Clinical Services Contract Crib Sheet

March 29, 2011

Our contract crib sheets are a checklist of recent clinical contract announcements from Premier. For more detail, refer to Supply Chain Advisor or www.premierinc.com.

Terumo Cardiovascular Systems agrees to FDA consent decree
Existing customers must sign a CN

Terumo CVS has entered into a consent decree agreement with the FDA over products manufactured at its Ann Arbor plant. This decree affects items contracted under the perfusion agreement PP-OR-509 with Premier. It is important to note this is not a recall. The attached documents were provided by Terumo to fully explain the situation and to provide guidance on what everyone can expect.

Products manufactured at the plant include heart-lung machines and cannulae used in cardiac surgery.

In addition, Terumo CVS will fully restrict two products that are not part of its current product portfolio:  CDI™ 101 Hematocrit/Oxygen Saturation Monitoring System (until the updated device receives a 510(k) clearance)

 Tenderflow™ Pediatric Arterial Cannula

FDA extends Steris SYSTEM 1 transition time to February 2, 2012

STERIS has received information indicating that the FDA extended by six months the previously announced timeframe for U.S. customers to transition from SYSTEM 1®to an alternate processing technology. STERIS will continue to support current SYSTEM 1 customers through February 2, 2012, the extended date for completion of the transition. Steris requested the extension in light of the FDA’s ongoing review of the SYSTEM 1E biological indicator 510(k) submission, and to allow customers additional time to assess their alternatives, make any necessary changes to internal protocols, install replacement devices and conduct appropriate operator training.

The FDA is continuing its review of the Company’s 510(k) submission for the SYSTEM 1E biological indicator. A biological indicator is not required by FDA for the proper use of SYSTEM 1E. No additional information on the timing can be made as to if or when the FDA may clear the indicator

BD decreases prices for flush syringes effective May 1, 2011

BD will decrease the prices for flush syringes on the standard hypodermic products agreement, PP-NS-618, effective May 1, 2011. The savings for the Premier membership will be approximately $5.3M or 16 percent in aggregate. Given the significance of these savings, BD has assured Premier that the savings will not affect Premier members’ tier level. The new pricing will be available in Supply Chain Advisor® as soon as BD provides a detailed price list to Premier.

Contract Launch: Ophthalmology Products

Products included in this portfolio are used for surgeries of the eye. They include intraocular lenses (IOLs), phacoemulsification units, viscoelastics, disposables, ophthalmic blades, instruments and suture.

The Awarded Suppliers

Premier’s Surgical Services Committee is pleased to announce new agreements for ophthalmology products have been awarded to incumbents Ambler Surgical LLC, Bausch & Lomb Incorporated, Beaver-Visitec International Inc. and Surgical Specialties Corporation dba Angiotech, as well as new suppliers PSI/Eye-KO Inc. dba Anodyne and Strategic Business Holdings Inc. Agreements are effective July 1, 2011, through June 30, 2014.

Current agreements with Ambler Surgical, AMO, Angiotech, Bausch & Lomb and Becton Dickinson expire on June 30, 2011.

Nursing Recall: Hospira issues nationwide recall alert on 0.9% Sodium Chloride Injection USP in 1000 mL Lot # 95-070-JT*

In a letter dated March 4, 2011, Hospira Inc. is voluntarily recalling one lot of 0.9% Sodium Chloride Injection USP in 1000 mL flexible plastic containers. Hospira has identified that there is a potential for solution to leak from the bag at the letter “L” in the “1000 mL” imprinted label copy at the top of the bag. This could result in contamination of the fluid inside the bag. This lot was distributed in December 2010 through February 2011. No other lots are impacted by this recall and replacement product is available. The cause has been identified as a burr on the imprint plate. Corrective and preventive measures have been implemented.

Covidien announces launch of new line of recycled disposable sharps containers

Covidien announced the launch of a new line of recycled disposable sharps containers through Premier agreement PP-NS-653. The new line will be rolling out over the next several weeks. In an effort to simplify conversions, item codes and pricing will not change. Therefore, participating members will not need to modify their ordering process or update their material management systems.

Nursing Recall: Moog issues urgent medical device recall

In a letter dated March 14, 2011, B. Braun Medical Inc. was notified by Moog Devices Group that they were conducting a voluntary medical device recall of the Moog Curlin Ambulatory Infusion Pump due to a situation where a software anomaly leads to software Error Code 45 (EC45). On March 10, 2011, Moog provided B. Braun with a full list of all affected products. Pumps affected are listed on the attached document.

