Document:

Amendment No. 2 to Credit Agreement

 Exhibit 10.6 
 K-V PHARMACEUTICAL COMPANY 
 SECOND AMENDED AND RESTATED REGISTRATION
RIGHTS AGREEMENT 
 March 2, 2011 

 TABLE OF CONTENTS 

Page 
  

							
	Section 1.	  	Definitions	  	 	1	  
	Section 2.	  	Initial Shelf Registration; Liquidated Damages	  	 	5	  
	Section 3.	  	Registrations	  	 	9	  
	Section 4.	  	Piggyback Registrations	  	 	11	  
	Section 5.	  	Registration Procedures	  	 	12	  
	Section 6.	  	Registration Expenses	  	 	16	  
	Section 7.	  	Indemnification and Contribution	  	 	17	  
	Section 8.	  	Underwritten Registrations; Suspended Distributions	  	 	19	  
	Section 9.	  	Current Public Information	  	 	20	  
	Section 10.	  	Subsidiary Public Offering	  	 	21	  
	Section 11.	  	Lock-up	  	 	21	  
	Section 12.	  	General Provisions	  	 	21	  

  
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 K-V PHARMACEUTICAL COMPANY 

SECOND AMENDED AND RESTATED REGISTRATION RIGHTS AGREEMENT 

THIS SECOND AMENDED AND RESTATED REGISTRATION RIGHTS AGREEMENT (this “Agreement”) is made as of March 2, 2011, by
and among K-V Pharmaceutical Company, a Delaware corporation (the “Company”), U.S. Healthcare I, L.L.C. (“U.S. Healthcare I”) and U.S. Healthcare II, L.L.C., (“U.S. Healthcare II”, and together with
U.S. Healthcare I and their registered assigns collectively referred to herein as the “USH Investor”), and hereby amends and replaces in its entirety that certain Amended and Restated Registration Rights Agreement (the
“Amended and Restated Registration Rights Agreement”), dated as of February 10, 2011, by and among the Company, U.S. Healthcare I and U.S. Healthcare II. Except as otherwise specified herein, all capitalized terms used in this
Agreement are defined in Section 1. 
 The Company and the USH Investor are parties to that certain (i) Stock
Warrant Purchase Agreement, dated as of November 17, 2010 (the “Purchase Agreement”), and (ii) Stock Warrant Purchase Agreement (Third Warrants), dated as of the date hereof (the “Additional Purchase
Agreement”, and together with the Original Purchase Agreement, the “Purchase Agreements”), pursuant to which the USH Investor purchased warrants to purchase shares of Class A Common Stock from the Company
(collectively, the “Warrants”). In order to induce the USH Investor to enter into the Purchase Agreements, the Company has agreed to provide the registration rights set forth in this Agreement. The execution and delivery of this
Agreement is a condition to the consummation of the transactions under the Purchase Agreements. 
 The Company is party to a
Registration Rights Agreement dated as of February 14, 2011 (the “PIPE Registration Rights Agreement”), by and among the Company and the investors listed on the “Schedule of Investors” attached thereto (each a
“PIPE Investor” and collectively, the “PIPE Investors”). Pursuant to the PIPE Registration Rights Agreement, the Company has agreed, among other things, to register under the Securities Act an aggregate of 9,950,000
shares of the Class A Common Stock of the Company issued to the PIPE Investors (the “PIPE Securities”). 

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties to this Agreement hereby agree as follows: 
 Section 1.
Definitions. Unless otherwise set forth below or elsewhere in this Agreement, other capitalized terms contained herein have the meanings set forth in the Purchase Agreements. 

“Affiliate” of any Person means any other Person controlled by, controlling or under common control with such Person;
provided that the Company and its Subsidiaries shall not be deemed to be Affiliates of any holder of Registrable Securities. As used in this definition, “control” (including, with its correlative meanings, “controlling,”
“controlled by” and “under common control with”) shall mean possession, directly or indirectly, of power to direct or cause the direction of management or policies (whether through ownership of securities, by contract or
otherwise). With respect to any Person who is an individual, “Affiliates” shall also include, without limitation, any member of such individual’s Family Group. 

 “Agreement” has the meaning set forth in the recitals. 

“Allowable Grace Period” has the meaning set forth in Section 2(c). 

“Amended and Restated Registration Rights Agreement” has the meaning set forth in the recitals. 

“Capital Stock” means (i) with respect to any Person that is a corporation, any and all shares, interests or
equivalents in capital stock of such corporation (whether voting or nonvoting and whether common or preferred) and (ii) with respect to any Person that is not a corporation, individual or governmental entity, any and all partnership,
membership, limited liability company or other equity interests of such Person that confer on the holder thereof the right to receive a share of the profits and losses of, or the distribution of assets of, the issuing Person, including in each case
any and all warrants (other than the Warrants), rights (including conversion and exchange rights) and options to purchase any of the foregoing. 
 “Common Stock” means the Company’s Class A common stock, par value $0.01 per share. 
 “Company” has the meaning set forth in the preamble. 

“Cut Back Shares” has the meaning set forth in Section 2(a)(i). 

“Demand Registrations” has the meaning set forth in Section 3(a). 

“Disclosure Date” has the meaning set forth in Section 2(d)(i). 

“Effectiveness Period” has the meaning set forth in Section 2(a)(i). 

“Event” has the meaning set forth in Section 2(b). 

“Event Date” has the meaning set forth in Section 2(b). 

“Exchange Act” means the Securities Exchange Act of 1934, as amended from time to time, or any successor federal law
then in force, together with all rules and regulations promulgated thereunder. 
 “Family Group” means, with
respect to a Person who is an individual, (i) such individual’s spouse and descendants (whether natural or adopted) (collectively, for purposes of this definition, “relatives”), (ii) such individual’s executor or
personal representative, (iii) any trust, the trustee of which is such individual or such individual’s executor or personal representative and which at all times is and remains solely for the benefit of such individual and/or such
individual’s relatives, (iv) any corporation, limited partnership, limited liability company or other tax flow-through entity the governing instruments of which provide that such individual or such individual’s executor or personal
representative shall have the exclusive, 

  
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nontransferable power to direct the management and policies of such entity and of which the sole owners of stock, partnership interests, membership interests or any other equity interests are
limited to such individual, such individual’s relatives and/or the trusts described in clause (iii) above, and (v) any retirement plan for such individual or such individual’s relatives. 

“Filing Deadline” has the meaning set forth in Section 2(a)(i). 

“FINRA” means the Financial Industry Regulatory Authority. 

“Grace Period” has the meaning set forth in Section 2(c). 

“Indemnified Parties” has the meaning set forth in Section 7(a). 

“Initial Shelf Registration” has the meaning set forth in Section 2(a)(i). 

“Issuer Free-Writing Prospectus” means an issuer free-writing prospectus as defined in Rule 433 under the Securities
Act. 
 “Long-Form Registrations” has the meaning set forth in Section 3(a). 

“Person” means an individual, a partnership, a corporation, a limited liability company, an association, a joint stock
company, a trust, a joint venture, an unincorporated organization and a governmental entity or any department, agency or political subdivision thereof. 
 “Piggyback Registrations” has the meaning set forth in Section 4(a). 
 “PIPE Investor” and “PIPE Investors” has the meaning set forth in the recitals. 
 “PIPE Registration Rights Agreement” has the meaning set forth in the recitals. 
 “PIPE Securities” has the meaning set forth in the recitals. 

