ex4_91.htm


    Exhibit
4.91


    


    


    


    


    


    Catherine
Soldano-Noble

    Executive
Director, Marketing & Business Development

    Medpace,
Inc.

    4620
Wesley Avenue

    Cincinnati,
OH 45212

    


    Re:  Amendment
#5 to the Letter Agreement (“Amendment #5”) for certain initial services for the
Ethyl-EPA Hypertriglyceridemia Studies between Amarin Pharma Inc., Amarin
Pharmaceuticals Ireland Limited, and Medpace, Inc. dated 1 December 2008, as
amended on 19 January 2009 and as further amended on 30 January 2009, 5 May 2009
and 3 August 2009 (the “Initial Services Letter Agreement”).

    


    Dear
Catherine:

    


    The
parties wish to amend the Initial Services Letter Agreement
in order to include new direct costs for Site Identification and
Selection for the 0017 study

    


    This
Amendment #5 is dated as of the date of last signature below.

    


    Defined
terms in this letter shall have the same meanings as given to such terms in the
Initial Services Letter Agreement unless otherwise defined herein

    


    In
consideration of the mutual covenants contained in the Initial Services Letter
Agreement IT IS NOW HEREBY
AGREED AS FOLLOWS:

    


    
      	
              1.  

            	
              Direct
      Fees

            


    

    
      	
              ·  

            	
              Medpace
      will perform CRF Development for the 0017 study, and Amarin will pay
      Medpace $11,019.58 for this
service.

            


    

    
      	
              ·  

            	
              Medpace
      will perform IVRS Development for the 0017 study, and Amarin will pay
      Medpace $25,890.00 for this
service.

            


    

    
      	
              ·  

            	
              Medpace
      will perform ICF services for the 0017 study, and Amarin will pay Medpace
      $2,772.00 for this service.

            


    

    
      	
              ·  

            	
              Medpace
      will Negotiate Site Budgets for the 0017 study, and Amarin will pay
      Medpace $40,710.00 for this
service.

            


    

    
      	
              ·  

            	
              Medpace
      will provide Study Master Files for the 0017 study, and Amarin will pay
      Medpace $13,068.00 for this
service.

            


    

    
      	
              ·  

            	
              Medpace
      will Collect Regulatory Documents for the 0017 study, and Amarin will pay
      Medpace $70,136.93 for this
service.

            


    

    
      	
              ·  

            	
              Medpace
      will perform Project Management for the 0017 study, and Amarin will pay
      Medpace $99,566.71 for this
service.

            


    

    
      	
              ·  

            	
              Medpace
      will conduct Teleconferences with the Sponsor for the 0017 study, and
      Amarin will pay Medpace $2,568.00 for this
  service.

            


    

    
      	
              ·  

            	
              Medpace
      will perform Qualification Visits for the 0017 study, and Amarin will pay
      Medpace $23,120.00 for this
service.

            


    


    
      
         


      

      
         


        
          

        

      

      
         


      

    


    


    
      	
              ·  

            	
              Medpace
      will provide a Monitoring Plan for the 0017 study, and Amarin will pay
      Medpace $1,106.80 for this service.

            


    

    
      	
              ·  

            	
              For
      the Direct Fees listed above, Amarin will pay Medpace $289,958.01 for
      the Initial
      Trial 0017 Services Letter Agreement upon signature of this Amendment
      #5.

            


    

    


    
      	
              2.  

            	
              Pass
      Through

            


    

    
      	
              ·  

            	
              Pass
      Through costs for Monitoring Travel have been added in the amount of
      $10,000.00.

            


    

    
      	
              ·  

            	
              Pass
      Through costs for Conference Calls have been added in the amount of
      $200.00.

            


    

    
      	
              ·  

            	
              For
      the Pass Through costs listed above, Amarin will pay Medpace $10,200.00
      for the Initial
      Trial 0017 Services Letter Agreement upon signature of this Amendment
      #5.

            


    

    


    
      	
              3.  

            	
              Escrow
      Fees

            


    

    
      	
              ·  

            	
              Escrow
      Fees for Central IRB have been added in the amount of
      $49,841.99.

            


    

    
      	
              ·  

            	
              For
      the Escrow Fees listed above, Amarin will pay Medpace $49,841.99 for
      the Initial
      Trial 0017 Services Letter Agreement upon signature of this Amendment
      #5.

            


    

    


    All other
provisions of the Initial Services Letter Agreement shall remain unchanged and
in full force and effect.

    


    Please
confirm your agreement with the above by signing this letter where indicated
below and returning a fully signed version to us.

    


    Yours
sincerely,

    


    Amarin
Pharma Inc.

    


    


    by:___________________________________

    Name:

    


    Title:

    


    Date:

    


    


    Amarin
Pharmaceuticals Ireland Limited

    


    


    by:___________________________________

    Name:

    


    Title:

    


    Date:


    
      
         


      

      
         


        
          

        

      

      
         


      

    


    


    


    


    


    AGREED
TO:  Medpace, Inc.

    


    


    by:___________________________________

    Name:

    


    Title:

    


    Date: