COVID-19 Weekly Trend Insights

COVID-19 Weekly Trend InsightsCompiled on 12/18/2020

Confidential

Executive Summary

2

• Given the recent launch of the Pfizer coronavirus vaccine , which was first distributed on December 14th, Symphony is monitoring vaccine NDC and CPT codes to provide clients with a first-look at the national roll-out efforts. We anticipate script activity for the latest vaccines to report in the coming weeks.

• Slide 5 and 6 provide a timeline of recent events in vaccine roll-out including: dosing, availability, logistics and cost for both Pfizer and Modernaproducts.

• Since our last COVID-19 insights report on November 20th, global cases have increased by approximately 9.09 million or 14%. • Overall cases in the U.S. have increased by 22% or 3.11 million since the last report. All states within the top 10 observed double digit growth in

confirmed cases. California, Ohio, and Pennsylvania witnessed case spikes of over 30% from our last report.

• Use of telemedicine has been on the rise since mid-November, corresponding to the spike in COVID-19 cases. Neoplasms and disease of the blood currently have the highest relative increase in use of telemedicine.

• All elective therapy trends are reporting -1% down from the previous insights report. Overall growth in elective therapy markets have been stagnant through-out the pandemic.

• As of week ending 12/11/2020, total prescription volumes remain -7% below prior year trends. The bulk of the decline is driven by fewer new prescriptions through November/December, a stark contrast to the recent upticks in COVID-19 diagnoses.

• Lower retail store activity in particular continues to drive overall national trends as we near the end of 2020.

COVID-19 News

& Latest Trends

Patient Monitoring Highlights

General Health Checks

• Amongst the Covid-19 diagnosed patients, 54% of the diagnosed patients are 50 years or older, the median age is 52. • 17% of the diagnosed patients had at least one record of inpatient care for their diagnosis. Amongst the most common locations of care for

Covid-19 diagnosed patients over most recent 4-week time period of Nov 15- Dec 12 patients seen in inpatient hospital setting are almost 20 years older than patients seen through outpatient, office, and telehealth.

• In the most recent 2-week period, Cleveland, Chicago, Philadelphia, Ann Arbor and Sioux Falls were the top cities with high Covid-19 diagnosed patients at ER or inpatient hospital settings. Miami, Cleveland, Minneapolis, Fort Wayne, and Grand Rapids were the top 5 citieswith high Covid-19 diagnosed patients at outpatient settings.

• Over the most recent 4-week period of Nov 15- Dec 12, Azithromycin and dexamethasone, continue to be most common treatments.

Confidential

Executive Summary

3

• COVID-19: Current Events & Latest Trends – Slide 4-9− COVID-19 Vaccine Update – Slide 5-6

• COVID-19 Patient Monitoring – Slide 10-19• General Market Pulse: Slide 26-35

− Telemedicine & Care Delivery Trends− National / Channel Summaries− Select Elective Therapy Monitoring – Slide 20-28

General Health Checks

COVID-19: Current Events

Confidential 4

COVID-19: Current Events & Latest Trends

There will be more than 6 million doses of Moderna vaccines shipped to over 3,200 sites (compared to Pfizer’s 636 sites).

Moderna's vaccine can be kept at about minus-20 degrees Celsius, or the temperature of a home freezer. Moderna's vaccine can also be kept in a refrigerator for 30 days

before it expires.

Moderna's vaccine distribution is being coordinated by McKesson, one of the largest medical supply distributors.

December 18th:

FDA approval is anticipated for the Emergency Use Authorization (EUA) of Moderna’s vaccine.

The vaccines will be administered in an order established by state and local authorities. Vaccine advisers to the CDC recommended that health care workers and residents of

long-term care facilities be first in line for any coronavirus vaccines that get emergency approval.

The 636 distribution sites are mainly large hospitals and other facilities able to meet the ultra-cold storage requirements. Within three weeks, vaccines should be delivered to all

vaccination sites identified by states, such as local pharmacies.

Pfizer will ship its vaccine using UPS and FedEx as its main distributors. In a key distribution challenge, the vaccine, co-developed with BioNTech, must be stored and

shipped at ultra-low temperatures — about 94 degrees below zero. Pfizer has developed a “cold chain” of shipping containers that use dry ice and GPS-enabled sensors which

will allow the company to track each shipment and ensure it stays cold.

December 14th:

The first shipments left Pfizer’s manufacturing plant in Kalamazoo, Michigan, by truck and then flown to regional hubs around the country.

COVID-19 VACCINES LAUNCH: PFIZER/BIONTECH vs. MODERNA

Sources:https://news.yahoo.com/us-allows-emergency-covid-19-023031066.htmlhttps://news.yahoo.com/many-doses-state-receive-152141112.htmlhttps://news.yahoo.com/side-effects-covid-19-vaccine-110035061.htmlhttps://www.cnn.com/2020/12/17/health/moderna-vaccine-what-we-know/index.html

https://news.yahoo.com/us-allows-emergency-covid-19-023031066.html

https://news.yahoo.com/many-doses-state-receive-152141112.html

https://news.yahoo.com/side-effects-covid-19-vaccine-110035061.html

https://www.cnn.com/2020/12/17/health/moderna-vaccine-what-we-know/index.html

Confidential 6

• DOSING: The Pfizer/BioNTech and the Moderna vaccines both require two doses, given 21 and 28 days apart, respectively.

− Pfizer's vaccine is administered as two, 30-microgram doses

− Moderna’s vaccine is administered as two, 100-microgram doses

• Each dose will report as a new fill (the 2nd dose will not be captured as a refill).

• Since the vaccines differ in composition, storage, and time between the two doses, experts say people must take the same vaccine for both doses.

• LOGISTICS: Differences in storage requirements suggest that Pfizer's vaccine may be used more for major institutions with established infrastructure like hospitals, while Moderna's may be more useful to smaller facilities like local chains or pharmacies.

• Medical distributor McKesson and pharmacy chains, including CVS and Walgreens, are involved in the initial rollout and vaccinations at nursing homes and assisted living centers.

COVID-19 VACCINES LAUNCH: PFIZER/BIONTECH vs. MODERNATRENDS TO WATCH

Sources:https://news.yahoo.com/us-allows-emergency-covid-19-023031066.htmlhttps://news.yahoo.com/many-doses-state-receive-152141112.htmlhttps://news.yahoo.com/side-effects-covid-19-vaccine-110035061.htmlhttps://www.cnn.com/2020/12/17/health/moderna-vaccine-what-we-know/index.html

• AVAILABILITY: The White House did not lock in an additional 100M doses of the Pfizer vaccine for delivery in Q2 2021 so additional Pfizer orders will be unavailable until some time after. As a result, Pfizer trends may dip after the initial round of vaccines are administered.

• The White House administration did purchase 100M doses of Moderna’s vaccine on top of the original order and contends there is now enough in the pipeline for all Americans to be vaccinated by Q2 2021.

• COST: Both vaccines are already funded through federal support of manufacturing and distribution. According to the CDC, vaccine doses purchased with U.S. taxpayer dollars will be given to the American people at no cost. However, vaccine providers will be able to charge administration fees for giving or administering the shot. Vaccine providers can get this fee reimbursed by the patient’s public or private insurance company or, for uninsured patients, by the Health Resources and Services Administration’s Provider Relief Fund.

DOSING & LOGISTICS

AVAILABILITY & COST

https://news.yahoo.com/us-allows-emergency-covid-19-023031066.html

https://news.yahoo.com/many-doses-state-receive-152141112.html

https://news.yahoo.com/side-effects-covid-19-vaccine-110035061.html

https://www.cnn.com/2020/12/17/health/moderna-vaccine-what-we-know/index.html

Confidential 7

Timeline: Latest COVID-19 Developments

A New York City intensive care unit nurse on Monday became the first person in the United

States to receive a coronavirus vaccine, saying she felt “healing is coming,” as the nation’s COVID-19 death toll crossed a staggering 300,000 lives lost.