“Public Offering” means any sale or distribution by the Company and/or holders of Registrable Securities to the public
of Common Stock of the Company pursuant to an offering registered under the Securities Act. 
 “Purchase
Agreements” has the meaning set forth in the recitals. 
 “Registrable Securities” means
(i) any Common Stock issued pursuant to the exercise of the Warrants or distributed (directly or indirectly) to the USH Investor or any of their respective Affiliates, and (ii) any Capital Stock of the Company or any Subsidiary of the
Company issued or issuable with respect to the securities referred to in clause (i) above by way of dividend, distribution, split or combination of securities, or any recapitalization, merger, consolidation or other reorganization. As to
any particular Registrable Securities, such securities shall cease to be Registrable Securities when they have been (a) sold or distributed pursuant to a Public Offering, (b) disposed of pursuant to Rule 144 or when all of the Registrable
Securities owned by the USH Investor and its Affiliates may be disposed of pursuant to Rule 144(b)(1) 

  
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without compliance with the current public information requirements of such rule, or subject to any volume, manner of sale or timing restrictions or conditions, or (c) repurchased by the
Company or a Subsidiary of the Company. For purposes of this Agreement, a Person shall be deemed to be a holder of Registrable Securities, and the Registrable Securities shall be deemed to be in existence, whenever such Person has the right to
acquire, directly or indirectly, such Registrable Securities (upon conversion or exercise in connection with a transfer of securities or otherwise, but disregarding any restrictions or limitations upon the exercise of such right), whether or not
such acquisition has actually been effected, and such Person shall be entitled to exercise the rights of a holder of Registrable Securities hereunder. 
 “Registration Deadline” has the meaning set forth in Section 2(b)(ii). 
 “Registration Expenses” has the meaning set forth in Section 6(a). 
 “Registration Statement” has the meaning set forth in Section 4(a). 
 “Restriction Termination Date” has the meaning set forth in Section 2(a)(ii). 
 “Rule 144”, “Rule 158”, “Rule 405”, “Rule 415” and “Rule 462” mean, in each case, such rule promulgated under the
Securities Act (or any successor provision) by the SEC, as the same shall be amended from time to time, or any successor rule then in force. 
 “SEC” means the United States Securities and Exchange Commission. 

“SEC Restrictions” has the meaning set forth in Section 2(a)(ii). 

“Securities Act” means the Securities Act of 1933, as amended from time to time, or any successor federal law then in
force, together with all rules and regulations promulgated thereunder. 
 “Shelf Registration” has the meaning
set forth in Section 3(c). 
 “Short-Form Registrations” has the meaning set forth in
Section 3(a). 
 “Subsidiary” means, with respect to the Company, any corporation, limited
liability company, partnership, association or other business entity of which (i) if a corporation, a majority of the total voting power of shares of stock entitled (without regard to the occurrence of any contingency) to vote in the election
of directors, managers or trustees thereof is at the time owned or controlled, directly or indirectly, by the Company or one or more of the other Subsidiaries of the Company or a combination thereof, or (ii) if a limited liability company,
partnership, association or other business entity, a majority of the limited liability company, partnership or other similar ownership interest thereof is at the time owned or controlled, directly or indirectly, by the Company or one or more
Subsidiaries of the Company or a combination thereof. For purposes hereof, a Person or Persons shall be deemed to have a majority ownership interest in a limited liability company, partnership, association or other business entity if such Person or
Persons shall be allocated a majority of limited liability company, partnership, association or other business entity gains or losses or shall be or control the managing director or general partner of such limited liability company, partnership,
association or other business entity. 

  
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 “Violation” has the meaning set forth in Section 7(a).

 “Warrants” has the meaning set forth in the recitals. 

“WKSI” means a “well-known seasoned issuer” as defined under Rule 405. 

“USH Investor” has the meaning set forth in the recitals. 

Section 2. Initial Shelf Registration; Liquidated Damages. 

(a) Initial Shelf Registration. 
 (i) Subject to the terms and conditions of this Agreement, the Company agrees to use its best efforts to prepare and file with the SEC, as soon as reasonably practicable, but in no event later than
June 15, 2011 (the “Filing Deadline”), a registration statement (together with the prospectus, amendments and supplements to such registration statement or prospectus, including pre- and post-effective amendments, all exhibits
thereto, and all material incorporated by reference or deemed to be incorporated by reference in such registration statement, the “Initial Shelf Registration”) covering the resale of all of the Registrable Securities that are owned
by the USH Investor or its Affiliates for an offering to be made on a continuous basis; provided, however, that the USH Investor shall not be named as an “underwriter” in the Initial Shelf Registration without the USH
Investor’s prior written consent. Subject to the terms of this Agreement, the Company shall use its best efforts to cause such Initial Shelf Registration to be declared effective under the Securities Act as promptly as possible after the filing
thereof, but in any event prior to July 31, 2011, and shall use its best efforts to keep such Initial Shelf Registration continuously effective under the Securities Act during the period (the “Effectiveness Period”) ending on
the earlier of (i) the date on which all Registrable Securities included in such registration have been sold or distributed pursuant to the Initial Shelf Registration, or (ii) the date as of which no Registrable Securities are outstanding.
The Initial Shelf Registration Statement may be used by the USH Investor and/or Affiliates from time to time to complete one or more underwritten offerings as contemplated by this Agreement. 

(ii) If at any time the SEC takes the position that the offering of some or all of the Registrable Securities in a Initial
Shelf Registration is not eligible to be made on a delayed or continuous basis under the provisions of Rule 415 under the Securities Act or requires the USH Investor to be named as an “underwriter”, the Company shall use its best efforts
to persuade the SEC that the offering contemplated by the Initial Shelf Registration is a valid secondary offering and not an offering “by or on behalf of the issuer” as defined in Rule 415 and that the USH Investor is not an
“underwriter”. The USH Investor shall have the right to participate or have their counsel participate in any meetings or discussions with the SEC regarding the SEC’s position and to comment or have their counsel comment on any written
submission made to the SEC with respect thereto. No such written submission shall be made to the SEC to which the USH 

  
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Investor’s counsel reasonably objects. In the event that, despite the Company’s best efforts and compliance with the terms of this Section 2(a)(ii), the SEC refuses to alter its
position, the Company shall (i) remove from the Initial Shelf Registration such portion of the Registrable Securities (the “Cut Back Shares”) and/or (ii) agree to such restrictions and limitations on the registration and
resale of the Registrable Securities as the SEC may require to assure the Company’s compliance with the requirements of Rule 415 (collectively, the “SEC Restrictions”); provided, however, that the Company shall
not agree to name the USH Investor as an “underwriter” in such Initial Shelf Registration without the prior written consent of the USH Investor. The Company shall use it best efforts to allocate any cut-back imposed on the USH Investor
pursuant to this Section 2(a)(ii) among the USH Investor and the PIPE Investors on a pro rata basis. No liquidated damages under Section 2(b) shall accrue as to any Cut Back Shares until such date as the Company is able to effect the
registration of such Cut Back Shares in accordance with any SEC Restrictions (such date, the “Restriction Termination Date” of such Cut Back Shares). From and after the Restriction Termination Date applicable to any Cut Back Shares,
all of the provisions of this Section 2(a) (including the liquidated damages provisions) shall again be applicable to such Cut Back Shares; provided, however, that (i) the filing deadline for the Initial Shelf Registration
including such Cut Back Shares shall be the later of June 15, 2011 and ten (10) Business Days after such Restriction Termination Date, and (ii) the date by which the Company is required to obtain effectiveness with respect to such Cut
Back Shares under Section 2(b) shall be the later of July 15, 2011 (or within 16 days thereafter, to the extent such extension is required a result of the SEC processing responses to SEC comments made regarding the filed Registration
Statement) and the 90th day immediately after the Restriction Termination Date. 
 (b) Liquidated Damages. If:
(i) the Initial Shelf Registration is not filed on or prior to Filing Deadline, (ii) the Company fails to have the Initial Shelf Registration declared effective under the Securities Act prior to July 31, 2011 (the
“Registration Deadline”), or (iii) after a Initial Shelf Registration is declared effective, such Initial Shelf Registration ceases for any reason to remain continuously effective as to all Registrable Securities included in
such Initial Shelf Registration, or the holders of such Registrable Securities are otherwise not permitted to utilize the prospectus therein to resell such Registrable Securities (other than during an Allowable Grace Period (as defined below)), or
(iv) a Grace Period (as defined below) exceeds the Allowable Grace Period (any such failure or breach being referred to as an “Event,” and for purposes of clause (i) and (ii), the date on which such Event occurs, or for
purposes of clause (iii) the date on which such Initial Shelf Registration ceases to be effective, or the holders of such Registrable Securities are otherwise not permitted to utilize the prospectus therein to resell such Registrable Securities
(other than during an Allowable Grace Period), or for purposes of clause (iv) the date on which the Allowable Grace Period is exceeded, being referred to as “Event Date”), then, in addition to any other rights the holders of
such Registrable Securities may have hereunder or under applicable law, on each such Event Date and on each monthly anniversary of each such Event Date (for the avoidance of doubt, if an Event is cured prior to a monthly anniversary of an Event
Date, the Company shall be responsible for paying to the holders of Registrable Securities their pro rata portion of the liquidated damages for that portion of the monthly anniversary period during which such Event is not cured) until the applicable
Event is cured, the Company shall pay to each holder of Registrable Securities their pro rata 

