The portfolio 2010 by Sharon Martin

year-end edition

26 marketing projects that made a difference in 2010

From the Marketing Department We are pleased to provide you with a copy of the 2010 year-end edition of The Portfolio. This publication reviews the Marketing Department’s activities during the year in support of our corporate goals, and it also highlights some of the more impactful programs.

year-end edition

In summary, it was a very busy and successful year. Several records were set, and the large majority of programs exceeded their goals. Here are a few noteworthy examples:

• A record number of outbound member communication programs were developed in support of plan administration, retail-to-mail programs, and brand-to-generic programs: 1,000 creative projects—5,000 direct-mail campaigns—95 million printed pieces.

table of contents

• A record number of media impressions were achieved with our PR and marketing efforts: 2.3 billion. Included in this number were 213 million social media impressions

From the Marketing Department

Managing the communications machine

Building the Medco brand

Growing medco.com®

Driving mail, generics, and specialty usage

from more than 1,400 blogs.

• A record number of online prescriptions and customer service transactions were achieved on medco.com: 32 million Rx’s and 92 million customer service transactions.

• A new Medicare member acquisition program helped drive increased enrollments. • The new Dr. Obvious consumer campaign was successfully tested. The directresponse campaign generated approximately 500K leads, falling just short of its ROI goal, and it increased brand awareness by 15% in just 10 weeks. The ROI for the online campaign exceeded its goal and will continue into 2011.

Helping win business and retain clients

Growing Medicare Part D

New initiatives for 2011

Key players

These results have been achieved because of a strong Marketing Department and excellent collaboration between the department and various business owners and support organizations across the company. If you have any questions or comments, you can contact me at jacka_smith@medco.com. Enjoy,

Jack A. Smith Senior Vice President and Chief Marketing Officer

Broadcasts Collateral NOW YOU HAVE AN OPPORTUNITY TO: INCREASE MEDICATION ADHERENCE PERSONALIZE DRUG THERAPIES BETTER MANAGE DRUG SPEND

HELP PATIENTS LIVE BETTER LIVES

E-mail

Managing the communications machine Direct mail

Multimedia use expands for B2B and B2C communications. A record number of communications were produced, managed, and delivered with near Six Sigma accuracy.

100M

40M

95M

84M

61M 20

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2008

2009

2010

E-mail

Mail

Live calls

AOM

Pieces mailed to members Other promotional Retail-to-Mail Brand-to-Generic Compliance

95M communication pieces printed and mailed

Member database mined for over 5,000 lists to support clinical and conversion campaigns in multiple media channels

Mail increased 13% in volume over 2009. The introduction of three new retail-to-mail conversion programs—Welcome to Medco, Best Use of Benefits, and Worry-free Fills—contributed to the growth. In addition, the plan administration book-of-business requirements continued to rise in other areas, with heavy volume in Medicare and brand-to-generic campaigns. Welcome Kit volume is also included in this category.

As the total number of outbound member communications grew in 2010, so did the number of targeted list pulls. New Retail-to-Mail and Brand-to-Generic conversion programs, in addition to the launch of the Medco Health Store, greatly contributed to increased activity for 2010. Over the last year, clinical programs (such as closing gaps in care) and operational programs (such as CMS compliance-related communications for Medicare) were also major drivers for the increased volume.

Results:

Volume by category:

• 2.5M direct-mail packages from three new retail-to-mail programs • Medicare D Explanation of Benefits up 25% • 40% increase in copay waiver program participation • Growth in generic programs (Generics Launch, Generics Awareness, Generics Education)

Retail-to-Mail: 47M Brand-to-Generic: 13M Other promotional: 34M (E-mail for the Medco Health Store is the main driver in this category.) Compliance: 2M

Med D retention brochure On Call with Dr Rob broadcast

A1C Diabetes test kit

Annual Report

Tips for choosing a Medicare prescription drug plan

A new addition to your prescription drug benefit will help you

Measure up to control your A1C

IFEBP invitation to Hawaii

WELCOME TO MEDCO, THE WORLD’S MOST ADVANCED PHARMACY ® PRESCRIPTION SAVINGS AND ENHANCED PHARMACY CARE AT YOUR FINGERTIPS As a BCBSIL member, your prescription drug benefit is managed by Medco. We provide personalized care designed to help improve and maintain the health of you and your family while helping you save on the medications you take every day. Here’s how.

Convenience, safety and savings through the Medco Pharmacy™ mail-order service

Direct mail

When you get long-term drugs* at a retail pharmacy, you could be paying more than you need to. With the Medco Pharmacy, you can get up to a 90-day supply delivered to you for just one copayment. Take advantage of the Medco Pharmacy and you also get:

Why choose a basic CDH plan when you can have the works?

■ 24/7 phone access to pharmacists who can focus on your prescriptions. ■ Easy refills online, over the phone or by mail. ■ Peace of mind in knowing that your prescriptions are undergoing safety

and advanced quality checks to help prevent harmful drug interactions.

(866) 544-6987

For short-term prescriptions, such as antibiotics, please continue using a participating retail pharmacy.

Enter this number into your phone today.

Enhanced care from Medco Specialist Pharmacists If you or your family members take medication used to treat certain long-term conditions, take advantage of the personalized care and expertise of Medco Specialist Pharmacists. They’re available by phone 24/7 to work with you and your doctor to help make sure that your medications work safely together and work well for you. These pharmacists have specialized training in the medications used to treat specific ongoing conditions, such as high cholesterol, high blood pressure, depression, diabetes, asthma, osteoporosis and cancer.