The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee voted 17-4 to recommend Pfizer and BioNTech’s

COVID-19 vaccine for Emergency Use Authorization (EUA) for individuals ages 16 and

above.

Moderna Inc’s COVID-19 vaccine appears set for regulatory authorization this week after U.S. Food and

Drug Administration staff endorsed it as safe and effective in documents released Tuesday.

The U.S. government is counting on the Moderna shot to help fulfill its promise to inoculate 20 million this

month.

The U.S. Food and Drug Administration on Tuesday authorized emergency use of the first over-the-

counter COVID-19 antigen test which can be used at home.

The test by Ellume offers a nasal swab analyzer that connects to a software application on the users’

smartphone and gives results in 20 minutes.

U.S. coronavirus deaths soared to a daily record of 3,580 and hospitalizations rose for the 19th straight

day on Wednesday, ramping up the stakes as regulators on Thursday considered whether to

approve a second COVID-19 vaccine from Moderna.

Another 232,255 cases were reported, the second highest daily case load on record, as California

became the first state to report more than 50,000 cases in a single day.

Dec 8th

Dec 16th

Dec 15th

Dec 17th

Sourceshttps://www.pharmalive.com/fda-vaccine-adcom-gives-green-light-to-pfizer-biontech-covid-19-vaccine/https://www.pharmalive.com/u-s-rollout-of-covid-19-vaccine-begins/https://www.pharmalive.com/fda-authorizes-first-over-the-counter-covid-19-antigen-test/https://www.pharmalive.com/moderna-nears-u-s-authorization-for-covid-19-shot-with-fda-staff-endorsement/https://www.pharmalive.com/covid-19-kills-daily-record-3580-in-u-s/

Dec 14th

https://www.pharmalive.com/fda-vaccine-adcom-gives-green-light-to-pfizer-biontech-covid-19-vaccine/

https://www.pharmalive.com/fda-authorizes-first-over-the-counter-covid-19-antigen-test/

https://www.pharmalive.com/moderna-nears-u-s-authorization-for-covid-19-shot-with-fda-staff-endorsement/

• Global cases continue to rise as COVID-19 outbreaks surge despite many countries implementing more restrictions.

• Since our last COVID-19 insights report on November 20th, global cases have increased by approximately 9.09 million or 14%.

Confidential 8Source: https://www.theguardian.com/world/2020/may/07/coronavirus-world-map-which-countries-have-the-most-cases-and-deaths

Confirmed Cases Worldwide

COVID-19 INSIGHTSConfirmed Cases

74,143,435

Deaths

1,641,458

Recovered

42,283,258

https://www.theguardian.com/world/2020/may/07/coronavirus-world-map-which-countries-have-the-most-cases-and-deaths

Confirmed Cases in the USA

Confidential 9

COVID-19 INSIGHTS

Source: https://www.theguardian.com/world/ng-interactive/2020/mar/27/coronavirus-map-of-the-us-latest-cases-state-by-state

• The United States continues to observe large spikes in cases all across the country. Overall cases in the U.S. have increased by 22% or 3.11 million since the last report.

• All states within the top 10 observed double digit growth in confirmed cases. California, Ohio, and Pennsylvania witnessed case spikes of over 30% from our last report.

• Deaths related to COVID-19 reached over 310,000, representing an increase of 13% since the last report.

Confirmed Cases

17,161,321

Deaths

310,039

State/Territory Tests Test % Change Confirmed Cases Case % Change Deaths Death % ChangeCalifornia 28,149,590 16% 1,671,081 34.1% 21,481 11%

Texas 12,511,684 14% 1,519,340 26.5% 24,394 12%Florida 8,018,462 9% 1,136,024 13.4% 20,490 8%Illinois 12,055,288 13% 870,600 16.3% 15,777 18%

New York 22,477,274 14% 804,555 21.1% 28,100 5%Ohio 7,040,469 13% 584,766 33.5% 7,777 17%

Pennsylvania 3,605,428 12% 519,369 38.3% 13,168 22%Georgia 4,817,908 10% 488,338 13.8% 10,228 7%