  
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portion of $900,000 in cash, for any month when the Event remains uncured, as partial liquidated damages and not as a penalty. Notwithstanding the foregoing, (A) no liquidated damages shall
accrue after the date as of which all of the Registrable Securities included in such registration are able to be sold by the USH Investor and its Affiliates and all other holders of Registrable Securities pursuant to Rule 144(b)(1) without
compliance with the current public information requirements of such rule, and (B) no liquidated damages shall accrue during any period during which the Company has advised the holders of Registrable Securities to suspend the use of any
prospectus, provided such period does not exceed the Allowable Grace Period. If the Company fails to pay any partial liquidated damages pursuant to this Section in full within seven calendar days after the date payable, the Company will pay interest
thereon at a rate of 12% per annum (or such lesser maximum amount that is permitted to be paid by applicable law) to the holders, accruing daily from the date such partial liquidated damages are due until such amounts, plus all such interest
thereon, are paid in full. The partial liquidated damages pursuant to the terms hereof shall apply on a daily pro rata basis for any portion of a month prior to the cure of an Event. Notwithstanding the foregoing, an “Event” shall not
include a Initial Shelf Registration not remaining effective if the Company has advised the holders of Registrable Securities to suspend the use of any prospectus pursuant to Section 2(c), provided such period does not exceed the
Allowable Grace Period. In addition, an “Event” with respect to the USH Investor shall not include an Event that occurs as a result of a Initial Shelf Registration not being filed, not being declared effective, or not remaining effective
as a result of the USH Investor failing to timely provide the Company with information requested by the Company and necessary to complete the Initial Shelf Registration in accordance with the requirements of the Securities Act, and then the
liquidated damages shall not be accrued or payable to the USH Investor who has not provided such information. 
 (c) Grace
Periods. Notwithstanding anything to the contrary herein, at any time after any Registration Statement (as defined below) has been declared effective by the SEC, the Company may delay the disclosure of material non-public information concerning
the Company if the disclosure of such information at the time is not, in the good faith judgment of the Company, in the best interests of the Company (a “Grace Period”); provided, however, the Company shall promptly
(i) notify the holders of Registrable Securities in writing (including via facsimile or other electronic transmission) of the existence of material non-public information giving rise to a Grace Period (provided that the Company shall not
disclose the content of such material non-public information to the holders) or the need to file a supplement or post-effective amendment, as applicable, and the date on which such Grace Period will begin, and (ii) notify the holders of
Registrable Securities in writing (including via facsimile or other electronic transmission) of the date on which the Grace Period ends; provided, further, that no single Grace Period shall exceed thirty (30) consecutive days, and during any
three hundred sixty-five (365) day period, the aggregate of all Grace Periods shall not exceed an aggregate of sixty (60) days (each Grace Period complying with this provision being an “Allowable Grace Period”). For
purposes of determining the length of a Grace Period, the Grace Period shall be deemed to begin on and include the date the holders receive the notice referred to in clause (i) above and shall end on and include the later of the date the
holders receive the notice referred to in clause (ii) above and the date referred to in such notice; provided, however, that no Grace Period shall be longer than an Allowable Grace Period. 

  
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 (d) Public Disclosure. The Company shall, and shall provide the USH Investor with a
written confirmation of the same, upon (x) the earliest to occur of (i) the announcement of the closing of the proposed $200 million senior secured note offering announced by the Company on a press release dated March 1, 2011 (the
“Note Offering”), which announcement must be made no later than one Business Day after the closing of the Note Offering, (ii) the termination or abandonment of the Note Offering, (iii) the refinancing of the Credit and
Guaranty Agreement, dated November 17, 2010, as amended by that certain Amended and Restated Amendment No. 1 to Credit Agreement dated as of January 6, 2011 and as amended by that certain Amendment No. 2 to Credit Agreement dated
as of March 2, 2011, by and among the Company, certain of the Company’s subsidiaries, U.S. Healthcare I and U.S. Healthcare II and (iv) March 31, 2011 (the “First Disclosure Date”), (y) the earlier of
(i) the Registration Deadline or (ii) the time the Initial Registration Statement is declared effective by the SEC as contemplated by Section 2(a)(i) of this Agreement (the “Second Disclosure Date”) and (z) any
time following the First Disclosure Date and for so long as the USH Investor or any of its Affiliates continues to own any Warrants, within three Business Days of being requested by the USH Investor (a “Subsequent Disclosure Date”,
and each of the First Disclosure Date, the Second Disclosure Date and a Subsequent Disclosure Date, a “Disclosure Date”), publicly disclose in a Current Report on Form 8-K or such other periodic report required or permitted to be
filed under the Exchange Act with the SEC all of the previously publicly undisclosed confidential information provided to the USH Investor or its Affiliates by the Company that in the Company’s reasonable judgment, after consultation with its
outside counsel, constitutes material non-public information (such disclosure made on the First Disclosure Date, the “First Disclosure”, such disclosure made on the Second Disclosure Date, the “Second Disclosure”
and such disclosure made on a Subsequent Disclosure Date, a “Subsequent Disclosure”, and each of the First Disclosure, the Second Disclosure and a Subsequent Disclosure, a “Disclosure”). Any such request for a
Subsequent Disclosure by the USH Investor shall be in writing and shall contain a representation by the USH Investor that it has a good faith belief that such disclosure is required in order for the USH Investor to engage in any type of transaction
that relates, directly or indirectly, to the Company’s Capital Stock, or other securities related thereto, when such three Business Day period expires. The Company shall provide the USH Investor with a copy of each Disclosure at least two
Business Days prior to its release. If the USH Investor has not delivered a Potential Supplemental Disclosure Notice (as defined below) with respect to a Disclosure prior to its release, the USH Investor shall not have the right to make a USH
Investor Disclosure (as defined below) with respect to such Disclosure. If the USH Investor believes the Company may have failed to make a Disclosure on or before the applicable Disclosure Date, fails to include in any Disclosure, or draft
Disclosure provided to the USH Investor prior to its release, all of the material non-public information previously provided to the USH Investor, the USH Investor may provide the Company with a written notice setting forth the material non-public
information which the Company has failed to disclose or include in such draft disclosure (a “Potential Supplemental Disclosure Notice”). The Company may, within two Business Days of receiving a Potential Supplemental Disclosure
Notice, provide the USH Investor with a written certification that, based on the reasonable advice of its outside counsel, the Company has determined that all or part of the information specified in the Potential Supplemental Disclosure Notice is
not material and therefore the USH Investor is not in possession of material non-public information received from the Company. The Company shall be obligated to publicly disclose all of the information in the Potential Supplemental Disclosure Notice
which it has failed to so certify is 

