Document:

Addendum No. 5 to Amended and Restated Master Services Agreement

 EXHIBIT 10.67 
 ADDENDUM No. 5 TO 
 AMENDED AND RESTATED MASTER SERVICES AGREEMENT 

 THIS ADDENDUM No. 5 (the “Addendum”) to the AMENDED AND RESTATED MASTER SERVICES AGREEMENT dated as of May 31, 2005, as
amended (collectively, the “Agreement”), by and between EXPRESS SCRIPTS SPECIALTY DISTRIBUTION SERVICES, INC. (“ESSDS”) and ORPHAN MEDICAL, INC. (“Orphan Medical”) and assigned to JAZZ
PHARMACEUTICALS, INC. (“Jazz Pharmaceuticals”), is entered into as of September 24, 2007 by and between ESSDS and Jazz Pharmaceuticals. Capitalized terms not otherwise defined herein shall have the same meanings as in the
Agreement. 
 RECITALS 
 WHEREAS, Jazz Pharmaceuticals desires ESSDS to administer a Jazz co-payment assistance
pilot program for Xyrem® (the “Copayment Program”); and 
 WHEREAS, the parties desire to amend the Agreement to add the Copayment Program services as part of the Agreement. 
 NOW,
THEREFORE, in consideration of the foregoing and the respective representations, warranties, covenants and agreements set forth herein and in the Agreement, the parties hereto agree as follows: 
 AGREEMENT 
 1. Copayment
Program Services. ESSDS shall perform the CoPayment Program services set forth in Exhibit A for Jazz Pharmaceuticals (the “Copayment Program Services”). 
 2. Term and Termination. The term of the Copayment Program shall commence on [ * ] and shall continue through [ * ]. Jazz Pharmaceuticals
may terminate this Addendum at any time upon thirty (30) days’ prior written notice to ESSDS. In addition, if the Agreement is terminated pursuant to its termination provisions stated therein, then this Addendum shall also be terminated at
such time. The Copayment Program Services will end upon the dispensing of the last Xyrem prescription for which Jazz Pharmaceuticals is providing copayment assistance, as described in Exhibit A (the period following termination/expiration of
the Copayment Program and the aforementioned last date of dispense shall be referred to herein as the “Copayment Program Run-Out Period”). 
 3. Fees. Jazz Pharmaceuticals shall pay ESSDS a non-refundable start-up fee of $[ * ] (“Start-Up Fee”). The Start-Up Fee is due and payable to ESSDS by Jazz Pharmaceuticals no later than
December 7, 2007. In addition, Jazz Pharmaceuticals shall pay ESSDS a Copayment Program management fee for each month (including the months during the Copayment Program Run-Out Period) ESSDS performs Copayment Program Services (each a
“Monthly Management Fee”), as follows: (i) $[ * ] for the 

