REQUEST FOR PROPOSALS SUPPLY OF FENTANYL TRANSDERMAL PATCHES. PHARMAC invites proposals for the supply of fentanyl transdermal patches in New Zealand.

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2 August 2007 Dear Supplier REQUEST FOR PROPOSALS SUPPLY OF FENTANYL TRANSDERMAL PATCHES PHARMAC invites proposals for the supply of fentanyl transdermal patches in New Zealand. This request for proposals (RFP) letter incorporates the following schedules: Schedule 1 specifies the pharmaceutical for which PHARMAC is requesting proposals and sets out the background to the RFP and the types of proposals sought; Schedule 2 describes the process that PHARMAC expects to follow in relation to the RFP; Schedule 3 sets out information about the estimated size of the current subsidised market for the pharmaceutical; and Schedule 4 contains the RFP form in which you are to provide details of your proposal. If you wish to submit a proposal, you must submit it to PHARMAC no later than 5.00 pm on 10 October 2007. If you have any questions about this RFP, please contact Geraldine MacGibbon or Steffan Crausaz at PHARMAC by telephone (04) 916-7514 (Geraldine) or (04) 916-7525 (Steffan) or email geraldine.macgibbon@pharmac.govt.nz or steffan.crausaz@pharmac.govt.nz. We look forward to receiving your proposal. Yours sincerely Matthew Brougham Acting Chief Executive A141607 - qa7574 1

Schedule 1: Pharmaceutical, background to RFP and types of proposals sought 1. Pharmaceutical PHARMAC is interested in considering any proposal from suppliers of fentanyl transdermal patches. 2. Background to RFP The background to this RFP is as follows: es at strengths of 25 mg per hour, 50 mg per hour, 75 mg per hour and 100 mg per hour are currently listed for community supply fully subsidised, subject to the application of Special Authority criteria, in the Opioid Analgesics category of Section B of the Pharmaceutical Schedule. Restrictions and Special Authority criteria applying to fentanyl transdermal patches in Section B of the Pharmaceutical Schedule are as follows: Only on a controlled drug form No patient co-payment payable SA0743 Special Authority for Subsidy Initial application only from a relevant specialist. Approvals valid for 3 months for applications meeting the following criteria: Both: 1 Patient is terminally ill and is opioid-responsive; and 2 Either: 2.1 is unable to take oral medication; or 2.2 is intolerant to morphine, or morphine is contraindicated.. Renewal only from a relevant specialist or general practitioner. Approvals valid for 3 months where the treatment remains appropriate and the patient is benefiting from treatment. The current price and subsidy for fentanyl transdermal patches is as follows: Pharmaceutical Form Strength Pack size Fentanyl Fentanyl Fentanyl Fentanyl Transdermal patch, matrix Transdermal patch, matrix Transdermal patch, matrix Transdermal patch, matrix Price and subsidy 25 mg per hour 5 $55.23 50 mg per hour 5 $100.52 75 mg per hour 5 $139.18 100 mg per hour 5 $171.22 es are currently supplied under the brand name Durogesic by Janssen-Cilag Pty Limited. Under this agreement, Durogesic has protection from subsidy reduction until 1 July 2009. When Durogesic was first listed on the Pharmaceutical Schedule in October 2004 it was in the form known as a "reservoir" patch. The reservoir patch is a "form-filland-seal" system that contains fentanyl and alcohol gelled in a drug reservoir. From 1 January 2007 a new matrix form of Durogesic was listed on the Schedule A141607 - qa7574 2

