1. Building Infrastructure for the Customer Marketing group
In January of 2007, the Customer Marketing Group was formed in order to provide a base
of support for Cytogen’s two most recently acquired products, Soltamox and Caphosol.
Historically Cytogen had not needed to work directly with Managed Market customers as
ProstaScint and Quadramet flowed seamlessly through nuclear medicine departments
with formularies and P&T committees rarely ever playing a role. One of our first
priorities was to develop a framework to create access which would make it possible for
our sales force to pull through sales of Soltamox and Caphosol by providing access
within Managed Care Organizations, PBMs and federal and state insurance programs.
In essence, when we started we were provided with paint, carpets and furnishings and no
place to put these items. We have needed to essentially build a structure (or a structure))
to place these items into as we moved forward into this market segment.
Building the foundation
Formulary Kit designed and approved
Top priority-establish a formulary kit for Caphosol. This is an integral part of dealing
with managed markets as every customer we have approached has requested a formulary
kit. Joe Farzetta worked and expedited the process. This allowed us to make formal
presentations and to compete for spots on P&T agendas—to essentially be officially
reviewed as this is the standard
Result: PRC approved formulary kit by 2/26/2007
Contracting Strategy
Historically we have not needed a contracting strategy for most of our customers with our
nuclear products. Because of this, our organization’s competency and preparedness was
somewhat limited. Frankly this was understandable but the acquisition of two more
traditional products has made being competent at contracting compulsory.
We recognized this need early and formulated a plan to obtain contract templates that
would be approved by our legal department as soon as possible. Since Cytogen had
never dealt with managed markets, it became essential to find people who could design
templates that would meet the needs of our customers and allow us to offer what our
customers expected.
Results: 3 Contract Templates(one for GPOs, MCOs and PBMs) were developed by
David Kline, our consultant and were put into place by 2/22/2007 These templates have
already been used with several accounts with whom we could not do business until we
had the ability to contract.
An additional need is contract monitoring for the purpose of issuing rebates. It was
critical to get this monitoring infrastructure in place because if rebates are missed,
contracts can get cancelled. We added Ed Collins to our group as a consultant to get this
process fully operational.

2. An example of a contract is below:
C:Documents and
SettingsggospeMy DocumentsCorp AccountsContractsCytogenMHAproposedbyMHAandrevi
Optimizing infrastructure for Medicaid and Medicare opportunities
We recognized that an opportunity existed with Medicaid. Since Cytogen has never
worked with Medicaid programs in the past, we sought the assistance of Brenda
McLaughlin, a consultant from MC Access to help us facilitate the process since this area
was completely new to us at Cytogen. Once we commenced with this process, Brenda
provided a great deal of assistance and made sure that we had all of the documentation in
place to provide the federally required 15.1% rebate for Soltamox. One item that came
up was the misalignment of the Soltamox NDC. It was still registered to Rosemont
pharmaceuticals and in order to pay the required rebate, we needed to obtain consent
from Rosemont to pay the rebate on our behalf to CMS. Brenda competently expedited
this process in order to meet the federal deadline and help provide another reimbursement
avenue for Soltamox.
Long term, the solution will be to reregister the product so that it will have a Cytogen
specific NDC.
Result: Cytogen is viewed with credibility where we previously were essentially
unknown. Rosemont will be processing rebates for Soltamox until it receives a Cytogen
specific NDC.
An additional and highly significant win also took place with California’s Medicaid
program, Medi-Cal. This took place because we recognized the strategic importance of
participating with Medi-Cal (it covers nearly 6.5 million Californians). Because of
Brenda and the development of the formulary kit, Caphosol is available with prior
authorization on the state of California Medicaid program.
In addition, we have also developed prior auth form to use for sales force pull through
once Caphosol or any product requiring prior auth is in place with any plan in any state.
C:Documents and
SettingsggospeMy DocumentsCorp AccountsReimbursementUnderstanding Prior Authorizatio
Strategy from here on out is to prioritize the top 12 Medicaid states and move forward
between now and the end of the year to leverage the CA win and obtain availability in
these states.
In summation, formulary kit, contract template, contract tracking, government affairs
NDC clarification and prior auth form are now set in place, On January 1; none of these