  
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not material (the “Supplemental Material Information”). If the Company fails to publicly disclose the Supplemental Material Information on or before the later of (i) the
applicable Disclosure Date and (ii) two Business Days after receiving the Potential Supplemental Disclosure Notice, then, without limitation on any other rights available to the USH Investor, the Company agrees that the USH Investor is
authorized to make the Supplemental Material Information or any portion thereof available to the public generally (a “USH Investor Disclosure”). The USH Investor shall not have any liability to the Company, its subsidiaries, or any
of its or their respective officers, directors, employees, stockholders or agents for any such disclosure. Notwithstanding the foregoing, solely after the First Disclosure Date, no disclosure of confidential information by the Company contemplated
by this Section 2(d) shall be required (i) during a Grace Period or (ii) if the USH Investor has accepted material non-public information for review after the First Disclosure Date in accordance with clause (i) of the last
paragraph of Section 9(a), if such disclosure would cause the Company to breach any material confidentiality obligation or the terms of any other material contract or agreement of the Company; provided, however, that the Company shall use
commercially reasonable efforts to amend or eliminate such confidentially obligations or contract or agreement terms that prevent such disclosure. 
 (e) Lock Up Agreement. During the period commencing on the date of this Agreement and continuing until the time the Initial Registration Statement is declared effective by the SEC as contemplated
pursuant to Section 2(a)(i) of this Agreement, the Company shall not: (i) offer, pledge, sell, contract to sell, sell any option or contract to purchase, purchase any option or contract to sell, grant any option, right or warrant to
purchase, lend, or otherwise transfer or dispose of, directly or indirectly, any shares of Common Stock or any securities convertible into or exercisable or exchangeable for Common Stock, (ii) enter into any swap or other arrangement that
transfers to another, in whole or in part, any of the economic consequences of ownership of the Common Stock, whether any such transaction described in clause (i) or (ii) above is to be settled by delivery of Common Stock or such other
securities, in cash or otherwise or (iii) permit any registration statement filed with the SEC relating to the offering of the PIPE Securities or any shares of Common Stock or any securities convertible into or exercisable or exchangeable for
Common Stock held by the PIPE Investors (or any of their transferees) to be declared effective by the SEC. Notwithstanding the foregoing, clauses (i) and (ii) of the immediately preceding sentence shall not apply to any Excluded Shares (as
defined in the Warrants). 
 Section 3. Registrations. 

(a) Requests for Registration. Subject to the terms and conditions of this Agreement, at any time, the holders of 25% or more of
the Registrable Securities may request registration under the Securities Act of all or any portion of their Registrable Securities on Form S-1 or any similar long-form registration (“Long-Form Registrations”), and the holders of 5%
or more of the Registrable Securities may request registration under the Securities Act of all or any portion of their Registrable Securities on Form S-3 (including pursuant to Rule 415) or any similar short-form registration
(“Short-Form Registrations”) if available. All registrations requested pursuant to this Section 3(a) are referred to herein as “Demand Registrations”. Each request for a Demand Registration shall specify the
approximate number of Registrable Securities requested to be registered and the intended method of distribution. Within ten days 

  
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after the filing of the registration statement relating to the Demand Registration, the Company shall give written notice of the Demand Registration to all other holders of Registrable Securities
and, subject to the terms of Section 2(d), shall include in such Demand Registration (and in all related registrations and qualifications under state blue sky laws and in any related underwriting) all Registrable Securities with respect to
which the Company has received written requests for inclusion therein within 15 days after the receipt of the Company’s notice. 
 (b) Long-Form Registrations. The holders of Registrable Securities shall be entitled to request up to three Long-Form Registrations in which the Company shall pay all Registration Expenses (as
defined in Section 6(a)), whether or not any such registration is consummated. 
 (c) Short-Form Registrations. In
addition to the Long-Form Registrations provided pursuant to Section 3(b), the holders of Registrable Securities shall be entitled to request an unlimited number of Short-Form Registrations in which the Company shall pay all Registration
Expenses. Demand Registrations shall be Short-Form Registrations whenever the Company is permitted to use any applicable short form and if the managing underwriters (if any) agree to the use of a Short-Form Registration. The Company shall make
Short-Form Registrations available for the sale of Registrable Securities. If the holders of the Registrable Securities request that a Short-Form Registration be filed pursuant to Rule 415 (a “Shelf Registration”), the Company shall
use best efforts to cause the Shelf Registration to be declared effective under the Securities Act as soon as practicable after filing, and once effective, the Company shall use best efforts to cause the Shelf Registration to remain effective for a
period ending on the earlier of (i) the date on which all Registrable Securities included in such registration have been sold or distributed pursuant to the Shelf Registration or (ii) the date as of which all of the Registrable Securities
included in such registration are able to be sold within a 90-day period in compliance with Rule 144. If for any reason the Company ceases to be a WKSI or becomes ineligible to utilize Form S-3, the Company shall prepare and file with the SEC a
registration statement or registration statements on such form that is available for the sale of Registrable Securities. 
 (d)
Priority on Registration Statements. The Company shall not include in any Registration Statement filed pursuant Section 2 or this Section 3 any securities which are not Registrable Securities without the prior written consent of a
majority of the holders of the Registrable Securities. If a Registration Statement is an underwritten offering and the managing underwriters advise the Company in writing that in their opinion the number of Registrable Securities and, if permitted
hereunder, other securities requested to be included in such offering exceeds the number of Registrable Securities and other securities, if any, which can be sold therein without adversely affecting the marketability, proposed offering price, timing
or method of distribution of the offering, the Company shall include in such registration prior to the inclusion of any securities which are not Registrable Securities the number of Registrable Securities requested to be included which, in the
opinion of such underwriters, can be sold, without any such adverse effect, pro rata among the respective holders thereof on the basis of the amount of Registrable Securities owned by each such holder. 

(e) Selection of Underwriters. The holders of a majority of the Registrable Securities included in an underwritten offering shall
have the right to select the investment banker(s) and manager(s) to administer the offering and the Company shall pay all reasonable expenses in connection therewith. 

  
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 (f) Other Registration Rights. The parties to this Agreement acknowledge that the
Company is party to a Settlement Agreement, dated as of November 15, 2010 (the “Settlement Agreement”), by among the Company, The Office of Inspector General of the United States Department of Health and Human Services, Sarah
Weltscheff and Marc Hermelin. Pursuant to the Settlement Agreement, the Company has agreed, among other things, to register under the Securities Act certain shares of the Class A Common Stock and Class B Common Stock of the Company beneficially
owned by Ms. Weltscheff and Mr. Hermelin. The parties acknowledge and agree that the Company shall be entitled to register such shares pursuant to a registration statement filed under the Securities Act and take such other actions
necessary to fulfill its obligations under the Settlement Agreement. During any period in which any amount remains unpaid under that certain Credit and Guaranty Agreement, dated as of November 17, 2010, by and among the Company, as borrower and
certain of its subsidiaries, as guarantors, the lenders party thereto from time to time and U.S. Healthcare I, as administrative agent and collateral agent (as amended, supplemented or otherwise modified from time to time, the “Credit
Agreement”), the Company shall not grant to any Persons the right to request the Company or any Subsidiary to register any Class A Common Stock or Class B Common Stock of the Company, or any securities convertible or exchangeable into
or exercisable for such securities, without the prior written consent of a majority of the holders of the Registrable Securities, except in respect of the Settlement Agreement. Following the repayment of all amounts under the Credit Agreement, the
Company shall not grant to any Persons the right to request the Company or any Subsidiary to register any Class A Common Stock or Class B Common Stock of the Company, or any securities convertible or exchangeable into or exercisable for such
securities, that are superior to or materially interfere with the intended plan of distribution of the holders of the Registrable Securities, except in respect of the Settlement Agreement. Furthermore, the Company shall cause the Registrable
Securities to be registered under the Securities Act no later than the date of registration of the shares of the Class A Common Stock and Class B Common Stock of the Company to be registered in accordance with the Settlement Agreement.