Lower costs, same health benefits with generics FDA-approved generics must meet the same FDA quality standards as brand-name drugs, yet they can cost about 30 to 80 percent less.† The My Rx Choices® prescription savings program lets you go online to www.medco.com/boeing to view potential cost-saving opportunities. Print them out and share them with your doctor. You could potentially save hundreds of dollars a year by using generics!

To start taking advantage of all your Medco prescription drug benefit offers, visit www.medco.com/boeing or call Member Services toll-free at 1-800-841-2797.

Online member video

*Long-term drugs are those you take to treat an ongoing condition, such as high blood pressure or high cholesterol. † U.S. Food and Drug Administration. Are you taking medication as prescribed? http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM165097.pdf. Published June 2009. Accessed June 24, 2010.

the world’s most advanced pharmacy, a d M Rx Choices a

d trademarks and M d

With the industry’s premier real-time, multidirectional data integration, Medco offers you more efficient information-sharing across your pharmacy, medical, and behavioral health benefit. By serving more CDH members than any other PBM or health plan, we know what it takes to support a successful plan.

• Dedicated operations, benefit design, and Member Services teams • Full range of member incentives to promote health and wellness • High-touch member outreach services to maximize best use of benefit

www.medco.com M d ©

If a plain vanilla CDH approach leaves you wanting more, look to a provider with the advanced technology and expertise to deliver better outcomes.

trademark of Medco Health Solutions, Inc.

Want the scoop on making your CDH pharmacy benefit better? Contact your Medco representative about the Medco Consumer Choice Plan® today or call Glenn Sungela at 1 201 269-2004.

Benefit fair collateral

Retail-to-Mail self-mailer

Labor trade show booth E-mail: MedcoSolutions@medco.com Medco and Medco Consumer Choice Plan are registered trademarks and Medco making medicine smarter is a trademark of Medco Health Solutions, Inc. © 2010 Medco Health Solutions, Inc. All rights reserved.

Almost 1,000 creative projects help drive business results from mail-order conversions to new business acquisitions In 2010, the in-house talent from the Creative Resources group developed projects across all media, including online videos, direct mail, B2B collateral, trade show booths, e-mail, and integrated campaigns. These communications reached diverse B2B and B2C audiences and changed behavior to reach and exceed business goals. Nearly every product, marketing, and sales team at Medco draws on the shared services of Creative Resources and the Medco Broadcasting Center. 6

CDH ad

Results:

• Direct-mail campaigns to convert prescriptions to mail order contribute millions in margin. • Over 430 member communications written, customized, and designed • Over 285 B2B and Medicare Part D projects completed • Over 260 broadcasts, videos, and editing projects completed, including two virtual meetings that saved over $2M in travel and venue costs • Over 3K communications customized to satisfy client requests • 95% client satisfaction rate for communications exceeds the previous high. 7

Twitter Medco Research Institute website

Media coverage

Chart blog

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T he Leading Inde p endent Ne wspaper for the Psychiatrist—Since 1973

W H AT ’ S N E W Physical and sexual abuse might raise the risk of type 2 diabetes, a study of almost 70,000 women suggests. 2

Poor Adherence Boosts Antidepressant Dosing BY DIANA MAHONEY

Nearly onequarter of U.S. high school students reported binge drinking in 2009. 4 A Chilean miner might get more emotional help from a colleague with whom he was trapped than from any mental health professional who rides into town, Dr. Paul J. Fink writes. 12

Dr. Michael F. Myers says awareness is central in efforts to avert physician suicide. 13

FROM THE AMERICAN PSYCHIATRIC ASSOCIATION INSTITUTE ON PSYCHIATRIC SERVICES

BOSTON – Nearly one-third of patients

on antidepressant pharmacotherapy in a large-scale analysis did not take their original antidepressant dose as prescribed within the 6 months prior to dose escalation, a study has shown. The findings suggest that the lack of adequate treatment response that drives dosage increases in many patients might be linked to suboptimal medication adherence rather than to dose insufficiency, Dr. David J. Muzina reported at the institute. To evaluate patient nonadherence to chronic antidepressant therapy and a re-

sulting upward dosage titration of the same medication, Dr. Muzina of Medco Health Solutions Inc. and his colleagues identified 53,530 patients from Medco’s administrative patient claims database who were on antidepressant medications at the same dosage level for at least 6 months, followed by a subsequent submission of claims for a higher dose. Patients with only one claim for antidepressant medication in a 6-month period were excluded from the analysis, as were those taking multiple antidepressants, Dr. Muzina explained. To measure adherence status – which was determined by the proportion of days the patient possessed a supply of the medication, or the medication possession ratio (MPR) – researchers required a minimum of two claims for the same

A survey of 53,530 patients found almost 30% got higher antidepressant doses despite failing to take original doses.

antidepressant drug. According to the National Committee for Quality Assurance’s antidepressant performance measures, adherence was defined as an MPR of at least 80%, Dr. Muzina said. With respect to patient demographics and prescription characteristics, the study cohort was predominantly female (72%), with a mean age of 51 years. More than two-thirds of the sample (68%) filled their antidepressant prescriptions at retail pharmacies, and 62% received generic medications, Dr. Muzina said. Most of the prescriptions were ordered by nonpsychiatrists, with only 15% ordered by psychiatrists; nearly half of the 49,524 patients for whom Chronic Disease Scores (CDS) were available had scores indicating a high degree of comorbidity, See Antidepressant page 59

Mental Health Homes Built for the Homeless BY DIANA MAHONEY

An Army program helps soldiers redirect the adrenaline rushes some of them experience when they return home. 18

Interdisciplinary teams can help nursing homes in their efforts to stop excessive use of psychoactive medications in residents. 30