Tennessee 5,161,287 12% 484,285 26.0% 5,668 21%Michigan 7,534,591 11% 482,815 19.8% 11,588 18%

https://www.theguardian.com/world/ng-interactive/2020/mar/27/coronavirus-map-of-the-us-latest-cases-state-by-state

COVID-19 Patient Monitoring:Demographics & Treatments

Confidential 10

COVID-19: Overview of PRA Real World Data

Through patient activity observed for diagnosis, testing, exposure or symptoms of Covid-19 infection, PRA is tracking about 25.9 million patients overall and 2.77 million diagnosed patients in its US real world data during the time period Feb 2 to Dec 10, 2020. Patients could be reported in multiple status categories based on claims captured and mapped to status

PRA US patient longitudinally linked medical and hospital claims data, raw patient volumes

PRA US Patient Real World Data COVID-19 Infection Trends

18-Jul 25-Jul 1-Aug 8-Aug 15-Aug 22-Aug 29-Aug 5-Sep 12-Sep 19-Sep 26-Sep 3-Oct 10-Oct 17-Oct 24-Oct 31-Oct 7-Nov 14-Nov 21-Nov 28-Nov 5-Dec 12-Dec

100,991 92,738 84,211 74,015 65,628 58,864 55,484 53,328 45,623 49,933 51,360 57,256 67,059 73,784 82,240 95,693 130,460 157,406 161,579 134,495 114,696 87,496

TOTAL DIAGNOSED PATIENT VOULMES BY WEEK ENDING DATE

PRA is tracking 528,566 Covid-19 patients during the most recent 4-week time period of Nov 15- Dec 12, 2020

Amongst the Covid-19 diagnosed patients:

− 54% of the diagnosed patients are 50 years or older

− Median age is 52

− 17% of the diagnosed patients had at least one record of inpatient care for their diagnosis.


PRA US Patient Real World Data COVID-19 Diagnosed Patients

*Patients could be covered by more than one payer type

Place of Service Distributions by Age for COVID-19 Diagnosed Patients (N=528,566)Amongst the most common locations of care for Covid-19 diagnosed patients over most recent 4-week time period of Nov 15- Dec 12 patients seen in inpatient hospital setting are almost 20 years older than patients seen through outpatient, office, and telehealth.


14Confidential

Observed Drug Use Within +/- 30 Days of COVID-19 Diagnosis PRA evaluated Covid-19 diagnosed patients for observed treatments within a 30- day window of diagnosis.Over the most recent 4-week period of Nov 15- Dec 12, 35% of these patients had an observed steroid use


Covid-19 diagnosed patients within +/- 30 days of

diagnosis

Observed Drug Use by Age within +/- 30 days of Covid-19 diagnosisN= 191,928

12%

21%

23%

27%

31%32%

29%

26%

21%

8% 8%

11%

15%

19%

21%

24%

28%

26%

9%

12%

16%

19%

21%

19%

16%

12%

10%10% 10%11% 11% 11% 11% 11%

10%9%

<=9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+

AZITHROMYCIN (27%) DEXAMETHASONE (20%) ALBUTEROL (16%) ONDANSETRON (11%)

15Confidential

Possible Treatments within 30 Days after COVID-19 Diagnosis PRA evaluated Covid-19 diagnosed patients for possible treatments within a 30- day window after diagnosis.Over the most recent 4-week period of Nov 15- Dec 12, Azithromycin and dexamethasone, continue to be most common treatments


Possible Treatments by Age within 30 days after Covid-19 diagnosisN= 48,645

27%

23%

28%

33%

38%40%

45%

51%49%

57% 57%

50%

45%

41%

36%

29%

24%

20%

11%

14% 15% 14%12%

9%7%

5%

1%3%

5% 6%

9%

12%

16%

20%

1% 0%2% 3% 3% 4% 5% 4% 5%

1% 1% 2% 3% 4% 5% 5% 6%

1% 1% 1% 2% 2% 2% 2%

0%

10%

20%

30%

40%

50%

60%

<=9 10-19. 20-29 30-39 40-49 50-59 60-69 70-79 80+

DEXAMETHASONE (42%) AZITHROMYCIN (34%) METHYLPREDNISOLONE (11%) APIXABAN (11%) REMDESIVIR (4%) RIVAROXABAN (4%) CONVALESCENT PLASMA (2%)

Confidential 16

The decrease in acute diagnosis has enabled care of Covid-19 patients outside of hospitals As mean patient age decreased, fewer Covid-19 diagnosed patients had respiratory failure, pneumonia, sepsis over time than in the earliest months. However, a rise in Acute Upper Respiratory Infections can be seen in recent weeks as overall Covid-19 cases spike.

