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May 10, 2017

P.O. Box 10841


Eugene, OR 97440 David Kopp
(541) 257-8878
CEO, Healthline Media
charles.fournier@t1df.org
www.t1df.org 600 Third Street
San Francisco, CA 94107
Attachments:
[dropbox link deleted]

Dear Mr. Kopp,

I write in response to a story published on Healthline Medias DiabetesMine blog on February


23, 2017: Insulin Price-Fixing Lawsuits and How Diabetes Advocates Are Involved, by Mike
Hoskins, available at http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits. A
section of this article discusses my organization, the Type 1 Diabetes Defense Foundation
(T1DF), a diabetes-focused legal rights and and consumer advocacy nonprofit.

I ask Healthline Media to:

(1) direct DiabetesMines editor to correct the numerous misleading statements,


omissions, and disparaging assertions made by Mr. Hoskins in this article and
subsequent update: to remove its characterization of our organization as an obscure
Twitter troll; to reflect the abundant corporate and social media information that was
publicly available to Mr. Hoskins at the time of publication; to credit to T1DF the
information regarding the PBM/ERISA cases that we had posted on Twitter and shared
with him in our extended email exchange; to note, at a minimum, the professional
qualification(s) of which Mr. Hoskins was aware at the time of writing via our email
exchanges and could easily have verified via public resources (LinkedIn); to remove the
articles suggestion that T1DFs officers had no connection to diabetes; and to identify
T1DFs relationship to the March 17, 2017, lawsuit Boss v. CVS et al, either by updating
the body of the article or by correcting the misleading update that currently attributes
the lawsuit to another organization;

Page 1 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
(2) direct Healthline Media to make same-page disclosure on DiabetesMine of its
editors commercial/consulting relationships (including, but not limited to, financial
relationships with Defendants Sanofi and NovoNordisk, and with Avalere Health,
consultant to Defendant Eli Lilly) in connection with any reporting on insulin pricing, the
insulin price litigation, and/or T1DF;

(3) direct Healthline Media to make same-page disclosure on DiabetesMine of


Healthline Media and Healthline Networks insurance/TPP business interests in
connection with any reporting on insulin pricing, the insulin price litigation, and/or
T1DF; and

(4) disclose, both on the general Healthline Media pages and its DiabetesMine blog, in
what specific respects, if any, DiabetesMine is exempt from Healthline Medias stringent
criteria for providing accurate, authoritative and unbiased content and, consequently,
in what specific respects the representation that [a]ll of Healthline Medias digital
properties meet the companys stringent criteria for providing accurate, authoritative
and unbiased content is inaccurate.

SUMMARY

The web of half-truths and misrepresentations crafted by DiabetesMines reporter, Mike


Hoskins, collectively tends to discredit our organization and its officers in the eyes of
DiabetesMine and Healthline Medias site users, undermining our organizations brand and
thus interfering with our efforts to gain community support or plaintiff involvement for our
impact litigation, to raise funds from the general public according to the usual practice of
501(c)(3) charities, and to engage other members of the diabetes community as directors or
advisors.

Mr. Hoskins used his February 23 article to present T1DF as a recently created Twitter troll
with no prior or otherwise verifiable existence. He described T1DF as an obscure group with
a dubious, undisclosed agenda. He reinforced this inaccurate and demeaning description by
further misreportingboth in his article and via the DiabetesMine Twitter accountthat T1DFs
officers had refused to answer any of his questions and suggesting that we could be running
a fundraising scam. He attacked our personal and professional standing by comparing T1DF

Page 2 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
to a husband and wife team of ambulance chasers with a questionable connection, if any, to
type 1 diabetes.

Even after T1DF and its president, Julia Boss, filed Boss v. CVS et al on March 17, 2017,
DiabetesMine left the original piece uncorrected, adding an update that misnamed the
organization responsible for the filing and failed to note that the lead plaintiff in the Boss case
is the same person Mr. Hoskinss uncorrected piece still invites readers to believe has no
connection to diabetes.

T1DF is not a newly established Twitter troll with questionable fundraising intentions. It is a
small 501(c)(3) public benefit nonprofit, initially founded in Washington State in 2015 as a
501(c)(4) and currently incorporated in Oregon, that openly tracks many of its activities, policy
goals, and motivations on public Twitter and Facebook accounts. Our website is scant
because we are not industry funded, but we are now legally registered or otherwise
authorized to fundraise in 32 states (with 4 additional registrations pending). T1DFs officers
exchanged 12 emails with Mr. Hoskins in which we openly discussed the organizations
history, our opinions regarding the insulin pricing lawsuit, and our broader advocacy agenda,
and we offered a Q&A format interview that DiabetesMine declined. We are professionals
with relevant experience in litigation support and lobbying. And we do have an obvious
personal connection to T1D. Most, if not all, of this information is publicly available on our
website and Twitter, Facebook and LinkedIn corporate pages and personal accounts.

The misrepresentations, half-truths and omissions of Mr. Hoskinss article and tweets might be
comparatively inconsequential had he presented them on a personal platform. But
DiabetesMine is not a personal blog; it is a digital property of Healthline Media. The broad
publication of Mr. Hoskinss misrepresentations on the online communication platform of
Healthline Media, a wholly owned subsidiary of Healthline Networks, has magnified the injury
caused to T1DF and to us personally. Healthline Media reports itself to be the second largest
health media network on the web, with over 65 million unique monthly visitors. Healthline
Media markets itself as a trusted provider of accurate, authoritative and unbiased content to
loyal medical information seekers. The stature and reputation of Healthline Media (and
DiabetesMine in the diabetes community) as a source of unbiased and trustworthy news
lends authority to Mr. Hoskinss misrepresentations and thus aggravates our injuries.

Page 3 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
Mr. Hoskinss injury to T1DFs reputation and integrity has been enabled by Healthline Medias
own half-truths, omissions and misrepresentations. Healthline Media misleads its readers via
public statements that all its media assets abide by a code of editorial integrity. Healthline
Media also failed to disclose patent conflicts of interest that would undermine, in the eyes of
its readers, its claim of editorial objectivity. DiabetesMine is a digital property of Healthline
Media, a wholly owned subsidiary of Healthline Networks. Healthline Networks owns Talix,
Inc., which offers IT services, including value pricing services, exclusively to insurance
company clients. We also note that two insurance companies provided early stage VC
funding to the Healthline group of companies.

Healthline Media claims in its marketing to industry clients that [a]ll of Healthline Medias
digital properties meet the companys stringent criteria for providing accurate, authoritative
and unbiased content. As stated above, DiabetesMines content relating to the Type 1
Diabetes Defense Foundation is not accurate. There is also cause to believe that Healthline
Media may be unable to report without bias regarding T1DFs advocacy against
manufacturers and insurers efforts to move to value-based pricing; T1DFs advocacy against
manufacturer and insurer participation in the current rebate sharing scheme alleged in our
lawsuit; and T1DFs advocacy in support of insulin net pricing disclosure. The extensive
network of commercial and financial relationships existing between the Healthline Networks
group and insurance companies such as Aetna, Kaiser Permanente and UnitedHealth, among
others, may preclude objective reporting on these topics by Healthline writers, including
those writing for DiabetesMine. There is further cause to believe that DiabetesMine cannot be
unbiased in relation to T1DF, given its editors direct commercial relationships to defendants
in a lawsuit in which T1DF and its president are named plaintiffs.

To uphold its own claims of editorial independence and objectivity, Healthline Media should
fully disclose the extent of Healthline Networks commercial relationships with third-party
payers (TPPs) in connection with any reporting that touches on PBMs and their insurance
company clients, including any future article that discusses insulin pricing and/or the insulin
legal actions. Additionally, Healthline Media should publicly clarify whether it is in fact
Healthline Media policy to exempt DiabetesMine from Healthline Media's editorial
guidelines, including from Healthline Medias commitment to accurate, authoritative and
unbiased contentand should thus clarify whether Healthline Media condones the

Page 4 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
publication of inaccurate and biased content exemplified by Mr. Hoskinss reporting on the
Type 1 Diabetes Defense Foundation.

FACTS

T1DF is a diabetes legal rights and and consumer advocacy non-profit, tax exempt under IRC
section 501(c)(3), founded in 2015 and now based in Oregon. Our Oregon registration
number is 1277418-90. Our EIN is 61-1811400. Trademark application is pending. Our
website is www.t1df.org (static page, under construction). We have maintained a Facebook
page (https://www.facebook.com/T1DefenseFoundation/) and tweeted on @t1df_advocacy
since October 2015. Our website links to both our Facebook page and Twitter account. Our
Twitter and FB posts describe some our organizations endeavors over the past two yearsa
campaign for K-12 school access and rights-based emergency care in Washington Sate (the
Office of Civil Rights of the U.S. Department of Justice initiated an extended investigation
based on our 2015 complaint); several public records requests related to emergency
glucagon filed with the Office of the Attorney General and other public entities in Washington
State; a December 2015 intervention with the Washington State Nursing Commission
Consistent Standards of Practice committee, requesting a new advisory opinion on school
emergency care (Glucagon administration). In addition to our corporate website, Twitter, and
Facebook pages, we have maintained a LinkedIn page for T1DF, and T1DFs officers maintain
detailed LinkedIn profiles that document our professional endeavors, experience and
qualifications. The amount of information readily available online is substantial.

On February 8, 2017, DiabetesMine managing editor Mike Hoskins reached out to T1DF,
stating that he wanted to find out more about the T1 Diabetes Defense Fund and your own
personal diabetes story, as well as your thoughts on this pending suit in the NJ District. We
offered to do a Q&A, as we were then raising questions about a recently filed insulin price
lawsuit that we feared might not be in the best interest of the class andunbeknownst to Mr.
Hoskinswe were preparing to file an insulin class action lawsuit ourselves. We did not want
to be misquoted or inadvertently reveal our intentions until after the filing had been
completed. We did not expect format to be an issueDiabetesMine routinely publishes free-
standing Q&A pieces. We exchanged about 12 emails with Mr. Hoskins between February 8
and February 14, 2017. T1DF answered some of his substantive questions regarding the
history of our organization and our views on the insulin action in the course of these emails.

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The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
Mr. Hoskins declined the Q&A interview, then narrowed his questions to repeatedly, and fairly
aggressively, asking for our personal diabetes story. We specifically stated that our
reservations about an unrestricted interview were related to our legal advocacy work and
made it clear that our reluctance to share personal details was related to protecting the
privacy of a minor child. While still communicating with us by email, Mr. Hoskins indirectly
referred to us on his personal Twitter account as ambulance chasersusing our #InsulinAction
hashtag to ensure the wider diabetes advocate community would see his tweet. At that point,
we stated our wish to postpone any DiabetesMine interview to a future date. The complete
exchange is attached to this letter.1

On February 23 Mr. Hoskins published his piece, which described T1DF as a relatively new,
obscure group that had emerged on Twitteran implied comparison to an anonymous
spring-up Twitter bot or troll account. Instead of using our emails and our public Twitter and
Facebook accounts to inform himself and his readers about our advocacy activities (and to
observe that those activities had begun in 2015), he focused solely on our decision to decline
to share any personal details and concluded by questioning our personal connection to
[type 1 diabetes]. Mr. Hoskins did not, in his article, clarify that we had had a substantive
written exchange with him regarding the insulin pricing lawsuit, our advocacy goals and
motivations; nor did his article mention that DiabetesMine refused our offer to interview in
the Q&A format we suggested. Mr. Hoskins was aware that we had raised questions on Twitter
about the potential connection between the insulin pricing issue and ongoing PBM/co-pay
clawback/insurance casesand we had discussed these issues in our substantive emails to
himbut his article used our opinions and cited the clawback cases without attribution to
T1DF. Mr. Hoskins was aware that I have a law degree (J.D.), but he did not mention this
obviously relevant qualification in his article, choosing instead to portray T1DF on narrowly
personal terms as a husband-wife team while attacking my professional credentials on his
personal Twitter account.

1DiabetesMines managing editor reached out to us for the purpose of conducting an interview and learning
more about our organization. We did not respond to his questions on on off-the-record basis. Mr. Hoskins could
have used this material as the basis of his article but decided otherwise. Mr. Hoskins should not have any
expectation of privacy; we reserve our right to publish this email exchange in its entirety to rebut the
misrepresentations included in his Healthline Media article.

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The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
On March 17, the Type 1 Diabetes Defense Foundation and its president Julia Boss filed as
plaintiffs in a new insulin class action, Boss v. CVS et al, which named PBMs as defendants,
alleging their participation in an insulin pricing scheme as agents for insurer co-conspirators
(manufacturers were also named as defendants). On March 30, T1DF issued a 4-page press
release that provided further explanation regarding our goals as well as the distinctive
features of our action.

DiabetesMine updated its article with the following post:

** UPDATE: On March 17, a new federal class-action lawsuit was filed in New Jersey
on behalf of the T1D Foundation [sic], accusing the Big Three Insulin Manufacturers as
well as PBMs of artificially inflating the price of insulin.

DiabetesMine made no attempt to contact us for correction or comment after we filed the
lawsuit, nor after reading our press release. (Mr. Hoskins tweeted on the DiabetesMine
account that he had read both the press release and the 300-page complaint: https://
twitter.com/DiabetesMine/status/848337904531361792.) Although the filing of Boss v. CVS
et al clearly establishes our personal connection to T1D, DiabetesMine did not remove or
correct the misleading statements included in the original article. The update misnames our
organization and does not cite the lawsuit by namethus sustaining the original articles
suggestion that T1DFs officers have no connection with diabetes. DiabetesMine authors
continue to link to the uncorrected article, most recently in April 26 coverage of the Lilly
Insulin Access summit: http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-
workshop-2017.

Meanwhile, T1DFs legal action has begun to have a significant social impact, having recently
been publicly credited with inspiring the Washington State Attorney Generals investigation
of Eli Lilly.

MISREPRESENTATIONS/OMISSIONS/FALSEHOODS

DiabetesMine ignored publicly available information; inappropriately described T1DF as


obscure and implied that the organization had emerged on Twitter in response to the

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The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
insulin lawsuit filed in January 2017; inaccurately reported that T1DF had refused an
interview; implied that T1DFs scant website is the only public-facing media platform from
which Mr. Hoskins or members of the general public could inform themselves about our
organization; dismissed T1DF as a husband-wife team while failing to note relevant
professional qualifications and describing us as ambulance chasers; attributed the March 17
insulin pricing lawsuit to an organization called the T1D Foundation rather than
acknowledging it was fact in filed, on the behalf of the Type 1 Diabetes Defense Foundation,
by the class action firm Keller Rohrback (known for its commitment to public interest impact
litigation), with one of T1DFs officers as lead plaintiff. Mr. Hoskins implied, on his personal
and DiabetesMine Twitter accounts, that T1DF was attempting to profit from insulin users
hardship and that our fundraising efforts were suspect. Both the original article and the later
update published half-truths and inaccuracies collectively tending to discredit our
organization and its officers.

T1DF is not a new group that emerged on Twitter in early 2017

DM representation: A relatively new, obscure group called the Type 1 Diabetes Defense
Foundation has emerged on Twitter . . .