and the reservoir form was delisted on 1 July 2007. In the matrix formulation, the fentanyl is embedded in the adhesive of the patch. The matrix formulation of Durogesic is a simple drug-in-adhesive matrix design that is bioequivalent to the Durogesic reservoir formulation. PHARMAC now seeks proposals for community and hospital supply of fentanyl transdermal patches in matrix or reservoir form, at strengths of 12.5 mg per hour, 25 mg per hour, 50 mg per hour, 75 mg per hour and 100 mg per hour. Proposals must include detailed information as to how the product does not infringe any valid patent. PHARMAC will treat this information as Confidential Information in terms of clause 5(j) of Schedule 2 of this RFP. The deadline for submission of proposals is 10 weeks to allow sufficient time for suppliers to identify any applicable patent(s) and to gather detailed information as to how the product does not infringe any such patent(s). In submitting your proposal you are to rely on your own knowledge, skill and independent advice or assessment of any patent(s) that may be applicable in connection with the proposed or actual supply of your product, and PHARMAC is to have no liability in that regard. 3. Types of proposals sought 3.1 Suppliers wishing to submit proposals must submit proposals for community and hospital supply of the 25 mg per hour, 50 mg per hour, 75 mg per hour and 100 mg per hour strengths of fentanyl transdermal patches, which may be in the form of matrix or reservoir construction. Inclusion of the 12.5 mg/hour strength is desirable but not obligatory. Proposals must include detailed information as to how the product does not infringe any valid patent. 3.2 In addition, PHARMAC is willing to consider the following types of proposals: proposals may include a period of sole subsidised supply and hospital supply status (hereinafter referred to as sole supply ) of up to, but no more than, two years, provided that the start of the sole supply period is not before 1 July 2009 and the end of the sole supply period does not extend beyond 30 June 2011. For the avoidance of doubt, if proposals include a period of sole supply, the proposed sole supply must be sole subsidised supply and hospital supply status for all strengths of fentanyl transdermal patches included in the proposal; proposals with a flexible start date to allow for stock availability issues to be resolved; and proposals requesting PHARMAC s support for priority assessment of Medsafe New Medicine Applications; and proposals for widening access. Please note that PHARMAC would consider widening access to include additional patient groups under a Special Authority (with the extent of access widening dependent on price reduction), and would also consider widening access by providing a general listing (i.e., with no Special Authority) where proposals provide a 65% or greater reduction in price from that of the current listings. Note that as a result of this RFP there may be a period of time up to 30 June 2009 where more A141607 - qa7574 3

than one brand of fentanyl transdermal patch is listed, potentially with different access criteria. Notwithstanding the above, PHARMAC reserves the right to widen access to fentanyl transdermal patches at any point in time regardless of the price. 3.3 PHARMAC is not willing to consider the following types of proposals: proposals that include pharmaceuticals other than fentanyl transdermal patches; proposals that do not include the supply of all of the 25 mg per hour, 50 mg per hour, 75 mg per hour and 100 mg per hour strengths of fentanyl transdermal patches; proposals that include sole supply for some but not all strengths of fentanyl transdermal patches included in the proposal; expenditure caps, rebates, bundling or any other expenditure risk-sharing mechanisms; and two-part pricing arrangements, whereby PHARMAC may make an up-front payment (in addition to any ongoing subsidy) in return for the listing of a pharmaceutical on specific terms. A141607 - qa7574 4

Schedule 2: RFP process PHARMAC expects to follow the process set out below in the sequence indicated. 1. Submission (a) You may submit more than one proposal. Each proposal will be considered as a separate proposal. (b) Proposals must be submitted no later than 5.00 p.m. (New Zealand time) on 10 October 2007. Late proposals will only be considered at PHARMAC s discretion. (c) You cannot withdraw your proposal, once submitted, while the RFP process is continuing. (d) All proposals must be submitted to PHARMAC at Level 14, Cigna House, 40 Mercer Street, PO Box 10-254, Wellington 6143, New Zealand, to the attention of Geraldine MacGibbon, either by hand delivery, by courier or by post (and not by facsimile or email). In addition to, but not instead of, providing PHARMAC with a hard copy of all proposals by hand delivery, courier or post, submitters must also provide a copy of all proposals by facsimile (+64 4 460 4995) or email (geraldine.macgibbon@pharmac.govt.nz). 2. Evaluation (a) (b) Following the deadline for submitting proposals an Evaluation Committee comprising PHARMAC staff (which may include PHARMAC s Legal Counsel) will evaluate each proposal to select its preferred proposal(s). The basis on which the Evaluation Committee will evaluate proposals, and the weight to be given to the criteria and other matters that it considers, are to be determined by the Evaluation Committee at its sole discretion. The matters to be taken into account by the Evaluation Committee will, however, include: (i) (ii) (iii) (iv) the decision criteria set out in PHARMAC s then current Operating Policies and Procedures (OPPs), as published on PHARMAC s website (www.pharmac.govt.nz), to the extent applicable; any clinical advice from PTAC or its relevant subcommittee; the detailed information you provide as to how the product does not infringe any valid patent, and any other information PHARMAC may have in connection with the infringement or likely infringement of any applicable patent(s)); and any other matters that the Evaluation Committee considers to be relevant (provided that PHARMAC will notify such matters and allow an opportunity for submitters of proposals to address them). (c) Each proposal will be evaluated on the basis that the price offered, the expenditure entailed, and any other terms included in the proposal, are the best that the supplier is able to offer. If you do not put forward your best terms you risk having your proposal excluded at the evaluation stage. A141607 - qa7574 5

