CINVANTI Situation Assessment

Questions for CINVANTI Users

Thank you for agreeing to participate in this short survey which aims to capture your feelings on the opportunity for CINVANTI based on what is happening with key accounts that you cover. We’ll ask you to speak to accounts that you cover when filling out the questions below and make sure to specify so that you can answer the questions accurately.

Please consider your accounts that have purchased CINVANTI in Q1 of 2019 when answering the questions on this page.

Question Title

* 1. Please list an account that purchased CINVANTI in Q1 of 2019 that is representative of your purchasing accounts

Question Title

* 2. Within this account, what is the current share of each of the following IV NK1 receptor antagonists used to prophylactically treat patients (defined as anti-emetics administered on the same day of chemo) receiving highly emetogenic (HEC) and moderately emetogenic (MEC) chemotherapy regimens?

IV Emend (fosaprepitant) Share (%)

IV CINVANTI (aprepitant injectable emulsion) Share (%)

IV Push CINVANTI (aprepitant injectable emulsion) Share (%)

IV Akynzeo (fosnetupitant/palonosetron) Share (%)

Question Title

* 3. What were the key product attributes that led to the adoption of CINVANTI in this account? [Allocate 100 points across options to show importance]

Economic Attributes (acquisition price, reimbursement, NCR, etc.)

Operational Attributes (preparation, administration, storage)

Clinical Attributes (Safety, Efficacy etc.)

Question Title

* 4. What are the drivers for this account’s decision to use Cinvanti IV? [Allocate 100 points across options shown below]

Better efficacy than other NK1 drugs

Better safety profile (less infusion site and hypersensitivity adverse events vs. Emend IV)

Synthetic surfactant free formulation (polysorbate 80-free)

Flexibility of administering as a 2-minute IV push

Favorable practice economics of Cinvanti IV contract

Vial can be stored at room temperature for up to 60 days if needed

Vial is an emulsion and there is no need for reconstitution

NCCN category 1 recommended NK1 option

Wide payor coverage with minimal reimbursement hurdles

Drug manufacturer support programs (e.g. patient co-pay assistance and Patient Assistance Programs)

Other

Question Title

* 5. If you allocated points to other, please indicate what driver you meant. If you did not select ‘other,’ please respond with N/A.

Question Title

* 6. How has the flexibility of CINVANTI IV Push Route of Administration changed this account’s share of CINVANTI compared to other NK1s?

Decreased share

No Change to share

Increased share

Question Title

* 7. Since IV Akynzeo has begun to increase its value offering (i.e. NCR around $200 per unit), what has happened to this account's CINVANTI market share?

Left the brand – they no longer use CINVANTI

Share has decreased – there has been some impact, but they continue to purchase CINVANTI

No change – account is not interested in IV Akynzeo

Share has increased

Question Title

* 8. When Generic IV Emend (fosaprepitant) enters the market, what we call the “arbitrage,” what will happen to this account's CINVANTI market share?

Fosaprepitant “arbitrage” is the time period following generic entry where the reimbursement (ASP + 4.3%) for generic fosaprepitant is the same as branded Emend IV (fosaprepitant) reimbursement (same J-code) while the acquisition cost of the generic is significantly lower than the brand creating a short term economic opportunity. Over time the reimbursement for generic fosaprepitant will drop with the increased utilization of the lower priced generics and the temporary economic opportunity disappears.

Decrease CINVANTI use

Maintain CINVANTI use

Increase CINVANTI use

Question Title

* 9. What will this account's share of CINVANTI be during the Fosaprepitant arbitrage?

Cinvanti Share (%)

Question Title

* 10. Do we expect this account to continue to purchase CINVANTI through the Fosaprepitant generic arbitrage?

Yes

Question Title

* 11. Why should we expect to retain business from this account during Fosaprepitant arbitrage? If you answered ‘No’ on the last question, please allocate 100 points to ‘this account will no longer use CINVANTI.’

[Allocate 100 points across options to show importance]

This account is clinically motivated and believes in CINVANTI’s clinical profile

This account is operationally motivated and believes in CINVANTI’s operational advantage via IV Push

Drug manufacturer support programs (e.g. patient co-pay assistance and Patient Assistance Programs) are very important for this account

This account will no longer use CINVANTI

Question Title

* 12. When the Fosaprepitant “arbitrage” period ends, what will happen to this account’s CINVANTI share?

They will not switch back to CINVANTI

Will continue to use CINVANTI

They will begin to use CINVANTI again

Question Title

* 13. What will this account's share of CINVANTI be post arbitrage? If you answered ‘They will not switch back to CINVANTI’ on the last question, please put 0 for expected CINVANTI share

Cinvanti Share (%)

CINVANTI Situation Assessment

Questions for CINVANTI Users

Question Title

* 1. Please list an account that purchased CINVANTI in Q1 of 2019 that is representative of your purchasing accounts

Question Title

* 2. Within this account, what is the current share of each of the following IV NK1 receptor antagonists used to prophylactically treat patients (defined as anti-emetics administered on the same day of chemo) receiving highly emetogenic (HEC) and moderately emetogenic (MEC) chemotherapy regimens?

Question Title

* 3. What were the key product attributes that led to the adoption of CINVANTI in this account? ​[Allocate 100 points across options to show importance]

Question Title

* 4. What are the drivers for this account’s decision to use Cinvanti IV? ​[Allocate 100 points across options shown below]

Question Title

* 5. If you allocated points to other, please indicate what driver you meant. If you did not select ‘other,’ please respond with N/A.

Question Title

* 6. How has the flexibility of CINVANTI IV Push Route of Administration changed this account’s share of CINVANTI compared to other NK1s?

Question Title

* 7. Since IV Akynzeo has begun to increase its value offering (i.e. NCR around $200 per unit), what has happened to this account's CINVANTI market share?

Question Title

Question Title

* 9. What will this account's share of CINVANTI be during the Fosaprepitant arbitrage?

Question Title

* 10. Do we expect this account to continue to purchase CINVANTI through the Fosaprepitant generic arbitrage?

Question Title

* 11. Why should we expect to retain business from this account during Fosaprepitant arbitrage?​ If you answered ‘No’ on the last question, please allocate 100 points to ‘this account will no longer use CINVANTI.’[Allocate 100 points across options to show importance]

Question Title

* 12. When the Fosaprepitant “arbitrage” period ends, what will happen to this account’s CINVANTI share?

Question Title

* 13. What will this account's share of CINVANTI be post arbitrage? If you answered ‘They will not switch back to CINVANTI’ on the last question, please put 0 for expected CINVANTI share

* 3. What were the key product attributes that led to the adoption of CINVANTI in this account? [Allocate 100 points across options to show importance]

* 4. What are the drivers for this account’s decision to use Cinvanti IV? [Allocate 100 points across options shown below]

* 11. Why should we expect to retain business from this account during Fosaprepitant arbitrage? If you answered ‘No’ on the last question, please allocate 100 points to ‘this account will no longer use CINVANTI.’

[Allocate 100 points across options to show importance]