S 4

FROM THE AMERICAN PSYCHIATRIC ASSOCIATION INSTITUTE ON PSYCHIATRIC SERVICES

BOSTON – There are no walls or even a

roof. But a new type of home being built in Jacksonville, Fla., seeks to shelter some of the city’s most vulnerable residents from the devastating effects of persistent mental illness. Through an academic–public sector collaboration between the University of Florida department of psychiatry and a comprehensive service facility called the S

Combination of print, TV, and online media delivers a record-high 2.3B impressions

Pharmacogenomics Reporter

In 2010, feature stories in national publications like the Wall Street Journal, USA Today, and Business Week helped position Medco clinicians as leading experts in the field. Additional buzz was generated through broadcast media, which provided a platform for the Medco position on healthcare reform and promoted groundbreaking studies from the Medco Research Institute.

Health blog

Print:

• Medco Research Institute studies on warfarin, women’s use of category X medications, and mammography compliance generate new buzz • Subject-matter experts featured in publications such as the Tampa Tribune, Human Resource Executive, Employee Benefit News, Managed Care, Oncology NetGuide, and Clinical Psychiatry News. • Major stories in leading international papers: Borsen-Zeitung, Les Echos, Frankfurter Allgemeine Zeitung, Financial Times Deutschland, Investment Professional, Le Monde, Finanz und Wirtschaf, Handelsblatt, and The Times of London.

TV and online:

• National coverage for Dr. Milayna Subar’s study on mammography compliance • A 7-minute in-depth analysis by Jim Cramer, praising Medco innovation • The Dave Snow healthcare reform speech at the Detroit Economic Club, which aired multiple times on C-SPAN

Social media outreach efforts result in a 150% increase in impressions Medco has raised its involvement in social media and seen a subsequent rise in influence through this growing channel. Targeting high-value bloggers and forums has exponentially increased the reach of Medco news.

Highlights:

• Nearly 213M impressions from more than 1,400 blogs • Over 3M impressions from more than 60 forums • Medco’s Twitter handle—@Medco—following grew by 65 percent. 11

Banner YouTube

TV commercial

Dr. Obvious consumer campaign generates 500K leads and increases brand awareness In May of 2010, Medco tested a 12-week, limited-market (Austin, Cincinnati, Milwaukee) consumer-branding campaign utilizing television, radio, print, and national search. Modeled after campaigns like those of Geico and Aflac, the campaign introduced the humorous character Dr. Obvious, Ph.D., to raise brand awareness for the Medco Pharmacy while also generating revenue.

Results:

• Generated 500K visitors to the campaign site—114% of goal • Achieved a 5 basis-point lift (16% increase) in brand awareness for the Medco Pharmacy— 100% of goal • The creative won the top Clio Award for creativity in the health category. • Nearly 50,000 Health Store coupons were distributed, and over 3,300 orders placed. • Over 2,000 leads were generated for Medicare Part D. • Achieved 43% ROI (86% of goal overall); online campaign achieved over 100% ROI. Opportunities: Continue with the online campaign in 2011. A $600K spend is projected to deliver on ROI in excess of 100%. 12

Gaps-in-care alert

Cobranded version of medco.com

Growing medco.com

Attention, <<First Name Last name>>: Important information about your prescription drug plan

Online Rx transfer

Are you missing out on extra savings? Find out at www.medco.com/savenow

Direct mail

Medco.com innovates and grows with a record-high 32M Rx transactions in 2010. New online “safety net” helps members stay healthy and lowers total healthcare costs.

Gap-in-care alerts

50M

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Video

100

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84.5M

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20 40

Are you protected from certain health risks related to your medications?

10 20

for your new online safety net.

5 0

0 2009

2010

2009

Growth in medco.com prescriptions

2010

Total Customer Service contacts

Medco.com is now the No. 1 member choice for refilling prescriptions, growing faster than all other channels Aggressive Web marketing, enhanced online programs, and new collaborations with clients proved effective in engaging members on medco.com and exceeding target goals for the year. medco.com also drove significant traffic and revenue for the Medco Health Store with interactive links and display messages.

Results:

• 14.7% increase in online refills • More than 8% increase in inbound call avoidance over 2009 • 1.1M online users directed to the Medco Health Store • Launched 25 client co-branded sites and 31 new client single sign-on solutions • Engaged members in eight client health programs with new messaging capability • Implemented Spanish-language capability to increase Web registration and use 16

Buckslip

Newly launched online capabilities help members close over 150K of their own gaps in care and save Medco $10M in outbound calling costs The Personalized Pharmacy Care Profile online was launched to close gaps in care by alerting members when they might be at risk of a medication-related issue. This online safety net helps members stay adherent with their medications and avoid unnecessary health risks. By giving members tools to proactively manage their health, the program has significantly reduced the number of costly outbound calls.

Highlights:

• Over 260K total patients engaged • More than 62K pieces of additional information collected about patient medication use • Gaps close whether member uses the Medco Pharmacy® or a retail pharmacy. • Action-oriented website to start closing gaps immediately • Access to a Medco Specialist Pharmacist offers another opportunity to close gaps. 17

Direct mail

Medco.com website

Attention, <<First Name Last name>>: Important information about your prescription drug plan

Are you missing out on extra savings? Find out at www.medco.com/savenow

Redesign increases successful first-time medco.com registrations by 50%, with projected 2011 value of $4.7M in incremental margin and call savings Medco is using a variety of tactics both online and offline to increase Web registration. An online redesign/simplification of the medco.com registration process resulted in a 50% increase in full registration since its fourth-quarter 2010 implementation. A direct-mail effort consisting of a variety of savings-opportunity messages on postcards resulted in more than 11K full registrations.