 Section 4. Piggyback Registrations. 
 (a) Right to Piggyback. Whenever the Company proposes to register any of its securities under the Securities Act (other than (i) pursuant to a Demand Registration or (ii) in connection
with registrations on Form S-4 or S-8 promulgated by the SEC or any successor or similar forms) and the registration form to be used may be used for the registration of Registrable Securities (a “Piggyback Registration”, and
together with the Initial Shelf Registration, the Demand Registration, the Shelf Registration, and any other registration of the Company’s securities under the Securities Act contemplated hereunder, each a “Registration
Statement” ), the Company shall give prompt written notice to all holders of Registrable Securities of its intention to effect such Piggyback Registration and, subject to the terms of Section 4(c) and Section 4(d), shall include
in such Piggyback Registration (and in all related registrations or qualifications under blue sky laws and in any related underwriting) all Registrable Securities with respect to which the Company has received written requests for inclusion therein
within 20 days after delivery of the Company’s notice. 

  
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 (b) Piggyback Expenses. The Registration Expenses of the holders of Registrable
Securities shall be paid by the Company in all Piggyback Registrations, whether or not any such registration became effective. 

(c) Priority on Primary Registrations. If a Piggyback Registration is an underwritten primary registration on behalf of the
Company, and the managing underwriters advise the Company in writing that in their opinion the number of securities requested to be included in such registration exceeds the number which can be sold in such offering without adversely affecting the
marketability, proposed offering price, timing or method of distribution of the offering, the Company shall include in such registration (i) first, the securities the Company proposes to sell, (ii) second, the Registrable Securities
requested to be included in such registration which, in the opinion of the underwriters, can be sold without any such adverse effect, pro rata among the holders of such Registrable Securities on the basis of the number of shares owned by each such
holder, and (iii) third, other securities requested to be included in such registration which, in the opinion of the underwriters, can be sold without any such adverse effect. 

(d) Priority on Secondary Registrations. If a Piggyback Registration is an underwritten secondary registration on behalf of
holders of the Company’s securities, and the managing underwriters advise the Company in writing that in their opinion the number of securities requested to be included in such registration exceeds the number which can be sold in such offering
without adversely affecting the marketability, proposed offering price, timing or method of distribution of the offering, the Company shall include in such registration (i) first, the securities requested to be included therein by the holders
requesting such registration and the Registrable Securities requested to be included in such registration which, in the opinion of the underwriters, can be sold without any such adverse effect, pro rata among the holders of such securities on the
basis of the number of securities owned by each such holder, and (ii) second, securities proposed to be included by the Company, and (iii) third, other securities requested to be included in such registration which, in the opinion of the
underwriters, can be sold without any such adverse effect. 
 Section 5. Registration Procedures. 

(a) Whenever the holders of Registrable Securities have requested that any Registrable Securities be registered pursuant
to this Agreement, the Company shall effect the registration and the sale of such Registrable Securities in accordance with the intended method of disposition thereof, and pursuant thereto the Company shall as promptly as reasonably practicable:

 (i) in accordance with the Securities Act and all applicable rules and regulations promulgated thereunder,
prepare and file with the SEC a registration statement, and all amendments and supplements thereto and related prospectuses, with respect to such Registrable Securities and use best efforts to cause such registration statement to become effective
(provided that before filing a registration statement or prospectus or any amendments or supplements thereto, the Company shall furnish to the counsel selected by the holders of the Registrable Securities covered by such registration statement
copies of all such documents proposed to be filed); 

  
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 (ii) notify each holder of Registrable Securities of (A) the issuance
by the SEC of any stop order suspending the effectiveness of any registration statement or the initiation of any proceedings for that purpose, (B) the receipt by the Company or its counsel of any notification with respect to the suspension of
the qualification of the Registrable Securities for sale in any jurisdiction or the initiation or threatening of any proceeding for such purpose, and (C) the effectiveness of each registration statement filed hereunder; 

(iii) prepare and file with the SEC such amendments and supplements to such registration statement and the prospectus used
in connection therewith as may be necessary to keep such registration statement effective for a period ending the earlier of (i) the Effectiveness Period, (ii) when all of the securities covered by such registration statement have been
disposed of in accordance with the intended methods of distribution by the sellers thereof set forth in such registration statement, and (iii) such date as when all Registrable Securities covered by the registration statement have been disposed
of or may be disposed of without volume or timing restrictions pursuant to Rule 144 (but not in any event before the expiration of any longer period required under the Securities Act or, if such registration statement relates to an underwritten
Public Offering, such longer period as in the opinion of counsel for the underwriters a prospectus is required by law to be delivered in connection with sale of Registrable Securities by an underwriter or dealer), and comply with the provisions of
the Securities Act with respect to the disposition of all securities covered by such registration statement during such period in accordance with the intended methods of disposition by the sellers thereof set forth in such registration statement;

 (iv) provide copies to and permit counsel designated by the USH Investor to review each Registration Statement
and all amendments and supplements thereto as far in advance as reasonably practicable prior to their filing with the SEC and not file any document to which such counsel reasonably objects; 

(v) furnish to each seller of Registrable Securities thereunder such number of copies of such registration statement, each
amendment and supplement thereto, the prospectus included in such registration statement (including each preliminary prospectus), each Issuer Free-Writing Prospectus and such other documents as such seller may reasonably request in order to
facilitate the disposition of the Registrable Securities owned by such seller; 
 (vi) register or qualify such
Registrable Securities under such other securities or blue sky laws of such jurisdictions as any seller reasonably requests and do any and all other acts and things which may be reasonably necessary or advisable to enable such seller to consummate
the disposition in such jurisdictions of the Registrable Securities owned by such seller, except that the Company shall not for any such purpose be required to (i) qualify generally to do business in any jurisdiction where it is not then so
qualified, (ii) subject itself to taxation in any such jurisdiction where it is not then so subject; 

  
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 (vii) notify each seller of such Registrable Securities (A) promptly
after it receives notice thereof, of the date and time when such registration statement and each post-effective amendment thereto has become effective or a prospectus or supplement to any prospectus relating to a registration statement has been
filed and when any registration or qualification has become effective under a state securities or blue sky law or any exemption thereunder has been obtained, (B) promptly after receipt thereof, of any request by the SEC for the amendment or
supplementing of such registration statement or prospectus or for additional information, and (C) at any time when a prospectus relating thereto is required to be delivered under the Securities Act, of the happening of any event as a result of
which the prospectus included in such registration statement contains an untrue statement of a material fact or omits any fact necessary to make the statements therein not misleading, and, at the request of any such seller, the Company shall prepare
a supplement or amendment to such prospectus so that, as thereafter delivered to the purchasers of such Registrable Securities, such prospectus shall not contain an untrue statement of a material fact or omit to state any fact necessary to make the
statements therein not misleading; 
 (viii) use best efforts to cause all such Registrable Securities to be
listed on each securities exchange on which similar securities issued by the Company are then listed and, if not so listed, to be listed on a securities exchange and, if not then listed on NYSE, to use its best efforts to arrange for at least two
market markers to register as such with respect to such Registrable Securities with FINRA; 
 (ix) provide a
transfer agent and registrar for all such Registrable Securities not later than the effective date of such registration statement; 
 (x) enter into and perform such customary agreements (including underwriting agreements in customary form) and take all such other actions as the holders of the Registrable Securities being sold or the
underwriters, if any, reasonably request in order to expedite or facilitate the disposition of such Registrable Securities (including, without limitation, effecting a stock split, combination of shares, recapitalization or reorganization);

 (xi) subject to execution of customary confidentiality arrangements, make available for inspection by any
seller of Registrable Securities, any underwriter participating in any disposition pursuant to such registration statement and any attorney, accountant or other agent retained by any such seller or underwriter, all financial and other records,
pertinent corporate and business documents and properties of the Company as shall be necessary to enable them to exercise their due diligence responsibility, and cause the Company’s officers, directors, employees, agents, representatives and
independent accountants to supply all information reasonably requested by any such seller, underwriter, attorney, accountant or agent in connection with such registration statement; 

(xii) take all reasonable actions to ensure that any Issuer Free-Writing Prospectus utilized in connection with any
Registration Statement hereunder complies in all material respects with the Securities Act, is filed in accordance with the Securities Act 

  
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to the extent required thereby, is retained in accordance with the Securities Act to the extent required thereby and, when taken together with the related prospectus, shall not contain any untrue
statement of a material fact or omit to state a material fact necessary to make the statements therein, in light of the circumstances under which they were made, not misleading; 

(xiii) otherwise comply with all applicable rules and regulations of the SEC, and make available to its security holders,
as soon as reasonably practicable, an earning statement covering the period of at least twelve months beginning with the first day of the Company’s first full calendar quarter after the effective date of the registration statement, which
earnings statement shall satisfy the provisions of Section 11(a) of the Securities Act and Rule 158. 