Factual response: T1DF was founded in 2015 and has been active on Twitter and Facebook
since its founding date.

We informed Mr. Hoskins when he first contacted us that we were founded in 2015. On
February 9, Julia Boss wrote to Mr. Hoskins that T1DF was founded in 2015: We initially
incorporated in Washington State in 2015 as the Type 1 Diabetes Defense Fund (a 501(c)(4)
public welfare organization). We reincorporated in Oregon at the end of 2016 as the Type 1
Diabetes Defense Foundation and have applied for 501(c)(3) status. We have received no
support, financial or otherwise, from any industry group. We are acting independently and to
date we are self-funded.

Mr. Hoskins could easily have confirmed most of this information via our corporate
registrations in Washington and Oregon. Our Facebook and Twitter accounts also date to

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The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
October 2015, and a quick scan of those accounts would confirm our activities from late 2015
forward.

Injury: The phrase emerged on Twitter implicitly compares T1DF to a Twitter bot or troll
account newly created for the sole purpose of shaping public opinion on hot-button topics.
The comparison would suggest to most readers a hidden, and likely dubious or manipulative,
agenda (especially when paired with the adjective obscuresee below). The
characterization is, in effect, a warning against T1DF rather than an illustration of Healthline
Medias marketing values, i.e. its commitment to accurate, authoritative and unbiased
content.

T1DF is not an obscure group that hides its agenda

DM representation: A relatively new, obscure group . . . with a scant webpage.


DiabetesMines ad hominem attack here may be partly in retaliation for our reluctance to
share the personal diabetes story Mr. Hoskins sought or to agree unconditionally to an
interview with him.

Factual response: T1DF is a registered public benefit corporation with public-facing media
platforms consistent with our size and resources. Our agenda is openly stated and
transparent.

Obscure is a charged descriptor suggesting a level of malevolence and deceptionand it was


interpreted by DiabetesMine readers as such. Merriam-Webster indicates the term obscure
implies a hiding or veiling of meaning through some inadequacy of expression or
withholding of full knowledge. Googles related searches for obscure organization include
strange clubs and societies, funny organizations, and weird groups to join.

When questioned by a reader on Twitter regarding the deprecating connotation of obscure,


Mr. Hoskins reiterated his characterization and raised further concerns regarding the motives
of our organizations fundraising drivean indirect reference to a fundraising tweet we posted
on February 23, 2017. https://twitter.com/DiabetesMine/status/834802505238323200.
T1DFs president, Julia Boss, intervened to point out some context regarding Mr. Hoskinss

Page 9 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
prior contacts with usspecifically, the openly adversarial and biased ambulance chaser
tweetagain, a direct attack on the professional endeavors and motivations of T1DF officers.
Mr. Hoskins responded that he would let [the] story speak for itself. https://twitter.com/
juliaboss5/status/834824365359271937

Mr. Hoskinss article implies that, in the absence of an interview, a trained journalist had no
means of discovering any information about T1DFs backstory and agenda. On the contrary:

Mr. Hoskins could easily have reported the corporate history we shared with him or accessed
our corporate records in Washington State (prior) or Oregon (current) to learn more about
T1DFs goals and commitments as stated in our articles of incorporation and bylaws. Our
officers are clearly identified in publicly available registration documents and readily
reachable via open Twitter DM, the contact email published on our website, and LinkedIn.
Those officers provide full resumes on public LinkedIn profiles. We responded to Mr.
Hoskinss inquiries with a substantive discussion of our organizations corporate history,
current priorities, and advocacy goals. We did not state that our emails were off the record,
and much of what we communicated to him in those emails he would have been able to
verify easily from public sources.

T1DF has only a static webpage (under construction, pending fundraising). Even from that
page Mr. Hoskins would have learned about our agenda (We believe in a world where
people with type 1 diabetes have full access to education, employment, and health care) and
our involvement with K-12 school access issues. It is not unusual for a small nonprofit that
does not accept industry funding to have a fairly spare website. That is not, however, the only
public-facing media platform from which Mr. Hoskins or members of the general public could
inform themselves about our organization. DiabetesMine was well aware that T1DF is active
on Twitter, and our web page links to our Facebook account. Mr. Hoskins would easily have
been able to determine from scrolling through these accounts that we use them to openly
discuss our advocacy goals and the motivations behind our workor that he could direct his
readers to those accounts for further information about T1DFs priorities. We have, on those
media platforms, messaged consistently and transparently about specific goals and activities:

T1DF campaigned for T1D accommodation in neighborhood public schools and all
district programs (e.g. TAG/gifted, Montessori, language-immersion) as a matter of

Page 10 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
right; K-12 school access to emergency glucagon as a matter of right, including training
and mandating non-nursing staff to deliver glucagon in a life-threatening emergency on
existing Epi-Pen legal frameworks;

T1DF advocates for net price transparency for insulin and exposure of the current
manufacturer/PBM/insurer insulin pricing scheme alleged in our lawsuit; we support
cost-plus insulin pricing models; we oppose value-pricing models for insulin. T1DF is, if
anything, more transparent regarding its specific advocacy goals than many larger
diabetes organizations with far greater resources (ADA, DPAC, NDVLC), who often ask
community members to trust them to resolve problems in closed-door meetings with
industry actors, and do not communicate publicly the specific changes or solutions they
support.

We were active complainants in an extended USDOJ investigation regarding school


accommodation, including refusal of emergency hypoglycemia care, in Washington
State over 18 months during 2015 and 2016; this investigation is, to our knowledge,
ongoing, though we are no longer directly involved. Assistant U.S. Attorney Kayla
Stahman praised our efforts in the following terms: Your willingness to step forward
initiated important developments for the rights of students with diabetes in our
community.

T1DF extensively investigated and documented transfer-or-waive policies employed


by some large Seattle-area public school districts to concentrate students with T1D into
a handful of schools with full-time nurses, and during 2015 and 2016 we helped some
affected families contact the USDOJ investigating attorney.

T1DF campaigned for rights-based school emergency glucagon access, including


submission of a formal request to the Washington State Nursing Commission Consistent
Standards of Practice committee in late November 2015 for a new advisory opinion on
school emergency care (Glucagon administration).

In a more formal Q&A interview context, we would have been happy to discuss other
advocacy efforts, including:

Page 11 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
An extended public document request effort (ongoing) in Washington State regarding
the school glucagon access issue, embracing Seattle Childrens Hospital, the University
of Washington (JV with SCH), Washington State Office of the Attorney General,
Washingtons Office of the Superintendent of Public Instruction, and other entities.

Our efforts to develop a class action lawsuit on a school-related T1D civil rights issue,
which we brought to Hagens Berman in fall 2015. (Hagens Berman decided not to
pursue this claim, but civil rights impact litigation remains a priority for T1DF.)

Injury: The DiabetesMine article strongly implies that T1DF is operating with a hidden
agenda. This misrepresentation interferes with our ability to gain public support for our
advocacy efforts, to sustain and expand those efforts through fundraising, and to interest
members of the diabetes community in joining as plaintiffs in T1DF legal action(s).

Healthline Media states that it prides itself on providing empathy-minded content as strategy
to earning consumer trust. Obviously, Healthline Media did not write this piece to earn our
trust and loyalty, or to provide accurate and unbiased information about T1DF that readers
could use to make their own decisions. Mr. Hoskins could not have chosen a better word than
obscure to sow suspicion regarding T1DF and to message to the larger community that we
are a questionable, shadowy entity from whom they should withhold support.

T1DF is not a fundraising scam and its fundraising activities comply with state laws

DM/Mike Hoskins: While Mr. Hoskins did not directly state in his article that readers should
not offer financial support to our organization, he tweeted from the DiabetesMine account
suggesting that our fundraising efforts should be met with suspicion.

Factual response: The Type 1 Diabetes Defense Foundation is fully registered as a public
benefit nonprofit corporation in the State of Oregon with tax exempt status under IRC 501(c)
(3) with an effective date of December 23, 2016. We were formerly registered in Washington
State, from late 2015 until late 2016, as the Type 1 Diabetes Defense Fund, a tax exempt
nonprofit under IRC 501(c)(4).

Page 12 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
T1DF is registered to accept donations in 5 states (Arkansas, Florida, North Carolina, Oregon,
Washington) with other registrations pending (including California, New York, and Ohio). We
have prioritized registrations in states where we have an existing Twitter following. We are
also currently eligible for passive fundraising via small-budget charity waiver or exemption, or
Charleston Principle, in 27 states: Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii,
Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Missouri,
Montana, Nebraska, New Jersey, New Mexico, Pennsylvania, South Dakota, Tennessee, Texas,
Vermont, West Virginia, Wisconsin, and Wyoming.

Our articles of incorporation and bylaws preclude donations from insurers, PBMs,
pharmaceutical and tech companies, or other healthcare industry actors.

Injury: We informed Mr. Hoskins in our emails that we were self-funded as of early 2017 and
did not accept industry funding, but that we hoped to begin crowdfunding efforts soon. This
is the effort that Mr. Hoskinss misleading reporting on T1DF (new, obscure, emerging on
Twitter, refused to disclose personal details), coupled with his DM tweets, undermines. Mr.
Hoskins de facto messaged to Healthline Media readers that T1DF is operating, and
fundraising, on false pretensesalmost to the point of suggesting that we are running a
fundraising scam.

T1DF founders arent just husband and wife; they certainly arent ambulance chasers

DM: T1DF is a husband-wife team with no relevant professional qualifications; Mr. Hoskinss
Twitter followers should suspect us of ambulance chasing.

Factual response: Although I do not practice law, I have a law degree (J.D.) from The George
Washington University Law School and a French engineering degree. T1DFs president, Julia
Boss, has professional experience in education, publishing, and grant-writing and is the lead
plaintiff in Boss v. CVS Health et al.

Instead of directly reporting on our professional credentials, Mr. Hoskins indirectly described
us as ambulance chasers, a charged professional slur used to describe a lawyer who seeks
to profit from someone elses injury. Mr. Hoskinss deliberately used the term ambulance

Page 13 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
chasing on his personal Twitter to question T1DFs motivesbut then failed to note Charles
Fourniers actual professional qualification in his reporting, where he led DiabetesMine
readers to believe T1DFs officers approached the insulin pricing lawsuit solely as obscure
amateurs who could not be expected to speak from any particular expertise or knowledge.
Mr. Hoskins used our #InsulinAction hashtag to ensure the wider diabetes advocate
community would see his tweet in connection to his DiabetesMine piece, in which he failed to
include any representation of our professional qualifications.

A law degree is an obviously relevant professional qualification for an officer of a legal


advocacy organization. See LinkedIn profile: https://www.linkedin.com/in/charlesfournier/
The several emails I exchanged with Mr. Hoskins all clearly indicate this professional
qualification in the signature block. I also clearly stated in an email of February 14 to Mr.
Hoskins that I have a law degree, though I also clarified in that email that I am not a practicing
attorney. Mr. Hoskins, while pressing us for personal details, failed to report on professional
qualifications directly relevant to T1DFs stated purpose.

Julias professional resume is also publicly available on LinkedIn: https://www.linkedin.com/


in/juliaboss/. She is a published academic with graduate and undergraduate degrees from
Yale. She has been personally active on Twitter since February 2015 on matters of interest to
the broader disability rights and diabetes communities (and had exchanged a couple of
tweets on insulin pricing with Mr. Hoskins via his personal Twitter account prior to February
2017). If Mr. Hoskins was not aware of Julia Bosss professional qualifications, it is only
because he made no effort to find them. There is only one Julia Boss on Twitter talking about
diabetes; she has a writer and historian profile and a clear statement also tweeting at
@T1DF_advocacy. There are only a handful of Julia Boss profiles on LinkedIn, one of whom is
a writer and historian living in Eugene, Oregon, and president of T1DF.

Mr. Hoskins was, however, able to infer from our public profiles and communications that
T1DFs officers were married to each other, a personal fact that we did not specifically
disclose to him and for which he did not seek confirmation from us.

Injury:
The omission of my professional credential is material to Mr. Hoskinss overall effort to
discredit T1DF, as a legal advocacy organization in which no officer has a legal education

Page 14 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
would be presumed to speak with reduced, if any, authority, if compared to a similar
organization run by a graduate of a well regarded U.S. law school. Instead of reporting on our
relevant professional qualifications, Mr. Hoskins chose to indirectly undermine them by using
a professional slur on his personal Twitter feed.

DiabetesMine knew in preparing its article update that Julia Boss of T1DF was lead plaintiff in
Boss v. CVS Health. Having publicly suggested that T1DFs officers were ambulance chasers
with no personal connection to the issue, DiabetesMine was remiss in its journalistic
responsibility by failing to correct the record in its update.

T1DFs founders do have a connection with type 1 diabetesalthough T1DF is not narrowly
defined by that connection

DM: We're left to assume that at least one of them has a personal connection to the issue (?)

Factual response: Mr. Hoskins repeatedly, and rather aggressively, asked us for our personal
diabetes story. He ignored publicly available information that indicated the existence of a
personal connection and used our fairly obvious messaging that we were trying to protect a
childs privacy as an excuse to question outright our connection to T1D.

Our personal diabetes story involves a minor child who was emotionally devastated by
school discrimination, including a two-month expulsion in retaliation for our refusal to waive
our childs right to hypoglycemia emergency care, in the year prior to our conversation with
Mr. Hoskins; its not a story to be shared with an unsympathetic audience or in connection
with what we had, by the close of our correspondence with him, increasing reason to fear
would be an unfairly biased article or hit piece.

Since beginning our public diabetes advocacy in 2015, we have tried hard to preserve our
childs privacy and not to use her personal story to seek community support. This is especially
true because a rights advocacy function may sometimes involve publicly espousing
unpopular views. T1DFs web page, Facebook, and Twitter accounts all make our extended
engagement with K-12 school issues abundantly clear, and Julia Boss has occasionally
tweeted about a childs school access issues on her personal account. Again, one cannot be

Page 15 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
lead plaintiff in an insulin pricing lawsuit without having a personal connection to diabetes
the complaint and T1DFs subsequent press release (Mr. Hoskins claims to have read both in
their entirety) describe purchase of insulin on behalf of a minor child.

It simply never occurred to us, after two years of unremunerated commitment to the difficult
cause of school accommodation and emergency-care access, that DiabetesMine would
deliberately invite its readers to doubt we were acting from some personal connection to the
issues. Particularly given our reminder to Mr. Hoskins about the privacy of minor children, his
insinuation that we had no connection to T1D was narrowly tailored to undermine our
credibility without expressly stating a lie.