Results:

• Overall, Web registrations increase 11% over previous year. • Completed registrations per household view rise from 30% to 43% after launch of redesign. • Mail campaign exceeds goal by 8%. • Each fully registered medco.com user has a value of $18.60. 18

Welcome letter Best Use of Benefits letter Medco Health Solutions, Inc. 100 Parsons Pond Drive Franklin Lakes, NJ 07417

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24/7.

Dear <<Sample A. Sample>>: This year, would you like to get more out of your <<employer/health plan>> prescription drug benefit? As the <<manager/administrator>> of your benefit, Medco wants to help you and your covered family members stay as healthy as possible and help lower your prescription costs.

'ETĂ&#x;THEĂ&#x;MOSTĂ&#x;OUTĂ&#x;OFĂ&#x;YOUR PRESCRIPTIONĂ&#x;BENEFIT

Three easy ways you may save in 2011: 1. Use the Medco Pharmacy mail service. You could join more than 7 million people who enjoy delivery of up to 90-day supplies of long-term medications (such as those used to treat high cholesterol or high blood pressure)â&#x20AC;&#x201D;with free standard shipping. 2. Use generic drugs. FDA-approved generic drugs provide the same health benefits as the brand versions, but at a lower cost to you. And they may save you money whether you order them through mail order or at a retail pharmacy. If youâ&#x20AC;&#x2122;re taking a brand-name drug, ask your doctor if a generic is a good option for you. 3. Save the most when you use both. Getting generic drugs through the Medco Pharmacy offers an even better way for you to reduce costs.

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Call to find out whether you are spending too much. A Medco benefit specialist can explain how you could pay less and help you get started with mail order. We can even contact your doctor for you to get a new prescription on most medications. Or, if you prefer, ask your doctor to use the enclosed form to fax a new 90-day prescription to the Medco Pharmacy. Please note that only your doctor can fax your prescriptions.

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Find the prescription savings that may already be waiting for you. And if you have questions about your medications, our pharmacists are available to help you 24/7. Call 1 800 633-2662 today.

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Clinical outreach program delivers 2M new mail-order Rxâ&#x20AC;&#x2122;s and over $20M in margin The TRC Clinical Counseling outbound calling campaign has a mix of Medco Specialist Pharmacists and Pharmacy Benefit Specialists who reach out to members receiving three or more medications for chronic conditions from retail pharmacies. These specialists give members clinical alerts and talk to them about getting more from their benefit. This proactive approach engaged patients and increased conversion. Since the calls are focused both on the clinical aspects and best use of benefits, a larger number of sensitive clients who donâ&#x20AC;&#x2122;t typically participate in other Medco conversion programs chose to opt in for clinical counseling.

Hereâ&#x20AC;&#x2122;s an example of how one new client benefited: State of North Carolina (January 1 to October 31, 2010) Client savings: $931K Member savings: $437K Medco margin: $1,893K

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New benefit education programs deliver almost $6M in margin In Q1 of 2010, two new educational campaignsâ&#x20AC;&#x201D;Welcome to Medco and Best Use of Benefitsâ&#x20AC;&#x201D; were launched to engage members early in the year and raise awareness of all the benefits associated with the Medco Pharmacy. The Welcome to Medco program was designed specifically for members of clients that signed on with Medco in 2010. For existing clients, the Best Use of Benefits campaign gave members a timely reintroduction to savings and services that they could access with just a call or a click.

Combined Welcome to Medco and Best Use of Benefits results

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Â&#x2021; Support 24/7. Our pharmacists and nurses are available around the clock to answer your questions regarding <<multiple sclerosis>> treatments. Nurses are also available for in-home medication administration, when it is ordered by your doctor and allowed by your plan.

You may be eligible to pay

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Â&#x2021; Drug safety monitoring. %HFDXVH 0HGFR PDQDJHV \RXU SUHVFULSWLRQ GUXJ EHQHĂ&#x20AC;W Accredo can access your prescription information to monitor for potential drug interactions and side effects of your medications.

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Â&#x2021; $FFUHGRÂˇV WHDP RI PXOWLSOH VFOHURVLV SKDUPDFLVWV DQG QXUVHV FDQ SURYLGH HGXFDWLRQ and training on the proper administration of interferon therapies and other injectable disease-modifying medications. Weâ&#x20AC;&#x2122;ll assist you in managing symptoms and side effects and can also help you pinpoint questions to ask your doctor.>>

Get started nowâ&#x20AC;&#x201D;itâ&#x20AC;&#x2122;s easy

0 3 Ă&#x;3EEĂ&#x;THEĂ&#x;ENCLOSEDĂ&#x;BROCHUREĂ&#x;FORĂ&#x;ANĂ&#x;OVERVIEWĂ&#x;OFĂ&#x;!CCREDOÂ´SĂ&#x;SERVICESĂ&#x;ANDĂ&#x;SAVINGS

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The enhanced care that Accredo provides for conditions like <<multiple sclerosis>> is already part of your current health plan.

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<RX FDQ UHO\ RQ $FFUHGR SKDUPDFLVWV WR ZRUN ZLWK \RXU GRFWRU WR PD[LPL]H WKH EHQHĂ&#x20AC;WV of your overall therapy. Thereâ&#x20AC;&#x2122;s no need to switch doctors or change plans â&#x20AC;&#x201D; itâ&#x20AC;&#x2122;s already part of your existing health coverage. One call is all it takes to get started with the enhanced care and personalized services of Accredo. Let us help make a difference in your health. Call 1 800 922-8279 today or visit www.accredo.com/medco for more information.

