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UNITED STATES PATENT AND TRADEMARK OFFICE
` BEFORE THE PATENT TRIAL AND APPEAL BOARD
`
`- - - - - - - - - - - - - - - +
`MYLAN PHARMACEUTICALS, INC.,
` Petitioner,
`vs.
`YEDA RESEARCH AND DEVELOPMENT
`CO., LTD.,
` Patent Owner.
`- - - - - - - - - - - - - - - +
` Case IPR2015-00643 (8,232,250)
` Case IPR2015-00644 (8,399,413)
` Case IPR2015-00830 (8,969,302)
` (And case numbers corresponding
` to the joined Amneal IPRs)
`
` Deposition of HENRY G. GRABOWSKI, Ph.D.,
`taken on behalf of Amneal Pharmaceuticals at the
`offices of Duane Morris LLP, 100 High Street, Suite
`2400, Boston, Massachusetts 02110, beginning at
`10:10 a.m. on February 10, 2016 before Dana Welch,
`CSR, RPR, CRR, CRC and Notary Public for the
`Commonwealth of Massachusetts.
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 1 of 121
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`YEDA EXHIBIT NO. 2148
`MYLAN PHARM. v YEDA
`IPR2015-00644
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`APPEARANCES:
`ON BEHALF OF MYLAN:
` BRANDON M. WHITE, ESQUIRE
` ROBERT D. SWANSON, ESQUIRE
` Perkins Coie
` 700 13th Street, Northwest
` Suite 600
` Washington, D.C. 20005-3960
` (202) 654-6200
` bmwhite@perkinscoie.com
` rswanson@perkinscoie.com
`
`ON BEHALF OF THE PATENT OWNER YEDA:
` NICHOLAS K. MITROKOSTAS, ESQUIRE
` Goodwin Procter LLP
` Exchange Place
` 53 State Street
` Boston, MA 02109
` 617.570.1000
` nmitrokostas@goodwinprocter.com
`
`--- appearances continue ---
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
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`APPEARANCES (continued)
`ON BEHALF OF AMNEAL PHARMACEUTICALS:
` VINCENT L. CAPUANO, Ph.D., ESQUIRE
` Duane Morris LLP
` 100 High Street, Suite 2400
` Boston, MA 02110-1724
` (857) 488-4250
` vcapuano@duanemorris.com
`
`Also present: Lori Wolfe, Teva Pharmaceuticals
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 3 of 121
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`YEDA EXHIBIT NO. 2148
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`

`
` I N D E X
`WITNESS:
` HENRY G. GRABOWSKI, Ph.D.
`
`4
`
`EXAMINATION: PAGE:
` BY MR CAPUANO 7
`EXHIBITS MARKED:
` NO. DESCRIPTION PAGE:
` None marked
`
`EXHIBITS PREVIOUSLY MARKED:
` NO. DESCRIPTION PAGE
` Yeda Exhibit 2105, List of Testimony of 15
` Henry G. Grabowski
` Yeda Exhibit 2107, Approval Timeline 55
` Multiple Sclerosis Drugs
` Yeda Exhibit 2108, Copaxone 40 mg/mL 20
` Wholesale Dollar Sales Q1 2014 - Q3 2015
` Yeda Exhibit 2109, Copaxone 40 mg/mL 29
` Extended Units Q1 2014 - Q3 2015
` Yeda Exhibit 2110, Copaxone 40 mg/mL Total 35
` Prescriptions Q1 2014 - Q3 2015
` Yeda Exhibit 2111, Copaxone 40 mg/mL New 36
` Prescriptions Q1 2014 - Q3 2015
` --- index continues ---
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` INDEX (continued)
` EXHIBITS PREVIOUSLY MARKED
` NO. DESCRIPTION PAGE
` Yeda Exhibit 2112, Multiple Sclerosis 42
` Drugs Share of Wholesale Dollar Sales Q4
` 2009 - Q3 2015
` Yeda Exhibit 2113 Multiple Sclerosis Drugs 45
` Share of Total Prescriptions Q4 2009 - Q3
` 2015
` Yeda Exhibit 2115, Rationale for 60
` Requesting Copaxone
` Yeda Exhibit 2117, Rationale for 65
` Discussing 20 mg and 40 mg for First Line
` Patients
` Yeda Exhibit 2118, Perceptions of Copaxone 80
` 40 mg vs. 20 mg
` Yeda Exhibit 2119, Perceptions of Copaxone 71
` 40 mg compared to Daily Generic GA
` Yeda Exhibit 2120, Copaxone Total 54
` Prescriptions Q4 2009 - Q3 2015
` Yeda Exhibit 2121, Copaxone 20 mg/mL, 68
` Copaxone 40 mg/mL and Glatopa Net
` Prescriptions Flow 10/26/12 - 10/9/15
` Yeda Exhibit 2122, Total Promotional 91
` Spending to Sales Ratio
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
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`6
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` INDEX (continued)
` EXHIBITS PREVIOUSLY MARKED
` NO. DESCRIPTION PAGE
` Yeda Exhibit 2133, Corrected Declaration 8
` of Henry G. Grabowski, Ph.D. In Support of
` Patent Owner Yeda's Response to
` Institution of Inter Partes Review
`
`NOTATIONS:
` Designation of transcript under protective 36
` order
`
` Exhibits retained by reporter, to be appended to
` transcript.
