May We Get to Know You?

How many patients do you see a day on average?

Are you currently utilizing pharmacogenomics testing?

Are you or have you ever dispensed Rx in your practice?

How familiar are you with NDC codes associated with

prescriptions?

Navigating Healthcare’s Changing Landscape

Physicians are looking for ways to practice precision medicinethat meet the following criteria:

Improves Patient Outcomes Supports the Practice Income Objectives Custom Cutting Edge Science

Risk Mitigation Turn-key Practice Solutions Includes Consulting & Support

Leading Science Excellent Practice Support Proven Track Record

Optimum Service Licensed & Insured Credentials & Regulation Compliant

We Evaluate Providers To Ensure:

Why Physicians Choose Biotech Medical Solutions

Dispensing for an Average PracticeThere are many options available for your patients and your practice

In-Office Dispensing PBSO – Pharmacy Benefit

Services Phamacogenetics Kit Toxicology Kit Injectables Medicated Kits Medical Foods

Other Services Compounding Pharmacy Services HIPAA & ICD-10 Training Patient Education Materials Physician & Staff Telephone Support

Our unique offering includes our 1st to market NDC-coded medicated kits.

1st To Market

Benefits of Dispensing to Patients

Patient Compliance and Care Monitoring• Studies have estimated that 30-40% of prescribed medications go unfilled• In-office dispensing respects patients’ time and will increase patient compliance

with medication regimens

Safety and Accuracy• 6-8% percent of patients who receive medication from a pharmacy receive

incorrect dosages or drugs• State regulatory boards have imposed harder restrictions for in-office dispensing

which has resulted in a reduction of error rates in comparison to filling medicationat a retail pharmacy

By implementing in-office dispensary you will be able to monitor a patient’s treatmentand prescription compliance, allowing for a higher level of safety and accuracy.

In the USA all 50 states have regulations governing physician dispensing, 46 statesallow physicians to participate in the profit from their practices that includesdispensing pharmaceuticals.

Pharmacy Benefits Service Organization (PBSO)

Full Service Dispensing Partner - What Sets Us Apart

Completion and Submission of all Credentialing Third-Party Payor Enrollments Real Time In-Office Eligibility Verification Pharmacy Billing Management Insurance, Cash, and Workers’ Comp Claim Adjudications Inventory Management Live Customer Service and On-Site Support Training 24 Hour Access to Dispensing Reports

- Patient Fulfillment - Accounting- Inventory

The Case For Pharmacogenetic Testing

Adverse Drug Reactions are the

4TH LEADINGCAUSE OF DEATHahead of pulmonary disease, diabetes, AIDS, and automobile deaths

Every year, more than 8.6 million adverse drug events

(ADRs) are reported in the US — 2.2 million of them are

severe.

In fact, ADRs are the fourth leading cause of death

nationwide, after heart disease, cancer and stroke, and

they place an enormous financial burden on the

healthcare system.

Pharmacogenetic testing provides insight into the four major “trial and error”

factors physicians have to battle with every prescription.

Which drug will work best for the patient?

How much does the patient need?

How will it interact with other substances?

Will it be likely to cause an adverse event or reaction?

Drug Metabolism, Interaction & Adverse Reactions

Preventing Adverse Drug Reactions

Even with proper prescribing, a

patient’s genetics can affect how they

metabolize and respond to drugs.

More than 85% of patients have

detectable variations in their DNA that

increase their risk for an ADR.

Pharmacogenetic testing determines a patient’s drug metabolizing capacity and physicians are able to quickly find the safest, most effective drug and dose for each patient’s unique genetics

How does pharmacogenetic testing alter the treatment course and patient response for chronic-pain patients in comparison with the current "trial-and-error" standard of care?

J Am Assoc Nurse Pract. 2014 Oct;26(10):530-6. doi: 10.1002/2327-6924.12154. Epub 2014 Aug 7.