ACUTE DIAGNOIS DISTRIBUTION WITHIN +/- 30 DAYS OF FIRST COVID-19 DIAGNOSIS (% OF PATIENTS BY WEEK)


ER and Inpatient Hospital- Top 50 CitiesPRA is tracking patients diagnosed with Covid-19 at Emergency Room and Inpatient Hospital settings to identified cities with high patient volume of severe cases. In the most recent 2-week period, Cleveland, Chicago, Philadelphia, Ann Arbor and Sioux Falls were the top cities with high Covid-19 diagnosed patients at ER or inpatient hospital settings.


Top 10 cities are highlighted in pink

Outpatient- Top 50 CitiesPRA is tracking patients diagnosed with Covid-19 at Outpatient settings to identify cities with high patient volume of Covid-19 cases. In the most recent 2-week period, Miami, Cleveland, Minneapolis, Fort Wayne, and Grand Rapids were the top 5 cities with high Covid-19 diagnosed patients at outpatient settings.


Top 10 cities are highlighted in pink

Confidential 19PRA US patient longitudinally linked medical and hospital claims data, raw patient volumes

Impact of changing patient demographics of Covid-19 diagnosed patients on location of care Currently, more than 50% of Covid-19 patients are receiving diagnosis at outpatient and office settings.

LOCATION OF COVID-19 DIAGNOSIS BY WEEK

RECENT 4-WEEK AVERAGE

HOSPITAL INPATIENT 13%

HOSPITAL- ER 6%

HOSPITAL OUTPATIENT 27%

OFFICE 21%

TELEHEALTH 10%

SKILLED NURSING 1%

URGENT CARE FACILITY 11%

OTHER 9%

General Market Pulse

Confidential 20

Care Delivery Trends: Telemedicine & Office Visits

National / Channel Summaries & Elective Therapy Monitoring

0

50

100

150

200

250

300

CERTAIN INFECTIOUS AND PARASITIC DISEASES

DISEASES OF THE BLOOD AND BLOOD-FORMING ORGANS AND CERTAIN DISORDERS INVOLVING THE IMMUNE MECHANISM

DISEASES OF THE CIRCULATORY SYSTEM

DISEASES OF THE DIGESTIVE SYSTEM

DISEASES OF THE GENITOURINARY SYSTEM

DISEASES OF THE NERVOUS SYSTEM

DISEASES OF THE RESPIRATORY SYSTEM

ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES

MENTAL AND BEHAVIORAL DISORDERS

NEOPLASMS

PREGNANCY, CHILDBIRTH AND THE PUERPERIUM

Confidential 21

Index = Current Week divided by the 12 Week Rolling Average (from the same time period in 2019)

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• Use of telemedicine has been on the rise since mid-November, corresponding to the spike in COVID-19 cases.

• Neoplasms and disease of the blood currently have the highest relative increase in use of telemedicine.

• All diagnosis groups are down over 50% from their peak in the week of May 1, but still many times their 2019 levels.

• Respiratory, genitourinary and infectious/parasitic diseases initially spiked, but have since returned to pre-COVID levels.

Telemedicine Visits:Diagnosis

• An index of 1 means the current week has the same number of claims as the 12 week rolling average from 2019 (100% of 2019 volume).• An index of 5 means there are 5 times as many claims in the current week as in the 12 week rolling average from 2019 (500% of 2019 volume).• An index of 0.5 means the current week had 50% fewer claims than the 12 week rolling average from 2019 (50% of 2019 volume).