(xiv) permit any holder of Registrable Securities which holder, in its sole and exclusive judgment, might be deemed to be
an underwriter or a controlling person of the Company, to participate in the preparation of such registration or comparable statement and to allow such holder to provide language for insertion therein, in form and substance satisfactory to the
Company, which in the judgment of such holder and its counsel should be included; 
 (xv) in the event of the
issuance of any stop order suspending the effectiveness of a registration statement, or the issuance of any order suspending or preventing the use of any related prospectus or suspending the qualification of any Common Stock included in such
registration statement for sale in any jurisdiction, use best efforts to promptly to obtain the withdrawal of such order; 
 (xvi) cause such Registrable Securities covered by such registration statement to be registered with or approved by such other governmental agencies or authorities as may be necessary to enable the
sellers thereof to consummate the disposition of such Registrable Securities; 
 (xvii) cooperate with the
holders of Registrable Securities covered by the registration statement and the managing underwriter or agent, if any, to facilitate the timely preparation and delivery of certificates (not bearing any restrictive legends) representing securities to
be sold under the registration statement and enable such securities to be in such denominations and registered in such names as the managing underwriter, or agent, if any, or such holders may request; 

(xviii) cooperate with each holder of Registrable Securities covered by the registration statement and each underwriter or
agent participating in the disposition of such Registrable Securities and their respective counsel in connection with any filings required to be made with FINRA; 

(xix) in connection with any underwritten offering, make available the executive officers of the Company to participate
with the holders of Registrable Securities and any underwriters in any “road shows” or other selling efforts that may be reasonably requested by the holders in connection with the methods of distribution for the Registrable Securities;

  
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 (xx) in connection with any underwritten offering, use best efforts to
obtain one or more cold comfort letters from the Company’s independent public accountants in customary form and covering such matters of the type customarily covered by cold comfort letters; and 

(xxi) in connection with any underwritten offering, use best efforts to provide a legal opinion of the Company’s
outside counsel, dated the effective date of such registration statement. 
 (b) The Company shall not undertake any
voluntary act intended to cause a Violation or result in the declaration of a Grace Period. During any Grace Period, and as may be extended hereunder, the Company shall correct or update any disclosure causing the Company to provide notice of the
Grace Period, and to file and cause to become effective or terminate the suspension of use or effectiveness, as the case may be, the subject registration statement. In the event that the Company shall exercise its right to delay or suspend the
filing or effectiveness of a registration hereunder, the applicable time period during which the registration statement is to remain effective shall be extended by a period of time equal to the duration of the Grace Period. The Company may extend
the Grace Period, for an additional consecutive 60 days with the consent of the holders of a majority of the Registrable Securities registered under the applicable registration statement, which consent shall not be unreasonably withheld. If so
directed by the Company, all holders of Registrable Securities registering shares under such registration statement shall (i) not offer to sell any Registrable Securities pursuant to the registration statement during the period in which the
delay or suspension is in effect after receiving notice of such delay or suspension and (ii) deliver to the Company (at the Company’s expense) all copies, other than permanent file copies then in such holders’ possession, of the
prospectus relating to such Registrable Securities current at the time of receipt of such notice. 
 Section 6.
Registration Expenses. 
 (a) The Company’s Obligation. All expenses incident to the Company’s
performance of or compliance with this Agreement (including, without limitation, all registration, qualification and filing fees, fees and expenses of compliance with securities or blue sky laws, printing expenses, messenger and delivery expenses,
fees and disbursements of custodians, and fees and disbursements of counsel for the Company, reasonable fees and expenses billed at the standard hourly rates of one counsel to the USH Investor and the USH Investor’s reasonable expenses in
connection with the registration, and all independent certified public accountants, underwriters and other Persons retained by the Company) (all such expenses being herein called “Registration Expenses”), shall be borne by the
Company. 
 (b) Counsel Fees and Disbursements. In connection with each Registration Statement, the Company shall
reimburse the holders of Registrable Securities included in such registration for the reasonable fees and disbursements of one counsel chosen by a majority of the 

  
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holders of the Registrable Securities requesting such registration for the purpose of rendering a legal opinion on behalf of such holder in connection with any underwritten Registration
Statement. 
 Section 7. Indemnification and Contribution. 

(a) By the Company. The Company shall indemnify and hold harmless, to the extent permitted by law, each holder of Registrable
Securities, such holder’s officers, directors employees, agents and representatives, and each Person who controls such holder (within the meaning of the Securities Act) (the “Indemnified Parties”) against all losses, claims,
actions, damages, liabilities and expenses (including with respect to actions or proceedings, whether commenced or threatened, and including attorney fees and expenses) caused by, resulting from, arising out of, based upon or related to any of the
following statements, omissions or violations (each a “Violation”) by the Company: (i) any untrue or alleged untrue statement of material fact contained in (A) any registration statement pursuant to which Registrable
Securities are registered, any prospectus, preliminary prospectus or Issuer Free-Writing Prospectus included in any such registration statement, or any amendment thereof or supplement thereto or (B) any application or other document or
communication (in this Section 7, collectively called an “application”) executed by or on behalf of the Company or based upon written information furnished by or on behalf of the Company filed in any jurisdiction in
order to qualify any Registrable Securities covered by such registration under the securities laws thereof, (ii) any omission or alleged omission of a material fact required to be stated therein or necessary to make the statements therein not
misleading or (iii) any violation or alleged violation by the Company of the Securities Act or any other similar federal or state securities laws or any rule or regulation promulgated thereunder applicable to the Company and relating to action
or inaction required of the Company in connection with any such registration, qualification or compliance; provided that the Company will not be liable for losses arising out of written information provided by a holder for inclusion in the
registration statement or sales of Registrable Securities made during a Grace Period, after notice has been given by the Company. In addition, the Company will reimburse such Indemnified Party for any reasonable legal or any other expenses incurred
by them in connection with investigating or defending any such losses. 
 (b) By Each Security Holder. In connection with
any registration statement in which a holder of Registrable Securities is participating, each such holder shall furnish to the Company in writing such information and affidavits as the Company reasonably requests for use in connection with any such
registration statement or prospectus and, to the extent permitted by law, shall indemnify the Company, its officers, directors, employees, agents and representatives, and each Person who controls the Company (within the meaning of the Securities
Act) against any losses, claims, damages, liabilities and expenses resulting from any untrue or alleged untrue statement of material fact contained in the registration statement, prospectus, preliminary prospectus or Issuer Free-Writing Prospectus
or any amendment thereof or supplement thereto or any omission or alleged omission of a material fact required to be stated therein or necessary to make the statements therein not misleading, but only to the extent that such untrue statement or
omission is contained in any information or affidavit so furnished in writing by such holder specifically for inclusion in such registration statement or prospectus or amendment or supplement thereto; provided that the obligation to indemnify
shall be individual, not joint and several, for each holder (with no holder being responsible for any misstatements or omissions of 

  
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any other holder) and shall be limited to the amount of proceeds (net of all expense paid by such holder in connection with any claim relating to this Section 7 and the amount of any
damages such holder has otherwise been required to pay by reason of such untrue statement or omission) received by such holder from the sale of securities pursuant to such registration statement giving rise to such indemnification obligation.