Mr. Hoskins exclusive and narrow focus on our connection to T1D, or alleged lack of thereof,
further undermines our broader message and allows him to eschew a discussion of the
substantive matter we raised both in our email communications with them and online via our
social media accounts. The Type 1 Diabetes Defense Foundation is not a social club or a
patient support group. Clubs and support groups are extremely valuable, and for such
groups an exclusive membership approachonly people with diabetes, and/or only parents
of children with diabetescan be useful in creating protected spaces in which to speak
without fear of judgment. BeyondType1 or the Diabetes UnConference are both good
examples of such protected community spaces. T1DFs function is very different: our purpose
embraces consumer advocacy and disability rights advocacy, and we work in part via impact
litigation to advance the welfare of the T1D community. That work may, at times, involve a
critical stance toward PAOs, other entities or individuals with connection to T1D if they
appear to be working or messaging against the interests of people with diabetes our
current lawsuit, and our public messaging around that lawsuit, including this letter, would be
obvious illustrations. We might embrace as an ally a person who does not have T1D but who
publicly supports rights-based neighborhood school access to insulin and emergency
glucagonbecause that model is the model we believe has the greatest potential to protect
all students with diabetes. T1DF might, on the other hand, publicly disagree with a person
who has type 1 diabetes but who advocates for a charity/volunteer-based school emergency
care model, on the rationale that volunteer models disproportionately benefit more
privileged members of the community while failing to protect K-12 students with type 1
diabetes whose families lack the power to self-advocate. In either case, we would be working
from the same policy position: Access to first-response care in a life-threatening emergency is

Page 16 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
a basic human right and a right protected in U.S. K-12 public schools under Section 504 of
the Rehabilitation Act of 1973 and subsequent legislation.

Because we work primarily on school access/accommodation issues and consumer/medical


care access issues that affect people with many different disabilities and chronic medical
conditions, many of our goals are broadly intersectional. Our corporate documents explicitly
embrace all conditions that require insulin T1D, T2D and other diabetes diagnoses
because we are focused not on the causes of diabetes but on the challenges of managing a
complex medical condition in social context. We work from a social model of disability
perspective, rather than a medical model, meaning that we see many diabetes issues
school discrimination, access to affordable medical careas connected to a broader
confrontation with social structures that are designed based on assumptions of universal
ability. We want to attract supporters who have diabetes, and we want to attract supporters
who dont have diabetes. To that end, we try to keep our focus onand we repeatedly
encouraged Mr. Hoskins to redirect his attention tothe social justice challenges faced by
people with diabetes, and the rational arguments behind the solutions we are proposing to
those challenges. Our childs privacy aside, we deflect attention from our personal story not
because we dont have one, but because we want discussion to focus on T1DFs policy goals.

Ironically, having a personal connection to a medical condition is, as Mr. Hoskinss conduct
has now demonstrated, no guarantee of empathy and support for others dealing with the
same condition either as patients, parents or #Insulin4All advocates. Mr. Hoskinss relentless
questioning regarding our private medical affairs and his subsequent social media bullying
raise serious questions regarding his integrity and professional skills. Failure, at a minimum, to
correct the DiabetesMine article when its insinuation was so obviously and publicly disproved
would suggest an intent to harm.

Injury: The article was expertly written to attack T1DF from every possible ad hominen angle:
by questioning our motivations, by omitting or questioning our professional credentials, and
finally by raising doubt regarding our connection to and thus commitment to the welfare of
people with T1D.

Mr. Hoskins is well aware that the disability-rights slogan Nothing About Us Without Us is
powerful in the diabetes community (a community that in some part embraces D-parents on

Page 17 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
terms of parity with adult PWDs, because T1D is typically diagnosed in childhood/young
adulthood, and parents may spend years actively managing a childs condition). His
implication that we are only pretending to have a connection to the community seriously
undermines our credibility.

Healthline Media knew or should have known the seriousness of this ad hominem attack.
Healthline Media describes itself as a sophisticated digital communication platform for
healthcare marketers with a long, deliberate, mission-driven journey, employing a user
research first strategy for its content. You state that your team leverages quantitative and
qualitative insights in the digital diabetes community to fine-tune content marketing and
media targeting for demand content campaigns. You are well aware that connection to the
medical condition is for many in the online diabetes community a fundamental prerequisite
for lending support. When coupled with allegations of a possible fundraising scam,
malevolent intent and doubtful professional qualifications, Mr. Hoskinss suggestion that we
might have no connection to T1D further worked to undermine our reputation and thus
ability to gain support. The injury caused by this misrepresentation is ongoing.

Failure to correct and update the article to accurately reflect that T1DF filed the March 17
lawsuit Boss v. CVS et al, and that T1DFs president Julia Boss is the lead plaintiff.

DM: The March 17 insulin pricing lawsuit was filed by an organization called the T1D
Foundation, and DiabetesMine states no connection to the Type 1 Diabetes Defense
Foundation or its officers.

Factual response: T1DF helped develop and filed as a named plaintiff in Boss v. CVS Health
Corp. et al., No. 17-cv-01823 (D.N.J.). T1DFs president is the lead plaintiff in that case.

After engaging in extensive research on insulin pricing from the fall of 2016, T1DF
helped develop and filed as a named plaintiff in an insulin price lawsuit with the national class
action firm Keller Rohrback on March 17, 2017: Boss v. CVS Health Corp. et al., No. 17-
cv-01823 (D.N.J.). The T1DF/Keller Rohrback lawsuit is the only one of several pending insulin
actions that seeks injunctive relief (disclosure of net pricing on insulin) designed to benefit
the class by protecting its members from overpricing of insulin in the future (KR press release:

Page 18 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
http://www.krcomplexlit.com/currentcases/insulin-overpricing/ and case page: http://
www.krcomplexlit.com/currentcases/insulin-overpricing/ ). DiabetesMine tweeted that T1DF
and Julia Boss were plaintiffs in the Boss complaint (https://twitter.com/DiabetesMine/status/
843855886561005569), but failed to correct its February 23 piece in light of this information.
Failure to accurately identify our organization and Julia Boss as lead plaintiff in the posted
article update means that the original articles implications regarding T1DFincluding the
suggestion that we have no personal connection to diabetesremain on the record.

Injury: DiabetesMines failure to report T1DFs correct relationship to the lawsuit (which would
directly refute Mr. Hoskinss allegations in the body of the article) allowed the prior
misrepresentation to stand on the record, uncorrected.

This failure further injures T1DF by interfering with our ability to attract plaintiffs to our action,
particularly when the case is presented as a footnote to Mr. Hoskinss detailed and laudatory
treatment of the Hagens Berman insulin action.

HEALTHLINE MEDIAS PUBLICATION AND ENABLING MISREPRESENTATIONS

Healthline Media and DiabetesMine published these misrepresentations regarding T1DF to a


wide audience. In both its consumer-facing pages and its advertiser-facing pages, Healthline
Media correctly represents its expansive reach and its significant influence with site users.
healthline.com's marketing materials describe its audience quality, its rapid growth and its
status as the second largest health media network on the web, with nearly 63 million unique
visitors per month as of June 2016. (ComScore, March 2016, also cited Healthline Medias
Healthweb as the second largest health media network on the web with over 61 million
unique visitors per month). EBizMBA ranked healthline.com 9 out of 15 most popular health
websites in April 2017.

As Healthline Medias CEO, you (David Kopp) have noted that the site has earned its status as
an ally for consumers by employing a 'user research first' strategy for its content.
Healthline Media stresses its empathy-minded content and asserts that its digital properties
meet the companys stringent criteria for providing accurate, authoritative, and unbiased
content. Healthline Media promotes its advertising performance against other health sites,

Page 19 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
including its use of data distilled from our Facebook communities and ratings as well as
content on the dot com site, along with additional first-party data from our owned and
exclusively-represented media properties [to leverage] quantitative and qualitative insights to
fine-tune content marketing.

While the goals of content marketing and delivering unbiased content may appear in some
cases to be mutually exclusive, Healthline Medias power as a platform is undisputed. As a
media source that promises [d]ifferentiated, empathy-minded content is our approach to
earning and retaining consumer trust (Healthline Editor-in-Chief, Tracy Stickler), Healthline
Media/DiabetesMine has significant power to impact public opinion regarding an
organization that is not yet securely established in the public eye. DiabetesMine and its
editors Amy Tenderich and Mike Hoskins are often cited by outside observers as key opinion
leaders in the diabetes world. It is unclear whether Mr. Hoskins made his own choices in
reporting on T1DF or whether he was in part responding to user research indicating
DiabetesMine readers are primarily interested in organization leaders personal stories rather
than the substance of their advocacy work. In either case, Healthline Media makes it clear that
he published his views on T1DF to a large audience carefully cultivated via what you have
described as a long, deliberate, mission-driven journey to trust what they read in
DiabetesMine.

Healthline Medias failure to address its apparent conflict of interest, disclose its business
interest with defendants or other entities potentially implicated in our insulin pricing lawsuit,
and specifically disclose the editorial discretion given to DiabetesMine, reinforce
DiabetesMines appearance of fairness and neutrality, thus sustaining the credibility of Mr.
Hoskinss attack on T1DF and its officers.

Healthline Media publishes a general claim that all its digital properties meet the companys
stringent criteria for providing accurate, authoritative and unbiased content. DiabetesMine
separately notes that it doesn't adhere to Healthline Media's editorial guidelines, but does
not clarify the extent or nature of its non-adherence. Healthline Media further fails to disclose
any conflicts of interest raised by its character as a marketing platform, by the seed funding
received from insurance companies and by its corporate association with Talix (formerly
Healthline HIT Solutions) and Healthline Networks. Healthline Medias misrepresentation of
the editorial policy governing publication on its digital domains and its failure to disclose its

Page 20 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
own substantial conflicts of interest directly resulted in further injuries to the T1DF and its
officers.

Mr. Hoskins represented himself to T1DFs officers as a journalist bound by the conventions of
journalismconventions that would prevent him from writing a piece that misrepresented
information known about a source, presented a sources knowledge or opinions as his own,
or omitted information readily available about a source (e.g. professional qualification,
corporate registration, plaintiff status in a lawsuit) that would impact the way his readers
viewed that source. These conventions would also require that he disclose any patent conflict
he or DiabetesMine might have, including those arising from their association with the
Healthline Networks group of companies. He did not disclose to T1DF Healthline Networks
extensive relationships with insurers/TPPs. Nor did he disclose the idiosyncrasies of
DiabetesMines editorial policy.

Healthline Media failed to disclose to T1DF, and to its broader readers, that its general
editorial policy statements to the public include a misrepresentation regarding quality/
impartiality of content. Healthline Media represents to the broader public that all its digital
properties are subject to the same editorial policy:

All of Healthline Medias digital properties meet the companys stringent criteria for
providing accurate, authoritative and unbiased content. https://www.pehub.com/
2016/05/healthline-media-buys/#

This is not in fact the case. Healthline Media includes in a pop-up window on the
DiabetesMine website a cryptic disclaimer that conveys the opposite message:

This content is created for Diabetes Mine, a consumer health blog focused on the
diabetes community and doesn't adhere to Healthline Media's editorial guidelines.

Healthline Media does not publicly expound the extent to which DiabetesMine does not
adhere to its policy of providing accurate, authoritative and unbiased content, and Mr.
Hoskins did not state to T1DFs officers when he contacted us for an interview that
DiabetesMine does not consider itself bound by Healthline Medias general editorial policy.
He did not reference the extended list of commercial relationships that DiabetesMines

Page 21 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
editors maintain with manufacturers (including Sanofi and NovoNordisk, named as
defendants in the insulin pricing lawsuit Mr. Hoskins sought to discuss with us) and with other
healthcare companies, including Avalere Health, which is currently closely working with Lilly
and Boehringer Ingelheim to develop value pricing and outcome-based pricing initiatives. He
replied to our request to review any shortened replies to a DiabetesMine Q&A (for any reply
you did not run in its entirety, wed need to see your edited/truncated version before
publication) in the following terms: As you know, being familiar with DiabetesMine, were a
news source. We do not operate that way outlined in your earlier email, as to prior review. He
further stated, Ive had many years of experience in legal journalism. In short, he
represented himself to us as a journalist, experienced in and limited by the rules of journalism
(although we still do not consider review of a quote edited or shortened by DiabetesMine to
be inconsistent with the general terms of a Q&A interview). Although Mr. Hoskins had read
our comments on Twitter regarding PBM/ERISA casescomments that clearly indicated we
believed insurers might be involved in the fact pattern for an insulin pricing lawsuitMr.
Hoskins did not disclose Healthline Networks extensive business relationships with insurers/
TPPs, nor DiabetesMine editors own commercial or consulting relationships with
manufacturers and Avalere Health.

Healthline Media has apparent and possibly actual conflicts of interest in covering T1DF
regarding disclosure of net insulin pricing and the substance of Boss v. CVS Health et al.
DiabetesMine has an apparent and possibly an actual conflict of interest in covering T1DF
regarding disclosure of net insulin pricing and the substance of Boss v. CVS Health et al. T1DF
is now plaintiff in a lawsuit that names manufacturers and PBMs (as agents for insurers) as
defendants. T1DFs public policy statements and action campaigns run directly contrary to
the interests of PBMs, manufacturers, and many insurers/TPPs. T1DF is outspoken in its
opposition to value-based pricing, its advocacy for cost-plus pricing of pharmaceuticals, and
its openness to single-payer or public-private insurance as possible solutions to the current
U.S. healthcare crisis (including the insulin price/access crisis that is the topic of our lawsuit
and Mr. Hoskins February 23 article).

Insurers/TPPs are a primary revenue source for Healthline Networks. Healthline Media,
Healthline Networks, and Talix, Inc. (formerly Healthline HIT Solutions) are all Delaware
registered corporations, and Delaware corporate registration documents are not immediately
publicly available (fee for access). It has, however, been widely reported in the media that

Page 22 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
both Healthline Media and Talix, though in early 2016 reorganized into separate business
units, remain wholly-owned subsidiaries of Healthline Networks. Talix provides IT services,
including value-based reimbursement systems, to insurance industry/TPP clients. The
Healthline Networks group of companies received 2007 early-stage financing from Aetna
Ventures, LLC, and Kaiser Permanente Ventures (Healthline Networks is one of the only three
U.S. organizations funded by two insurance companies). Healthline partnered in 2008 with
Aetna to create Aetna SmartSource, which draws on Aetnas electronic medical records for
the people it insures, to offer personalized results for health-related searches (an initiative
broadly opposed by consumer privacy advocates). Talix explains that it helps insurers
calculate the risk scores of patient populations managed under risk-based contracts; it is a
leading provider of risk analytics solutions for value-based care, and apparently does so by
uniquely mining the fast-growing trove of both unstructured and structured patient data
often buried in electronic medical record (EMR). Talix customers reportedly include Microsoft
IBM Watson, Aetna, UnitedHealth, Elsevier, and AARP. Given Healthline Networks
longstanding financial relationships to the insurance industry, Healthline Media may be
understood to have a patent conflict of interest with the advocacy goals, legal activism and
public messaging of T1DF.

If DiabetesMine is indeed bound by Healthline Medias broader commitment to accurate and


unbiased reporting, then DiabetesMine must disclose Healthline Medias business cross-
interests when seeking to interview sources or reporting on any matters related to insurance
companies/TPPsa category that would obviously include any discussion of insulin pricing or
related litigation. Nor does DiabetesMines qualification of its published statements as the
views and opinions of its authors automatically exempt its writers from reasonable
standards of accuracy. Its disclosure statement claims, All posts here are honest and
credible, implyingthough not in fact statingthat DiabetesMines content is factually
accurate. If DiabetesMines editorial policy goal is instead a commitment to credibility but not
accuracy, then it should make that distinction in its reader-facing disclosure section and
clearly communicate the distinction to any potential source.

