1. MTAC – Association Presentation August 1, 2007

2. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION About PCMA  The Pharmaceutical Care Management Association (PCMA) is the national association representing Pharmacy Benefit Managers (PBMs). PCMA is dedicated to enhancing the proven tools and techniques that PBMs have pioneered in the marketplace and working to lower the cost of prescription drugs for more than 210 million Americans with coverage provided through Fortune 500 employers, health insurers, labor unions, and Medicare Part D.  As a trade association, PCMA offers member companies a full range of lobbying, advocacy, and business networking services.

3. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION PCMA Members

4. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION What PBMs Do PCMA continues to lead the effort in further promoting PBMs and the proven tools they utilize which are recognized by consumers, employers, policymakers, and others as a key driver in lowering prescription drug costs while also increasing access. The tools and techniques pioneered by PBMs are projected to save Medicare and the commercial market more than $1.3 trillion dollars on prescription drug costs from 2008 to 2017. These tools include:  Generic substitution;  Mail-service pharmacy;  Pharmacy and therapeutic (P&T) committee formulary development and review;  Pharmacy network management;  Negotiation and administration of product discounts, including manufacturer rebates;  Drug utilization review (DUR);  Clinical prior authorization and step therapy;  Consumer and physician education;  Disease management; and  Consumer compliance programs.

5. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION PCMA Affiliates PBMs work closely with pharmaceutical manufacturers on a wide array of issues, including issues surrounding cost reduction, safety, and delivery.

6. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION MTAC Members  Arnie Epstein - Express Scripts  Tom Underkoffler – Medco

7. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION MTAC Benefits – USPS Usage  Membership utilizes many USPS products –Parcels  Express Mail  Priority Mail  First Class  Standard  Parcel Select –Letters  First Class  Standard –Flats  First Class  Standard

8. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION PBM Statistics - 2006  Mail Order exceeded 194M Rx’s  Retail exceeded 1.3B Rx’s

9. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION PBM Statistics  Placed end to end, 2006 packages would wrap around the earth at the equator – with overlap

10. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION Which Number is Higher? Hummingbird Heartbeat at Rest 2006 Packages Delivered per Second ABor

11. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION Hummingbird Heartbeat at Rest 2006 Packages Delivered per Second A B 4.2 Beats / Sec * During Delivery Hours 11.9 Packages / Sec

12. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION PBM Information  Industry has seen steady growth –Drives increased mail volume  MTAC –Source of pertinent information –Arena to learn and share –Opportunity to participate in workgroups –Expect to have increased MTAC exposure

13. P HARMACEUTICAL C ARE M ANAGEMENT A SSOCIATION  www.pcmanet.org