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, has been omitted and filed
separately with the Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 
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period of [ * ] through [ * ]; (ii) [ * ] for the period of [ * ] through [ * ]; and (iii) $[ * ] for the period of [ * ], through [ * ]. Should
the parties determine that [ * ] of Copayment Program [ * ] is [ * ] the Copayment Program, Jazz Pharmaceuticals shall pay ESSDS a $[ * ] Monthly Management Fee for that [ * ]. Each Monthly Management Fee shall be paid by Jazz Pharmaceuticals within
thirty (30) days following receipt of ESSDS’ invoice pertaining thereto. Late payments will be subject to interest at the rate specified in the Agreement. The Start-Up Fee and the Monthly Management Fee constitute full and complete payment
for performance of the Copayment Program Services under this Addendum, other than the actual Jazz Copayment Amounts to be paid pursuant to Section 4 hereof. If Jazz Pharmaceuticals remains materially delinquent on any undisputed fees owed
hereunder, including, but not limited to, payment of the Copayment Amounts, for a period of [ * ] following receipt of written notice of same, then ESSDS shall have the right to suspend services until full payment of such fees is made. Jazz
Pharmaceuticals agrees that: (1) the Start-Up Fee and the Monthly Management Fee for the Copayment Program Services constitutes compensation for bona fide services; (2) the Copayment Program is not intended to diminish the objectivity or
professional judgment of ESSDS; (3) the Copayment Program does not involve the counseling or promotion of any off-label use of Jazz Pharmaceutical products; (4) the Start-Up Fee and the Monthly Management Fee are not intended in any way as
remuneration for referrals or for other business generated; and (5) the Start-Up Fee and the Monthly Management Fee represent fair market value for the Copayment Program Services based on arms-length negotiations. The parties acknowledge that
the Start-Up Fee and the Monthly Management Fee are not intended in any way as a payment related to drug formulary or drug formulary activities and have not been negotiated or discussed between the parties in connection with any such drug formulary
or formulary activities. 
 4. Copayment Amounts. In accordance with Exhibit A attached hereto, Jazz Pharmaceuticals
shall be responsible for portions of the copayment or coinsurance obligations of patients properly enrolled in the Copayment Program (the “Jazz Copayment Amounts”). Jazz Pharmaceuticals shall pay ESSDS the Jazz Copayment Amounts due within
thirty (30) days of Jazz Pharmaceuticals’ receipt of ESSDS’s invoice pertaining thereto. Delinquent payments shall be subject to interest at the rate specified in the Agreement. 
 5. Data. Subject to the limitations set forth in this Section 5, ESSDS shall provide monthly data reports to Jazz Pharmaceuticals
relating to the Copayment Program in accordance with Exhibit B attached hereto. Such reports shall be delivered in accordance with a mutually agreed upon timeframe and format. The parties intend that all reports and other data provided by
ESSDS to Jazz Pharmaceuticals pursuant to this Addendum will be in accordance with HIPAA and all other applicable federal or state laws pertaining to patient confidentiality (collectively, the “Privacy Laws”). Accordingly, notwithstanding
anything to the contrary herein, except as otherwise permitted by applicable law or pursuant to a valid HIPAA authorization on file at ESSDS, ESSDS will not disclose or report any data fields that are prohibited under the HIPAA de-identification
safe harbor as described in 45 C.F.R. 164.514(b)(2), and Jazz Pharmaceuticals agrees not to use, either directly or indirectly, any such information to 

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, has been omitted and filed
separately with the Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 
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attempt to identify any patient who may be the subject of such information, unless such information was disclosed by ESSDS pursuant to a valid HIPAA
authorization. To the extent ESSDS is providing dates in the data reports provided to Jazz Pharmaceuticals, Jazz Pharmaceuticals represents and warrants that such dates are necessary for payment purposes to ESSDS. ESSDS’s failure to provide any
of the requested data because of restrictions under the Privacy Laws, or any laws applicable to physician privacy, shall not be deemed a breach of this Addendum by ESSDS; however, should the data provided by ESSDS be insufficient to confirm Jazz
Pharmaceuticals’ payment obligations, these payment obligations will be excused without penalty until otherwise confirmed to Jazz Pharmaceuticals’ reasonable satisfaction. 
 6. Audit Rights. Jazz Pharmaceuticals shall have the right to inspect ESSDS records related to the Copayment Program Services at reasonable
times. Such records will be made available for copying during such inspection. Jazz Pharmaceuticals will provide reasonable notice to ESSDS of the date and time of any such inspection and ESSDS will reasonably cooperate with such inspection. ESSDS
will not permit disclosure of Patient Identifiable Information to Jazz Pharmaceuticals’ auditors. 
 7. Miscellaneous.

  

	 	a.	Jazz Pharmaceuticals is responsible for the structure and design of the Copayment Program, as set forth in Exhibit A, including any supplemental materials that may be
prepared or approved by Jazz Pharmaceuticals for use in connection with the Copayment Program, and Jazz Pharmaceuticals represents and warrants that such structure and design complies with all applicable law. 

  

	 	b.	ESSDS agrees to perform the Copayment Program Services with due care in accordance with the standards and practices which are generally accepted in the industry and exercised by
other persons engaged in performing similar services in the local area and in accordance with all applicable federal and state laws and regulations. 

  

	 	c.	To the extent there is a conflict between the terms and conditions of this Addendum and the terms and conditions of the Agreement, this Addendum shall control.

  

	 	d.	This Addendum may be executed in one or more counterpart copies, each of which shall be deemed an original, and all of which shall together be deemed to constitute one agreement.
Facsimile execution and delivery of this Addendum is legal, valid and binding execution and delivery for all purposes. 

  

	 	e.	Sections 1 (until expiration of the Copayment Program Run-Out Period), 3, 4, 6 and 7 shall survive termination of this Addendum. 

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, has been omitted and filed
separately with the Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 
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 IN WITNESS WHEREOF, the parties have executed or caused this Addendum to be executed effective as of the Addendum
Effective Date. 
  