Nursing Free CEU webcast:

“Use of new technologies to reduce the incidence of CLABSI”

This webcast will discuss the risks related to CLABSI, causes of CLABSI-general, extraluminal, intraluminal, and CLABSI prevention strategies.

Previous Updates

Companies with manufacturing operations in Japan indicate no substantial delays or shortages due to tsunami

In the past week, Premier has contacted all suppliers in the medical/surgical portfolio that indicated in their RFI that products on the respective contracts were manufactured in Japan. Suppliers contacted included BD, Fujifilm, Iris Diagnostics, Nihon Kohden, Olympus, Roche Diagnostics, Skytron, Sysmex America, and Toshiba. All suppliers contacted indicated that they did not expect severe product shipment delays in the short term. Many suppliers indicated that there is substantial inventory on hand in the U.S.

Several suppliers have already sent letters to their customers to provide an update on the status of their manufacturing operations and shipments during this difficult time in Japan. As you are aware, the situation in Japan is still very fluid with the ongoing nuclear situation. Premier will continue to work closely with contracted suppliers to monitor product availability and will communicate updates via a file posted on the home page of Supply Chain Advisor®.

If you have additional questions or concerns about specific contracts, please contact the Premier Solution Center at 877.777.1552.

Press Ganey and Premier agree to cancel contract

Press Ganey Associates and Premier Purchasing Partners, L.P. mutually agree to cancel contracts PP-HR-042 and AS-HR-042 for Satisfaction Engagement Surveys, effective April 1, 2011.

NURSING: Price increase on products in the patient lifts and lateral transfer devices portfolio from ArjoHuntleigh

Effective April 1, 2011, ArjoHuntleigh will implement a price increase for the patient lifts and lateral transfer devices agreement (PP-NS-556). The pricing on ArjoHuntleigh’s patient lifts and lateral transfer devices agreement has been firm since the effective date of the agreement: August 1, 2009. The increase is allowed per the terms of the agreement and was requested due to the rise in raw material costs. Premier negotiated the total price increase per line item to 2.5 percent.ArjoHuntleigh is allowed up to 3 percent per line item per the terms and conditions of the agreement.

NURSING: Baxter announces discontinuation of Heparin Sodium in 5% Dextrose

In a letter dated January 2011, Baxter Healthcare Corporation announced they are discontinuing the manufacturing and distribution of Heparin Sodium in 5 percent Dextrose Injection liquid premix products. The affected product codes are 2B0807, 2B0802 and 2B0808.

Baxter Healthcare Corporation will continue to supply Heparin Sodium and 0.9 percent Sodium Chloride Injection (product codes 2B0953 and 2B0944). These are available through Premier agreement PP-IV-033. They have resumed production of 2B0953 and plan to resume production of 2B0944 in early 2011. These products will be manufactured in accordance with the new USP standard.

Current Baxter Healthcare Corporation (PP-IV-033) details are available in Premier’s electronic catalog at http://www.premierinc.com. If you have questions, please contact your local Premier representative or Premier’s Solution Center at 877.777.1552 or .

Group Buy Program – Current Events

Please refer to the Group Buy Website at www.premierinc.com/groupbuy.

Patient beds and mattresses (Hill-Rom) – Dates 3/15/11 – 4/15/11
Premier is pleased to announce a group buy with Hill-Rom Company for patient beds at the best national discount (up to 36 percent off list price) from March 15 to April 15, 2011.

EXPIRES SOON! Imaging Equipment (Toshiba) – Dates 1/1/11 -3/31/11

Exceptional value from $6,000 to more than $600,000 above Premier contract pricing across five Imaging product categories.

o  Anesthesia Equipment and Physiological Monitoring (Datex Ohmeda Inc., a GE Healthcare business) – Dates 3/1/11 – 5/15/11

§  2% discount above volume tier on anesthesia equipment and physiological monitors.

§  3% discount above volume tier on anesthesia equipment when purchased together with physiological monitors during this group buy.

o  Non-invasive ventilators (Respironics California Inc.) – Dates 3/1/11 – 5/31/11

§  Additional 6 percent savings over those available through the national agreement

§  BiPAP Vision - $2,500 trade-in value; S/T-D 30* or competitive non-invasive ventilator - $250 rebate

o  Physicist Services (Landauer) – Dates 1/1/11 – 9/30/11

§  Exceptional incentive tier pricing and services including, Imaging Physics Services, Therapy Physics Services, Commissioning Services

q  IV therapy educational series

Intended audience

RNs, CNOs, CIOs, materials management, pharmacy, quality assurance, infection prevention, IT, biomedical engineering

Encourage members to attend the six-course IV therapy educational series. Next session: April 1, 2011.

q  Imaging Education

Available on demand: CME webinar on radiation dose reduction.

