Pursuant to 17 CFR 229.601(b)(10)(iv), confidential information (indicated by [***]) has been omitted from this exhibit because it is both not material and
      would likely cause competitive harm to the registrant if publicly disclosed.

    

    Exhibit 10.11.4

     

    AMENDMENT NO. 3 TO

      CONTRACT MANUFACTURING AGREEMENT (Metreleptin SLD)

     

    THIS AMENDMENT NO. 3 (the “Amendment”) is made as of 8th July 2013 (the “Amendment Effective Date”) by and between Amylin Pharmaceuticals, LLC (formerly known as and successor in interest to Amylin Pharmaceuticals, Inc.) with
      offices at 9625 Towne Centre Drive, San Diego, California 92121, USA (“Amylin”) and Sandoz GmbH, with a principal place of business at Biochemiestr. 10, A6250 Kundl, Austria (“Sandoz”).

     

    WITNESSETH:

     

    WHEREAS, Amylin and Sandoz are parties to a certain Contract Manufacturing Agreement in relation to Metreleptin SLD dated as of 30
      September 2010, as amended (the “Agreement”); and

     

    WHEREAS, Amylin and Sandoz desire to integrate the Agreement to reflect mutually agreed upon terms in accordance with the provisions
      of this Amendment.

     

    NOW, THEREFORE, in consideration of the mutual covenants and agreements set forth herein and for other good and valuable
      consideration, the receipt and adequacy of which are hereby acknowledged, Amylin and Sandoz agree as follows:

     

    	1.	Definitions.


     

    Capitalized terms used herein, but not otherwise defined, shall have the meanings ascribed to them in the Agreement.

     

    	2.	Amendments.


     

    2.1       Sandoz Release Specifications Table set forth in Schedule 2 of the Agreement, as amended and replaced by Clause 7 of the First
      Amendment to the Agreement, is hereby amended and entirely replaced by the document CP-No. / CP-Version 7206.3, which is incorporated herein by reference.

     

    2.2       Amylin’s address and contact information has changed; therefore Section 30(1)1. is amended and replaced with the following:

     

    	 	If to Amylin, address to:	
            Amylin Pharmaceuticals, LLC

            9625 Towne Centre Drive

            San Diego, CA 921212

            Attention:

            [***]

            [***]

          
	 	 	 
	 	With a copy to:	
            Vice President and Associate General Counsel,

            Transactions

            Contracts Center of Excellence

            Bristol-Myers Squibb Company

          


     
    
      
        
 

    

     

    	 	Route 206 & Province Line Road

            Princeton, New Jersey 08543-4000


     

    	3.	Reference to and Effect on the Agreement.


     

    3.1       On and after the Amendment Effective Date, each reference to “this Agreement,” “hereunder,” “hereof,” “herein,” or words of like
      import shall mean and be a reference to the Agreement as amended hereby. No reference to this Amendment need be made in any instrument or document at any time referring to the Agreement, a reference to the Agreement in any of such instrument or
      document to be deemed to be a reference to the Agreement as amended or integrated hereby.

     

    3.2       Except as expressly amended or integrated by this Amendment including the Exhibit A attached hereto, the provisions of the Agreement
      shall remain in full force and effect.

     

    	4.	Counterparts.


     

    This Amendment may be executed in any number of counterparts, each such counterpart shall be deemed to be an original instrument, and all such
      counterparts together shall constitute but one agreement. Any such counterpart may contain one or more signature pages. This Amendment may be executed by facsimile signature pages.

     

    IN WITNESS WHEREOF, the undersigned have caused this amendment to be executed and delivered on the date first written above.

     

    	Sandoz GmbH	Amylin Pharmaceuticals, LLC	

          


     

    	Date:	Aug 08, 2013	 	Date:	08 Aug 2013
	 	 	 	 	 
	By:	[***]	 	By:	[***]
	 	 	 	 	 
	Name:	[***]	 	Name:	[***]
	 	 	 	 	 
	Title:	[***]	 	Title:	[***] 


     

    Sandoz GmbH

     

    	Date:	August 1, 2013	 
	 	 	 
	By:	[***]	 
	 	 	 
	Name:	[***]	 
	 	 	 
	Title:	[***]