0 on new generic prescriptions.

Sincerely,

#ALLĂ&#x; Ă&#x; Ă&#x; Ă&#x;TOĂ&#x;GETĂ&#x;STA ARRTTEEDĂ&#x;WITHĂ&#x;!CCREDO OĂ&#x;TO ODAY

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Tracy L. Furgiuele, R.Ph. Senior Vice President & Chief Pharmacist Medco

See reverse side for detailsÂ

P.S. Please see the reverse side for more information about Accredo. XXXXXXX

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Get started with Accredo today. Call 1 800 922-8279 or visit www.accredo.com/medco for more information.

Specialty pharmacy programs boost margin $3.3M with more personalized messages Three types of personalization lifted direct-mail performance in 2010, including incorporating the memberâ&#x20AC;&#x2122;s condition, medication, and annual savings. In addition to more personalized messages, one Retail-to-Mail program featured a savings offer and a second highlighted superior service. The programs delivered almost 17K specialty Rx conversionsâ&#x20AC;&#x201D;more than any other voluntary conversion campaign. The response rate outperformed nonâ&#x20AC;&#x201C;condition-specific communications by over 50%!

Additional results:

â&#x20AC;˘ $71M in revenue â&#x20AC;˘ 16.8K specialty Rx conversions â&#x20AC;˘ 23% increase over 2009 and exceeded target goals 24

Generics Copay Waiver program drives $17M in margin This successful program offers a strong incentive to members for transferring retail prescriptions to the Medco Pharmacyâ&#x20AC;&#x201D;a $0 copay for a 90-day supply of generic medication. For members, itâ&#x20AC;&#x2122;s like getting 3 monthsâ&#x20AC;&#x2122; worth of medication for free. In 2010, various direct-mail packages were tested to optimize the best performer.

Highlights:

â&#x20AC;˘ Over 350 clients participating â&#x20AC;˘ 11M members eligible 25

Drug Trend Symposium Best Practices Workshops B2B Peer reports 20 BEST PRACTICES 10 WORKSHOP

Helping win business and retain clients Proposals Game Changers website

B2B marketing programs attract prospects, build client relationships, and help win and retain clients.

Environmental design at event

Event binder

Direct-mail packages

Drug Trend Report Executive Summary

Medco produces over 600 proposals and helps win $5.4B in drug spend A typical proposal has over 240 questions, is almost 300 pages long, and must be completed in approximately 14 days. To meet this demand, the Medco Proposals Department draws on a network of over 350 subject-matter experts throughout the company to address the increasingly complex questions included in these requests for proposals (RFPs). At least 60% of the proposals submitted in 2010 for high-value opportunities led to Best & Final presentations. For these opportunities, Medco’s win ratio was 54%.

Event badge

Drug Trend Symposium attracts 690 guests, including 55 prospects—six of which became clients

Additional results:

• 66 winning proposals, representing an estimated 5.8M lives • $5.4B in annualized drug spend includes $1.2B for new clients and 4.2B for renewed clients. • New wins—Wal-Mart Stores, Pitney Bowes, and New Mexico health plan for state employees and teachers • Renewals—Towers Watson Rx Group Purchasing, United Airlines, Merck & Co., Inc., and North Carolina State Health Plan for Teachers and State Employees • 609 proposals completed, plus an additional 39 on behalf of health plan clients 28

Despite a constrained economy, 380 companies sent 690 guests to Drug Trend to learn about what’s next in healthcare.

• Direct-marketing efforts helped exceed attendance goals by 12%. • Registration-to-attendance ratios improved by 3%, resulting in an all-time low attrition rate of 16%. • Attendees rated the event a 4.6 out of 5. • Attendees were able to choose from eight different breakout sessions and hear eight speakers talk on important benefit management issues.

Specialty Pharmacy direct mail TRC clinical calling programs

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See reverse side for details

C0pay waiver buckslip

Worry-free Fills direct mail

21 distinct marketing programs were managed in 2010, producing 36M member communications, delivering 6.1M Rx’s and $98M in gross margin, and exceeding all goals.

9 Trends peer report

Rx Intelligence peer report “Rx Intelligence is very well done and confirms Medco’s dedication to Labor. In addition, it indicates the need to use proactive measures in the future to help promote health and contain costs.”

Folder

Web registration

Mark Chanzis, Director of Administration for the Joint Industry Board of the Electrical Industry

THE GAME IS

CHANGING Find out how your peers are planning to stay ahead of it

Reserve your FREE copy of our 2010 9 Trends report today

NEW THIS YEAR!

INSIGHTS from BENEFIT ADVISORS

Postcard

Game Changers home page

Targeted B2B marketing enhances Medco’s standing as a thought leader and generates hundreds of leads Direct-mail packages

Best Practices Workshops in New York and Las Vegas attracted 360 guests from 252 different companies The “Get Smart” workshops attracted clients and prospects who wanted to learn practical solutions to everyday benefit plans in order to lower costs and improve healthcare outcomes.

• Attracted 193 attendees who had not been to a Medco event in the past year • 15 booths provided showcases for all Medco offerings in personalized medicine. • 82 guests toured Medco pharmacies. • Event received high satisfaction ratings 30

This year, Medco expanded the range of business intelligence available to clients, prospects, brokers, and consultants. In addition to the annual 9 Leading Trends in Plan Management study for Employer Accounts, a new report was created for the Key Account business—Rx Intelligence. Also new for 2010 was an online lead generation site, Medco Game Changers, that offers unique articles, videos, and downloads. The insights on peer trends, new legislation, and future innovations demonstrate how Medco is helping shape the industry for the better and have led to leads for sales teams.