 (c) Claim Procedure. Any Person entitled to indemnification hereunder shall (i) give prompt written notice to the
indemnifying party of any claim with respect to which it seeks indemnification (provided that the failure to give prompt notice shall impair any Person’s right to indemnification hereunder only to the extent such failure has prejudiced the
indemnifying party) and (ii) unless in such indemnified party’s judgment a conflict of interest between such indemnified and indemnifying parties may exist with respect to such claim, permit such indemnifying party to assume the defense of
such claim with counsel reasonably satisfactory to the indemnified party. If such defense is assumed, the indemnifying party shall not be subject to any liability for any settlement made by the indemnified party without its consent (but such consent
shall not be unreasonably withheld, conditioned or delayed). An indemnifying party who is not entitled to, or elects not to, assume the defense of a claim shall not be obligated to pay the fees and expenses of more than one counsel for all parties
indemnified by such indemnifying party with respect to such claim, unless in the judgment of any indemnified party a conflict of interest may exist between such indemnified party and any other of such indemnified parties with respect to such claim.
In such instance, the conflicted indemnified parties shall have a right to retain one separate counsel, chosen by the holders of the Registrable Securities included in the registration if such holders are indemnified parties, at the expense of the
indemnifying party. 
 (d) Contribution. If the indemnification provided for in this Section 7 is held by a
court of competent jurisdiction to be unavailable to, or is insufficient to hold harmless, an indemnified party or is otherwise unenforceable with respect to any loss, claim, damage, liability or action referred to herein, then the indemnifying
party shall contribute to the amounts paid or payable by such indemnified party as a result of such loss, claim, damage, liability or action in such proportion as is appropriate to reflect the relative fault of the indemnifying party on the one hand
and of the indemnified party on the other hand in connection with the statements or omissions which resulted in such loss, claim, damage, liability or action as well as any other relevant equitable considerations. The relative fault of the
indemnifying party and of the indemnified party shall be determined by reference to, among other things, whether the untrue or alleged untrue statement of a material fact or the omission to state a material fact relates to information supplied by
the indemnifying party or by the indemnified party and the parties’ relative intent, knowledge, access to information and opportunity to correct or prevent such statement or omission. The parties hereto agree that it would not be just or
equitable if the contribution pursuant to this Section 7(d) were to be determined by pro rata allocation or by any other method of allocation that does not take into account such equitable considerations. The amount paid or payable by an
indemnified party as a result of the losses, claims, damages, liabilities or expenses referred to herein shall be deemed to include any legal or other expenses reasonably incurred by such indemnified party in connection with investigating or
defending against any action or claim which is the subject hereof. No person guilty of fraudulent misrepresentation (within the meaning of Section 11(f) of the Securities Act) shall be entitled to contribution from any Person who is not guilty
of such fraudulent misrepresentation. 

  
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Notwithstanding anything to the contrary, in no event shall the contribution obligation of a holder of Registrable Securities be greater in amount than the dollar amount of the proceeds (net of
all expenses paid by such holder in connection with any claim relating to this Section 7 and the amount of any damages such holder has otherwise been required to pay by reason of such untrue or alleged untrue statement or omission or
alleged omission) received by it upon the sale of the Registrable Securities giving rise to such contribution obligation. 
 (e)
Release. No indemnifying party shall, except with the consent of the indemnified party, consent to the entry of any judgment or enter into any settlement that does not include as an unconditional term thereof giving by the claimant or
plaintiff to such indemnified party of a release from all liability in respect to such claim or litigation. 
 (f)
Non-exclusive Remedy; Survival. The indemnification and contribution provided for under this Agreement shall be in addition to any other rights to indemnification or contribution that any indemnified party may have pursuant to law or contract
and shall remain in full force and effect regardless of any investigation made by or on behalf of the indemnified party or any officer, director or controlling Person of such indemnified party and shall survive the transfer of Registrable Securities
and the termination or expiration of this Agreement. 
 Section 8. Underwritten Registrations; Suspended
Distributions. 
 (a) Participation. No Person may participate in any registration hereunder which is underwritten
unless such Person (i) agrees to sell such Person’s securities on the basis provided in any underwriting arrangements approved by the Person or Persons entitled hereunder to approve such arrangements (including, without limitation,
pursuant to any over-allotment or “green shoe” option requested by the underwriters; provided that no holder of Registrable Securities shall be required to sell more than the number of Registrable Securities such holder has
requested to include) and (ii) completes and executes all questionnaires, powers of attorney, indemnities, underwriting agreements and other documents required under the terms of such underwriting arrangements; provided that no holder of
Registrable Securities included in any underwritten registration shall be required to make any representations or warranties to the Company or the underwriters (other than representations and warranties regarding such holder and such holder’s
intended method of distribution) or to undertake any indemnification obligations to the Company or the underwriters with respect thereto that are materially more burdensome than those provided in Section 7. 

(b) Suspended Distributions. Each Person that is participating in any registration under this Agreement, upon receipt of any
notice from the Company of the happening of any event giving rise to a Grace Period, shall immediately discontinue the disposition of its Registrable Securities pursuant to the registration statement until such Person’s receipt of the copies of
a supplemented or amended prospectus as contemplated by Section 5(a)(vii). In the event the Company has given any such notice, the applicable time period set forth in Section 5(a)(ii) during which a Registration Statement is
to remain effective shall be extended by the number of days during the period from and including the date of the giving of such notice pursuant to this Section 8(b) to and including the date when each seller of Registrable Securities
covered by such registration statement shall have received the copies of the supplemented or amended prospectus contemplated by Section 5(a)(vii). 

  
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 Section 9. Current Public Information At all times after the earlier of
(i) the Registration Deadline or (ii) the time the Initial Registration Statement is declared effective by the SEC as contemplated pursuant to Section 2(a)(i) of this Agreement, the Company shall file all reports required to be filed
by it under the Securities Act and the Exchange Act (including all reports that were previously required to be filed prior to such time) on or prior to the date that is required to be so filed under the applicable rules and regulations of the SEC
(which date shall include any additional period provided in Rule 12b-25 under the Exchange Act for the filing to be deemed timely filed, provided that the Company makes such filing within the applicable additional period) and shall take such further
action as any holder or holders of Registrable Securities may reasonably request, all to the extent required to enable such holders to sell Registrable Securities pursuant to Rule 144. Upon request, the Company shall deliver to any holder of
Registrable Securities a written statement as to whether it has complied with such requirements. If at any time following the date on which the Company is required to comply with this Section 9, Company fails to file a report required by the
Exchange Act on or prior to the date that is required to be so filed under the applicable rules and regulations of the SEC (a “Reporting Event”), in addition to any other rights the holders of such Registrable Securities may have
hereunder or under applicable law, on each such Reporting Event and on each monthly anniversary of each such Reporting Event (for the avoidance of doubt, if a Reporting Event is cured prior to a monthly anniversary of a Reporting Event, the Company
shall be responsible for paying to the holders of Registrable Securities their pro rata portion of the liquidated damages for that portion of the monthly anniversary period during which such Reporting Event is not cured) until the applicable
Reporting Event is cured, the Company shall pay to each holder of Registrable Securities their pro rata portion of $900,000 in cash, as partial liquidated damages and not as a penalty. Notwithstanding the foregoing, the amount of any such partial
liquidated damages payable under this Section 9 shall be reduced by the amount of any liquidated damages payable by the Company pursuant to Section 2(b) hereof. If the Company fails to pay any partial liquidated damages pursuant to this
Section 9 in full within seven calendar days after the date payable, the Company will pay interest thereon at a rate of 12% per annum (or such lesser maximum amount that is permitted to be paid by applicable law) to the holders, accruing
daily from the date such partial liquidated damages are due until such amounts, plus all such interest thereon, are paid in full. The partial liquidated damages pursuant to the terms hereof shall apply on a daily pro rata basis for any portion of a
month prior to the cure of a Reporting Event. 
 (a) Due Diligence Review; Information. Subject to the following
paragraph of this section, the Company shall make available, during normal business hours, for inspection and review by the USH Investor, advisors to and representatives of the USH Investor (who may or may not be affiliated with the USH Investor and
who are reasonably acceptable to the Company), all financial and other records, all 1934 Act Filings and other filings with the SEC, and all other corporate documents and properties of the Company as may be reasonably necessary for the purpose of
such review, and cause the Company’s officers, directors and employees, within a reasonable time period, to supply all such information reasonably requested by the USH Investor or any such representative, advisor or underwriter in connection
with such Registration Statement (including, without limitation, in response to all questions and other inquiries reasonably made or submitted by any of them), prior to and from time to time after the filing and effectiveness of the Registration
Statement for the sole purpose of enabling the USH Investor and such representatives, advisors and underwriters and their respective accountants and attorneys to conduct initial and ongoing due diligence with respect to the Company and the accuracy
of such Registration Statement. 

