Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need.

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1 Thank you for downloading this patient assistance document from NeedyMeds. We hope this program will help you get the medicine you need. Did you know that NeedyMeds has thousands of other free resources? Here s a look at more ways we can help you save money on medicine and healthcare costs. Each one can be found under the Patient Savings tab on our website: Diagnosis-Based Assistance NeedyMeds lists thousands of assistance programs for almost any health condition. If you are going through chemo treatment for cancer, there are programs that can help with wig costs and scalp-cooling products. We also list resources for free diabetes testing supplies, caregiver lodging support, and much more. Free, Low Cost, and Sliding Scale Clinics This popular collection contains information on 16,000+ free, low cost, and sliding scale medical and dental clinics across the U.S. It s a great resource if you need affordable medical treatment and don t know where to go. Coupons, Rebates & More You can use the NeedyMeds website to find nearly 2,000 cost-saving opportunities for both prescription and over-the-counter drugs and medical supplies. Medical Transportation Need help getting to the doctor s office or medical facility? You may be eligible for financial assistance if you meet certain requirements. NeedyMeds also offers information on diagnosis-based camps and retreats, recreational programs, scholarships, government programs, $4 generic drug programs, and more. Finally, I want to tell you about the NeedyMeds Drug Discount Card. Thousands of people use this free, anonymous, and easy-to-use tool to get the best price on their medications. To date, our drug discount card has saved patients over $244,000,000. Check out the next page to learn more. Feel free to call our toll-free helpline if you have any questions. You can reach us at Monday-Friday, 9am-5pm Eastern Time. Thanks for using NeedyMeds! Please let us know if we can do anything else to help you afford the costs of your healthcare. Rich Sagall, MD President, NeedyMeds

2 Clip the card and save NeedyMeds NeedyMeds.org DRUG DISCOUNT CARD BIN: RX PCN: NMEDS RX GRP: PDFPDF ID: NMNA This is a drug discount program, not an insurance plan. NeedyMeds Drug Discount Card Patient: Simply present this card to a participating pharmacy to receive a discount on your prescription. Patients who have Medicare, including Part D, Medicaid or any state or federal prescription insurance can only use this card if they choose not to use their government-sponsored drug plan for their purchase. The card is not valid in combination with those programs. For questions concerning the card, call or visit Pharmacist: Card must be presented to receive program benefits. Clear system of prior cardholder information associated with this universal cardholder ID. For processing questions, call Argus Health Systems at Save up to 80% Use at over 65,000 pharmacies nationwide including all major chains Share the card with friends and family Use the card as often as needed Free, no fees or registration Never expires What if I have insurance? Anyone can use the card, but it can t be combined with insurance. You can use the card instead of insurance if: A drug isn t covered by your insurance Your insurance has no drug coverage You have a high drug deductible You have met a low medicine cap The card offers a better price than your copay You are in the Medicare Part D donut hole What drugs are covered? The card is good for prescription drugs, over-the-counter medicines and medical supplies if written on a prescription blank, and pet prescription medicines purchased at a pharmacy. You ll save on most, but not all, prescriptions. To obtain a plastic drug discount card, send a self-addressed stamped envelope to: NeedyMeds-PAP PO Box 219 Gloucester, MA The card is not valid in combination with other insurance plans, including Medicare, Medicaid or any state or federal prescription insurance. The card can be used only if you decide not to use your government-sponsored drug plan for your purchases.

3 ORAL LIQUID For relief of pain due to oral mucositis Information for patients

4 episil oral liquid Starts working within 5 minutes 1,2 Long-lasting effect, for up to 8 hours 1 Ready-to-use, pocket-sized device 3 Won t make your mouth feel numb 3 No mixing, gargling or rinsing required 3 Can eat within minutes 1 What is oral mucositis? Oral mucositis is an inflammatory condition in the mouth. It is a frequent side effect of chemo- and radiotherapy. The condition causes redness, mouth sores and ulcers that can be very painful, making it difficult to eat, drink and speak. What is episil oral liquid? episil oral liquid is used for the relief of oral pain associated with oral mucositis and other treatment-related oral lesions. When applied in the mouth, episil oral liquid forms a bioadhesive film that protects and soothes oral lesions, thereby providing fast-acting and significant oral pain relief that starts working within 5 minutes and lasts for up to 8 hours. Content Glycerol dioleate, Phosphatidylcholine (soy lecithin), Ethanol, Propylene glycol, Polysorbate 80 and Peppermint oil You should not use this product if you are allergic to any of its components. Dosage 1-3 pump strokes, 2-3 times per day or as needed Storage Keep out of reach and sight of small children Store in the original packaging at room temperature