Telemedicine Visits by Diagnosis

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

CERTAIN INFECTIOUS AND PARASITIC DISEASES

DISEASES OF THE BLOOD AND BLOOD-FORMING ORGANS AND CERTAIN DISORDERS INVOLVING THE IMMUNE MECHANISM

DISEASES OF THE CIRCULATORY SYSTEM

DISEASES OF THE DIGESTIVE SYSTEM

DISEASES OF THE GENITOURINARY SYSTEM

DISEASES OF THE NERVOUS SYSTEM

DISEASES OF THE RESPIRATORY SYSTEM

ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES

MENTAL AND BEHAVIORAL DISORDERS

NEOPLASMS

PREGNANCY, CHILDBIRTH AND THE PUERPERIUM

Confidential 22

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• As of the week of December, office visits for all diagnosis groups except nervous system, infection/parasitic diseases, mental/behavioral health and diseases of the respiratory are at or above 2019 levels.

• Visits for pregnancy and childbirth were the least affected diagnosis group.

• Diseases of the respiratory system and mental and behavioral health -which bottomed out during the week of April 17 - have improved but still remain below 2019 levels (down 64% and 32% respectively).

Office Visits:Diagnosis



Office Visits by Diagnosis

Confidential 23

• Since mid-November, there has been a slight uptick in the use of telemedicine for most specialties.

• Use of telemedicine by all specialties remain at least 20 times their 2019 levels.

• Cardiologists remain the highest among specialties tracked for telemedicine usage.

Telemedicine Visits:Specialty


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0

50

100

150

200

250

300

350

400

20

20-0

2-0

7

20

20-0

2-1

4

20

20-0

2-2

1

20

20-0

2-2

8

20

20-0

3-0

6

20

20-0

3-1

3

20

20-0

3-2

0

20

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3-2

7

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3

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0

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7

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4

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8

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5

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9

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2

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6-1

9

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6

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3

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7

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1

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7

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8-1

4

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8-2

1

20

20-0

8-2

8

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20-0

9-0

4

20

20-0

9-1

1

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9-1

8

20

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9-2

5

20

20-1

0-0

2

20

20-1

0-0

9

20

20-1

0-1

6

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3

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20-1

0-3

0

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20-1

1-0

6

20

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0

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7

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1

CARDIOVASCULAR DISEASES

FAMILY GENERAL PRACTICE

GENERAL PREVENTIVE MEDICINE

INTERNAL MEDICINE

NEUROLOGY

NURSE PRACTITIONER

OBSTETRICS AND GYNECOLOGY

ONCOLOGY MEDICAL

PEDIATRICS

PSYCHIATRY

Telemedicine Visits by Specialty

Confidential 24

• Psychiatry office visits remain down by more than 60% and visits to pediatricians are down 35% compared to 2019 levels. Both have shown little or no signs of improvement since August.

• Office visits for all other specialties are at least 85% of 2019 levels while oncology, obstetrics and gynecology, and cardiologists are above 2019 levels.

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Office Visits:Specialty



0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

20

20-0

2-0

7

20

20-0

2-1

4

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1

20

20-0

2-2

82

020

-03

-06

20

20-0

3-1

32

020

-03

-20

20

20-0

3-2

72

020

-04

-03

20

20-0

4-1

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4-1

72

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-04

-24

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1

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52

020

-05

-22

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6

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72

020

-07

-24

20

20-0

7-3

12

020

-08

-07

20

20-0

8-1

4

20

20-0

8-2

1

20

20-0

8-2

82

020

-09

-04

20

20-0

9-1

1

20

20-0

9-1

82

020

-09

-25

20

20-1

0-0

2

20

20-1

0-0

9

20

20-1

0-1

62

020

-10

-23

20

20-1

0-3

02

020

-11

-06

20

20-1

1-1

32

020

-11

-20

20

20-1

1-2

72

020

-12

-04

20

20-1

2-1

1

CARDIOVASCULAR DISEASES

FAMILY GENERAL PRACTICE

GENERAL PREVENTIVE MEDICINE

INTERNAL MEDICINE

NEUROLOGY

NURSE PRACTITIONER

OBSTETRICS AND GYNECOLOGY

ONCOLOGY MEDICAL

PEDIATRICS

PSYCHIATRY

Office Visits by Specialty

25

Visits:Payment Type

• Use of telemedicine for Medicare and Medicaid patients has increased dramatically in recent weeks as the COVID infection rate has spiked, both reaching levels not seen since the height of the initial outbreak in March and April.

