EFTA02235685

To: Jefffrey Epstein[jeevacation©gmail.com] From: Lesley Groff Sent: Fri 1/12/2018 11:47:05 AM Subject: Kristin Kaw from Dr. Rony Shimony re Repatha -Looking a labs sent from early this month, lipids done was calculated as opposed to direct LDL. Insurance companies look for the direct 101 when approving medications because this is a more accurate count, therefore, representing a more accurate cardiovascular risk equivalent. When the triglycerides is high, such as in the case of Mr. Epstein, the lab cannot provide an accurate LDL count. As you can see there was no LDL value given -If you want to proceed with insurance approval, he will need to re-take labs with direct LDL. He cannot start Repatha prior to rechecking labs because it will not be an accurate reflection of his baseline without medications. -If he wants to self pay, Century Specialty Pharmacy I is willing to give him a 10% discount if he purchases minimum of 6 months. They will ship the medication over as soon as it's ordered and have it virtually the next day. -Here is the breakdown of cost: For the once a month injection $1,250/month (with 10% discount if he buys minimum of 6 months) For the twice a month injection $1,150/month (with 10% discount if he buys minimum of 6 months) Hope that answers all your questions. I will be available tomorrow if you have any questions. Please let me know what his decision is prescription to the pharmacy is pending his ok. Thanks KK EFTA_R1_00996888 EFTA02235685