`
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` P R O C E E D I N G S
` HENRY G. GRABOWSKI, Ph.D., sworn
` MR. CAPUANO: I guess we should start by
` putting our appearances on the record.
` For petitioner Amneal, my name is
` Vincent Capuano with Duane Morris LLP.
` MR. WHITE: For petitioner Mylan,
` Brandon White and Rob Swanson from Perkins Coie.
` MR. MITROKOSTAS: For patent owner and the
` witness, Dr. Grabowski, Nick Mitrokostas of Goodwin
` Procter, and also present today is Lori Wolfe of
` Teva.
` EXAMINATION
` BY MR CAPUANO:
` Q. Good morning, Dr. Grabowski.
` A. Good morning.
` Q. I won't bother you with the rules of
` depositions, with the understanding that you've
` been through many depositions.
` And if you have any questions or I need to
` clarify anything, you'll let me know. Okay?
` A. Yes.
` Q. And, of course, if you ever need to take a
` break, we can do that any time you want. I just
` ask that we not do it while a question is pending.
`
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` Is that okay?
` A. Sure.
` Q. Okay. I'm going to hand you what is
` Exhibit 2133 in IPR number 2015-00643.
` MR. CAPUANO: And, I guess, as we go
` through today, I'm going to refer to exhibit
` numbers, and we have three IPRs. I think the
` exhibit numbers correspond across the IPRs, I'll
` assume they do. To the extent they don't, either
` let me know or we can deal with it after. But I
` don't want to have three sets of every exhibit, one
` for each IPR.
` Is that okay, counsel?
` MR. MITROKOSTAS: Yes. If there's an
` issue, I will identify it for you.
` MR. CAPUANO: Okay. Thank you.
` MR. MITROKOSTAS: But it's my
` understanding the exhibit numbers are the same.
` BY MR. CAPUANO:
` Q. Dr. Grabowski, do you understand --
` MR. CAPUANO: Sorry, strike that.
` Q. Do you recognize Exhibit 2133 that's been
` handed to you?
` A. Yes.
` Q. Okay. And what is Exhibit 2133?
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` A. It's a declaration I made in this case
` involving an IPR action, and specifically with
` respect to the '250 patent.
` Q. Can you tell me when you were first
` contacted with regard to this IPR action?
` A. I think it was in the early fall of 2015.
` Q. Okay. And did you draft the declaration
` that is Exhibit 2133?
` A. Yes, I did. I drafted it, but also in
` collaboration with some colleagues -- or not -- who
` are in a group called Cornerstone Research.
` Q. And what is Cornerstone Research?
` A. They're a consulting company that has
` various tasks, but one of the things they do is to
` assist experts in litigation.
` Q. Okay. So Cornerstone Research is not a
` company that you own; is that right?
` A. That's correct.
` Q. Are you employed by Cornerstone Research?
` A. No.
` Q. Okay. So you contract with them to help
` you; is that how it worked?
` A. I don't think it's a formal contract, but
` yes, they work with me. They have for several
` years.
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` Q. Okay. And for the work they do, do they
` invoice you?
` A. No.
` Q. They invoice Teva?
` A. Yes.
` Q. Okay. And what are the names of the
` people at Cornerstone that helped you with this
` report?
` A. There is Dr. Rahul Guha in Cornerstone in
` their New York office and Dr. Lisa Tichy in the New
` York office, and then there were some assistants
` with them.
` Q. Okay. And did they work under your
` direction in preparing this report?
` A. Yes.
` Q. Okay. And did they do research for you to
` prepare this report?
