovered and tested.

    ``The way they're charging for it now is absolutely immoral. There is
    no other word for it,'' Dr. Walshe told me. ``It is totally immoral. It
    is business at its worst!''

    For more than 20 years I took Cuprimine and never paid more than $60 a
    month for it. Today, it costs $31,426 a month making it the 13th most
    expensive prescription drug in 2018.

    Discovering the first treatment for Wilson disease

    Listening to the story of Dr. Walshe's drug discovery, it's easy to
    understand why he's incredulous about its cost.

    The story began in 1954, when Dr. Walshe traveled to the United States
    for a Fulbright Fellowship in Boston. ``I was working with Charlie
    Davidson who was a liver doctor, and we were asked to see a Wilson
    disease patient who had gone into liver failure,'' said Dr. Walshe.

    They couldn't do anything to help the patient then, but crossing the
    ``bridge'' from what was then Boston City Hospital where the patient
    was being cared for, back to Thorndike Laboratory where he worked, Dr.
    Walshe had what he calls as inspiration: ``I said to Charlie Davidson,
    `You know what this chap really needs is penicillamine.' And Charlie
    Davidson said `What's that?' I told him I discovered this new amino
    acid that had never been seen in human urine before,'' said Dr. Walshe.

    Previously, while working in London during the early 1950s, Dr. Walshe
    had studied laboratory samples from people who were given the
    antibiotic penicillin. He observed that penicillamine--a derivative of
    penicillin--binds with copper. It's a process called chelation. His
    theory was that penicillamine could search out the excess copper in
    people with Wilson disease, bind with it, and then remove it from the
    body through urination.

    Proving his idea

    To test his theory, Dr. Walshe obtained some penicillamine from a
    chemist at MIT. Then, he did what would be unheard of today--he tried
    it on himself first. ``It didn't do me any harm and the next day I was
    alive and well,'' he said. ``I decided if it was safe for me, it was
    safe for the patient.''

    Dr. Walshe gave penicillamine to the WD patient--who was in liver
    failure at Boston City Hospital--and as he predicted, it got copper
    out. When his fellowship in Boston ended, he returned to London with a
    small supply of penicillamine to continue his experiments there.

    ``My father was England's leading neurologist at the time, and I asked
    him to find some Wilson disease patients for me to try it out on,''
    said Dr. Walshe. His father came through with a handful of patients,
    and in 1956 Dr. Walshe reported in the American Journal of Medicine
    that his drug discovery worked.

    After that, Dr. Walshe searched for chemical companies willing to make
    penicillamine so the new treatment could be made available to WD
    patients as soon as possible. This was years before the start of the
    current FDA drug approval process that requires costly and extensive
    testing before a drug can be considered for marketing.

    Developing an alternative

    As word spread that there was a treatment for Wilson disease, doctors
    started prescribing penicillamine for their patients. However, as more
    patients took it, they found that some developed severe side effects.
    So, Dr. Walshe looked for a second option.

    ``We had run into trouble with penicillamine, and I wanted an
    alternative treatment,'' said Dr. Walshe.

    By this time he was working at the University of Cambridge, and one
    morning he ran into a biochemist named Dr. Hal Dixon. Dr. Walshe
    explained his predicament, and Dr. Dixon pulled a chemical called
    triethylene tetramine off his laboratory shelf.

    ``He said it was non-toxic and known to bind with copper,'' said Dr.
    Walshe. ``He told me to try it, and that's how we got the drug
    trientine. It was Hal Dixon's idea, and my work proving that it worked
    and it was safe.''

    Walshe made the drug himself

    For years, Dr. Walshe and his assistant made trientine in their
    laboratory until they could no longer keep up with demand.Dr. Dixon had
    explained how to purify the chemical so it would be safe to use in
    people. So, as he had done with penicillamine, Dr. Walshe searched for
    a chemical company to make and distribute trientine. In 1985, trientine
    became the fifth drug approved through the Orphan Drug Act.

    ``The trouble now is the people who make trientine behave so badly
    about pricing,'' said Dr. Walshe. ``No doubt about it, they have
    behaved appallingly badly about pricing.''

    Univar Europe charges the UK's National Health Service the equivalent
    of $96,000 to treat a patient for a year. Because of the high cost, the
    NHS debated whether or not it could continue paying for the drug in
    2019. The North American company Valeant Pharmaceuticals--now Bausch
    Health--charges even more for its brand-name version, Syprine.

    Investigating high drug costs

    In 2016, Senator Susan Collins (R-Maine) launched a bipartisan
    investigation into the extreme spikes that were being seen in drugs
    that were off-patent. ``For example, the price of a Valeant drug that
    is used to treat Wilson disease,'' said Collins, ``increased from $652
    per month to more than $21,000 per month. That's more than a 3,000
    percent increase in price with no justification.''

    ``It's monstrous, it's iniquitous what they're charging for it,'' said
    Dr. Walshe. For several years he made trientine in his laboratory. ``I
    sent it out for free on my basic laboratory expense allowance without
    upsetting it. It was cheap!''

    In the United States, Bausch Health now markets Syprine (the brand-name
    version of trientine) as well as Cuprimine.The company acquired both
    drugs in 2010 and, soon after, boosted the prices astronomically.
    Despite extensive adverse publicity, a Congressional hearing, and the
    addition of generic equivalents the company has yet to lower the drugs'
    unjustified cost.

    Walshe never profited from his drug discoveries

    It's been almost 65 years since Dr. John Walshe had his ``inspiration''
    while walking across the bridge at Harvard. I asked him where the idea
    came from. He simply pointed to the sky and posed the rhetorical
    question: ``Where do ideas come from?''

    Dr. Walshe's discovery of penicillamine and the development of
    trientine turned Wilson disease from a death sentence into a treatable
    disease. Today, the challenge for patients is not finding treatment,
    but being able to pay for it. Dr. Walshe says he never made any money
    from the two drugs, instead devoting his medical career to helping
    people with WD.

    His idea saved my life. Now with the prices being charged for his
    discoveries, will others be so lucky?