If Mr. Hoskins had disclosed the nature of DiabetesMines exemption from Healthline Medias
editorial guidelines or Healthline Networks extensive relationship to the insurance industry,
those disclosures might have influenced T1DF communications with him. If Healthline Media
clearly indicated the nature of DiabetesMines exemption from its general editorial

Page 23 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
guidelines, or disclosed its business interests (including its relationship to the insurance
industry) to readers, those readers might greet Mr. Hoskinss disparaging treatment of T1DF
and its officers with skepticism, rather than with the unqualified trust and loyalty DiabetesMine
and Healthline Media have worked to cultivate.

If DiabetesMine is not bound by Healthline Medias editorial policy in regard to accuracy and
absence of bias, then Healthline Medias marketing materials and public statements are
misleading. Healthline Media must clearly state that it does condone bias and inaccurate
content in some of its digital properties, and must clearly identify those digital properties
both in general statements and in presentation of the editorial policies of said digital
properties.

REQUEST FOR CORRECTION & DISCLOSURE OF CONFLICTS

We therefore request that Healthline Media immediately:

(1) direct DiabetesMines editor to correct the numerous misleading statements,


omissions, and disparaging assertions made by Mr. Hoskins in this article and
subsequent update; to remove its inappropriate characterization of our organization as
an obscure Twitter troll; to reflect the abundant corporate and social media
information that was publicly available to Mr. Hoskins at the time of publication; to
properly credit to T1DF the information regarding the PBM/ERISA cases that we had
posted on Twitter and shared with him in our extended email exchange; to note, at a
minimum, the professional qualification(s) of which Mr. Hoskins was aware at the time of
writing via our email exchanges and could easily have verified via public resources
(LinkedIn); to remove its inappropriate suggestion that T1DFs officers had no
connection to diabetes; and to correctly identify T1DFs relationship to the March 17,
2017 lawsuit Boss v. CVS et al, either by updating the body of the article or by correcting
the misleading update that currently attributes the lawsuit to another organization;

(2) direct DiabetesMine to make same-page disclosure of its editors commercial/


consulting relationships (including, but not limited to, financial relationships with
Defendants Sanofi and NovoNordisk, and with Avalere Health, consultant to Defendant

Page 24 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
Lilly) in connection with any future reporting on insulin pricing, PBMs, the insulin price
litigation, and/or T1DF;

(3) direct DiabetesMine to make same-page disclosure of Healthline Media and


Healthline Networks insurance/TPP business interests in connection with any future
reporting on insulin pricing, PBMs, the insulin price litigation, and/or T1DF; and

(4) clarify, both on the general Healthline Media pages and DiabetesMine pages, in what
specific respects, if any, DiabetesMine is exempt from Healthline Medias stringent
criteria for providing accurate, authoritative and unbiased content and, consequently,
in what specific respects the representation that [a]ll of Healthline Medias digital
properties meet the companys stringent criteria for providing accurate, authoritative
and unbiased content may be inaccurate.

Please note that nothing in this letter should be interpreted as a waiver of any rights that the
Type 1 Diabetes Defense Foundation and its officers might have nor of any remedies to which
T1DF and its officers might be entitled in connection with the above-mentioned misleading
statements, omissions, and disparaging assertions, nor as a final settlement offer for any
claims arising from the above-mentioned facts, and T1DF and its officers hereby expressly
reserve all such rights and remedies. We may also choose to make public this letter and/or its
attachments.

Thank you for your consideration and for your attention to this matter. Please do not hesitate
to contact me if you have any questions. We look forward to reading the corrected piece in
DiabetesMine.

Regards,

Charles Fournier, J.D.


Vice President

Page 25 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
cc:
Tracy Stickler, Senior Vice President, Content & Design
Amy Tenderich, Editor-in-Chief, DiabetesMine
Julia Boss, President, T1DF

Attachments:
A1 Email exchange between T1DF and Mike Hoskins

A2 Mike Hoskins, Insulin Price Fixing Lawsuits, DiabetesMine, 2/23/17

A3 Type 1 Diabetes Defense Foundation web page (www.t1df.org).

A4 @T1DF_advocacy Twitter page (partial)

A5 T1DF Facebook https://www.facebook.com/T1DefenseFoundation/

A6 Mike Hoskins, Lilly Diabetes Hosts Insulin Pricing and Access Workshop,
DiabetesMine, 4/26/17

A7 @DiabetesMine/MH and @GilmerHealthLaw Twitter regarding T1DF 2/23/17

A8 @DiabetesMine/MH et al Twitter regarding T1DF 2/23/17

A9 Charles Fournier LinkedIn profile

A10 Julia Boss LinkedIn profile

A11 T1DF press release: T1DF Files Lawsuit to Compel Disclosure, 3/30/2017

A12 Keller Rohrback press release for Boss v. CVS Health et al

A13 Keller Rohrback case page for Boss v. CVS Health et al

A14 @DiabetesMine on T1DF lawsuit, 3/20/17

A15 @DiabetesMine Twitter noting press release and complaint, 4/1/17

A16 Healthline Media Buys . . ., Luisa Beltran, 5/2/2016, citing stringent editorial
criteria.

A17 DiabetesMine sponsor disclosure

A18 DiabetesMine disclaimer: non-adherence to Healthline editorial policies

Page 26 of 26
The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit 501(c)(3) dedicated to advancing equal rights and opportunities for
people who need insulin to live. T1DF accepts no industry funding.
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

Healthline Diabetes Diabetes Mine Insulin Price-Fixing Lawsuits and How Diabetes Advocates Are Involved

Insulin Price-Fixing Lawsuits and How Diabetes


Advocates Are Involved
Written by Mike Hoskins | Published on February 23, 2017

You may have heard that the battle over insulin access and aordability has
made its way into court, challenging status quo drug-pricing methods and
actually accusing the three Big Insulin makers of illegal price-gouging that
endangers people with diabetes.

This issue has been making lots of headlines over the past year, and we at
the 'Mine have covered it from a variety of angles -- from the insulin makers'
response to the historical context to the human cost, and how middle-men
such as pharmacy benet managers (PBMs) manipulate this process.

There have been some broad advocacy eorts to nd solutions, including a


meeting of national stakeholders, a grassroots initiative to provide insulin to
those in need, lawmakers calling for Congressional hearings, and most
recently, the American Diabetes Association itself launching a
#MakeInsulinAordable campaign.

Not surprisingly, news of several related federal lawsuits on this issue was
met with cheers and virtual st-pumps across the Diabetes Community, with
many echoing sentiments like, "FINALLY!," "It's about time," and "Hopefully
this results in change!" (See this CBS story on the litigation and responses.)

Today, we continue our own brand of coverage of #InsulinPrices and


#PBMsExposed by examining this litigation, and how it may or may not
make a dierence among our D-Community:

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 1 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

The Insulin Pricing


Litigation
Technically, a handful of dierent
lawsuits against the Big Three insulin
makers -- Lilly, Novo, and Sano -- have
made their way into court.

A class-action lawsuit was led on


Jan. 30 in Massachusetts on behalf
of 11 plaintis, a mix of people with
both types of diabetes dependent
on various brands of insulin and
insurance plans. Days later, it was
re-led in the District of New Jersey
and added one new PWD (person
with diabetes) as a plainti. The
171-page lawsuit is captioned
Chaires, et al. v. Novo Nordisk, et al,
No. 3:17-cv-00699.

A second PWD-led suit came on Feb. 13, mirroring much of the same
allegations made in the earlier case against the Big Three. This case
involves a father-son pair from Florida who are suing over 'insulin
unaordability' on the grounds that it endangers their lives. The 110-
page lawsuit is Hector Valdes, et al v. Sano-Aventis U.S., et al., No. 3:17-
cv-00939.

In the same NJ federal court, a federal securities lawsuit was led in


January against Novo Nordisk specically, by the Lehigh County
Employees' Retirement System in Pennsylvania -- accusing the insulin
manufacturer of misleading stockholders and inating business
prospects for insulin. That 24-page lawsuit is Lehigh County Employees'
Retirement System v. Novo Nordisk A/S, No. 17-cv-00209.

Another securities case against Novo appeared in January, alleging


similar things relating to inated, share-impacting insulin pricing
practices. That 35-page lawsuit is captioned Don Zuk v. Novo Nordisk, et
al, No. 3:17-cv-358.

The PWD-led lawsuits are being combined into one over-arching case. One
of the attorneys on the case, Steve Berman from the national class-action law
rm Hagens Berman, says this about the rst case in this line of litigation:

The insulin makers have raised their prices so signicantly just so that they
can oer these other actors [pharmacy benet managers] deeper discounts.
The discounts serve as a quid pro quo for agreements to funnel patient
business towards those drug makers. The aim of this lawsuit is to bring the

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 2 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

insulin makers deceptive and unfair conduct to light and to force an end to
such behavior. This lawsuit seeks to compensate people living with diabetes
who have been deeply harmed by the drug companies price increases.

Both lawsuits led by PWDs against the insulin companies make similar
claims against the insulin companies and PBMs involved in the pricing
process. They outline not only the striking price-hikes seen in recent years,
but how the drug-pricing system works to the advantage of manufacturers
and PBMs without regard to the human lives dependent on these
medications.

Some of the share-worthy excerpts from the lawsuits include:

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 3 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

The lawsuits specically note that recent moves by Lilly and Novo to lower
price-hikes and oer discount programs are not adequate to oset the
skyrocketing costs overall. Specically:

In these patient lawsuits, they're arguing the insulin companies have violated
the federal racketeering law and are also making claims under all 50 states'
consumer fraud statutes. Since they're being combined, the plaintis will

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 4 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

have until mid-March to le a consolidated complaint and then the insulin


companies have until mid-May to respond. While 15 PWDs are involved as
plaintis at the moment, others in the D-Community can also join the
litigation through the law rm's website.

As to the securities litigation against Novo, the shareholders in those lawsuits


claim Novo colluded with Lilly and Sano to set the prices for insulin, thereby
falsely inating its share price.

Of course, the Big Three have all denied these claims and insist they follow
the law -- and that you know, what the plaintis are experiencing is just a
result of the overly complex, multi-faceted system of healthcare and drug
pricing in the United States.

Tackling Drug Pricing at Large


But do those cases go far enough, and will they be successful in court?

Not everyone thinks so.

Beyond insulin and diabetes concerns, there are other cases pending across
the country that target insurers and PBMs on this maddening issue of drug
pricing. It's all part of a wave of litigation against PBMs that has arisen over
the past 10 years.

In particular, the two most recent cases against PBMs are In Re Cigna PBM
Litigation, No. 3:16-cv-1702 in Connecticut and in Fellgreen v.
UnitedHealthGroup, No. 16-cv-03914. In both cases, insurers are accused of
charging excessive co-pays and cheating customers in setting drug prices and
with their overall business practices. Much of the detail provided in these
cases is what some believe the insulin pricing litigation is missing.

A relatively new, obscure group called


the T1 Diabetes Defense Foundation
has emerged on Twitter, following the
litigation using the hashtag
#InsulinAction. Structured as a 501(c)3
non-prot, it's run by husband-wife pair
Julia Boss and Charles Fournier in
Eugene, OR, and has been critical of the
lawsuit consolidation, and particularly
of the lead counsel James Cecci, who this T1DF group claims has conicts of
interest in representing both patient-plaintis and the shareholders suing
Novo.

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 5 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

We reached out to the T1DF founders to learn their backstory and agenda,
given that their website is quite scant, but the pair declined to share any
personal details and noted that any "personal diabetes story" is protected
medical information that may involve a child. Instead, they encouraged us to
simply follow the hashtag and to focus on the lawsuit claims themselves.

We're left to assume that at least one of them has a personal connection to
the issue (?)

Diabetes Advocates, Unite!


Meanwhile, we're thrilled to see the
passionate T1International group
playing a part in the above-mentioned
litigation against insulin producers,
specically by working to connect PWDs

with the law rm that led the cases.

"We have always encouraged patients to stand up for their rights and to
speak out against the injustice of outlandish insulin prices, so we are hopeful
that the outcome of this case can change things in the long term for many
patients with diabetes," T1International founder and fellow T1D Elizabeth
Rowley writes to us from Europe.

The group has been using the #Insulin4All hashtag to highlight its eorts on
global accessibility and aordability, and this lawsuit-related activity builds on
its eorts to address the problem and give D-advocates tools to get involved.

Honestly, what T1International has done on this issue over the past year is
pretty remarkable:

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 6 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

Access Charter: T1International created an Access Charter vowing


access to insulin and diabetes items for all of those who need it, globally.
More than 630 have signed the charter from 52 countries, and we're
proud that the 'Mine is included in that.

Survey Says: In 2016, the group conducted an Insulin and Supply Survey
that highlighted some harrowing information about aordability in the
US and echoed a common theme that diabetes costs (insulin in
particular) can drain a persons monthly income and push them into
poverty. The survey found that US-based PWDs on average pay $571.69
per month for diabetes necessities.

Advocacy Toolkit: The group launched an online advocacy resource in


late 2016, comprised of ve sections to guide the reader through various
stages of the process -- from understanding a particular issue and goal,
dening advocacy, planning action, ways to execute that action and put
pressure on your target, and stepping back to evaluate advocacy eorts.
This resource is free for anyone to download from T1I's website. It's also
pretty cool that another grassroots advocacy group, Beyond Type 1,
helped fund this toolkit, that's being printed and shared among 12
countries (Ghana, India, Sierra Leone, Austria, Brazil, Tanzania, Kenya,
South Africa, Argentina, Saudi Arabia, Kuwait and the US).

"We continue to encourage the ADA and others to work in collaboration with
those of us in the diabetes space who have been carrying out similar
initiatives for some time," Rowley says. "Duplicating eorts can waste
valuable time, considering these issues are truly life-or-death. It is also
important ensure that everyone who wants to take action can do so with one
powerful, united voice. Unication and open coordination is happening on
some fronts, but we look forward to the opportunity to work with all
organizations invested in this issue. After all, we are all working towards the
same goal: to improve the lives of people with diabetes."

She adds: "I truly feel that, despite diering issues and focuses, we can all
work better together by openly sharing and supporting one-another.
Discussing best practice, talking strategy and learning from each other is the
best way to create lasting change."

We at the 'Mine completely agree, Elizabeth! We're intrigued to see all of this
advocacy happening, in line with the litigation that will hopefully shed more
light on the insulin pricing problem and the bigger drug cost debacle.

While it will be some time before we see any end-result from these ongoing
court cases, our D-Community will obviously be keeping tabs on the action
and hopefully working together to move towards tangible improvements.

http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 7 of 11
Insulin Pricing Lawsuits - How Diabetes Advocates Are Involved 5/1/17, 10(04 PM

** UPDATE: On March 17, a new federal class-action lawsuit was led in New
Jersey on behalf of the T1D Foundation, accusing the Big Three Insulin
Manufactures as well as PBMs of articially inating the price of insulin.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

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1 Comment Sort by Oldest

Add a comment...

Charles Fournier Board Member at Type 1 Diabetes Defense Foundation


We exchanged several emails in response to your request for an interview. The
presence of a click-through link to the Hagens Berman website on the DiabetesMine
home page indicated an editorial bias in favor of their class action, about which we have
publicly raised concerns. You refused our offer to do a Q&A on reasonable terms, e.g.
not embedded in a negative article.