` A. They did some background analysis. For
` instance, if I said I want you to look at the
` medical literature on MS -- and I do it also
` myself, but it's another pair of eyes to kind of
` search the relevant literature.
` Q. Okay. And so is it the case that some of
` the information in this declaration was first
` identified by the people at Cornerstone and then
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` passed on to you?
` MR. MITROKOSTAS: Objection to the form.
` A. It's possible. But in most cases they
` identify material that I'm already familiar with.
` Q. Okay. And do they prepare the first draft
` of the declaration?
` MR. CAPUANO: Strike that.
` Q. For this report, did they prepare the
` first draft?
` MR. MITROKOSTAS: Objection to the form.
` A. I prepared a first draft in terms of a
` very detailed outline and then they collaborated
` with me in some of the sections.
` Q. Did you send them an outline by e-mail?
` A. No.
` Q. You sent your outline to counsel; is that
` how it worked?
` A. No.
` MR. MITROKOSTAS: Objection to the form.
` And I would caution the witness not to reveal the
` content of any communications with attorneys.
` A. You know, I discussed it over the phone in
` terms of what would be the kind of report that I
` wanted to put together.
` Q. Okay. So over the phone you outlined the
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` issues you wanted to talk about and gave direction
` to Cornerstone to begin to prepare a draft
` declaration according to the outline you gave them
` over the phone; is that a fair way to summarize it?
` MR. MITROKOSTAS: Objection.
` A. That's the first step.
` MR. MITROKOSTAS: Objection to form.
` A. First step would be that. And then I will
` also start drafting and sending them some drafts
` that get incorporated here.
` Q. And then you go back and forth with
` Cornerstone a few times until you're satisfied with
` the first draft, is that how it worked?
` A. Yes.
` Q. In the end you reviewed the entire report
` and then signed it as summarizing your opinions; is
` that fair?
` MR. MITROKOSTAS: Objection to the form.
` A. You know, I authored -- yes, it represents
` my opinions.
` Q. Okay. In paragraph 3, you mention that
` you testified several times before Congress.
` Do you see that?
` A. Yes.
` Q. Were you ever compensated for the
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` testimony you gave before Congress?
` A. I think in the early days the
` congressional staff would pay for your travel, but
` they don't even do that anymore.
` Q. Did you give testimony before Congress on
` behalf of any pharmaceutical company?
` A. No. I was contacted by a staffer who said
` we're going to have hearings on this issue and we
` understand you've done research on it and we'd like
` you to be part of a panel or testify on it, and
` that's how the testimony came about.
` Q. And did you prepare for any testimony you
` gave in front of Congress?
` MR. MITROKOSTAS: Objection to the form.
` A. Yes. I mean, you're given a certain time,
` so I prepared a statement. And, you know,
` generally you have to edit that statement orally
` because it's too long. But they put it in the
` record.
` Q. And in preparing for testimony in front of
` Congress, did you work with any pharmaceutical
` company or with the Pharmaceutical Research
` Manufacturers' Association?
` MR. MITROKOSTAS: Objection to the form.
` A. Well, in terms of I may have shown it to
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` various parties, foundations, the pharmaceutical
` industry, insurers, you know, I -- generally my
` research is open to comments from any sets of
` groups.
` Q. In paragraph 5 of your report -- and I can
` tell you, you know, my plan. I just sort of want
` to plow through this report. I'm not going to try
` to be tricky about it. I just want to get through
` it and have you explain it to me.
` So on paragraph 5 you start by saying, "I
` have done extensive research." Do you see that?
` You say you "performed several studies on
` pharmaceutical R&D costs and profits."
` Do you see where you say that?
` A. Yes.
` Q. Has any of your research or studies been
` funded by Teva?
` MR. MITROKOSTAS: Objection to the form.
` A. No.
` Q. How about BIO, the Biotechnology Industry
` Organization, has any of your research or any of
` your work been funded by BIO?
` A. I don't think so. You know, I presented
` at BIO conferences, but I can't recall ever getting
` funding from BIO.
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` Q. And what about P-h-R-M-A or PhRMA, has any
` of your work be funded by PhRMA?
` A. They've been sponsored by PhRMA, yes.
` There have been some studies where -- and I usually
` or I -- we could go through my CV, but where I get
` funding from PhRMA, I acknowledge that.
` Q. So let's look at, I'm going to hand you
` Exhibit 2105. Exhibit 2105 is a list of testimony
` of Henry Grabowski that you attached to your
` declaration, correct?
