Integrated eprescribing Patient Coupon Solutions If You re Not in the HCP Workflow, You re Out

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1 Integrated eprescribing Patient Coupon Solutions If You re Not in the HCP Workflow, You re Out Devin Paullin EVP, Corporate Business Development Physicians Interactive Dan Pucci Director of National Sales, Emerging Markets Allscripts

2 Today s Discussion Sweeping changes in healthcare Creating HCP value-added service for your brand within the HCP workflow EHR and eprescribing trends and landscape The value of integrating your coupon offering into a larger offering Conclusions and recommendations for success Questions? Call or info@physiciansinteractive.com Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

3 Physicians Interactive Background Empowering HCPs To Do More To Do Better 480,000+ US physician digital reach 78% (210,000) of Surescripts eprescribers 82,000 Allied health US prescribers (NPs/PAs) 240,000 Non-prescribing US nurses 2 Million registered users Web and mobile product education Direct HCP esampling and ecoupon access Mobile (app-based) clinical decision support eprescribing and EHR workflow solutions Our Vision: Empower medical professionals everywhere to deliver the highest quality patient care with instant access to valued solutions and information Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential 3

4 Background: Allscripts Current Market Footprint 1 of 3 MDs (48% Rev) 1 of 3 Hospitals (43% Rev) 15,000 Post-acute Care Providers (9% Rev) Source: Allscripts Form 10Q Quarterly Report for period ended 9/30/11. GAAP revenue percentage based on 9 month period.

5 Sweeping Changes in Healthcare Healthcare Reform + 31 MM Americans are new to the healthcare system ACOs movement away from fee for service HCP Concerns By 2020 there will be a shortage of ~150,000 clinicians Estimated 1 PCP: 8,000 Patients vs. today s 1 PCP: 2,500 Patients Consumer Concerns National Coordinator Health IT (ONC) has increased resources for a 2-year study of consumer attitudes toward the privacy of their personal information due to the growing use of mobile devices in exchanging personal health information 5

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8 It s not only innovation It s about how we integrate elements into the HCP workflow and and align with appropriate incentives Information Relevance Incentives HCP Patient Engagement & Outcomes Access (To Resources) Continuous Collaboration Levers of Integration We must integrate with the vehicles stakeholders need, when and where they need it Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential 8

9 Example - When Integration Levers Align: HCP Need to Meet Patient Demand Drives esampling Physician esample requests up over 365% of previous year Over 85,000 requests per month, expect to break 1 MM in 2012 Emerging mobile access, coupon print on-demand access Brand Participation will eclipse 100 by mid ,000 Sample Orders Continue to Rise Brand Orders March, 2010 Through July, ,000 76,908 70,000 62,307 60,000 50,000 40,000 30,000 20,000 43,046 35,527 33,854 32,190 29,672 28,644 24,183 16,633 18,724 18,524 47,680 10,000 0 Mar 10 Apr 10 May 10 Jun10 Jul10 Aug 10 Sep 10 Oct10 Nov10 Dec10 Jan 11 Feb 11 Mar 11 Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

10 Workflow Value of EHR and eprescribing Pharma Integration Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

11 Ecosystem Overview: Pharma s Point-of-Care (PoC) Role Patients and Providers PoC: Key Opportunity to Engage Pharma Pharmacies HCP Workflow Channels EHR/eRx MOBILE WEB Solution Partners Technology Partners Content Partners Surescripts Medispan Payors Patient Portal An Evolution First Data Bank PBMs 11

12 Key Accelerators of Adoption: Funding EHR Stimulus Incentives HITECH: The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009 First Adopters Will Benefit The Most (Sliding Incentives) $30 Billion set aside by US Government for adoption of EHR Physicians can earn between $44,000 to $64,000 over five years Hospitals can earn up to $2M to $10M + As of December 8, 2011, Medicare has distributed about $920M in EHR incentive payments to: 10,155 eligible healthcare providers and 401 hospitals Medicaid has distributed about $916M in EHR incentive payments to 11,270 eligible healthcare providers and 800 hospitals Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential 12

13 Electronic Health Record Adoption is Growing Rapidly Especially Among Larger Medical Groups 70% of funding gone by 2013, so the rush is on Steeper curve in large segment % overall physician adoption by 2019* 26+ Providers Providers 4-9 Providers 1-3 Providers *CBO Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential 13

14 eprescribing Has Reached Critical Mass 291K+ HCPs Impacting Pharma Revenue Daily (Surescripts, 2011) 38 % Number of HCPs The number of eprescriptions written nationally (all vendors): 2010: 326 million 2011: 500 million* (Allscripts = est. 40% Share) 50 % % 234, , , , *Source-surecripts.com accessed 11\15\11