DeFeo K1, Sykora K, Eley S, Vincent D.

PURPOSE: To evaluate if pharmacogenetic testing (PT) holds value for pain-managementpractitioners by identifying the potential applications of pharmacogenetic research as well asapplications in practice.

DATA SOURCES: A review of the literature was conducted utilizing the databases EBSCOhost,Biomedical Reference Collection, CINAHL, Health Business: Full Text, Health Source:Nursing/Academic Edition, and MEDLINE with the keywords, personalized medicine, cytochromeP450, and phamacogenetics.

CONCLUSIONS: Chronic-pain patients present some of the most challenging patients to managemedically. Often paired with persistent, life-altering pain, they might also have oncologic andpsychological comorbidities that can further complicate their management. One-step in-office PTis now widely available to optimize management of complicated patients and affectively removethe "trial-and-error" process of medication therapy.

IMPLICATIONS FOR PRACTICE: Practitioners must be familiar with the genetic determinants thataffect a patient's response to medications in order to decrease preventable morbidity andmortality associated with drug-drug and patient-drug interactions, and to provide cost-effectivecare through avoidance of inappropriate medications. Improved pain managements will improvepatient outcomes and satisfaction.

©2014 American Association of Nurse Practitioners.

Clinical Study

A Pharmacogenetic Test may be utilized to determine a

patient’s precision drug therapy, allowing physicians to:

Identify patients carrying a genetic polymorphism that causes

increased or decreased CYP450 enzyme activity to metabolize

certain medications

Identify individuals with higher risk of adverse drug reactions

Choose more effective medications at safer dosages

Minimize drug interactions

Optimize pain management

Avoid time-consuming sequential and ineffective drug trials

Minimizing Risk with Testing

Improving Patient Outcomes

Options for Integration Into Practice

Point of Care vs. Pharmacy Dispensing

• Pharmacogenomic tests can be administered with a topicalanalgesic for pain. When a FDA approved kit with a NDC numberis utilized it is billed through a patient’s pharmaceutical benefits.

• Pharmacogenomic tests can also be administered without atopical analgesic for pain and billed only through point of care(POC).

• Depending upon insurance benefits, patients may have a co-payfor the laboratory services and there is typically a co-pay for aphysician dispensed medicated kit.

Injectables in Practice

With the changing reimbursements, types of health care insurance, and new regulationswith regards to treatment, a medical practitioner and his or her team is under immensetime pressure to treat patients quickly, efficiently, and safely.

If a patient requires a singular or even multiple injections, the medical practitioner must rely on his or her team to first:

Locate the necessary and correct injectable medications

Ensure dating is current

Ensure the top has not been contaminated

Ensure they are the correct strength andpercentage

Ensure the liquid is not crystallized or containing growth

Ensure there is sufficient medication in the vial

Ensure that the injection has been stored at the proper temperature and humidity

As well as all other possible related materials and safety precautions needed to treat the patient.

CDC Safe Practices

Whenever possible, use of single-dose vials is preferred over multiple-dose vials, especially when medications will be administered to multiplepatients.

Outbreaks related to unsafe injection practices indicate that somehealthcare personnel are unaware of, do not understand, or do not adhereto basic principles of infection control and aseptic technique.

A survey of US healthcare workers who provide medication throughinjection found that 1% to 3% reused the same needle and/or syringe onmultiple patients.

Among the deficiencies identified in recent outbreaks were a lack ofoversight of personnel and failure to follow-up on reported breaches ininfection control practices in ambulatory settings.

Therefore, to ensure that all healthcare workers understand and adhereto recommended practices, principles of infection control and aseptictechnique need to be reinforced in training programs and incorporated intoinstitutional polices that are monitored for adherence.

Utilizing Sterile NCD Coded Kits

The use of FDA approved single use NDC Coded Kits may bean easy way to ensure that your practice is following CDCguidelines.