` A. Yes.
` Q. Now, is it the case that all of these
` cases in which you presented testimony, your
` testimony was on behalf of a pharmaceutical
` company?
` MR. MITROKOSTAS: Objection to the form.
` A. Appears to be the case over the last four
` years, but certainly not the case historically.
` Q. So some of these cases are Hatch-Waxman
` district court cases; is that right?
` A. Yes.
` Q. And in those Hatch-Waxman district court
` cases in which you gave testimony on behalf of the
` pharmaceutical company, was it always on behalf of
` the pharmaceutical company who was the patent
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` owner?
` MR. MITROKOSTAS: Objection to the form.
` A. No.
` Q. Okay. Which cases on your list here were
` on behalf of the non-patent owner?
` A. I think Dey versus Sunovion was a case in
` which the patent owner was Dey and I was
` representing Sunovion.
` Q. Okay. Any others?
` A. I think that's it.
` Q. Okay. Would you say that the majority of
` these cases were cases in which you gave testimony
` that there was commercial success of a
` pharmaceutical product that was due to a patented
` invention?
` A. You mean of all the cases listed here or
` are we just talking about the Hatch-Waxman cases?
` Q. Well, let's start with the Hatch-Waxman
` cases.
` A. The majority of the cases, yes, are cases
` in which I've testified that the product had
` commercial success. But it's not the universe of
` cases that I have been asked to testify, and in
` some cases, I indicate that I don't -- it's
` problematic that I can determine there's commercial
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` success and that I'm not usually hired for those
` cases.
` Q. So have you ever given testimony in any of
` these cases in which your opinion was that there
` was not commercial success due to patented features
` of a pharmaceutical product?
` MR. MITROKOSTAS: Objection to the form.
` A. Yes. In Dey versus Sunovion.
` Q. And besides Dey versus Sunovion, any
` others?
` A. No.
` Q. In Dey versus Sunovion, did you give
` testimony regarding your opinion that there was not
` commercial success due to the patented invention?
` MR. MITROKOSTAS: Objection to the form.
` A. Yes.
` Q. And that's the only one on this list in
` which you gave testimony that there was not
` commercial success; is that right?
` A. Yes. I think that's true.
` Q. Okay. Let's move over to paragraph 12 of
` your declaration. Paragraph 12 is the first
` paragraph in a section called "Summary of
` Opinions."
` Do you see that?
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` A. Yes.
` Q. And you offer the summary that you
` "conclude that Copaxone 40 milligrams per
` milliliter is a commercial success."
` Do you see that? You see that, right?
` A. Yes.
` Q. And we're going to go through the details
` of your report, but I'd first like to understand
` what criteria you used in determining that Copaxone
` 40 milligrams per milliliter is a commercial
` success. And so -- and you might want to look at
` paragraphs 24 and 25.
` But the question is, what were the
` criteria you considered in arriving at your
` conclusion that Copaxone 40 milligrams per
` milliliter is a commercial success?
` MR. MITROKOSTAS: Objection to the form.
` A. Well, I think there's a lot of detail in
` paragraphs 26 through 33 which provides this, you
` know, at a highest level, its significant sales in
` the relevant market. So I looked at dollar sales;
` I looked at unit sales; I looked at prescriptions,
` both new and total prescriptions. And so I looked
` at those metrics and looked at the growth over
` time.
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
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` The 40 milligram has only been on the
` market right now about two years, and my data was
` about 20 months, so I had a limited period to look
` at. But within that 20 months, Copaxone 40
` milligram has sold more than $ billion in sales.
` It has, I think, a little less than
` million units, those are syringes, one-milliliter
` syringes with Copaxone 40 milligrams. It has very
` significant levels of new and total prescriptions,
` very strong growth in a short period of time.
` And then I focus on the relevant market,
` which are essentially products approved for MS,
` relapsing, or MS that's -- prescribed for relapsing
` forms of MS. And there's a series of products that
` have such an approval.
` And so I then look at the shares in terms
` of sales and prescriptions in my analysis. And
` it's achieved very significant shares in a short
` period of time.
` And then I also look at some analysts'
` reports that also look at the commercial success of
` Copaxone.
` Q. Okay. Let's start with where you
` referenced starting in paragraph 26. In paragraph
` 26 you reference Exhibit 2108.
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 19 of 121
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`YEDA EXHIBIT NO. 2148
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` Do you see that?
` A. Yes.
` Q. So let me hand you that exhibit.