Results: 9 Trends peer report Prospect requests increased by more than 50% vs. 2009 Over 500 requests overall to date for this year’s edition

• •

Rx Intelligence peer report Over 500 requests overall for the inaugural edition Benefit and Compensation Digest (IFEBP publication) has invited Medco to write a Q1-2011 op-ed.

• •

Medco Game Changers website 9.3% of targeted prospects visited medcogamechangers.com since the July launch. Generated a bid opportunity from a national prospect with 35K+ active employees and 8K+ Medicare Part D eligibles

• •

Five-star enrollment campaign

Health Plan Service Guide

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)MPORTANT BENEÂ˝T CHANGE TO HELP YOU LOWER YOUR -EDICARE PRESCRIPTION COSTS IN PLAN YEAR

Growing Medicare Part D

New for <<plan year>>: Pay less for your medications with mail order Under your <<plan year>> plan, <<plan name>> has made it easy for you to spend less on your long-term medications when you use the Medco Pharmacy, your mail-order pharmacy.* Youâ&#x20AC;&#x2122;ll get a 3-month supply of the medications you take on an ongoing basis delivered right to your door, and generally for less than you may be paying now at a retail network pharmacy. Using the Medco Pharmacy is just one of the new ways you can begin saving on your medications. In addition to savings, the Medco Pharmacy has specialist pharmacists who have expertise in the medications used to treat specific conditions like diabetes and heart disease. Our pharmacists are available to you 24 hours a day, 7 days a week. You can call them anytime, even in the middle of the night, with any questions or concerns.

9OUR PLAN YEAR -EDICARE PRESCRIPTION PLAN INCLUDES IMPORTANT UPDATES THAT HELP YOU TAKE CONTROL OF YOUR PRESCRIPTION COSTS Â&#x201E; ,OWER YOUR CO PAYMENTS BY ACTIVATING YOUR MAIL ORDER BENEÂ˝T TODAY Â&#x201E; %NJOY ADDITIONAL SAVINGS BY CHOOSING SAFE EFFECTIVE &$! APPROVED GENERIC MEDICATIONS

The Medco Pharmacy also helps ensure your safety. Your medications go through multiple live and automated checkpoints and are screened for any potentially unsafe drug interactions. Simply activate your mail-order benefit today, and weâ&#x20AC;&#x2122;ll make sure your long-term medications are delivered on time with free standard shipping. The Medco Pharmacy provides an easier, affordable way to get your medications. Also new for <<plan year>>: Additional savings with generic medications In addition to activating your mail-order benefit, you could save even more by choosing <<preferred>> generic medications. FDA-approved generics are safe, effective, and typically cost less than brand-name medications. Genericequivalent drugs have the same quality and strength as their brand-name counterparts. If your plan has a Coverage Gap stage, where you may pay 100 percent of your drug costs, using generic medications could help you lower your prescription costs now and help you delay reaching the Coverage Gap. So whenever you have a prescription to be filled, ask your doctor if low-cost generics are right for you.

(over, please) <<CMS Material ID>> <<CMS Approval: XX/XX/XX>>

<<KeycodeXXXXXXX>> <<LTXXXXXX>>

CMS Compliance Guide

Mail-order conversion

Medicare business had unprecedented increase in client satisfaction rates, drove over 40K new enrollments into the Medco PDP, and drove initiatives reaching nearly 1M mail-order prescriptions.

Prospect mailer

Compliance Practices Guide

Medco Medicare website

Five-star campaign for Medco Prescription Drug Plan increases enrollment In an increasingly complex environment, where the average Medicare beneficiary has a choice of at least 41 prescription drug plans, the Medco Medicare Prescription Plan used a brand-new five-star rating to gain an advantage in the marketplace. Although the Centers for Medicare & Medicaid Services (CMS) published its “Star Ratings” only 5 days before the start of the enrollment period, Medco’s five-star rating was rapidly incorporated into a multichannel acquisition and retention strategy for plan year 2011.

Additional results:

• An 85% increase in the number of enrollments through the CMS “Plan Finder” service, where the five-star rating is prominently displayed • An increase of 35% in the over-the-phone conversion rate • Direct-mail response rate of 6% • Search Engine Marketing (SEM) campaign that increased overall online enrollments by 33% 34

Industry-first CMS compliance resource contributes to client satisfaction of 91% In 2010, Medicare plans received 327 new directives from CMS. Medco created the industry’s first Compliance Practices Guide to help Medicare Part D clients understand how we support and administer their programs. Over 2,000 pages of content were organized into a searchable, client-specific DVD. The materials were cited as a key best practice for demonstrating operational readiness and compliance with Medicare by clients and prospects, as well as the CMS regional office.

Results:

• Contributed to an increase of 9 percentage points in overall satisfaction with Medco Medicare support • Improved clients’ impression of Medco’s ability to meet CMS requirements by 9 percentage points • Resulted in a 91% client satisfaction score for “setting clear service expectations” 35

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)MPORTANT BENEÂ˝T CHANGE TO HELP YOU LOWER YOUR -EDICARE PRESCRIPTION COSTS IN PLAN YEAR

Dear John Q. Sample, There are important changes to your Medicare prescription drug plan for <<plan year>>. As a member of <<plan name>>, you now have the opportunity to pay less for your medications when you activate your mail-order benefit. Medco, the company that administers your Medicare prescription drug plan on behalf of <<plan name>>, is sharing news of this important change so that you can take full advantage of these savings throughout your <<plan year>> plan year. New for <<plan year>>: Pay less for your medications with mail order Under your <<plan year>> plan, <<plan name>> has made it easy for you to spend less on your long-term medications when you use the Medco Pharmacy, your mail-order pharmacy.* Youâ&#x20AC;&#x2122;ll get a 3-month supply of the medications you take on an ongoing basis delivered right to your door, and generally for less than you may be paying now at a retail network pharmacy. Using the Medco Pharmacy is just one of the new ways you can begin saving on your medications. In addition to savings, the Medco Pharmacy has specialist pharmacists who have expertise in the medications used to treat specific conditions like diabetes and heart disease. Our pharmacists are available to you 24 hours a day, 7 days a week. You can call them anytime, even in the middle of the night, with any questions or concerns.