Storage for the material is in a single per use box

No preparing injection trays

Kits contain everything needed to provide a safe procedure

Services Offered

Let’s Look at anAverage Practice

Pharmacogenetic Medicated Kit Dispensing

Number of Practices 1 Number of Patients per Month 320Number of Doctors per Practice 1 Patient Capture Rate 10%Number of Work Days per Week 4 Average Co-Pay 21%Number of Patients per Day 20 Collect Co-Pays YES

Revenue ESTIMATED PHYSICIAN REVENUE PROJECTIONS

Advanced DNA Medicated Collection Kit™

Net Sales

Cost of Goods Sold

Gross Profit

Operation Expenses

Membership Fee *$499 for first six months. $299 after six months.

Clearinghouse Fee *Waived if member exceeds 100 transactions in the given month.

Transaction Fee per Adjudication$7.50

Total Operation Expenses

Net Income

PROJECTED MONTHLY NET REVENUE

PROJECTED ANNUAL NET REVENUE

$18,493

$789

$240

$50

$499 $231,389

$18,493

$221,921PROJECTED ANNUAL GROSS REVENUE

Co-Pay

$19,282PROJECTED MONTHLY GROSS REVENUE

$17,677

$19,282

$3,200

$22,482

$4,806

Joint, Tunnel, and Trigger Injection Kits

Number of Practices 1 Number of Patients per Month 320Number of Doctors per Practice 1 Patient Capture Rate 10%Number of Work Days per Week 4 Average Co-Pay 25%Number of Patients per Day 20 Collect Co-Pays YES

Revenue ESTIMATED PHYSICIAN REVENUE PROJECTIONS

Physicians EZ Use Joint, Tunnel, and Trigger Injection Kit™

Net Sales

Cost of Goods Sold

Gross Profit

Operation Expenses

Membership Fee *$499 for first six months. $299 after six months.

Clearinghouse Fee *Waived if member exceeds 100 transactions in the given month.

Transaction Fee per Adjudication$7.50

Total Operation Expenses

Net Income

PROJECTED MONTHLY NET REVENUE

PROJECTED ANNUAL NET REVENUE

$6,703

$789

$240

$50

$499 $89,907

$6,703

$80,439PROJECTED ANNUAL GROSS REVENUE

Co-Pay

$7,492PROJECTED MONTHLY GROSS REVENUE

$8,066

$7,492

$3,296

$10,788

$2,722

B-12 Injection Kits

Number of Practices 1 Number of Patients per Month 320Number of Doctors per Practice 1 Patient Capture Rate 10%Number of Work Days per Week 4 Average Co-Pay 32%Number of Patients per Day 20 Collect Co-Pays YES

Revenue ESTIMATED PHYSICIAN REVENUE PROJECTIONS

Physicians EZ Use B-12 Compliance Injection Kit™

Net Sales

Cost of Goods Sold

Gross Profit

Operation Expenses

Membership Fee *$499 for first six months. $299 after six months.

Clearinghouse Fee *Waived if member exceeds 100 transactions in the given month.

Transaction Fee per Adjudication$7.50

Total Operation Expenses

Net Income

PROJECTED MONTHLY NET REVENUE

PROJECTED ANNUAL NET REVENUE

$5,629

$789

$240

$50

$499 $77,019

$5,629

$67,551PROJECTED ANNUAL GROSS REVENUE

Co-Pay

$6,418PROJECTED MONTHLY GROSS REVENUE

$5,934

$6,418

$2,336

$8,754

$2,820

Practice Projection with 10% Penetration

Pharmacogenetic Medicated Kit Dispensing $18,493

Joint, Tunnel and Trigger Injection Kits $6,703

B-12 Compliance Injection $5,629

Total Monthly Net Revenue $30,825.00

Total Annual Net Revenue $369,900.00

Let’s Get Your Questions Answered

How do I get started?

What are the costs?

What are the steps in the process?

Who schedules my staff trainings?

What else do you need to know in order to get started?