3. items were in place. As of May 1, Cytogen has large pharma like Managed Markets
infrastructure and can compete in the PBM, MCO and government segments.
Developing a plan
Built target list of top 50 PBMs and MCOs- this list encompasses about 80-85
percent of covered managed care lives.
Divided list between account managers to ensure adequate coverage (see file below)
C:Documents and
SettingsggospeMy DocumentsCorp AccountsMC AccessCytogen Account Assignments.xls
Trade responsibility established between account mangers-see attached file
C:Documents and
SettingsggospeMy DocumentsTrade and GPOs May 2007.xls
Results of having list and targeting account varies from plan to plan and state to state but
in first 4 months we have managed to establish access for Soltamox and Caphosol as
shown on the spreadsheet that is attached:
C:Documents and
SettingsggospeMy DocumentsFormulary Status MCOPBMBCBS May.xls
Refining our Plan
It is our goal to contract with accounts whenever they either require us to do so or if they
are willing to help drive market share. Since both products are relatively new to our
customers, this is something that we will monitor on an ongoing basis. One detail that is
important to know is that PBMs and MCOs have levels of demand and use that they need
to see in order to adjudicate a rebate oriented contract so this rarely takes place for
products that are new, unless they provide a documented cost savings to the account. It
has been our standard operating procedure to see reimbursement or inclusion on
formularies at tier 3 because that is where we can usually obtain placement and in some
instances, certain accounts like RX America were willing to place our contract onto tier 2
as they saw the value of our products and were willing to provide us with better
placement up front.
Assisting the Field
Special Projects

4. Removal of Caphosol from Medicare Part D
In early March, CMS removed all non drug items from Part D coverage. This required
our group to professionally develop a plan for the field to ensure no interruptions in
Cytogen’s Caphosol business. After consulting with Pinnacle Health, it was determined
that we would handle this issue on a case by case basis since not all PBMs and MCOs
were going to respond to this change during the same time frame.
Our group worked closely with Pinnacle Health to determine usable HCPCS codes and to
formulate a game plan to ensure business continuity-Non PRC approved lists formulated
to assist the field with reimbursement questions. A plan was also developed to have the
field contact Customer Marketing (specifically Patrick and Greg) as well as Pinnacle
Health with any and all questions related to reimbursement for Caphosol.
Greg and Patrick Worked closely with Pinnacle health to develop a FAQ list on Caphosol
(see attached) that will answer questions about the transition from Part D to Part B. This
issue turned out to be less of a stumbling block than initially feared, primarily due to the
amount of benefits available in Part B and the lower amount of oversight on this part.
Customer Marketing conducted an education session at Manager’s meeting at ONS to
share latest information and strategies for reimbursement with field management and to
obtain their feedback. This has resulted in a company wide communication plan being
developed:
C:Documents and
SettingsggospeMy DocumentsCorp AccountsCaphosolCaphosol Communication Plan 043007
This plan will provide ongoing updates to the field. Implementation will start on Monday
May 7, on a company wide conference call. All objectives will be discussed on this call
at 11 am.
Solutions to Medicare Part B
During our attendance at AMCP, we were able to meet with a key member of Walgreen’s
Pharmacy team and found out that Walgreens actively seeks out Part B business. This
account is very interested in Caphosol and sees it as a great addition to what they
currently offer. Our plan is to meet with Walgreens during May and work out initial
plans to roll out a program that can provide access to Caphosol within the entire
Walgreens Pharmacy Chain.
Caphosol stocking issue –Mid March
Issues arose with initial stocking and availability the first week after launch as several of
our sales people found pharmacies that had not yet stocked Caphosol within the first few
days of launch. In a couple of instances there were customers who came to pharmacies
with an order in hand and customer marketing was able to facilitate the delivery of
Caphosol to the store using our network of wholesalers. The bottom line is that customer
marketing was able to help out in an expeditious and professional manner and ultimately
several early sales were preserved.