15 eprescribing Channels are Impactful Today Top 10 eprescribed Pharma Brands in Allscripts eprescribe ( ) Drug Name Company # Doctors # Patients # Scripts Lipitor Pfizer 16, , ,347 Synthroid Abbott 15, , ,926 Crestor Astra Zeneca 14, , ,944 Plavix Sanofi 15, , ,572 Singulair Merck 14, , ,494 NexIUM Astra Zeneca 16, , ,551 Lexapro Forest Laboraties 14, , ,116 ProAir HFA Teva 13, , ,308 Cymbalta Lilly 13,619 89, ,645 Advair Diskus GSK 13, , ,310 Source: Allscripts Data July 2011 through June 2012 Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential 15

16 EHR Leaders: Which Companies Hold the Best Position With HCPs? Top EMRs by Market Share 1 Notable EHR Players/Models (1) Allscripts (2) Epic (3) eclinicalworks (4) GE (5) Cerner (6) NextGen (7) McKesson (8) Sage (9) e-mds (10) Amazing Charts AthenaHealth Greenway DrFirst Practice Fusion 1. AmericanEHR, 2011 Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

17 Goodwill Drives Physician Integration Needs: Clinicians Rank Pharma Need in EHR Resource Allscripts EPIC GE Health Cerner Patient Co-Pay Assistance Coupons 55% 47% 50% 38% Medication Vouchers 50% 57% 46% 57% Medication Samples 35% 33% 21% 48% Patient education materials 32% 34% 21% 24% RxGuide 30% 24% 25% 14% Diagnosis decision support tool 30% 34% 21% 19% New indications 25% 36% 21% 43% 70% Common reactions 25% 21% 14% 19% Calculators 24% 16% 29% 33% Compliance programs 20% 29% 14% 19% Patient websites 20% 19% 7% 5% Safety alerts 17% 7% 25% 29% AE Reporting/Pharma support line 14% 24% 18% 19% REMS 2% 7% 7% 43% Tested highest in research * Results from a Physicians Interactive survey, 2011, on erx/emr usage survey to 1,700 PCP and 600 NP/PA PIH users in Aug

18 71% Physicians Want More Information High- & low- card users alike want info about patient support Physician interest in receiving discount and patient support program information Percent of MDs How interested would you be with receiving more information on discount programs and patient support services offered by pharma manufacturers? Source: McKesson Corporation Physician and Patient Research,

19 Discounts promote adherence 70% found discounts somewhat to extremely important Importance of Discounts to Promote Patient Adherence Percent of MDs To what extent do you view co-pay cards, coupons or vouchers as important vehicles for promoting patient adherence or getting patients to stay on therapy? Source: McKesson Corporation Physician and Patient Research,

20 Co-pay Discount Cards/Coupons Overwhelmingly positive patient experiences 74% patients say they are a tremendous help financially 77% patients say they are easy to use Select a number from 0 to 10 where a 0 means that you Completely disagree with the statement and a 10 means that you Completely agree with the statement. They are a tremendous help to me financially Overall, how easy was it to begin using your medication discount card(s)/coupon(s)? Select any number from 0 to 10 where a 0 means Extremely difficult and a 10 means Extremely Easy. Source: McKesson Corporation Physician and Patient Research,

21 ecoupon Increasing HCP-to-Patient Value Coupons/ vouchers InfoScripts HRA RATIONALE Visible, zero-click digital coupon solution with no interruption to the prescriber workflow Click-tocall links Patient education Sample requests Prior authorization Alerts Dosing calculators DESCRIPTION Expand reach to more providers and patients through diversified channels by tapping into a network of online prescribers at the pointof-care Increase access and adherence to your brand ecoupon promotion directly integrated within the Allscripts eprescribe workflow Increase prescription brand redemptions/refills Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

22 Step 1: Select a Patient Patient Header Enter patient name here to search Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

23 Step 2: Search Medication or View History, and Icon is displayed Enter medication name to search View in Patient or Prescriber History eprescribers are immediately informed of available patient vouchers or Co-Pay support via icon Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

24 Step 3: Select Med, Add to Script Pad Click check box to select medication Click Add to Script Pad or Review Script Pad Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

25 Step 4: Land on Script Pad, Coupon displays, Process Script, Sends to Pharmacy The offer displays and the evoucher or Coupon can be printed. Automatically sends to pharmacy. Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

26 Conclusions & Key Recommendations for Success CONCLUSIONS It is critical for life science companies to build value into the clinician s workflow in addition to utilizing traditional methods Penetration within EHR/eRx creates relevance for many key therapeutic classes Physicians want access to services in EHR/eRx which create goodwill with patient KEY RECOMMENDATIONS Work with a partner with at least three to five years of experience in EHR/eRx programs (with Pharma) Conduct pre-reviews with partner, medical and legal stakeholders Work with solutions that demonstrate thoughtful integration of solutions with minimal disruptions in a clinician s EHR workflow Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

27 Questions? Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential

28 Thank You Physicians Interactive Devin Paullin EVP, Corporate Business Development Allscripts Dan Pucci Director of National Sales, Emerging Markets Questions? Call or Copyright Physicians Interactive, a division of Skyscape.com, Inc. Confidential