5 How and when to use episil oral liquid Use episil oral liquid for fast-acting and effective pain relief of oral mucositis. Remove the protective cap from the metering pump. Prior to the first use, prime the pump mechanism by firmly pumping into a tissue until an even stream of liquid is delivered. Firmly press the pump and apply the liquid stream to the oral cavity 1-3 times. Distribute to affected areas in the mouth and wait a few minutes for the liquid to gel and protective film to form. Repeat the treatment 2-3 times a day, or as needed. episil oral liquid can also be applied prior to eating. episil oral liquid is intended for continuous use up to 30 days. Possible side effects episil oral liquid had no reported side effects in clinical studies. However, episil oral liquid contains small amounts of ethanol (alcohol), which may cause a short, temporary burning sensation when applied to affected areas in the mouth. If you notice any side effects of episil oral liquid, discontinue the treatment and contact your doctor. For more information about episil oral liquid, please see the accompanying package insert. References 1. Hadjieva, T., Cavallin-Ståhl, E., Linden, M. and Tiberg, F. (2014) Treatment of oral mucositis pain following radiation therapy for head-and-neck cancer using a bioadhesive barrier-forming lipid solution. Support Care Cancer, 22(6): Seidenspinner, I., Adamietz, I. A., Strohm, G. L. and Tiberg, T. (2015) Effects of episil oral liquid in cancer patients with oral mucositis: an observational study. Poster presented at MASCC, R-Pharm US. episil package leaflet (2016). Please see accompanying full Prescribing Information.

6 ORAL LIQUID episil Direct program R-Pharm US, the distributor of episil oral liquid, has partnered with Cardinal Health Specialty Pharmacy to create the episil Direct pharmacy program. Support for patients Home delivery of episil oral liquid Education and instructions for use Patient outreach to confirm receipt Co-pay program automatically applied by episil Direct Patients with commercial insurance will pay a maximum of $40 per prescription For patients who are uninsured or whose insurance does not cover episil oral liquid, patient assistance is available Support for healthcare providers Payer claim adjudication Registered pharmacist available for 24-hour pharmacy support episil Direct ordering episil oral liquid prescriptions received by 1:00 PM ET (with no additional information needed) will be processed and shipped the same day If additional insurance information is required, a Cardinal Health Specialty Pharmacy licensed pharmacy technician will: Collect the additional information Follow up with your office and the patient as needed for approval Notify the patient and deliver episil oral liquid directly to the patient s home within 24 hours of approval Call and a licensed pharmacy technician will collect the necessary patient information. Fax a prescription on the customized episil Direct order form to Select Cardinal Health Specialty Pharmacy in your escribe system, and send electronically. If you need help locating Cardinal Health Specialty Pharmacy, please contact your system administrator. episil Direct support line Questions regarding an episil oral liquid prescription The episil Direct support line is available to healthcare providers and patients: Call Monday-Friday 8:00 AM to 8:00 PM ET Registered pharmacist available for 24-hour pharmacy support For general inquiries, please InfoCHSPRx@cardinalhealth.com Please see accompanying full Prescribing Information. 2016, R-PHARM US. All rights reserved. EPI e 09/16

7 ORAL LIQUID Package leaflet: Information for the user Read this entire leaflet carefully because it contains important information for you. You should use episil carefully and according to instructions given to obtain the best results. Keep this leaflet. You may need to read it again. Contact your doctor or pharmacist if you need more information or advice. If you notice any side effect not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. Description 2. Indications for use 3. Contraindications 4. Precautions 5. How to use episil 6. Adverse reactions 7. How to store episil 8. Further Information/How Supplied Description episil is a lipid based oral liquid in a multi-dose container. episil gives relief of pain via mechanical action by a protective film that forms in the oral cavity and adheres to the oral mucosa. Indications for use episil has a mechanical action indicated for the management of pain and relief of pain, by adhering to the mucosal surface of the mouth, soothing oral lesions of various etiologies, including Oral Mucositis/Stomatitis (may be caused by chemo therapy or radio therapy). Contraindications Do not use episil if you are: allergic (hypersensitive) to any of the ingredients, to peanuts or soya, to peppermint oil. Precautions episil contains a small amount of ethanol (alcohol), less than 100 mg per dose, which may cause a burning sensation when applied to sore mucosal surfaces. episil contains a small amount of ethanol (alcohol); if you should by accident swallow the whole content of a bottle you may be affected. episil contains propylene glycol which may cause skin irritation and peppermint oil which may cause allergic reaction. How to use episil Instructions for use: Remove the protective cap from the metering pump. Prime the pump mechanism prior to the first dose by pumping into a paper cloth until an even liquid stream occurs. Firmly press the pump and apply the liquid stream to the oral cavity 1-3 times. Distribute to affected areas in the mouth and wait a few minutes for the liquid to gel and protective film to form. episil is intended for use in the oral cavity as far as the pharynx. Do not swallow. Dosing: Firmly press the pump and apply the stream to the oral cavity 1-3 times. Use 2-3 times per day or as needed. Duration of treatment: episil is normally intended for continuous use for not more than 30 days. Adverse reactions None known. How to store episil Keep out of the reach and sight of children. Do not use after the expiry date which is stated on the bottle after abbreviation Exp. Use within one month of first use. Each bottle should be used by one person only. Store the bottle in the outer carton and at room temperature. Further information/how supplied Content: Glycerol dioleate, soy phosphatidylcholine (lecithin), ethanol, propylene glycol, polysorbate 80, peppermint oil. Each amber glass bottle contains 10 ml of episil and provides 65 applications. Caution: Federal law restricts this device to sale by or on the order of a physician. For additional information about episil : Visit: episilusa.com Contact: CA This leaflet was last updated: May 2016 Manufacturer: Camurus AB, Sölvegatan 41 A, Lund, Sweden RX Only Distributed by: R-Pharm US LLC, Princeton, NJ USA