9OUR PLAN YEAR -EDICARE PRESCRIPTION PLAN INCLUDES IMPORTANT UPDATES THAT HELP YOU TAKE CONTROL OF YOUR PRESCRIPTION COSTS Â&#x201E; ,OWER YOUR

CO PAYMENTS BY ACTIVATING YOUR MAIL ORDER

BENEÂ˝T TODAY Â&#x201E; %NJOY ADDITIONAL SAVINGS BY CHOOSING SAFE EFFECTIVE &$! APPROVED GENERIC MEDICATIONS

(over, please) <<CMS Material ID>> <<CMS Approval: XX/XX/XX>>

<<KeycodeXXXXXXX>> <<LTXXXXXX>>

$3.8M in net incremental margin from new Medicare Part D mail-order conversion campaign Medco works with clients to help optimize their plan design for Medicare, and it offers a full portfolio of marketing campaigns to present members with plan savings opportunities through the Medco Pharmacy. Through a multichannel campaign, members were introduced to benefits such as first-time availability of savings through their mail-order pharmacy, the value of preferred generics, and $0 co-payments on generics through the Medco Pharmacy.

Results:

â&#x20AC;˘ 350K total fills via mail in 2010 â&#x20AC;˘ Delivered 408% ROI â&#x20AC;˘ Generated $3.8M in additional revenue 36

HealthStage™

Generics Rx Advantage website Why choose a basic CDH plan when you can have the works?

If a plain vanilla CDH approach leaves you wanting more, look to a provider with the advanced technology and expertise to deliver better outcomes. With the industry’s premier real-time, multidirectional data integration, Medco offers you more efficient information-sharing across your pharmacy, medical, and behavioral health benefit. By serving more CDH members than any other PBM or health plan, we know what it takes to support a successful plan.

New initiatives for 2011 Want the scoop on making your CDH pharmacy benefit better? Contact your Medco representative about the Medco Consumer Choice Plan® today or call Glenn Sungela at 1 201 269-2004.

E-mail: MedcoSolutions@medco.com

Medco Pharmacy app

Early in 2011, three new initiatives will launch: patient-centric communications programs, an enhanced generics incentive program, and a mobile app that gives members Medco on the go.

The four segments that Medco has identified.

Medco Pharmacy app

My Rx Choices

My Medicine Cabinet

Medco goes mobile with a member app In 2011, Medco will transform our member communications by applying a new patient segmentation named HealthStage ™ HealthStage patient segmentation uses pharmacy and medical data to identify where a patient is in his or her medication therapy life cycle. Using this information, Medco can deliver event-based communications to members to add value early in the decision process. Members will receive information that’s more relevant, timely, and useful to their specific conditions.

Projected results:

• Member research suggests higher response numbers for segments • Higher Retail-to-Mail conversion projected • Event-based clinical communications expected to drive higher client participation in marketing programs • Fewer communications could drive higher yield 40

In Q1 2011, Medco will launch a mobile app aimed at helping members get more from their plan. Instant access to the Medco Pharmacy on a smart phone makes My Rx Choices, the Medicine Cabinet, and a virtual prescription ID card just a touch away. Using special alerts and reminders, it’s easier for members to stay compliant with their medication.

Features: My Rx Choices® Look up potential lower-cost prescription options available under your plan and discuss them with your doctor—even while you’re still in the doctor’s office!

•

My Medicine Cabinet Set medication alert reminders Get personalized alerts if there’s a possible health risk related to your medications. And you can add over-the-counter medications, vitamins, and supplements to check for possible interactions with your prescriptions!

• •

Virtual prescription ID card Use your phone to display a virtual card at the pharmacy, anytime.

•

Soon available on all phones Initially launched for Android and Blackberry devices for Verizon, app service will be extended to multiple devices and all carriers as of March 2011.

•

Member website

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$20M in margin projected for new Generics Rx Advantage program in 2011 Generic Rx Advantage (GRxA) is an incentive program that drives conversions with offers of $0 copays and discounts when members order from the Medco Pharmacy. The launch of Generics Rx Advantage in January 2011 includes enhanced online capabilities for members and will kick off with a multichannel marketing effort that includes direct mail, Web, and outbound calls.