Our LinkedIn profiles, which you apparently chose not to consult, are public. Our
medical information is private, and we may not wish to share it for the first time in an
interview with a publication or journalist who may have adverse intent or conflict of
interest.

Charles Fournier, J.D.


Vice-President
Type 1 Diabetes Defense Foundation
www.t1df.org
Like Reply Feb 23, 2017 12:51pm

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http://www.healthline.com/diabetesmine/insulin-price-fixing-lawsuits#9 Page 11 of 11
TY P E 1 D I A B E T E S D E F E N S E F O U N DAT I O N

The Type 1 Diabetes Defense Foundation, a 501(c)(3) nonprofit


charitable organization, is committed to fighting discrimination and
seeking equal protection for people with t1d. We believe in a world
where people with type 1 diabetes have full access to education,
employment, and health care.

We work through lobbying, litigation, and campaigns to raise public


awareness about discrimination that affects people with type 1
diabetes, whether this discrimination involves direct limits on
access or demands to waive legal rights to accommodation as a
condition of access. Current projects focus on K-12 school
discrimination and insulin pricing (follow #InsulinAction on
Twitter).

Contact:

Julia Boss ~ media@t1df.org

T1DF, P.O. Box 10841, Eugene, OR 97440

JOIN US ON TWITTER

VISIT OUR FACEBOOK PAGE

F O L LOW U S O N L I N K E D I N
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T1DDefenseFoundation @T1DF_advocacy Apr 30
501(c)(3) nonprofit advocating for the civil
4/28 Boss plaintis/T1DF request Keller Rohrback be appointed as interim co-
and consumer rights of people with type
lead class counsel for #InsulinActions:
1 diabetes. Following and RTs do not
imply endorsement.
Application for Interim Co-Lead Class Counsel for t
United States For the millions of people in the proposed classes who
rely on insulin, the single most important consideration
t1df.org
here is to assemble the best legal t...
Joined October 2015 scribd.com

33 Photos and videos


1

T1DDefenseFoundation @T1DF_advocacy 19h


Replying to @T1DF_advocacy @LillyPad @ExpressScripts
Rebate amount paid in 2014 to PBMs/insurers for Humalog = 56% o list price.
Source: Credit Suisse, Global Pharma Report 2015.

Now ~60-70%

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Follow .@LillyPad @ExpressScripts give 60%+ discount o list $ to insurers, oer 33%
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Tweeting about this
Jesse Ellis O'Brien @JesseOBrienOR
How much do you know about Community Catalyst? The idea that they are
2017 Twitter About Help Center Terms
Privacy policy Cookies Ads info "permanent friend" of insurers is fairly ludicrous
twitter.com/T1DF_advocacy/

1 1

T1DDefenseFoundation @T1DF_advocacy May 7


Replying to @T1DF_advocacy @QuintilesIMS_US
But continues to hide from public magnitude of rebates paid to PBMs/TPPs on
biologics (including analog insulin), only reports net spending.
1

T1DDefenseFoundation @T1DF_advocacy May 7


.@QuintilesIMS_US total spending graph shows net spending, invoice spending,
and, on average, 28% discounts/rebates across all drug classes.

Murray Aitken @Murray_Aitken


US #medicines growth slowed by half in 2016 to 4.8% on
a net basis. Learn more >> bit.ly/2phJMUy

1 1 1

T1DDefenseFoundation @T1DF_advocacy May 7


But aren't insurers (including union plans as TPPs) 'permanent friends' and
funders of Community Catalyst, with which OSPIRG is associated?

Jesse Ellis O'Brien @JesseOBrienOR


No permanent friends, no permanent enemies in politics. I'll team up w/
anyone to stop #AHCApocalypse, reserve right to fight them later.
twitter.com/PamAqua2017/st

1 2

T1DDefenseFoundation @T1DF_advocacy May 7


"However, a minority of patients face substantial out-of-pocket costs and
experience dramatically dierent trend than the system overall."

QuintilesIMS @QuintilesIMS
Decade of #data shows real net per capita #drug spend
has been relatively unchanged. Learn more >>
bit.ly/2qAOPmA

T1DDefenseFoundation @T1DF_advocacy May 6


WTAE notes insulin lawsuit, quotes Irl Hirsch on PBMs: One of the main reasons
why insulin [prices] have increased

T1DDefenseFoundation @T1DF_advocacy May 3


Replying to @T1DF_advocacy @fleshlerd and 3 others
Want #Insulin4All? Want to put an end to insulin overpricing? Sign up as a
plainti in T1DF's #InsulinAction: krcomplexlit.com/currentcases/i

3 6

T1DDefenseFoundation @T1DF_advocacy May 3


Key point here from @fleshlerd: Need leverage to negotiate with @PhRMA,
@pcmanet, @AHIPCoverage. T1DFs lawsuit gives PWDs that leverage.

DiabetesMine @DiabetesMine
DiabetesMine @DiabetesMine
"Calling Pharmacy Benefit Managers to the Carpet" w/ref
2 @T1DF_advocacy lawsuit ow.ly/23v030boxsR TY
@fleshlerd #DOC #PBMsExposed -AT

1 1 2

You Retweeted
Elisabeth Rosenthal @RosenthalHealth May 2
Legal scholars question the legality of common hospital billing practices.
#anamericansickness. Time for some suits? ajmc.com/journals/issue

2 6 20

T1DDefenseFoundation @T1DF_advocacy May 2


T1DFs #InsulinAction inspires Washington's Attorney General to probe insulin
pricing, manufacturer rebating to PBMs acting for insurers.

FiercePharma @FiercePharma
Eli Lilly's insulin pricing scrutiny intensifies with newly disclosed state AG
probes fiercepharma.com/pharma/eli-lil $LLY

1 2 4

You Retweeted
Melinda Wedding @MelindaMWedding May 2
@T1DF_advocacy and @juliaboss5 nice shoutout here. Thanks for your hard
work!

FiercePharma @FiercePharma
Eli Lilly's insulin pricing scrutiny intensifies with newly disclosed state AG
probes fiercepharma.com/pharma/eli-lil $LLY

2 6

T1DDefenseFoundation @T1DF_advocacy Apr 30


T1Ds/T2Ds/anyone who buys insulin: contact Keller Rohrback to be part of this
fundamental #Insulin4All legal action: krcomplexlit.com/currentcases/i

9 9

T1DDefenseFoundation @T1DF_advocacy Apr 30


Keller Rohrback application notes T1DF #InsulinAction uniquely features
important claims for injunctive relief and future transparency.

T1DDefenseFoundation @T1DF_advocacy
4/28 Boss plaintis/T1DF request Keller Rohrback be appointed as interim
co-lead class counsel for #InsulinActions: scribd.com/document/34677

1 2

You followed BioPharma Dive, R. Adams Dudley, Better Call Carl and 11 others
Following Following
BioPharma Dive R. Adams Dudley
@BioPharmaDive @RAdamsDudleyMD
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T1DDefenseFoundation @T1DF_advocacy Apr 27


Replying to @T1DF_advocacy @LillyDiabetes
In 2016, 86% of American public favored disclosure of drug net prices and
rebates = widespread support for goals of T1DFs #InsulinAction.

2 1

T1DDefenseFoundation @T1DF_advocacy Apr 27


Replying to @T1DF_advocacy @LillyDiabetes
T1DFs lawsuit seeking injunctive relief = only patient advocacy action now
pushing insulin net price disclosure.

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Healthline Diabetes Diabetes Mine Lilly Diabetes Hosts Insulin Pricing and Access Workshop

Lilly Diabetes Hosts Insulin Pricing and Access


Workshop
Written by Mike Hoskins | Published on April 26, 2017

In the front lobby of Lillys corporate


headquarters in Indianapolis stands a
towering 12-foot tall statue of a mother Advertisement

holding her child in her arms, sick and


starving to death due to lack of insulin.

Its an artistic rendering of a real-life


mother who took her son to insulin's
birthplace in Toronto once upon a time,
before the medication's discovery in
1921, when a diabetes diagnosis was a
death sentence. As the Lilly folks
describe it today, the statute is a visible
reminder of what they are all about
changing the eld of science and
getting people the medication they
need to stay healthy, even stay alive.

Unfortunately, the reality in 2017 is an


incredible crisis in insulin a ordability
and access for many with diabetes, to
the extent that people in our D-
Community are losing everything
because of lack of insulin, and facing life-and-death situations in some cases.

All of this was the big, sobering, anger-inducing backdrop of a recent Lilly-
hosted insulin access workshop on April 20, where the Pharma giant Advertisement

brought in a dozen diabetes advocates to discuss action plans to start


addressing this growing crisis.

This gathering came just before Lillys rst quarter earnings call on April 24,
when the company reported that just for its 20-year-old Humalog insulin

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 1/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

alone, sales revenue in the U.S. went up 24% in the rst months of this year,
Topics & Tools
which generated all kinds of positive momentum on the company's Newsletter Search

revenue. Just seeing those gures made many clinch our sts in rage, and it's
tough to stomach -- particularly as this issue is hitting some so hard, as
shown in a NBC Nightly News segment aired earlier this week and the sad
story of Shane Patrick Boyle's death recently.

No one is happy with the current state of a airs, even those in the top brass
at Lilly Diabetes. It was clear that the people present at this meeting care,
deeply. Just like many of us, they have personal D-connections -- one on the
marketing team who just marked her 20th dia-versary with T1D, another on
the advocacy and payer side with a husband with type 1, and several others
who shared stories recognizing need and hardship in the D-community.

It is a crime, I agree with you on this, and we are not OK with the status quo,
said Lillys Jordyn Wells, who works on the payer and corporate marketing
team. There are going to be a number of solutions that exist in this space
some may come from Pharma, or from others in the industry, some will be
organizations, and from the Diabetes Community. Only by partnering are we
going to get to the other side.

There were roughly two dozen people in the room 12 patients from the
Diabetes Online Community, and the rest representing Lilly Diabetes
(@LillyDiabetes). The DOC advocates present, including myself, were:

Cherise Shockley (@DiabetesSocMed)


Meri Schuhmacher-Jackson (@Our3DLife)
Rick Phillips (@lawrPhil)
Kelly Kunik (@diabetesalish)
Tom Karlya (@diabetesdad)
Scott Johnson (@scottkjohnson)
Mike Hoskins (@DiabetesMine)
Ally Ferlito (@Verylightnosuga)
Mila Ferrer (@dulce_guerrero)
Bennet Dunlap (@Badshoe)
Amelia Dmowska (@DiatribeNews)
Christel Marchand Aprigliano (@DiabetesPAC)

Attending on behalf of the 'Mine, my role was simple: Observe and report, to
help inform those who couldnt be there in person, and to assure that
everything I might contribute to the conversation came from my personal
POV as a longtime type 1. The group was mainly using Twitter hashtags
#InsulinPrices and #InsulinAccess.
http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 2/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

(Disclosure: I declined Lillys o er to y me from Detroit to Indy, instead


choosing to drive my own car and pay for my own gas, meals Topics & Tools
and parking. Newsletter Search

Lilly did pay for two nights at the Le Meridien Hotel in downtown Indy, as well
as some hors doevres, snacks, and beverages. As always, Lilly was clear there
was no pressure or expectation for us to write anything in their interest;
everything reported here is my own observation and thought based on my
personal experience.)

In a nutshell, what I saw gave me hope that we have the ability to in uence
this insulin access and drug pricing crisis instead of waiting on Congress or
other leaders to weigh in. The blame game can take us round and round, but
while thats happening the advocacy plans being put into motion are
potential game-changers, IMHO even if they arent perfect or end-all-be-all
xes on their own.

It was a full daylong agenda. Heres a recap of my takeaways from the Lilly
workshop, for whatever its worth:

Building Momentum and Connecting Dots


To be clear, this Lilly workshop was a follow-up to e orts that have been
underway over the past year, in particular a larger insulin pricing round-table
in November 2016 coordinated by the National Diabetes Volunteer
Leadership Council (NDVLC). Read our recap of that round-table here.

Certainly, not every player involved in this issue could or would be present at
these meetings, including the much-decried Pharmacy Bene t Managers
(PBMs) who have so much in uence but remain aloof. And by no means did
anyone present believe that this single meeting would solve the worlds
problems or x this issue once and for all. There are no silver bullets here,
Folks.

Over the past several months, both Lilly and NDVLC have been among those
in the D-advocacy community talking with payers and working to better
understand the market dynamics of how the pricing scheme all ts together.
Speci cally, what can be done from an economic and business model
standpoint to in uence tangible change?

George Huntley, a longtime type 1 himself who serves as treasurer of the


non-pro t NDVLC, spoke at the Lilly workshop about what the group has
learned so far. As many of these discussions go, the theme was its
complicated -- as demonstrated by the maze of players who all have a hand
in setting drug prices.

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 3/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

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This hasnt happened overnight, its been a slow evolution of plan design
over the course of the past 15 years, he said. Now, its reached a tipping
point where its outrageous no, we are passed that tipping point. But now,
its incumbent upon us to express that outrage. Yelling about it is a great
start, but there is a di erence between being an educated consumer and just
a consumer on re.

So, what can we do?

'Need to Do Better'
http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 4/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

On Lilly's behalf, Jordyn Wells explained that most of what Lilly has been able
Topics & Tools
to introduce into the marketplace recently are basically "band-aids" that Newsletter Search

clearly are not ideal, but are a starting point. Those include better
promoting the Patient Assistance Programs (PAPs) that can help certain
eligible people in need, to the BlinkHealth partnership o ering limited
discounts of up to 40% at CVS Health pharmacies to those eligible uninsured
or under-insured PWDs.

Very true, and while some in the room were vocal about how inadequate
these programs are for many in the D-Community, there was a recognition
that they're just pieces of a much larger puzzle. Wells said these programs
are short-term solutions that t into larger systematic e orts to help those in
need.

Taking it to Employers
There were a lot of stats and slides presented at this workshop, but the
bottom line was: insurance isnt helping patients the way that it should. One
slide showed that in 2016, 57% of people with diabetes who use insulin were
exposed to unexpected, high or full costs at the pharmacy at some point
during the year. Another set of market research stats showed 51% of people
in the U.S. are on commercial, employer-provided plans (including those that
are self-funded by employers).

Then consider the telling gure that PBMs are responsible for 75%-80% of
insured lives in this country as PBMs create many of the employer health
plans o ered to employees each year. As non-medical switching becomes
more common (go on Lantus instead of Levemir, because theyre "essentially
the same"), this need to change the conversation at the PBM level is ever
more important.

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 5/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

And who has the most sway over PBMs? Yep, employers do because they
Topics
are the clients who have a choice in which PBM they ultimately & Tools
hire for the Newsletter Search

job. If employees arent happy and communicate that, and employers listen
and take that message to the PBMs, the hope is that we can start e ectuating
change.