• Office visits for Cash patients remain down over 40% from 2019 levels. This may be due, at least in part, to increased unemployment.

• Office visits for non-cash patients have gradually recovered since their lowest point during the week of April 17th, reaching +85% of 2019 levels as of week ending December 11th.

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Telemedicine Visits by

Payment Type

Office Visits by Payment Type



0

10

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2020

-02-

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2020

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06

2020

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13

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20

2020

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27

2020

-04-

03

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10

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-04-

17

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2020

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01

2020

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2020

-06-

05

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2020

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26

2020

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03

2020

-07-

10

2020

-07-

17

2020

-07-

24

2020

-07-

31

2020

-08-

07

2020

-08-

14

2020

-08-

21

2020

-08-

28

2020

-09-

04

2020

-09-

11

2020

-09-

18

2020

-09-

25

2020

-10-

02

2020

-10-

09

2020

-10-

16

2020

-10-

23

2020

-10-

30

2020

-11-

06

2020

-11-

13

2020

-11-

20

2020

-11-

27

2020

-12-

04

2020

-12-

11

Cash Commercial/Third Party Medicaid Medicare

0

0.2

0.4

0.6

0.8

1

1.2

1.4

2020

-02-

07

2020

-02-

14

2020

-02-

21

2020

-02-

28

2020

-03-

06

2020

-03-

13

2020

-03-

20

2020

-03-

27

2020

-04-

03

2020

-04-

10

2020

-04-

17

2020

-04-

24

2020

-05-

01

2020

-05-

08

2020

-05-

15

2020

-05-

22

2020

-05-

29

2020

-06-

05

2020

-06-

12

2020

-06-

19

2020

-06-

26

2020

-07-

03

2020

-07-

10

2020

-07-

17

2020

-07-

24

2020

-07-

31

2020

-08-

07

2020

-08-

14

2020

-08-

21

2020

-08-

28

2020

-09-

04

2020

-09-

11

2020

-09-

18

2020

-09-

25

2020

-10-

02

2020

-10-

09

2020

-10-

16

2020

-10-

23

2020

-10-

30

2020

-11-

06

2020

-11-

13

2020

-11-

20

2020

-11-

27

2020

-12-

04

2020

-12-

11

Cash Commercial/Third Party Medicaid Medicare

Confidential 26

Data Week 50: December 11th, 2020Projected Retail, Unprojected Mail Order, Projected LTC, All Other NRx/TRx Counts

NATIONAL TRENDS: As of week ending 12/11/2020, total prescription volumes remain -7% below prior year trends. The bulk of the decline is driven by fewer new prescriptions through November/December, a stark contrast to the recent upticks in COVID-19 diagnoses.

National TrendsCurrent vs. Prior Year (TRx)

Q3 2020 NRx/TRx % CHANGE COMPARED TO PRIOR YEAR

1st Peak Pandemic Period:

Late March to Early June

Pandemic Resurgence:Late October

To-Date

Confidential 27

NATIONAL TRENDS: Lower retail store activity in particular continues to drive overall national trends as we near the end of 2020.

Data Week 50: December 11th, 2020Projected Retail TRx CountsUnprojected Mail Order TRx Counts

Mail Order Weekly TRxRetail Weekly TRx

March 20th: Peak Week of

COVID-19 Response

Confidential 28

-8% below prior year





ELECTIVE THERAPIES: All elective therapy trends are reporting -1% down from the previous insights report. Overall growth in elective therapy markets have been stagnant through-out the pandemic.

Data Week 50: December 11th, 2020Projected Retail, Unprojected Mail Order, Projected LTC, All Other TRx Counts

COVID-19 Weekly Trend Insights

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