Highlights:

â&#x20AC;˘ Enhanced website scored well in usability tests â&#x20AC;˘ Easily accessible from medco.com or by phone â&#x20AC;˘ Wide client participation expected, since GRxA increases client savings and member savings 42

1 Plan Administration

Dana Dunleavy Peggy Gavan Eric Rhinehart James Wintraub Michael Elephonte Alisa Albano Noreen Fitzsimons Jenn Connell

The Marketing Campaign Management Group

2 List Pulls

Key players

Andy Brubaker Chad Bucher Gene Carbine John Derrico Arnold Detoito Robert Didio Scott Doscher Andrew Gullestad Jan Hartman Jonathan Hollander Jhaveri Nayna Phillip Johnson Andy Kwok David Mastrogiovanni Celeste Medwid Paul Merlino Alex Muniz Jennifer Purnell Cindy Rinehart, Ingo Rolke Craig Schweizer Mark Skaleski Lisa Smith Lisa Stauber Lisa Thomas Nelson Wagler Mark Wusinich

4 PR Impressions Lowell Weiner Ann Smith Jennifer Luddy Melissa Mackey Robert Marzulli

5 Social Media Impressions Ann Smith Melissa Mackey Jennifer Luddy Maria DiCostanzo Christine Ciccone

6 Dr. Obvious Campaign Amvrosios Ioannidis Brad Epstein Jay Silverstein Jack Smith Christine Ciccone Mike Cassetta Maria DiCostanzo Christine McNabb

3 Creative Resources Projects Ken Hart Jane Byron Dennis Weinberg Valerie Trainor Rachel Butera John Barrachina Jate Perillo Glenn Herdling Mark Puzio Sharon Martin Brad Lund Pam Rutheford Brian Lehmbeck Diana Magnet

7 medco.com速 prescription growth Kathy Zaccone Anna Tsafatinos Kevin D. Smith Shannon Zimmerman Cynthea Ryder Barbara Delle Donna Steve Hiltabiddle Jennifer Marks Volodya Krul

8 Gaps in Care Online Shannon Zimmerman John Gobinski Richard Shami Jay Cortes Jennifer Dunham Amy Foley Vicente Caride Brad Lund Pam Rutheford Brian Lehmbeck Diana Magnet

9 medco.com redesign Registration redesign: Steve Hiltabiddle Brian Ezrow Jennifer Marks Kevin D. Smith Amy Foley Nancy Wellman Direct marketing: Christine Ciccone

10 Clinical outreach Allen Jacobs James Bieber John Barrachina Nancy Wellman Jennifer Aden Ken Malley Melissa Carr Pooja Sharma Mary Rooney Neil Prezioso Beth Easton CTI Ed Ferraca Mike DiTroia PSDM Scott Doscher Mark Wusinich

11 New benefit education program Allen Jacobs Robert Lahoda Ken Hart Steven Rice Noreen Fitzsimons Scott Doscher James Bieber John Barrachina Nancy Wellman Noreen Fitzsimons Jennifer Aden Rachel Butera

12 Specialty pharmacy personalized messaging Linda Coombs Marianne Oteri Lisa Pollio John Barrachina Mark Skaleski Phil Johnson Marianne Oteri

13 Generics copay waiver program Melissa Carr Pooja Sharma Jeff Spaldi Jim Bieber Christina Miller Pam Smith eCommerce Health Care Operations Creative Resources

14 Proposals Medco, Systemed and Accredo Proposal Staff

15 Drug Trend Symposium Glenn Nichols Linda Levy Teresa Cirillo Cathy Vallestero Betty Lyons Cindy Callahan Mark Puzio Barbara Menzel Libby Mell Gail Chirico Brad Epstein James Wintraub Dennis Weinberg Pamela Magee Michael Elefonte Alisa Albano Diane Milani Justine Michellini Franklin Morales Andrew Clark Dan McIsaac Rajani Normula Jeff Simek Margery Nathanson Anthony Zolfo

Marianne Oteri Alisa Albano Brad Epstein James Wintraub Rx Intelligence: Rick Guior Janardhan N. Vellore Soraya Rodriguez-Balzac James Wintraub Channing Stave Matt Patella Bart Gerbe Andy Benoit Jill Stearns Roger Holland Game Changers.com: Nancy Wybolt Janine Nowatzky Jon Blauman James Wintraub

18 Five star campaign Mary Schneider Jennifer Russo Karen Cha Tina Thau Michele Paige James Wintraub Dana Dunleavy Sharon Martin Peggy Gavan Mike Elefonte Alisa Albano Christine Sabatino Jennifer Luddy Ken Pfeifer John Consigli Charles Hroc Brian Ezrow Vanitha Jeyaprakas Jennifer Delacru Brian Landzinsk Beverly Volk

16 Best Practices Workshop Glenn Nichols Linda Levy Teresa Cirillo Cathy Vallestero Betty Lyons Cindy Callahan Mark Puzio James Wintraub Michael Elefonte Alisa Albano

17 B2B marketing 9Trends: Jon Blauman Janine Nowatzky Nancy Wybolt Dana Dunleavy Wayne Martelli

19 CMS compliance Jennifer Russo Susan Haber Dana Dunleavy Marianne Oteri Barnett Group Scott Helmus Coleen Sullivangh

20 Medicare Part D mail order conversion program Kassandra Monfiletto Audra LoBalbo Nawrocki Michele Paige Roz Gohagen Sharon Uber Daniele Stirling Arnold Detoito Alex Muniz Vitaly Gomelskiy

21 HealthStage Jack Smith Brad Epstein Jay Silverstein Jon Hollander Melissa Carr Channing Stave

22 Mobile app Shannon Zimmerman John Gobinski Richard Shami Jay Cortes Amy Foley Vicente Caride Tom Feitel

23 Generic Rx Advantage Ken Malley Melissa Carr Pooja Sharma Jeff Spaldi Jim Bieber Christina Miller PSDM PES BFG/Account Teams CTI HCO eCommerce eSD Team Nancy Wellman

To see your departmentâ&#x20AC;&#x2122;s next breakout marketing project in the pages of the portfolio, contact Vasilia Maikisch at 1 201 269- 4400.

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To see your departmentâ&#x20AC;&#x2122;s next breakout marketing project in the pages of the portfolio, contact Vasilia Maikisch at 1 201 269- 4400.

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