									
	EXPRESS SCRIPTS SPECIALTY DISTRIBUTION SERVICES, INC.	 		 	JAZZ PHARMACEUTICALS, INC.
					
	By:	 	/s/ Gerard A. Carino	 		 	By:	 	/s/ Julie Anne Smith
	Its:	 	President	 		 	Its:	 	 Vice President Marketing and
 New Product Planning

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, has been omitted and filed
separately with the Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 
 4

 EXHIBIT A 
 COPAYMENT PROGRAM 
 Overview 
 The Copayment Program is designed to [ * ] the Xyrem Success Program. Under the Copayment Program, Jazz Pharmaceuticals will provide up to $[ * ] in copayment assistance to patients properly enrolled by ESSDS in the
Copayment Program for each shipment of Xyrem that occurs during the [ * ] period following the initial shipment. 
 Eligibility 
  

	 	•	 	 Patients who are enrolled in a “federal health care program” (as defined in 42 U.S.C. 1320a-7b(f)) that provides coverage for Xyrem, either as primary
coverage or secondary coverage, are NOT eligible for participation in the Copayment Program. In addition, patients who [ * ] are not eligible for the Copayment Program. During the initial enrollment process, and prior to each
subsequent fill during participation in the Copayment Program, ESSDS shall confirm with the patient via a Q & A process that the patient has elected to participate in the Copayment Program and does not fall within one of these excluded
categories. Conducting this Q & A process with each patient and creating a record of each patient’s response shall be ESSDS’ only obligation with respect to this eligibility requirement. 

  

	 	•	 	 Only patients who have not participated in the Xyrem Success Program during the [ * ] period prior to receipt by ESSDS of their initial prescription for Xyrem are
eligible for the Copayment Program. 

  

	 	•	 	 Patients enrolled in Jazz Pharmaceuticals’[ * ] are [ * ] eligible to participate in the Copayment Program. 

  

	 	•	 	 The enrollment period for the Copayment Program will end on [ * ]. ESSDS will not enroll any patients after this time without the express written consent of Jazz
Pharmaceuticals. 

  

	 	•	 	 Enrollment into the Copayment Program may only occur as a result of an initial live conversation that occurs on Thursday or Friday between a patient and an ESSDS
Reimbursement Specialist. Patients who have their initial conversation with an ESSDS Reimbursement Specialist on Monday, Tuesday, or Wednesday will not be enrolled into the Copayment Program. Exceptions for enrollments on Monday, Tuesday or
Wednesday must be approved in writing by either Jazz Pharmaceuticals’ Executive Director, Marketing or Vice President, Marketing and Product Development. 

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, is filed with the
Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 

	 	•	 	 Jazz Pharmaceuticals also may impose additional eligibility criteria for the Copayment Program, as communicated by Jazz Pharmaceuticals to ESSDS in writing.

 Duration of Copayment Assistance 
  

	 	•	 	 Co-pay assistance is available to patients properly enrolled in the Copayment Program for each shipment of Xyrem made during the [ * ] period following that
patient’s initial shipment; however, for patients who participate in the [ * ], the [ * ] period of eligibility for copayment assistance starts with the first [ * ] shipment. No co-pay assistance will be provided under the Copayment Program for
shipments made under the [ * ]. ESSDS will not charge Jazz Pharmaceuticals under the Copayment Program for services provided pursuant to the [ * ]. 

  

	 	•	 	 If a patient is enrolled in the Copayment Program and subsequently becomes eligible for [ * ] payer specified in the [ * ], the patient shall become ineligible for
continued participation in the Copayment Program upon ESSDS’ discovery of this change in [ * ] coverage. 

 Amount of Copayment
Assistance 
  

	 	•	 	 Each patient enrolled in the Copayment Program will be responsible for the first $[ * ] of his or her copayment/coinsurance obligation applicable to each shipment
of Xyrem, with Jazz Pharmaceuticals responsible for the remaining amount up to a maximum of $[ * ] per month. If the patient’s copayment/coinsurance obligation exceeds the maximum amount Jazz Pharmaceuticals will pay pursuant to the preceding
sentence, then the patient will be responsible for such excess amount in addition to the first $[ * ]. 

 Scripting

  

	 	•	 	 Appropriate scripting will be developed jointly by the parties, with Jazz Pharmaceuticals having final approval of the script. The script must be finalized prior to
commencement of the Copayment Program services. 