` Is this exhibit something that Cornerstone
` put together for you?
` A. Under my direction, yes, they produced the
` graph. But I analyzed the data and told them what
` I wanted, and they produced it, yes.
` Q. What data are you referring to?
` A. It's the IMS NPS data that charts
` wholesale dollar sales.
` Q. And the dollar figures that you have
` summarized in Exhibit 2108, this is based on you
` said wholesale dollar sales; is that right?
` A. Yes.
` Q. So is this based on the published list
` price for Copaxone 40-milligram per milliliter?
` MR. MITROKOSTAS: Objection to the form.
` A. Well, I'm not sure how you define list
` price. It's based on the invoice price.
` Q. Invoice to who?
` A. Basically Copaxone is supplied through
` wholesalers, people like Cardinal and McKesson,
` firms like that, and sometimes directly to
` pharmacies. And there is an invoice that is the
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 20 of 121
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`YEDA EXHIBIT NO. 2148
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` price, and the units that are sold. And there is
` an audit of those invoices and that's how IMS
` prepares sales.
` Q. So this is an invoice from the
` manufacturer to the wholesaler?
` A. Yes.
` Q. Okay. That price is not the price that is
` borne by the patient, correct?
` A. That's correct. There's usually a markup
` by a pharmacy.
` Q. And on that price also --
` MR. CAPUANO: Strike that.
` Q. The wholesale dollar sales numbers that
` you used to prepare Exhibit 2108 doesn't account
` for price discounts; is that right?
` A. It accounts for some discounts, but not
` all discounts.
` Q. Okay. Which discounts does it account
` for?
` A. Well, there is a -- anything that's a
` discount that's on the invoice, volume discounts,
` for instance, would be accounted for, so that any
` discount that's normally reflected in an invoice.
` Q. It doesn't include any discount subsequent
` to the invoice from the manufacturer, right?
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 21 of 121
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`YEDA EXHIBIT NO. 2148
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` MR. MITROKOSTAS: Objection to the form.
` A. It would not include discounts associated
` with the providers.
` Q. And it wouldn't include any rebates
` either, would it?
` A. Yes, that's what I meant. I should have
` said insurers. Any rebates to insurers are usually
` done on a quarterly basis, so it's not reflected in
` any of the IMS data, or generally those data
` rebates are not generally made available by
` companies for competitive reasons.
` Q. Okay. And it also doesn't include any
` other sort of coupons or price reductions that are
` available to patients; is that correct?
` A. Yes, that's correct.
` Q. Is it your opinion that wholesale dollar
` sales alone can establish commercial success?
` A. It's a very important factor, because in
` the pharmaceutical industry a large part of sales
` fall to the bottom line, particularly for a product
` like this, which has very little promotion as a
` percentage of sales, so that wholesale dollar sales
` are, you know, a very important metric that
` security analysts and the companies focus on.
` But generally, as I said, I look at more
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 22 of 121
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` than just wholesale dollar sales. I look at units,
` I look at prescriptions. I look at shares within
` the relevant market.
` Q. And we'll get to that. I'm just focused
` on this exhibit.
` The use of wholesale dollar sales, because
` it doesn't take into account price discounts,
` rebates, and coupons subsequent to the initial
` invoice from the manufacturer cannot be used to
` reliably calculate revenue; is that right?
` MR. MITROKOSTAS: Objection to the form.
` A. No. I wouldn't agree with that. My
` experience is that, you know, while it doesn't
` include those, those are not so large that they
` would cause a product to not achieve a significant
` profit. There is -- you know, coupons are limited
` in size and share of the total sales and that's
` also true of rebates.
` So it, you know, it's a -- there are
` discounts that are not reflected in any of the
` audit data because the companies keep those --
` generally keep them to themselves because of
` competitive reasons.
` Q. Now, you say that in your experience those
` kind of discounts are not so large that they would
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
`Page 23 of 121
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` significantly impact profit. Do you know in your
` experience how large can these kind of rebates be
` in terms of percentage of sales?
` MR. MITROKOSTAS: Objection to the form.
` A. You know, there's a mandatory rebate for
` Medicaid. It was initially 15 percent or best
` price, essentially your best price discount, and it
` has increased to 20 percent, but that's confined to
` Medicaid.
` And my general experience is that it's
` less to the general marketplace, unless one is in a
` highly competitive situation where particularly if
` there are generics in the marketplace and they are
` taking, you know, they could -- the rebates could
` get larger than 20, from 15 to 20 percent. But
` generally, they're less than that.