“Improving Patient Safety in Diagnostic Imaging: Lowering Radiation Dose in CT Imaging” is now available online with 1 CME credit.

q  Nursing

CareFusion’s move from Cardinal Health IT platform could lead to possible changes in Cardinal’s distribution pricing model for CareFusion products.

Effective April 1, 2011, CareFusion will implement a wholly owned IT platform and sever their current dependence on Cardinal’s IT system for manufacturing and sales tracking. CareFusion legally separated from Cardinal Health on September 1, 2009, and during the interim has been using Cardinal’s operating platform. As a result of this change, CareFusion has advised Premier that Cardinal Health may make some changes to their model of pricing for CareFusion products distributed through Cardinal.

q  Solution Symposium: Needle-Free Connectors: Critical Design Features and Infection Risk

MARK YOUR CALENDAR! March 18, 2011, 12:30 p.m. ET/11:30 a.m. CT/10:30 a.m. MT/9:30 a.m. PT

Intended audience

RNs, CNOs, CIOs, materials management, pharmacy, quality assurance, infection prevention, IT, biomedical engineering

Program overview

This presentation will enhance the clinician's understanding of device classification and will examine recent data that give new perspective on risk factors associated with the use of needle-free connectors.

This presentation is part of a six-course IV therapy educational series.

http://www.premierinc.com/about/events-education/newsletters/Solutions-Symposium/IV-Therapy-Series-3-4-11.jsp

q  Cardiology: Medtronic adds the first and only pacemaker in the U.S. specifically designed for the MRI environment to its Premier agreement

Medtronic has added to contract the first and only pacemaker designed specifically for use in a Magnetic Resonance Imaging (MRI) environment and approved as MRI-Conditional. The addition of the Revo MRI™ SureScan™ pacing system and compatible leads to Premier agreement PP-CA-160 was effective February 15, 2011. This addition comes on the heels of the recent approval by the U.S. Food and Drug Administration for this product. Until now, an estimated 200,000 pacemaker patients in the United States have had to forgo MRI scans due to the potential for serious adverse events.

q  Cardiology: Cook Medical offers promotional savings off Torcon NB® Advantage Beacon® Tip Angiographic Catheter

Save $3 off each Torcon NB Advantage Beacon Tip Angiographic Catheter (HNBR4.0) or save $15 off per box. No limits.

q  Surgical Services: Price increase by Olympus for surgical endoscopy and video equipment products

Olympus America Inc. notified Premier of its right per the terms and conditions to implement an annual price increase for the Surgical Endoscopy products agreement (PP-OR-505), effective April 1, 2011. The pending price increase affects all tiers and is a weighted average increase of 2.71 percent.

q  Nursing: CareFusion experiencing product supply shortage affecting procedure tray products used for paracentesis and thoracentesis procedures

CareFusion is experiencing a supply shortage of sterile 10ml specimen vials with caps, one of the tray components in their paracentesis and thoracentesis trays. These trays are available on Premier agreements PP-NS-588 and AS-NS-588. To best maintain product availability, CareFusionhas elected to temporarily manufacture paracentesis and thoracentesis procedure trays without the 10ml vial with cap.

q  Promotions: For details, log into Supply Chain Advisor and filter for promotions/rebates in News/Resources

March expiration

o  CentiCare offers promotional pricing on stainless steel bedside/commode chair plus shipping for under $900 Rays (fka NightRays) offers promotional discount off professional fees for teleradiology services

o  Nihon Kohden offers up to 37 percent savings with EEG+ DV value package deal Expires Compression Therapy Concepts (CTC) offers a special six-month introductory incentive to new customers

o  Cepheid offers promotion on PCR Molecular Diagnostics instruments and assays
*Expires 3/31/1; 6/30/11

May expiration

o  Color Me Well offers promotional pricing on ‘My Visit to the Emergency Department’ coloring book

o  Cook Medical offers promotional savings off Torcon NB® Advantage Beacon® Tip Angiographic Catheter

Long-Term

o  Siemens offers long-term reduction on blood gas pricing Expires 9/30/11

o  B. Braun offers trade-in incentives plus limited-time options and flexible lease plans with its Infusion Pump Transition Program and rebates with its Disposable Program Expires 7/14/12

o  Free freight with no minimum order on all MSC In-Stock Items No expiration date

o  Access the Premier savings on new and existing Verizon Wireless accounts online No expiration date