  

	 	•	 	 The script, and any patient materials subsequently developed for the Copayment Program, will clearly indicate that the Copayment Program is funded by Jazz
Pharmaceuticals, and not ESSDS. 

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, is filed with the
Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 

 EXHIBIT B 
 COPAYMENT PROGRAM DATA 
 Data to be provided monthly by ESSDS 
  

													
	 	  	Pilot Patients	  	Non-Pilot
Patients	  	Past Pilot
Patients
	 Number of Patients Enrolled
	  		  		  	
	 Number of Patients Currently Participating
	  		  		  	
	 Percentage of Patients Currently Participating
	  		  		  	
	 Number of Patients Shipped through mm/dd/yyyy
	  		  		  	
	 Percentage of Patients Shipped
	  		  		  	
	 Average Number of Fills per Patient
	  		  		  	
	 Number of Pending Patients
	  		  		  	
	 Percentage of Pending Patients
	  		  		  	
	 Number of Approved Patients
	  		  		  	
	 Percentage of Approved Patients
	  		  		  	
	 Number of On Hold Patients
	  		  		  	
	 Percentage of On Hold Patients
	  		  		  	
	 Number of Discontinued Patients
	  		  		  	
	 Percentage of Discontinued Patients
	  		  		  	
	 Number of Disenrolled Patients
	  		  		  	
	 Percentage of Disenrolled Patients
	  		  		  	
							
	 Disenrolled Patients Breakout:
	  	Count	  	%	  	Count	  	%	  	Count	  	%
	 Disenrolled – Declined co-pay assistance
	  		  		  		  		  		  	
	 Disenrolled – Cost
	  		  		  		  		  		  	
	 Disenrolled – Refused Shipment
	  		  		  		  		  		  	
	 Disenrolled – MD Credential
	  		  		  		  		  		  	
	 Disenrolled – Drug/Medical Concern
	  		  		  		  		  		  	
	 Disenrolled – Insurance Denial
	  		  		  		  		  		  	
	 Disenrolled – Pt. Expired
	  		  		  		  		  		  	
	 Disenrolled – Dr. not responding
	  		  		  		  		  		  	
	 Disenrolled – Physician Request
	  		  		  		  		  		  	
	 Disenrolled – Voluntarily
	  		  		  		  		  		  	
	 Disenrolled – Unknown Reason
	  		  		  		  		  		  	
	 Disenrolled – Unable to Contact
	  		  		  		  		  		  	
	 Disenrolled – Prefers Alternate Therapy
	  		  		  		  		  		  	
	 Total
	  	0	  		  	0	  		  	0	  	
							
	 Discontinued Patients Breakout:
	  	Count	  	%	  	Count	  	%	  	Count	  	%
	 Discontinued – Cost
	  		  		  		  		  		  	
	 Discontinued – Refused Shipment
	  		  		  		  		  		  	
	 Discontinued – Insurance Denial
	  		  		  		  		  		  	
	 Discontinued – MD Credential
	  		  		  		  		  		  	
	 Discontinued – Pt. Expired
	  		  		  		  		  		  	
	 Discontinued – Noncompliance
	  		  		  		  		  		  	
	 Discontinued – Drug Not Effective
	  		  		  		  		  		  	

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, is filed with the
Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended. 

													
	 Discontinued - Diversion
	  		  		  		  		  		  	
	 Discontinued – Physician Request
	  		  		  		  		  		  	
	 Discontinued – Personal/Voluntary
	  		  		  		  		  		  	
	 Discontinued – Unknown Reason
	  		  		  		  		  		  	
	 Discontinued – Unable to Contact
	  		  		  		  		  		  	
	 Discontinued – Side Effects
	  		  		  		  		  		  	
	 Discontinued – Inactivity
	  		  		  		  		  		  	
	 Total
	  	0	  		  	0	  		  	0	  	

  

			
	Patient ID	  	de-identified
	Intake Date	  	
	Physician CHIP ID	  	
	Physician JPI ID	  	
	Physician First Name	  	
	Physician Last Name	  	
	Territory	  	
	Current Case Status	  	
	Total Fills	  	
	Case Status at First Shipment	  	
	First Patient Copay	  	
	First Jazz Copay	  	
	Case Status at Second Shipment	  	
	Second Patient Copay	  	
	Second Jazz Copay	  	
	Case Status at Third Shipment	  	
	Third Patient Copay	  	
	Third Jazz Copay	  	