(d) PHARMAC is not bound to select the lowest priced proposal or any proposal. 3. Negotiation (a) (b) (c) (d) (e) PHARMAC may negotiate with the submitter(s) of one or more preferred proposals, in the latter case whether or not the acceptance of either supplier s proposal would exclude acceptance of the other proposal. Negotiations will proceed on the basis that PHARMAC s standard terms and conditions for supply of pharmaceuticals, which are available on request from PHARMAC, will apply. Given that PHARMAC expects your proposal to be the best you can offer, PHARMAC does not intend to initiate negotiation with you on price. However, PHARMAC does not exclude the possibility that the final price agreed will be different from the price put forward in your proposal, as a result of the impact that other negotiated terms may have on price. PHARMAC may negotiate and enter into a provisional agreement with a preferred supplier(s) on whatever special terms, in addition to PHARMAC s standard terms and conditions, PHARMAC considers appropriate. If PHARMAC and the supplier(s) are unable to reach a provisional agreement within what PHARMAC considers to be a reasonable time, PHARMAC may terminate those negotiations and negotiate with a different supplier(s). 4. Consultation and approval (a) (b) (c) (d) (e) Any provisional agreement will be conditional on consultation with suppliers and other interested parties, to the extent PHARMAC considers consultation to be necessary or appropriate, and on Board approval (or approval by PHARMAC's Chief Executive under delegated authority). PHARMAC will not consider any counter-offers received during consultation. The provisional agreement and responses to consultation will be considered by PHARMAC's Board (or by PHARMAC s Chief Executive under delegated authority) in accordance with the decision criteria in PHARMAC s then current OPPs. If the Board or the Chief Executive does not approve the provisional agreement, then PHARMAC may initiate negotiations for a provisional agreement with any other supplier(s). The RFP process will be complete once PHARMAC has notified suppliers of either: (i) (ii) the Board's or its Chief Executive's decision to accept a negotiated agreement; or the termination of the RFP process. 5. Miscellaneous (a) PHARMAC reserves the right: A141607 - qa7574 6

(i) (ii) (iii) (iv) (v) (vi) (vii) (viii) to make such adjustments to the above RFP process as it considers appropriate, at any time during the process, provided that it notifies suppliers affected by those changes; not to accept any proposal; to seek clarification of any proposal; to meet with any supplier in relation to its proposal; to enter into an agreement or arrangement that differs in material respects from that envisaged in this RFP letter; to suspend this RFP process. For example, if during the RFP process (and before a provisional agreement is entered into) it becomes apparent to PHARMAC that further consultation is appropriate or required we may suspend the RFP process in order to consult. In this situation we may ask you to adapt and resubmit your proposal in light of consultation, or alternatively we may request that new proposals be submitted; to terminate this RFP process at any time, by notifying suppliers who submitted proposals, and, following termination, to negotiate with any supplier(s) on whatever terms PHARMAC thinks fit; to re-advertise for proposals. (b) (c) (d) (e) (f) (g) (h) PHARMAC may consult or seek clinical advice from PTAC or its relevant subcommittee at any stage of the RFP process. PHARMAC will notify you if the clinical advice results in any changes to the terms of the RFP. You must not initiate or engage in any communication with other suppliers in relation to the RFP, whether before or after submitting their proposal(s), until such time as a provisional agreement is accepted by PHARMAC s Board or Chief Executive. You must not at any time initiate any communication with PHARMAC s directors or officers, the Ministry of Health, the Minister of Health or District Health Boards, with a view to influencing the outcome of this RFP process. You must pay your own costs for preparing and submitting your proposal. Proposals are submitted in reliance on your own knowledge, skill, and independent advice, and not in reliance on any representations made by PHARMAC. Your submission of a proposal will be taken as acceptance of the terms contained in this RFP letter. PHARMAC may exclude your proposal if you do not comply with any of the terms contained in this RFP letter. This is an RFP and not a tender. Your proposal is not an offer capable of being converted into a contract for the supply of fentanyl transdermal patches by PHARMAC's apparent acceptance and instead a separate agreement needs to be negotiated. A141607 - qa7574 7

(i) (j) PHARMAC is not liable in any way whatsoever for any direct or indirect loss (including loss of profit), damage or cost of any kind incurred by you or any other person in relation to this RFP. PHARMAC will consider your proposal and information exchanged between us in any negotiations relating to your proposal, excluding information already in the public domain, to be confidential to us and our employees, legal advisors and other consultants, the Ministry of Health and DHBs (Confidential Information). However, you acknowledge that it may be necessary or appropriate for PHARMAC to release Confidential Information: (i) (ii) (iii) (iv) pursuant to the Official Information Act 1982; or in the course of consultation on a provisional agreement entered into with a supplier; or in publicly notifying any approval by the PHARMAC Board of that agreement; or otherwise pursuant to PHARMAC s public law or any other legal obligations. PHARMAC may consult with you before deciding whether to disclose Confidential Information for the purposes described in sub-clauses (i) to (iv) above. You acknowledge, however, that it is for PHARMAC to decide, in its absolute discretion, whether it is necessary or appropriate to disclose information for any of the above purposes, provided that PHARMAC shall act in good faith in disclosing any Confidential Information. 6. Anticipated timetable (a) Following receipt of proposals, PHARMAC anticipates: (i) the Evaluation Committee evaluating proposals in October/November 2007; (ii) negotiating with submitter(s) of one or more preferred proposals in November 2007; (iii) consulting on a provisional agreement in December 2007/January 2008. (iv) PHARMAC s Board or Chief Executive considering this provisional agreement in or after January 2008, provided that the above timeframes are only approximate and may be extended, without notice being required from PHARMAC, if any stages of the RFP process take longer than anticipated. (b) Under this indicative timetable, the earliest that changes to the Pharmaceutical Schedule could be implemented is 1 March 2008. A141607 - qa7574 8

