TOP 10 RX BY COST BENCHMARK Percent of Specialty Drug 2021 Claimants by Condition Drug Name Common Diagnoses Claimants Services Services per Pharmacy % of total Paid per Service 1000 Paid Paid DUPIXENT SYRINGE Eczema 1 12 23.1 $36,451 9.6% $3,037.57 DIMETHYL FUMARATE Multiple Sclerosis 1 5 9.6 $32,052 8.4% $6,410.38 SILIQ Anti-inflammatory 1 8 15.4 $29,727 7.8% $3,715.86 LUPRON DEPOT-PED Endometriosis, Prostate Cancer 1 2 3.9 $20,550 5.4% $10,275.20 MYCOPHENOLIC ACID Immunosuppressive Agents 2 24 46.3 $11,442 3.0% $476.73 JARDIANCE Type II Diabetes 4 31 59.7 $10,748 2.8% $346.72 TACROLIMUS Organ Rejection 6 30 57.8 $9,810 2.6% $327.00 DUPIXENT PEN Eczema 1 3 5.8 $9,053 2.4% $3,017.57 NUCYNTA ER Pain Reliever (Opioid) 1 13 25.1 $8,588 2.3% $660.65 MESALAMINE Ulcerative Colitis 1 10 19.3 $8,551 2.3% $855.14 Total: Selected Filter(s) 16 138 266.0 $176,972 46.6% $1,282.41 Total: All Others 490 5,765 11,111.5 $202,509 53.4% $35.13 Total: All 490 5,903 11,377.4 $379,481 100.0% $64.29 2020 Drug Name Common Diagnoses Claimants Services Services per Pharmacy % of total Paid Paid per 1000 Paid Service • ABC Drug Spend accounts for 14% TECFIDERA Multiple Sclerosis 1 4 8.0 $62,842 19.8% $15,710.54 SILIQ Anti-inflammatory 1 9 18.0 $31,524 9.9% $3,502.70 of total plan spend in 2021, and MYCOPHENOLATE MOFETIL Lupus, RA 1 9 18.0 $12,439 3.9% $1,382.12 11% in 2020 TACROLIMUS Organ Rejection 9 42 84.0 $10,453 3.3% $248.89 NUCYNTA ER Pain Reliever (Opioid) 1 13 26.0 $8,724 2.7% $671.11 JARDIANCE Type II Diabetes 5 25 50.0 $8,526 2.7% $341.05 • The norm is upwards of 25-28% TRUVADA HIV 1 9 18.0 $8,417 2.6% $935.25 DEXTROAMPHETAMINE-AMPH ADHD 18 160 319.9 $7,716 2.4% $48.23 XARELTO Blood Clot Prevention 4 26 52.0 $6,822 2.1% $262.40 ELIQUIS Blood Clot Prevention 3 24 48.0 $6,606 2.1% $275.24 Total: Selected Filter(s) 39 321 641.8 $164,071 51.6% $511.13 Total: All Others 425 4,641 9,278.9 $153,853 48.4% $33.15 Total: All 427 4,962 9,920.7 $317,924 100.0% $64.07 [ 11 ] [ 11