  

 [ * ] = Certain confidential information contained in this document, marked by brackets, is filed with the
Securities and Exchange Commission pursuant to Rule 24B-2 of the Securities Exchange Act of 1934, as amended.Amendment No. 1 to Amended and Restated Xyrem License and Distribution Agreement

 Exhibit 10.68 
 Jazz Pharmaceuticals 
 Amendment No. 1 to 
 Amended and Restated Xyrem License and Distribution Agreement 
 This Amendment No. 1 (the
“Amendment”) to the Amended and Restated Xyrem License and Distribution Agreement dated as of June 30, 2006 (the “Agreement”) by and between Jazz Pharmaceuticals, Inc., having its principal place of business at
3180 Porter Drive, Palo Alto, California 94304, USA (together with its Affiliates, “Jazz Pharmaceuticals”) and UCB Pharma Limited, a company organized under the laws of England having its principal place of business at 208 Bath
Road, Slough, Berkshire, SL1 3WE (together with its Affiliates, “UCB”), is entered into as of the 21 day of December, 2007 (the “Execution Date”). Capitalized terms not otherwise defined herein shall have the same
meanings as in the Agreement. 
 RECITALS 
 WHEREAS, in accordance with Section 17.5 of the Agreement, the parties wish to amend the Agreement to revise certain terms and conditions governing the disposition of Product by UCB upon termination of the
Agreement. 
 NOW THEREFORE, in consideration of the mutual agreements and covenants set forth hereinafter and in the Agreement and other
good and valuable consideration, receipt of which is hereby acknowledged, Jazz Pharmaceuticals and UCB hereby agree as follows: 
  

	 	1.	Amendment of Rights and Obligations on Termination. Jazz Pharmaceuticals and UCB hereby amend Section 14.5 to remove the last clause of Section 14.5(iii), so that
Section 14.5(iii) will read as follows: “Jazz Pharmaceuticals may, if UCB elects not to pursue its sell-off rights under Section14.7, repurchase UCB’s inventory of non-obsolete and non-expired Product at the price paid by UCB for such
Product or direct UCB to sell them to the Third Party or parties selected by Jazz Pharmaceuticals at the price paid by UCB.” 

  

	 	2.	Amendment of Sell-Off Period. Jazz Pharmaceuticals and UCB hereby amend and restate Section 14.7 in its entirety to read as follows: 

 “14.7 Sell-Off Period. Notwithstanding anything to the contrary in Section 14.4 hereto, upon expiration or termination of this Agreement,
UCB shall have the right to continue to distribute its existing inventory of non-expired Product for a period of twelve (12) months after the effective date of expiration or the effective date of termination of this Agreement as the case may
be. Any such continued distribution shall be in accordance with all applicable laws and regulations and the terms of this Agreement.” 
  

	 	3.	No Other Changes. Except as provided in this Amendment, the Agreement remains in full force and effect as originally executed. 

  

	 	4.	Governing Law. This Amendment will be governed by and interpreted in accordance with the internal laws of the State of New York, without regard to its conflicts of laws
rules. 

  

	 	5.	Headings. Headings in this Amendment are for convenience of reference only and shall not be considered in construing this Amendment. 

  

	 	6.	Severability. If any provision of this Amendment is held unenforceable by a court or tribunal of competent jurisdiction because it is invalid or conflicts with any law of any
relevant jurisdiction, the validity of the remaining provisions shall not be affected. In such event, the parties shall negotiate a substitute provision that, to the extent possible, accomplishes the original business purpose.

  

	 	7.	Counterparts. This Agreement may be executed in two counterparts, each of which shall be deemed an original, but both of which together shall constitute one and the same
instrument. Signatures provided by facsimile transmission shall be deemed to be original signatures. 

 IN WITNESS
WHEREOF, the parties have executed this Amendment by their duly authorized representatives as of the Execution Date. 
  

					
	UCB PHARMA LIMITED	 	
			
	By:	 	/s/ Tim Stow	 	/s/ Mark Hardy
	Name:	 	Tim Stow	 	Mark Hardy
	Title:	 	VP Legal Affairs	 	VP UK Corporate Services
		
	By:	 	 
	Name:	 	
	Title:	 	

			
	
	JAZZ PHARMACEUTICALS, INC.
		
	By:	 	/s/ Jason Levin
	Name:	 	Jason Levin
	Title:	 	Vice President, Licensing & Acquisitions

  

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