5. Problems identified and solved with national product databases-Redbook,
Medispan, First Data Bank and Gold Standard
Item number and pricing had been incorrectly entered into database item was identified
and steps were taken to fully correct this issue so that all purchasing entities had access to
the correct information.
Managed budget effectively, attending numerous seminars and meetings resulting in
numerous introductions with key customers from MCOs, PBMS and trade accounts
(see cardscan list).
Some of the meetings include: ACCC, NCCN, AHIP, AMCP, Confera Reimbursement
Summit, PCMA and ONS. These introductions have led to meetings for Cytogen with
key managed market customers, trade account customers and GPO customers which have
resulted in formulary access for both products and/or positive reimbursement outcomes
through Medicare Part B as well as key contracting opportunities with GPOs such as
Innovatix and MHA.
ACCC
March 30, met with Key people in Baltimore at National Meeting, reviewing partnership
concepts against their capabilities for Soltamox pull through. Results of this meeting are
follow up meeting that will take place at ASCO in Chicago in June where rollout of
publication on Soltamox letter will be finalized. We are a platinum member as an
emerging biopharmaceutical company which is providing us with better access and
publicity
AMCP
Key contacts were made with Walgreens, who is actively involved with billing under
Medicare Part B and is very interested in Caphosol. A meeting is anticipated to move
this to the next level sometime in May. In addition key meetings took place with
WellPoint/Next RX, Wellcare, RX America and MemberHealth. Follow up meetings and
contract presentations will be made over the next 30-90 days.
PCMA
Specialty Pharmacy conference yielded executive suite contacts within this growing
segment which will enable us to provide Caphosol through this emerging protocol driven
pharmacy segment. Examples of some of the organizations involved are Caremark,
Active Care Network.
Kaiser Permanente
Greg organized a presentation that was made on April 16th to the systemwide contracts
and pharmacy information office in Livermore California. A commitment was obtained
to query their oncology staff about initiating trial use of Caphosol in their system which

6. could easily lead to system wide adoption of Caphosol. This is extremely significant as
this account represents more than 8.5 million lives.
Moving Forward our Focus Remains Essentially the Same
Managed Care Organizations
Recent appointments have taken place with Kaiser Permanente, WellPoint, and Prime
Therapeutics.
• Continue to obtain tier status for Soltamox
• Continue to work towards either RX status for Caphosol or coverage under
medical benefits
PBMs
Significant wins have taken place with key PBMs such as Medco, MedImpact, Express
Scripts.
• Appointments and presentations have taken place with Caremark, RX America
and Next RX.
• Strive for inclusion of Caphosol as a drug benefit under the premise that it will
help the plan save money on other treatments
• Aim for tier three or better inclusion for Soltamox, focusing on patients who
currently receive compounded formulations of tamoxifen and patients on
tamoxifen who have documented swallowing problems.
Trade Accounts
Direct to customer initiatives and mailings have been done or are in the process of being
done with
• Cardinal Health
• HD Smith.
• Similar initiatives are being developed with our nuclear trade partners as well.
Specialty Pharmacy and Long Term Care
A number of interactions have taken place with specialty pharmacies which can result in
reasonable volume being developed due to the fact that this is a growing segment which
operates in a protocol driven manner.
• Active Care Network
• Caremark
• Acredo
• Corum
Long term care will be more accessible and will be placed higher onto the priority list
once we resolve the HCPCS coding issue and/or the federal rebate issue. Once this takes
place, organizations like Omni Care will also be added to the list.

7. Medicaid
We continue to target the top 12 states and leverage our early success with California.
Once the issue of the HCPCS code is resolved this will open the door and enable us to
pull through this significant opportunity equal to about 12% of the covered lives in the
US
Medicare Part B
We see this as a large opportunity for Caphosol and we already possess a great deal of
competencies in this area. There are already a number of organizations we can work with
regardless of the status of our product specific HCPCS code. Included in this grouping
are
• Walgreens
• Acredo
• Caremark
• Active Care Network
• Corum
• OTN (Direct to physician initiatives for both Medical and Radiation Oncology)
VA DOD
New contracts have been put into place for Caphosol and contracts for our other products
(Quadramet and ProstaScint) have been solidified.
The bottom line is that we have exceeded what was expected of our department in a very
short period of time. A quick summary of our accomplishments includes:
The building of a department from the ground up to include capabilities in
• Contracting
• Rebate Monitoring
• Negotiations with MCOs and PBMs
o Resulting in inclusion of Soltamox on more than 30 major plans and
PBMs
o A growing number of places where Caphosol is reimbursed either under
Part B or Part D
Soltamox-How to handle issue of unsold stock in trade accounts
Partner with wholesale partner and Susan B Komen foundation to provide a sizable
Soltamox donation that can be accessed through OTN or some other wholesaler to deal
with the inevitable disposition of much of this product that is in the pipeline. This will
provide a win-win for us and our wholesale partners.
In short, we have been able to provide access for our products and have provided and will
continue to provide updates to our field partners on the plans which are reimbursing our
products. As our volume grows we expect to be able to work on a growing number of
field based pull through programs which only become feasible when volume develops
due to the national reach of nearly every plan and PBM that we are calling on.