Lillys Ideas
Here are the ideas Lilly presented for
employer-focused reform:

Manufacturers must take more


responsibility in pushing for point-of-
sale bene ts from rebates. More work
needs to be done to pass along these
insider "rebates" to consumers/patients.
Free Insulin to clinics: An idea that Lilly
mentioned as still being in development,
and not nalized by any means, is an
e ort to work with non-pro t groups
over the next year to get insulin into free
health clinics in select places nationally.
Interestingly, not all free clinics are
equipped to handle donations for free
insulin, and so this is all in the works.
Hopefully we all hear more soon.
First dollar obligations before
deductibles. Employers can contribute
to health savings or reimbursement
accounts on Jan. 1, rather than gradually
paying into those accounts throughout
the year. This could help employees pay
for insulin from the rst day of the year.
Again, not addressing the true pricing
problem, but its something that could
help.
Exempt insulin from deductibles: This
is something Lillys already been doing
as a large employer, but it wants to
encourage more employers to adopt:
insulin could/should be categorized as
one of the essential, life-or-death meds
that isnt subject to a high-deductible,
but rather just a at co-pay. Wells said
the high-deductible plan system was
setup to drive people to cheaper
generics, and to go to primary care
doctors instead of higher-cost ERs. But
with insulin, it doesnt make sense.
Insulin should be treated di erently.

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 6/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

(This is) something we can do tomorrow -- go to employers to start playing


Topics
the puppet-strings and advocating PBMs for this change," Wells & Tools
said. Newsletter Search

NDVLC Campaign
The NDVLC also presented its related campaign that will be rolling out over
the course of the next month or so.

Based on the NDVLC research, the cost for an employer to tweak bene t plan
designs via PBMs equates to an average 22 cents per person per plan.

If they were smart politically, theyd do this immediately, Huntley said. "This
would help quiet the restorm over PBMs.

Asked about unintended downstream consequences, he said there are


hardly any relating to nancial impacts on PBMs. They make $12 Billion (!) a
year, whereas a PWD who pays $1,400 a month for insulin is facing serious,
life-changing health consequences.

Our system has evolved to a point where now, employers are hurting their
people, Huntley said. They are the ones in the free market who can do this,
and they dont know they can do this. Employers are assuming they are
helping their people and that the systems built correctly, but its not. So as
consumers and employees, we must raise our voices to make them stand up
to PBMs about bene t plan design. Because the human cost is not
acceptable.

DPACs Advocacy Tools


A ordable Insulin Project: Another exciting development was hearing
DPAC co-founder Christel Aprigliano describe one of the many projects
they've been working on since November creating an online portal for our

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 7/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

D-Community to get more involved in advocacy on this, appropriately named


the A ordable Insulin Project. This is being rolled out in theTopics & Tools
next weeks, Newsletter Search

we're told, and is aimed at providing resources/tools/awareness on how the


system all works, ways PWDs can easily approach and take this message to
their employers, and what other policy advocacy tools might exist for
insurance reform on the state and Congressional levels.

Advocacy App: While it wasnt speci cally connected to this workshop, just
days before the Lilly forum DPAC launched a new mobile app designed to
help people reach out via social media, phone or snail mail to their
Congressional leaders in DC.

All of these tools feed into the ght for better healthcare reform and
a ordable insulin on a national level, legislative calls for pricing transparency
and lower drug prices, suing Big Insulin and PBMs in court to put more
pressure on them for disclosure and transparency, and creating a needed
media blitz to keep this whole issue on the general publics radar.

Health Literacy, Consumerism and Stigma


Of course, there's the reality that employer-focused advocacy isnt foolproof,
as this recent Bloomberg story shows. There are legitimate questions about
stigma and workplace discrimination, and whether PWDs are comfortable
with even sharing with coworkers or HR folk that they have diabetes, let
alone advocating for company-wide insurance changes for their own bene t.
And there's the issue of simply not being informed enough about the
insurance coverage system, bene ts design and legal rights.

On these challenges, the diaTribe Foundation presented a new six-part series


that its about to launch at the end of May and run through years end to help
tackle stigma and health literacy issues. The topics they have in mind at this
point are:

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 8/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

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One idea born from the brainstorm discussion was the possibility of Lilly
helping to pay for materials that could be printed and displayed not only in
doctor's o ces and in multiple languages, but also in free clinics/ churches/
community centers, or even kiosks that could be set up to view and print
materials for people who might not have Internet access at home.

Everyone in the D-Community is invited to be a part of what diaTribe is


developing here and submit their ideas. Those interested can contact:
amelia.dmowska@diatribe.org.

Overall, the days agenda was packaged as a top-down, bottom-up


approach that encouraged tactics we can start implementing immediately --
even with the understanding that the a ordability and access crisis is huge,
so we have to be patient with incremental change. There were also many
other aspects touched on, but this report summarizes the main points from
my POV.

Balancing the Blame and PR


Clearly, Lilly is funding some of this from a grant to DPAC to help develop
the mobile community advocacy app to supporting the diaTribe series
described above.

Sure, they do share some of the blame in creating the problem, but it's
become increasingly clear to us over the past two years just how complex the
system is, and that pointing the nger solely at the Big Insulin makers is
neither accurate nor productive.

None of the major players are wearing a white hat here when it comes to
how this all operates, and Big Insulin certainly should not be portrayed as
innocent victims.

http://www.healthline.com/diabetesmine/lilly-diabetes-insulin-access-workshop-2017 9/13
5/11/2017 Lilly Diabetes Hosts Insulin Access Workshop | DiabetesMine

Yet the truth is that Lilly and other companies do good in this world,
alongside some bad. They train nurses in schools to manage Topics & Tools
diabetes and Newsletter Search

treat dangerous hypos; they donate lots of insulin globally to developing


counties; and they help send kids to D-camps, college, and conferences while
also raising national awareness about diabetes through marketing, PR and
celebrity spokes-folks campaigns. Not to mention, they support non-pro ts
and various D-advocacy resources and even startups such as Beta Bionics
creating the iLET closed loop system.

For all of those activities, we say Thank You. And it behooves us as patients to
work alongside them to try to nd positive solutions. They should be
providing funds for all this! They make plenty of pro t here, so let's let them
foot the bill for much of the work that needs to be done.

It was also good to hear Lilly invite -- no, urge -- everyone in the D-
Community to keep reminding them where gaps exist and what they can do
better, especially when it comes to middle class a ordability, the uninsured,
and those facing poverty and cultural barriers.

Its easy to be mad. And we all are.

But its not always easy to think critically and have a rational, intelligent
conversation about upsetting topics, and then nd some constructive action
to take. I'm personally proud of our Diabetes Community for keeping our
wits about us and pushing ahead, even in the most heart-breaking moments,
like when we lose some of our kin because they don't have access to
a ordable insulin.

We must all work together to change this, to reach a day when none of us are
forced to carry the weight of tragedy due to the inaccessibility of life-
sustaining insulin.

Other DOC perspectives on this Lilly workshop:


Just Talking Podcast, featuring Cherise Shockley and her POV on the recent
discussion.

Let's Work For Better, by D-Mom Meri Schuhmacher-Jackson at Our Diabetic


Life.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

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3 Comments Sort by Oldest

Add a comment...

Dan Fleshler Harvard University


What about allowing prescription drugs to be imported from Canada? Was that
discussed?
Like Reply Apr 26, 2017 6:36am

DiabetesMine.com
Sure, it came up some as broader discussions on the many aspects of bigger
Congressional actions. But again this was largely focused on trying to drill down
into the "here and now" actions that can begin now and start impacting change,
all the while those bigger legislative action and reform is going on, of course. As
noted, there are so many facets of this and there are a big number working the
crisis from different angles. -MH
Like Reply Apr 26, 2017 7:17am

Corinna Cornejo University of California, Davis


Was there any discussion about Medicaid and/or Medicare?
Like Reply Apr 26, 2017 11:12am

Rick Phillips Nova Southeastern University


Corinna Cornejo, there was. I offered that we need to advance proposals to
allow patients to use manufacturer rebate programs. I also discussed the need
for assistance to native peoples healthcare recipients. For Medicaid patients it
was discussed that reimbursement to manufacturers is slightly below the cost of
manufacture.

The discussion centered on commercial insurance and ACA plans. But I know
of the terrible cost being paid by people who have Medicare and who do not
use pumps.
Like Reply 1 Apr 26, 2017 5:22pm

Rick Phillips Nova Southeastern University


Mike, I believe you gave a terric summary of events. I look forward to forming a
consensus of how to proceed. We have much to do as a community.
Like Reply 1 Apr 26, 2017 5:24pm

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Construction Assurance Audit (Oil & Gas,
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Press Release: T1DF Files


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Summary Hire independent Intellectual


Property Lawyers like
~ Capability Summary Charles
An entrepreneurial, bilingual French-English business strategy and construction advisory
professional with extensive experience leading teams that solve client problems: dispute resolution,
claims negotiation and performance audit. Post your project It's free
See Intellectual Property Lawyers available for hire
Previously a director with a global consulting company, leading dispute resolution and construction
audit teams in Australia. Provide capital project turnaround and claims services to infrastructure,
mining and energy clients, as well as expert testimony in support of formal disputes and arbitrations.

Recognized for unique blend of practical management experience, tactical acumen, and focus on
developing challenge-proof fact-based approaches for resolving the most challenging disputes.

~ Key Consulting Expertise

Help clients with complex commercial negotiation and contractual matters, including quantication of
losses, entitlement assessment and negotiation trade-offs valuation.

Have assessed claims with aggregate value over $2 billion arising from 43 construction projects
amounting to $64 billion under construction.

Matters include: contract modications, varied works, delays and lost-productivity claims;
commercial negotiations, litigations, international arbitration, adjudications, fraud investigation and
straightforward construction disputes; FIDIC, AS, and ad hoc contracts.

~ Key Technical Competencies

Capital project performance audit, performance and contractual risk mitigation strategy, project
turnaround and claims negotiation

Forensic delay analysis using time impact analysis (TIA) and critical path methodologies
Professional service management, organizational and technical capability building

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~ Highlighted Sector Experience Sign in Join now

- Oil & Gas (upstream, pipeline, offshore)


- Mining (open cut, pit-to-port, export facilities)
- Power generation
- Infrastructure & transportation (road, bridge, rail)

Experience

Vice President, Director of Legal Advocacy


Type 1 Diabetes Defense Foundation
March 2017 Present (3 months) Eugene, Oregon Area

Responsible for the overall management of the legal advocacy function (volunteer position).

T1DF retained legal counsel, Keller Rohrbach, and recently led, on the behalf of people with
insulin-dependent diabetes (e.g. type 1 diabetes), a class action lawsuit: Boss et al v. CVS Health
Corporation et al (2:17-cv-01823).

Managing Director
Long International
December 2015 March 2017 (1 year 4 months) Eugene, Oregon Area

Managing Director
PwC Canada
January 2015 November 2015 (11 months) Calgary, Canada Area

Infrastructure & Project Finance in Calgary, AB. Moved back to Seattle, WA, in December 2015.

Director, Contract Services & Dispute Advisory (Oil & Gas,


Mining)
Turner & Townsend
March 2012 December 2014 (2 years 10 months)

China Australia Practice Group - supporting China ODI in Australia and Africa

Director, Dispute Advisory Services (Oil & Gas)


Hill International, Construction Claims
April 2011 March 2012 (1 year)

Senior Consultant
FTI Consulting, Construction Solutions
September 2009 March 2011 (1 year 7 months)

Staff Engineer
Capital Project Management, Inc.
December 2000 July 2004 (3 years 8 months)

Volunteer Experience & Causes

Board Member
Type 1 Diabetes Defense Fund
December 2015 Present (1 year 6 months) Civil Rights and Social Action

Education

The George Washington University Law School


J.D., Law
2004 2007

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Interned as law clerk with National Association of Federal Credit Unions (NAFCU)
and the Grameen Foundation (micronance) Sign in Join now
Activities and Societies: Founder and Chair, Banking Law Society (2006-2007)

Ecole Spciale Militaire de Saint Cyr


M.S. in Mathematical Physics & Engineering (Diplme dIngnieur), Materials Science
1991 1994

Intern with CARNEADE project (Digitized Air Land Battle for Analysis, Training and Decision-
Making) at Dassault Electronique (now Thomson-CSF DETEXIS). C++ software development,
UNIX.

Lyce Militaire de Saint Cyr


B.S. in Mathematics with a Mathematical Physics Concentration, Mathematics and Physics
1989 1991

Classes Prparatoires aux Grandes Ecoles (CPGE), Mathmatiques Suprieures et Spciales

Certications

Planning & Scheduling Professional (PSP)


Association of Cost Engineering International (AACEI), License 689-10 - lapsed in March
2014 (not renewed)

Certied Construction Auditor (CCA)


National Association of Construction Auditors, License A13036
August 2013 Present

Organizations

Dispute Resolution Board Foundation (DRBF)


Member
Starting April 2016

http://www.drb.org/

Society of Petroleum Engineers


Starting 2009

Association of International Petroleum Negotiators (AIPN)


Executive Board, MENA Chapter
Starting 2010

Association for the Advancement of Cost Engineering International


(AACEI)
Board of Directors, UAE Chapter (2011)
Starting 2011

Dubai International Arbitration Center


Expert Member (oil and gas, construction law)

Western Australian Institute of Dispute Management (WAIDM)


Afliate Member
2012 2013

Organization dissolved by Murdoch University; faculty moved to Curtin University

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Australian Cost engineering Society Sign in Join now


May 2013 December 2014

The ACES is a technical society of Engineers Australia and a section of the Association for the
Advancement of Cost Engineering International (AACEI)

Publications

Claims Mitigation for U.S. Nuclear Power Plant Construction: Should


Outage Scope Management Principles be Applied?
Long International
October 2016

In order to reduce construction project delays, more project controls managers and planners with
outage experience should oversee new-build nuclear power plant construction. It wont, however, be
sufcient simply to up-skill project controls teams. Application of outage techniques without the
organizational capabilities required to manage these enhanced processes would be
counterproductive. Accelerated scheduling requires tight scope control; it also requires the
leadership and organizational capability to fulll its mandate. In turn, scope control and operational
efciency together require a paradigm shift towards a renewed focus on constructability and delivery
efciency starting from the conceptual planning stage of the project, i.e., the transfer of lean
shutdown best practices to new-build construction.
Authors: Charles Fournier

Claims Management Challenges in the "Modularized" Project Execution


Environment
Long International
March 2016

Modularization and fabrication offshoring have created new challenges for claims management and
dispute resolution. As co-users of project controls data, claims managers have a critical role to play
in the design and implementation of project-wide data management strategies. I reviewed some of
these challenges and suggested solutions that may be applicable not only to multibillion-dollar gas
liquefaction projects in the northern shores of Ural, but also, closer to home, in the burgeoning
modular building industry
Authors: Charles Fournier

Time to rethink mega-project assurance?