Schedule 3: Current listing and market information The following information relates to the estimated subsidised market size of fentanyl transdermal patches (matrix and/or reservoir) in the community, and estimated market size of fentanyl transdermal patches (matrix and/or reservoir) being sold to DHB Hospitals (although note PHARMAC does not currently have a percentage of market share for fentanyl transdermal patches in relation to sales to DHB Hospitals). The information is approximate and indicative only. PHARMAC makes no representation as to the accuracy of this information or as to the level of sales or likely sales of fentanyl transdermal patches in the community and to DHB Hospitals and, while PHARMAC has taken all reasonable care in preparing the information set out below, it accepts no liability for any errors or omissions in the information. PHARMAC is not obliged to notify you in the event of any change to the figures below. Chemical entity es Percentage market share (prescriptions) in the community in the period April 2006 to March 2007 0.62% of opioid analgesics The number of subsidised units (patches) for fentanyl transdermal patches in the community for the years ending June 2005, June 2006 and March 2007 is shown below (note that fentanyl transdermal patches were not subsidised in the community prior to October 2004): Pharmaceutical/form/ strength October 2004 to June 2005 July 2005 to June 2006 April 2006 to March 2007 25 mg/hour 2617 7448 8960 50 mg/hour 1824 4708 6808 75 mg/hour 963 3024 3513 100 mg/hour 2346 7367 8882 The number of units (patches) for fentanyl transdermal patches purchased by DHB Hospitals for the years ending June 2005, June 2006 and March 2007 is shown below: Pharmaceutical/form/ strength July 2004 to June 2005 July 2005 to June 2006 April 2006 to March 2007 25 mg/hour 2820 3861 3018 50 mg/hour 1418 1963 2184 A141607 - qa7574 9

Pharmaceutical/form/ strength July 2004 to June 2005 July 2005 to June 2006 April 2006 to March 2007 75 mg/hour 410 810 715 100 mg/hour 834 1108 1042 A141607 - qa7574 10

Schedule 4: Proposal form You should expand the boxes as necessary. An electronic version of this form can be emailed to you on request. [Supplier to insert date] Chief Executive C/- Geraldine MacGibbon PHARMAC PO Box 10-254 (or for courier delivery: Level 14, Cigna House 40 Mercer Street) Wellington New Zealand Dear Geraldine Proposal for the supply of fentanyl transdermal patches In response to your request for proposals (RFP) dated 2 August 2007, we put forward the following proposal in respect of 25 mg per hour, 50 mg per hour, 75 mg per hour and 100 mg per hour strengths [with or without the 12.5 mg per hour strength, as applicable] of fentanyl transdermal patches: Set out below is further information in support of our proposal. (a) Our contact details: Name of supplier Contact person Address Phone Facsimile Email address (b) Details of pharmaceutical presentation: [Repeat for each strength of fentanyl transdermal patch] Chemical name Strength (e.g. 25 mg per hour) Form (e.g. matrix patch) Brand name Pack size (e.g. 5 s) A141607 - qa7574 11

(c) Key features of our proposal: (d) Information relating to pricing ($NZ, GST exclusive), including any related conditions or proposed terms affecting cost for PHARMAC (e.g. price in return for sole supply, reference price protection, etc.): (e) Evidence of market approval and any other required consents: Date of market approval (please attach copy of Medsafe Gazette notice) OR Date of submission of dossier (please attach confirmation from Medsafe that dossier has been submitted) OR Expected date of dossier submission to Medsafe Insert any other consents required for pharmaceutical (f) Detailed information as to how the product does not infringe any valid patent: (g) Information about our ability to ensure the continuity of supply of the pharmaceutical: A141607 - qa7574 12

(h) Information about our previous supply performance and relevant expertise: (i) Reasons why PHARMAC should accept our proposal: (j) Additional information that PHARMAC should consider when evaluating our proposal: A141607 - qa7574 13