` Q. Did you look into whether Teva offered
` discounts or rebates for Copaxone 40?
` A. I cite that they offered a co-pay
` arrangement and that -- and so that's one of the
` factors I looked into.
` Q. You didn't consider that in a quantitative
` way, though; is that right?
` MR. MITROKOSTAS: Objection to the form.
` A. That's correct. Well, I indicated the
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
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` nature of it.
` Q. You didn't indicate it in a quantitative
` way in your analysis, though, right?
` A. Well, I'm not sure what you mean by a
` quantitative way. The co-pays are generally a
` small part of the net price, and so they're not so
` large as to change my opinion that this is -- as
` one security analyst said, this is the best launch
` ever for an MS product. And these dollar sales are
` reflected in a strong stock price over this period
` for Teva.
` Q. What part of the net price was the co-pay
` for Copaxone 40?
` A. That varies by insurer. Depends on where
` they are on the formulary. But in this product,
` generally the co-pays are a relatively small
` portion relative to the net price.
` Q. Do you know what the net --
` MR. CAPUANO: Strike that.
` Q. Do you know what the co-pay was for
` Copaxone 40 relative to the net price at the time
` Copaxone 40 was launched?
` A. I know that -- I know the price that was
` the invoice price. It's roughly a thousand dollars
` a week for Copaxone 40 and -- or you know, it's
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
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` three pills a week, so that's a little less than
` $400 -- not a pill, but $400 a syringe. And of
` that, you know, you're not charging patients --
` there aren't many insurers, unless they don't cover
` the product, who charge patients anywhere near a
` thousand dollars a week. So the co-pay is some
` fraction of that.
` And we have representative values in -- by
` Kaiser and other people, for -- you know, generally
` for insurance purposes, and they can range up in
` the $50 a prescription. Prescription is usually a
` package of 12. So that's a representative co-pay.
` Q. Is it your testimony that Teva offered $50
` co-pay for each prescription of Copaxone 40?
` MR. MITROKOSTAS: Objection to form.
` A. No, absolutely not.
` Q. Sorry. I'm just trying to understand.
` Quantitatively what was the fraction of
` the price --
` MR. CAPUANO: Sorry.
` Q. I'm trying to understand, what fraction of
` the price was the co-pay?
` A. What I said is it varies by insurer. If
` you're on the second tier of the insurer, you'd
` probably pay a minuscule percentage, and then if
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
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` you're on a higher tier, you could pay a higher
` percentage. But it's not going to be such a burden
` to the patient that it makes them unwilling to take
` a product that is beneficial to them in the normal
` case of things.
` So, you know, I'm just telling you that
` there was a co-pay arrangement. It could be as
` much as $50, but it certainly is not every patient
` that took this product.
` Q. Could be more than $50, too, right; you
` just don't know?
` A. In some cases it could be more than $50.
` There could be restrictions on this. But you know,
` anybody who -- in this state of Massachusetts,
` they're not eligible for coupons. Anybody on
` Medicaid is not eligible for a coupon. Anybody on
` Medicare is not eligible for a coupon. So my
` experience is these are not -- these coupon
` arrangements are not, you know, they're -- because
` of so many insurers like the federal government
` don't allow them quantitatively, it's not a large
` expense from the top line.
` Q. What about rebates? You don't consider
` rebates in Exhibit 2108 either, right?
` MR. MITROKOSTAS: Objection to the form.
`
`The Little Reporting Company
` (646) 650-5055 | www.littlereporting.com
`
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` A. That's correct.
` Q. Did you look into the rebates that Teva
` offered for Copaxone 40 at the time of launch?
` A. No. I didn't have that data.
` Q. Did you look at rebates that Teva offered
` for Copaxone 40 at any time?
` A. No. As I indicated, I would expect that
` on a product that has these medical benefits that's
` a new product that the rebates would be minimal.
` Q. But you didn't look into it to know
` whether in fact that's the case, right?
` MR. MITROKOSTAS: Objection to the form.
` A. I didn't have that data available.
` Q. Are you aware that for some products,
` rebates and coupons can be as large as 60 percent
` of the wholesale price?
` A. Yes. As I indicated, if an area becomes
` genericized and the products are close in
` therapeutic value, rebates can get very large.
` I've seen that in some cases. But they're unusual
` cases and they're cases that involved very close
` therapeutic substitutes in the presence of generic
` competition.
` Q. Okay. Because you

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