Linkedin post
April 2014

Business as usual is no longer a policy option for publicly listed IOCs, international resource
companies and contractors. When CAPEX variances amount in the billions and the delays in years,
a failure in reporting compliance could be misconstrued as withholding material information from
shareholders. With optimism bias a given and power plays the rule, a company can ultimately best
improve decision making by fostering accountability and disclosure, i.e. by assuring the integrity of
the underlying project controls rather than by focusing solely on rationalizing a decision-making
process that has already proved ineffective.
Authors: Charles Fournier, Julia Boss

Learning from things that go boom... Defense-industry assurance


processes for leaner hydrocarbon mega-projects?
Linkedin post
May 2014

Can and should mining and hydrocarbon operators look to defense industry project-management
systems for tools they might adapt to improve delivery on complex mega projects? Will these
management tools deliver expected improvements without the benet of a general productivity
optimization framework and lean culture? In a world where knowledge sharing is now viewed as an
essential source of competitive advantage, two recently launched organizations approach these
questions from different perspectives, but with the same drive for cross-industry cooperation.
Authors: Charles Fournier, Julia Boss

Game-Changer: Can a $40 Billion Spill Transform an Industry?


FTI Consulting, Construction Solutions Newsletter, Issue 4 (Energy), Winter 2010.
Republished on the blog of The George Washington Journal of Energy and Environmental
Law (JEEL), February 15, 2011.
January 2010

In the end, the focal issue may be the management of risk: even with robust efforts to prevent oil-
related incidents, they can and will happenat which point the crucial question is how to cope with
the consequences. Deepwater Horizon Oil Spill: Selected Issues for Congress, CRS Report
R41262, July 30, 2010

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Authors: Charles Fournier
Sign in Join now

More MENA Mega-Projects: What Can the Oil & Gas Sector Learn from
Dubai's Construction Bust?
FTI Consulting, Construction Solutions Newsletter, Issue 4 (Energy), Winter 2010.
December 2010

As MENA oil-producing countries step into the mega-project spotlight, Dubais painful experience
should remind us that mega projects come with mega risks. Oil and gas producers may be
comparatively sheltered from economic bubble dynamics (global dependence on petroleum is more
predictable than demand for ofce space in Dubai), but signicant risk factors including political
instability and security risks, raw material and commodity price instabilityare pushing the regions
large- scale oil and gas projects over budget and schedule. And when a mega project gets out of
hand, the consequences can be dramatic.
Authors: Charles Fournier

Credit Unions Urged to Review Compliance with National Flood Insurance


Programs Initial Flood Hazard Determination Requirements
NAFCU Regulatory Newsletter, August 2006
August 2006

With an overhaul bill moving through Congress and a 2005 hurricane season that has left a cash-
trapped FEMA desperate for better coverage of eligible properties, compliance with the National
Flood Insurance Program will likely be in every regulators (and examiners) mind during the
upcoming hurricane season.
Authors: Charles Fournier, Anthony Demangone

Regulation D: Reserve Requirements - 12 CFR 204


Compliance Guide for Credit Unions, edited by NAFCU and published by Sheshunoff
Information Services, 2006

Revised and augmented Regulation D chapter.

The Federal Reserve Act requires any insured credit union as dened in section 101 of the Federal
Credit Union Act or any credit union that is eligible to apply to become an insured credit union under
section 201 of such Act to maintain reserves against its reservable liabilities, as prescribed by
Federal Reserve Board regulations. Regulation D, Reserve Requirements of Depository Institutions,
denes reservable liabilities, reserve calculation, maintenance requirements, and associated
periodic reporting to the Federal Reserve.
Authors: Charles Fournier, Multiple

Projects

Speaker: "Claims 101 - Where do we stand on standards," PMCOS Annual


Conference
Starting May 2016

Project Management College of Scheduling Annual Conference Scheduling the Future, May 15-18,
2016, Chicago.

The body of knowledge addressing delay analysis has been growing at an exponential pace. And
very soon, the ASCE will issue its own Standard for Schedule Delay Analysis, joining the existing
Society of Construction Law [SCL] Delay and Disruption Protocol and AACE International
Recommended Practice No. 29R-03 Forensic Schedule Analysis.

This most recent attempt to provide a broader framework for delay analysis should encourage us to
take a step back and review these standards within their diverse industry context. Are the existing
and forthcoming standards broad enough to cover all types of projects? Have they fully embraced
the increasing diversity of the scheduling environment? Are there subject areas within the standards
that require further attention or improvement?

Building on 15 years experience with claims management and delay analysis from haul road
resurfacing in Oregon to LNG megaprojects in Western Australia, this presentation will (1) reposition
the above standards within the broader context of delay analysis, (2) map some still-uncharted
territories (e.g. linear non-CPM scheduling) and (3) highlight some of the most common risks
emerging from the gaps between existing standards and the increasingly complex scheduling
context within which these standards operate.
Team members: Charles Fournier

Panelist: "A History of Scheduling: Looking Back, Moving Forward",


PMCOS Annual Conference
Starting May 2016

From mainframe computer scheduling in the 60s and 70s to microcomputer scheduling in the 80s
and 90s and beyond. What was it like at the birth of CPM scheduling? Why has the quality of

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schedules on many of our projects deteriorated over the years? And, what steps can the College
and the profession-at-large take to right the ship in the very near future? These are just a few of the Sign in Join now
topics/questions well address in a wide-ranging discussion of scheduling: then, now and tomorrow.
Team members: Charles Fournier

Speaker: Society of Construction Law - National Conference 2013


Starting August 2013

Speaker -- iNotice: Contractual Notices in the Era of Field Communication Systems, Charles
Fournier
Sunday August 4th 2013 - Second morning session.
Team members: Charles Fournier

Speaker: "Legal or Contractual? The $20,000 question", RICS Matrics


Seminar
Starting June 2014

RICS Matrics Seminar


Wednesday, 2 July 2014
Venue: Central Park, 152-158 St Georges Terrace, Perth WA 6000
Team members: Charles Fournier

Speaker: Project Planning, Control & Management (Tonkin's Conference,


endorsed by the Australian Institute of Project Management)
Starting November 2012

Speaker -- Case Study/Discussion: "Protecting yourself from every WA Project Managersnightmare


- adjudication"

Asking the critical question: how to cope with the consequences of what can and will happen i.e. a
large payment claim
Managing adjudication risks by pre-negotiating your liabilities and tightening your contract
specications
Attempting to resolve complex disputes arising from technical, managerial and organisational
disruptions can this ever be done in 14 days?
Looking at lessons learned from two real-life adjudication scenarios
Team members: Charles Fournier

Panel Chair: Does Corporate Law Have Anything To Do With Poverty


Reduction?
Starting February 2006

Organizer and Chair, panel, Does Corporate Law Have Anything To Do With Poverty Reduction?
Conference on Poverty and Human Rights, GW Law School, February 23, 2006
Team members: Charles Fournier

Boss et al v. CVS Health Corporation et al (2:17-cv-01823)


Starting March 2017

T1DF retained legal counsel, Keller Rohrbach, and recently led, on the behalf of people with
insulin-dependent diabetes (e.g. type 1 diabetes), a class action lawsuit: Boss et al v. CVS Health
Corporation et al (2:17-cv-01823). You can download a copy at https://goo.gl/SjStlF.

The injury described in the complaint may be in the billions of dollars; it could potentially earn this
lawsuit a place among the largest patient class actions against the Pharma industry. The injunctive
relief it seeks also has the potential to change signicantly the operation of health insurance in the
U.S.
Team members: Charles Fournier, Julia Boss

Skills

Contract Management Dispute Resolution Analysis Construction Energy

Strategy Change Management Business Process Improvement Forensic Analysis

Mining Delay Claims Procurement Leadership Business Development

Expert Witness See 16+

Languages
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English French

Groups

AACE International M Lean Construction Ne CHINA REGION - CON North America's LNG

IACCM - International Construction Law Gr Compliance and Audi


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President at Type 1 Diabetes Defense Foundation
Type 1 Diabetes Defense Foundation Yale University Edit your public profile
Eugene, Oregon Area 70
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The Type 1 Diabetes Defense Foundation is a 501(c)(3) nonprofit organization committed to fighting discrimination
and seeking equal protection for people with t1d. We believe in a world where people with type 1 diabete See more

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President
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Nov 2015 Present 1 yr 7 mos
Eugene, Oregon Area
Contact and Personal Info
Cofounder of T1DF, a nonprofit organization (501(c)(3) status pending) committed to fighting discrimination Julias Profile and Email
and seeking equal protection for people with type 1 diabetes. T1DF works through lobbying, litigation, and
campaigns to raise public awareness about discrimination that aects people with t1d, whether as direct Show more
limit on access or as refusal of accommodation required to facilitate access. Current campaigns focus on
insulin pricing and K-12 school discrimination. People Also Viewed
See less Daniel Ruck 3rd
Artificial Pancreas Research
Educator, RN, CDE at The Ba
Writer and Editor Center for Type 1 Diabetes
Julia Boss Editorial
1994 Present 23 yrs Christopher No all 2nd
Eugene, Oregon Area Type 1 Diabetic, Founder, O
Organic Diabetic. Blogger
See description Extraordinaire at Diabetes D

Natalie Strand 2nd


Graduate Research Fellow Interventional Pain Manage
University of Pennsylvania Physician. In addition, signi
experience with public spea
2000 2001 1 yr
television.
Greater Philadelphia Area

See description Thom Scher 2nd


COO at Beyond Type 1

Ph.D. Student (ABD)


Roxana Reynolds 2nd
Yale University Author of Help My Child Has
1994 2001 7 yrs Diabetes
New Haven, Connecticut
Gabrielle Kemble 2nd
See description Certified Diabetes Educator
Manager at Fit4D, Personali
Diabetes Coaching
Assistant Editor and Associate Director of Subsidiary Rights
Algonquin Books Cem Demirci 2nd
1991 1994 3 yrs Director, Type 1 diabetes pr
Connecticut Children's Med
New York, New York
Messaging

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See description 1 Sarah Try
Jane Blacksher
Premium
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for Freeat Sarahn
with Type 1 Diabetes

Education Corey B. Miller 3rd


Program Associate - Type 1
Leona M. and Harry B. Helm
Yale University
Charitable Trust
M.Phil., History and Renaissance Studies, with distinction
1996 1998 Alaina Metivier 2nd
Secondary Mathematics Tea
Vrain Valley Schools
Yale University
M.A., Renaissance Studies
1994 1996 Add new skills with these courses

Learning Ebook Publishing


University of Oxford Viewers: 15,798
1989 1990

Word 2013: Tips, Tricks, and


See description
Shortcuts
Viewers: 14,678

Yale University Grammar Fundamentals


B.A., History, summa cum laude Viewers: 69,264
1985 1989

See fewer education See my recommendat

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Accomplishments

4 Projects
Book review: Dimitry Elias Lger, God Loves Haiti (2015) Book contribution: Writing a Relic. In
Colonial Saints: Discovering the Holy in the Americas (2003). Translation assistant: Julia Kristeva,
Melanie Klein (2001). Translation: "The Life and Death of Mother Marie de Saint Joseph," in
Religions of the United States in Practice (2001)

2 Languages
English French

Interests

Pulse University of Washington


1,529,516 followers 357,743 followers

Type 1 Diabetes Defense Fund (T1DF) Yale University


8 members 157,070 followers

Yale University University of Oxford


153,270 followers 276,883 followers
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Contact: The Type 1 Diabetes Defense Foundation Files


Communications
Lawsuit to Compel Disclosure of Manufacturers
Director
(541) 257-8878 Effective Net Realized Prices for Insulin
media@t1df.org
For immediate release: March 30, 2017
www.t1df.org
Summary: The Type 1 Diabetes Defense Foundation has filed a
Issues: lawsuit in federal court seeking disclosure of manufacturers net
Drug pricing, insulin, realized prices on insulin and now calls for support to expand its
discrimination, patient
campaign to make insulin affordable again. The lawsuit alleges that
advocacy organizations,
for years insulin manufacturers and PBMs have conspired to hide the
diabetes standard of
actual U.S. price of insulinthe heavily rebated prices that PBMs and
care
insurers actually pay, instead of the artificially inflated list prices used
by PBMs to calculate consumer pre-deductible and coinsurance
Documents:
https://goo.gl/zmV7oE payments. T1DF separately observes that the American Diabetes
Association has continued to fundraise off the staggering cost of
diabetes and engaged in behind-the-scenes meetings with insulin
manufacturers, but has failed to take direct action to expose the
exploitative dual-pricing scheme and protect people with diabetes
from artificially high insulin prices and cost-related stigma. T1DF now
seeks to fill the crucial role of U.S. diabetes watchdog that the ADA
has thus surrendered.

March 30, 2017 - Eugene, OR. The Type 1 Diabetes Defense Foundation has retained
class-action law firm Keller Rohrback and on March 17, 2017, filed a lawsuit against the
nations three largest pharmacy benefit managers, Express Scripts, OptumRx, and CVS
Caremark, and the three major insulin manufacturers, Sanofi-Aventis, Novo Nordisk, and
Eli Lilly (Boss v. CVS Health Corp, 3:17-cv-01823). Learn more about Keller Rohrback's
insulin overpricing case.

Page 1 of 4
The lawsuit alleges that PBMs, insurers and insulin manufacturers have conspired to hide
from consumers their dual pricing scheme and to mislead consumers to believe that
unrebated list pricesassessed at the pharmacy point of sale and used by PBMs to
calculate pre-deductible or coinsurance paymentsrepresented the actual costs PBMs
and insurers paid for insulin, while hiding the increasingly large kickbacks received from
manufacturers (kept by PBMs and insurers), and thus the much lower effective net prices
realized by manufacturers on analog insulins.

The following is a statement from the Type 1 Diabetes Defense Foundation:

Contrary to statements by the American Diabetes Association, the insulin pricing process
is not mysterious: as PBMs have demanded ever larger rebates, manufacturers have
exponentially increased analog insulin list prices to preserve their profit margins. Nor is
price inflation new: Truven Health Analytics data reported last September by Business
Insider shows list prices for Novolog and Humalog had already increased by 150%
between 2000 and 2010, in the run-up to overall price increases of over 300%. By early
2016, the out-of-control "gross-to-net" pricing bubble, warped rebate-driven channel
incentives and related wasteful costs had been thoroughly documented. Restrictive
formulary manipulationscritical for extracting rebates from manufacturershad become
so prevalent that Express Scripts described these in their April 2016 answer to an Anthem
lawsuit (Anthem, Inc. v. Express Scripts, Inc. (16 Civ. 2048)) as standard industry practice
consistent with modern benefit designs. By the close of 2016, just one crucial missing
piece remained to be exposed: the actual net prices realized by manufacturers, after
delivering rebates on analog insulins potentially as high as 75% off public list prices.

Journalist David Lazarus wrote on insulin pricing late in 2016, Drug companies respond
only to the public embarrassment of being caught exploiting the misfortunes of the sick.
Charles Fournier, T1DFs Director of Legal Advocacy, notes that drug companies also
respond to lawsuits. But nearly a year after Yale endocrinologist Kasia Lipskas Break Up
the Insulin Racket was published in The New York Times, first bringing PBM rebating on

Page 2 of 4
insulin to public attention, PBMs, manufacturers and insurers had neither been
embarrassed into ending PBM-controlled

When people are dying because they dual pricing for insulin nor sued to disclose

cant afford insulin, it is no longer time manufacturers effective net prices.


for continued dialogue across the
Throughout 2016, despite increasing social
diabetes marketplace. Its time to
media pressure from activists inside and
compel disclosure of manufacturers net
realized pricing. Charles Fournier, outside the U.S. (including T1Internationals

T1DF Director of Legal Advocacy #Insulin4All campaign) and attention from


investigative journalists, industry-financed
patient advocacy organizationsincluding the ADA and JDRFthe Endocrine Society, and
sponsored diabetes news outlets instead engaged in evasive action. They called for
conciliatory continued dialogue across the diabetes marketplace, endorsed
manufacturer Patient Assistance Programs that charge patients almost twice
manufacturers apparent net realized prices, and misleadingly blamed insulin price
increases on unspecified government-protected monopolies. The ADA and the
Endocrine Society even suggested walking back the analog standard of care. Following a
November 2016 meeting with insulin manufacturers, the ADA claimed only a
Congressional investigation could reveal why analog insulin prices had skyrocketed, and
then launched a public petition campaign and online hub for insulin affordability
advocates that made no mention of pricing mechanisms, thus effectively leaving Pharma
lobbyists in control of proposing solutions to Congress.

For years, the ADA and JDRF have contributed to stigma against people with diabetes
by fundraising for research off the staggering cost of diabetes in America, indirectly
blaming people with diabetes for costing U.S. taxpayers in excess of $200 billion annually
in Medicare dollars alone, says Fournier. Yet as the exploitative nature of the dual
pricing scheme has become increasingly clear, these diabetes PAOs have taken no
concrete action to bring down that artificially inflated staggering cost. When people are
dying because they cant afford insulin, it is no longer time for petitioning and behind-

Page 3 of 4
the-scenes meetings. It is time to publicly embarrass PBMs, manufacturers, and insurers
for exploiting people with diabetes, time to embrace price transparency lawsuits, to
campaign for the end of rebate-driven dual pricing, and to demand immediate full
disclosure of the effective net price for analog insulins actually realized by
manufacturers.

For the pharmaceutical industry, the stakes are high. The stakes are even higher for
patients. With the 2016 issuing of the CMS Final Rule on Medicaid pricingand its best
price available mandatethe industrys current challenge is to anchor all prices,
including Medicaid reimbursement prices, at the highest possible point. T1DF retained
Keller Rohrback and filed Boss v. CVS Health in pursuit of the opposite goal: to make
insulin affordable again. Net price transparency and cost-based pricing will also benefit
people with other costly chronic conditions including HIV/AIDS and hemophilia. We are
now asking individuals and philanthropic organizations who care about U.S. drug
affordability to lend their vocal support and to fund T1DFs fight for pricing transparency.

About T1DF. The Type 1 Diabetes Defense Foundation is an Oregon-based nonprofit


501(c)(3) dedicated to advancing equal rights and opportunities for people who need
insulin to live. T1DF accepts no industry funding.

Page 4 of 4
5/10/2017 Keller Rohrback Investigates the Inated Price of Insulin - Keller Rohrback-Complex Litigation Law Firm

Select Page
a

Keller Rohrback Investigates the In ated Price of


Insulin
On March 17, 2017, the nationally recognized class-action law rm of Keller Rohrback L.L.P. led suit
against the nations three largest pharmacy bene t managers (PBMs), Express Scripts (ESRX:US),
OptumRx (UNH:US), and CVS Caremark (CVS:US), and three major drug manufacturers, Sano -Aventis
(SNY:US), Novo Nordisk (NVO:US), and Eli Lilly (LLY:US), who produce the widely-prescribed analog
insulins: Lantus, Apidra, Levemir, Humalog, and Novolog.

The complaint, which was led in the New Jersey federal district court, alleges that the PBMs
insurance industry middlemen who negotiate drug pricesconspired with the insulin manufacturers
to arti cially in ate the price of insulin for their own collective bene t. This pro t-seeking move has
directly injured individual patients and other purchasers of insulin nancially and put the lives of
millions of diabetes su erers at risk.

While drug manufacturers certainly contribute to the problem, they do not act alone. Rather,
manufacturers collude with PBMs to raise insulin list priceswhich the PBMs direct consumers to
paythus reaping outsized pro ts from people who need insulin to stay alive.

http://www.krcomplexlit.com/2017/05/keller-rohrback-investigates-inated-price-insulin/ 1/4
5/10/2017 Keller Rohrback Investigates the Inated Price of Insulin - Keller Rohrback-Complex Litigation Law Firm

The Plainti s complaint explains how the PBMs and manufacturers are gaming the system. Instead of
competing based on the lowest price to the consumer, manufactures are competing based on the
highest rebates to the PBMs. In return, manufacturers receive exclusionary or preferential status on
the PBMs formularies. Formularies are ranked lists of drugs maintained by PBMs that health insurers
rely upon to determine how much of their members drug costs they will cover. Manufacturers sales
pro ts depend on access to these enormous pools of members.

To prevent the rebates from cutting into their pro ts, the manufacturers raise what they call the list
price of insulin. The higher the list price, the higher the rebate and other fees, and the larger the
pro t to the PBMs. The result is a vicious cycle of list price increases by manufacturers, vying to win
the favor of the PBMs.

Consumers with out-of-pocket payment obligations, a large and growing population, are charged an
amount based upon the arti cially in ated list price. This includes the uninsured and people in a
variety of types of health plans with co-insurance, co-payment, and high-deductible requirements.

The arti cially high cost of insulin, as well as other diabetic medications and supplies,
needlessly in icts physical, emotional, and nancial harm on patients and their families. If you
or someone you know, purchases diabetes pharmaceuticals, please contact attorneys Michael
Meredith or Gretchen Obrist to learn more about whether you too have been subject to
unlawful pricing. Call 800.776.6044 or email consumer@kellerrohrback.com.

Keller Rohrback L.L.P. serves as lead and co-lead counsel in class action lawsuits throughout the
country, including actions asserting RICO, ERISA, and consumer claims against PBMs. With o ces in
New York, Seattle, Phoenix, Ronan, Oakland, and Santa Barbara, our Complex Litigation Group is
proud to o er its expertise to clients nationwide. Our trial lawyers have obtained judgments and
settlements on behalf of clients in excess of eighteen billion dollars.

Learn more about our insulin overpricing case.

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5/10/2017 Insulin Overpricing - Keller Rohrback-Complex Litigation Law Firm

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Insulin Overpricing
Boss, et al. v. CVS Health Corp. et al.
United States District Court, District of New Jersey
No. 3:17-cv-01823-BRM-LHG

Case Overview
On March 17, 2017, the nationally recognized class-action law rm of Keller Rohrback L.L.P. led suit
against the nations three largest pharmacy bene t managers (PBMs), Express Scripts, OptumRx, and
CVS Caremark, and the three major insulin manufacturers, Sano -Aventis, Novo Nordisk, and Eli Lilly, who
produce the well-known and widely-prescribed analog insulins: Lantus, Apidra, Levemir, Humalog, and
Novolog. The complaint, which was led in the New Jersey federal district court, alleges that the PBMs
insurance industry middlemen who negotiate drug prices and create drug formularies that determine
how much patients payconspired with the insulin manufacturers to arti cially in ate the price of insulin
for their own collective bene t. This pro t-seeking move has directly injured individual patients and other
purchasers of insulin nancially and put the lives of millions of diabetes su erers at risk.

Insulin Pricing Scheme Explained


The Insulin Pricing Scheme alleged in Plainti s complaint explains how PBMs sell exclusionary or
preferential access to their formularies in exchange for a cut of rebates and other fees paid by the drug
manufacturers to the PBMs. Formularies are ranked lists of drugs that health insurers rely upon to
determine how much of their members drug costs they will cover. Manufacturers sales depend on
access to these enormous purchaser pools for their pro ts. Although the PBMs claim the rebates and
other payments lower the cost of insulin, in fact, this is misleading. The rebates and other payments
decrease the cost of insulin for the PBMs and the insurers with whom the rebates are shared, but drive
up the cost for consumers, whose pre-deductible or coinsurance payments at the pharmacy point-of-sale
are based on the unrebated list price.

The PBMs and manufacturers game the system. Instead of competing on price for access to the PBMs
formularies, the manufacturers compete based on the amount of the rebate and other fees that they pay
to the PBMs. To prevent the rebates and other feesand the wasteful transactional costs created by an
increasingly convoluted system of paymentsfrom cutting into their pro ts, the manufacturers raise
what they call the list price of insulin.

http://www.krcomplexlit.com/currentcases/insulin-overpricing/ 1/2
5/10/2017 Insulin Overpricing - Keller Rohrback-Complex Litigation Law Firm

Meanwhile, considerable rebates to PBMs maintain at a steady point the net price actually realized by
the manufacturers. The higher the list price, the higher the rebate and other fees, and the larger the
pro t to the PBMs. The result is a vicious cycle of list price increases by manufacturers, vying to win the
favor of the PBMs. Consumers with out-of-pocket payment obligations, a large and growing population,
are charged an amount based upon the arti cially in ated list price. This includes the uninsured and
people in a variety of types of health plans with co-insurance, co-payment, and high-deductible
requirements.

Relief Sought
Plainti s complaint seeks both monetary and injunctive relief on behalf of four Classes of health plan
participants and bene ciaries, as well as uninsured consumers. Plainti s are requesting remedies that
would refund their overpayments and force Defendants to disgorge their ill-gotten gains. Critically, the
injunctive relief that is unique to the Boss case would impose disclosure requirements going forward that
will increase transparency in a market where a hidden dual pricing system has driven insulin prices
through the roofat severe nancial and physical costs to users and purchasers of insulin. Disclosure of
this information will make it more di cult for the Defendants to manipulate the cost of insulin in the
future, should they attempt to replace the current system with some other scheme.

If you purchase prescription insulin produced by any of the above-listed manufacturers, you may be
paying arti cially in ated and anti-competitive prices. Please contact an attorney to learn more about
whether you too have been subject to unlawful pricing. Call 800.776.6044 or email
consumer@kellerrohrback.com.

Attorney Advertising. Prior results do not guarantee a similar outcome. Not licensed to practice law in all states.
Please refer to our website for details.

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Attorneys
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Michael W. Meredith

Gretchen Obrist

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A COMMUNITY FOR PROFESSIONALS IN PRIVATE CAPITAL

Healthline Media buys


MedicalNewsToday.com and
MediLexicon.com
May 2, 2016 By Luisa Beltran

Healthline Media, which is backed by Summit Partners, has acquired


MedicalNewsToday.com and MediLexicon.com. MediLexicon International Ltd was
the seller. Financial terms werent announced. MedicalNewsToday.com is a leading
website in the medical news category, boasting over 132 therapy areas.
MediLexicon.com is an online database of medical abbreviations with over 200,000
denitions that are constantly updated.

PRESS RELEASE

SAN FRANCISCO, CA (PRWEB) MAY 02, 2016

Healthline.com, relied on by over 25 million (comScore, 2016) consumers for health and
wellness information, today announced it has acquired sister websites
MedicalNewsToday.com and MediLexicon.com to advance its mission to be your most
trusted ally in your pursuit of health and well-being. Both websites are part of
MediLexicon International Ltd., and its team and oces will remain in the United
Kingdom.

In its rst major announcement since raising $95 million in growth equity
nancing earlier this year, the transaction will bring the sites into Healthlines
Healthweb, strengthening its position as the second largest health media network on
the web with over 61 million unique visitors a month (ComScore, March 2016). All of
Healthline Medias digital properties meet the companys stringent criteria for providing
accurate, authoritative and unbiased content.
No matter where they are in the world or their health and wellness journey, our
mission at Healthline is to be an ally to health seekers and physicians, providing them
with content that is informative, easy to understand and engaging, says David Kopp,
CEO of Healthline Media. We have long been impressed with the content and growth of
MediLexicon.com and MedicalNewsToday.com. Today, we are excited to add these sites
to the Healthline family and further expand our ability to positively impact health-
seeking users.

Founded in 2006 and established as a standalone entity in January 2016, Healthline


Media helps health seekers better understand and live with medical conditions through
all of its digital properties, which include 22 communities on Facebook. Over the last
two years, Healthline.com has been the fastest growing health information site and now
has 25.9 million monthly U.S.-based users (comScore, March 2016) and 50 million
monthly global visitors (source: Google Analytics, March 2016). According to comScore,
Healthline is currently the fourth-largest health information site, with growth 8x its
competitors.

Under the terms of the deal, MedicalNewsToday.com, currently the number one ranked
(Google and Yahoo) website in the medical news category, boasting over 132 therapy
areas, joins Healthline.com, Drugs.com and Livestrong.com as Healthlines family of
exclusively-represented leading health properties. Also joining the Healthline Media
family is MediLexicon.com, a comprehensive online database of medical abbreviations
with over 200,000 denitions that are constantly updated. Both resources are free to
use, allowing people to instantly look up news and information on conditions,
treatments and medications, as well as meanings for acronyms and abbreviations from
the elds of medicine, pharmacy, biotechnology, agrochemicals, healthcare and more.

As a founder, you strive to build a company that makes an impact, says Alastair Hazell,
managing director and founder of MediLexicon International Ltd. Our partnership with
Healthline Media enables us to implement many of their learnings and best practices so
we can grow our trac and have an even greater impact. Our evidence based approach
naturally complements Healthlines empathetic, authoritative content and their vision to
create a stronger, healthier world aligns well with our values. Andrew Barnsley, founder
and Managing Partner of London based Adam Street Advisers, advised the shareholders
of MediLexicon International Ltd. on the transaction.

For more information or to speak with Healthline Media for additional details about
todays announcement, please contact Kimberly Angell at
kim(dot)angell(at)wishpr(dot)com.

About Healthline Media


Healthline Media is a San Francisco, CA-based company that provides health and
wellness information to consumers through its website, Healthline.com. The companys
mission is to be its users most trusted ally in their pursuit of health and well-being.
Healthline.com, which is the fourth largest and fastest-growing consumer health
information site, oers medically reviewed clinical content that is authoritative,
approachable and actionable. The privately held company is headquartered in San
Francisco with oces in New York, NY. For more information please call (415) 281-3100
or visit Healthline.com.

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Disclosures
Written by Amy Tenderich | Published on February 16, 2010

* Last updated April 27, 2015 *

This blog is written and edited by Editor-in-Chief Amy Tenderich and Managing Editor Mike Hoskins, with some
regular contributors and occasional guest authors. This blog does not accept any form of paid or commercial
editorial content. However, we will and do accept and keep free products*, services, travel, event tickets, and
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Exposure to the above may inuence topics or posts made in this blog. The blog owners are not compensated
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All advertising spots are clearly identied as such, and appear separately from editorial post content.

The owners of this blog would like to disclose the following existing relationships. These are companies and
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Healthline, Insulet, Integrated Diabetes Services, Johnson & Johnson, Liberty Medical, Medingo, Novo Nordisk,
Roche Diabetes Care, Sano Diabetes, Tandem Diabetes Care, Valeritas.

Note: These companies do not dictate the content found on DiabetesMine.com. All posts here are honest and
credible, any existing professional relationships notwithstanding.

* DEXCOM DISCLOSURE:

The folks at Dexcom have chosen to sponsor selected bloggers in the diabetes community, and Amy Tenderich
here at the 'Mine is honored to be included! As of June 2011, Dexcom is providing free products to Amy, for her
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