  
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 Anything in the foregoing notwithstanding, after the First Disclosure Date, the Company
shall not disclose material nonpublic information to the USH Investor, or to advisors to or representatives of the USH Investor, unless prior to disclosure of such information the Company identifies such information as being material nonpublic
information and provides the USH Investor, such advisors and representatives with the opportunity to (i) accept such material nonpublic information for review, (ii) refuse to accept such material nonpublic information for review or
(iii) to direct the Company to deliver any such material, nonpublic information to a division, affiliate or advisor of the USH Investor which is segregated from the USH Investor such that its receipt of such material, nonpublic information does
not restrict such USH Investor from trading in the securities of the Company and any USH Investor, division, affiliate, advisor or representative, as applicable, wishing to obtain such information enters into an appropriate confidentiality agreement
with the Company with respect thereto. 
 Section 10. Subsidiary Public Offering. If, after an initial Public
Offering of the Capital Stock of one of its Subsidiaries, the Company distributes securities of such Subsidiary to its equity holders, then the rights and obligations of the Company pursuant to this Agreement shall apply, mutatis mutandis, to
securities of such Subsidiary, and the Company shall cause such Subsidiary to comply with such Subsidiary’s obligations under this Agreement. 
 Section 11. Lock-up. For a period of 45 days after the date of the effectiveness of the Registration Statement the Company will not offer, sell, contract to sell, pledge or otherwise dispose
of, directly or indirectly any additional shares of its securities or securities convertible into or exchangeable or exercisable for any shares of its securities, excluding (i) options granted to employees, directors or consultants under the
Company’s stock option plans, (ii) the conversion or exercise of convertible or exercisable securities outstanding on the date hereof, (iii) the issuance of shares in connection with debt financing or similar transactions that are
primarily of a non-equity financing nature and approved by the Company’s Board of Directors, (iv) securities issued pursuant to acquisitions or strategic transactions approved by the Company’s Board of Directors, and
(v) securities issued in exchange for outstanding debt. 
 Section 12. General Provisions. 

(a) Amendments and Waivers. Except as otherwise provided herein, the provisions of this Agreement may be amended, modified or
waived only with the prior written consent of the Company and a majority of the holders of the Registrable Securities. The failure or delay of any Person to enforce any of the provisions of this Agreement shall in no way be construed as a waiver of
such provisions and shall not affect the right of such Person thereafter to enforce each and every provision of this Agreement in accordance with its terms. A waiver or consent to or of any breach or default by any Person in the performance by that
Person of his, her or its obligations under this Agreement shall not be deemed to be a consent or waiver to or of any other breach or default in the performance by that Person of the same or any other obligations of that Person under this Agreement.

  
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 (b) Remedies. The parties to this Agreement shall be entitled to enforce their rights
under this Agreement specifically (without posting a bond or other security), to recover damages caused by reason of any breach of any provision of this Agreement and to exercise all other rights existing in their favor. The parties hereto agree and
acknowledge that a breach of this Agreement would cause irreparable harm and money damages would not be an adequate remedy for any such breach and that, in addition to any other rights and remedies existing hereunder, any party shall be entitled to
specific performance and/or other injunctive relief from any court of law or equity of competent jurisdiction (without posting any bond or other security) in order to enforce or prevent violation of the provisions of this Agreement. 

(c) Severability. Whenever possible, each provision of this Agreement shall be interpreted in such manner as to be effective and
valid under applicable law, but if any provision of this Agreement is held to be prohibited, invalid, illegal or unenforceable in any respect under any applicable law or regulation in any jurisdiction, such prohibition, invalidity, illegality or
unenforceability shall not affect the validity, legality or enforceability of any other provision of this Agreement in such jurisdiction or in any other jurisdiction, but this Agreement shall be reformed, construed and enforced in such jurisdiction
as if such prohibited, invalid, illegal or unenforceable provision had never been contained herein. 
 (d) Entire
Agreement. Except as otherwise provided herein, this Agreement contains the complete agreement and understanding among the parties hereto with respect to the subject matter hereof and supersedes and preempts any prior understandings, agreements
or representations by or among the parties hereto, written or oral, which may have related to the subject matter hereof in any way, except as may be contained in the Purchase Agreements or the Warrants. 

(e) Successors and Assigns. Except as otherwise provided herein, this Agreement shall bind and inure to the benefit and be
enforceable by the Company and its successors and assigns and the holders of Registrable Securities and their respective successors and permitted assigns (whether so expressed or not). In addition, whether or not any express assignment has been
made, the provisions of this Agreement which are for the benefit of purchasers or holders of Registrable Securities are also for the benefit of, and enforceable by, any subsequent holder of Registrable Securities. 

(f) Notices. All notices, demands or other communications to be given or delivered under or by reason of the provisions of this
Agreement will be in writing and will be delivered personally, mailed by certified or registered mail, return receipt requested and postage prepaid, or sent by reputable overnight courier service (charges prepaid), to the recipient. Such notices,
demands and other communications will be sent to the Company or the USH Investor specified below: 
 The Company:

 K-V Pharmaceutical Company 
 One Corporate Woods Drive 
 Bridgeton, MO 63044 

Attn: CEO and President 
 Fax: 314-646-3785 

  
 -22-

 With a copy to: 

Thompson Coburn LLP 
 One US Bank Plaza 
 St. Louis, MO 63101 

Attention: Thomas A. Litz 
 Facsimile: 314-552-7000 
 USH Investors: 

U.S. Healthcare I, L.L.C. 
 c/o Kirkland & Ellis LLP 
 601 Lexington Avenue 

New York, New York 10022 
 Attn: Leonard Klingbaum, Esq. 
 Fax: 212-446-6460 

U.S. Healthcare II, L.L.C. 
 c/o Kirkland & Ellis LLP 
 601 Lexington Avenue 

New York, New York 10022 
 Attn: Leonard Klingbaum, Esq. 
 Fax: 212-446-6460 

or to such other address or to the attention of such other person as the recipient party has specified by prior written notice to the sending party. All
such notices, demands or other communications will be deemed to have been given when actually received or refused by the recipient or when returned to the sender as undeliverable. 

(g) Business Days. If any time period for giving notice or taking action hereunder expires on a day that is not a Business Day,
the time period shall automatically be extended to the Business Day immediately following such Saturday, Sunday or legal holiday. 
 (h) Governing Law. The corporation laws of the State of Delaware shall govern all issues concerning the relative rights of the Company and its stockholders. All other questions concerning the
construction, validity, enforcement and interpretation of this Agreement shall be governed by the internal law of the State of New York, without giving effect to any choice of law or conflict of law provision or rule (whether of the State of New
York or any other jurisdictions) that would cause the application of the laws of any jurisdictions other than the State of New York. 
 (i) MUTUAL WAIVER OF JURY TRIAL. AS A SPECIFICALLY BARGAINED FOR INDUCEMENT FOR EACH OF THE PARTIES HERETO TO ENTER INTO THIS AGREEMENT (AFTER HAVING THE OPPORTUNITY TO CONSULT WITH COUNSEL), EACH
PARTY HERETO EXPRESSLY WAIVES THE RIGHT TO TRIAL BY JURY IN ANY LAWSUIT OR PROCEEDING RELATING TO OR ARISING IN ANY WAY FROM THIS AGREEMENT OR THE MATTERS CONTEMPLATED HEREBY. 

  
 -23-

 (j) CONSENT TO JURISDICTION AND SERVICE OF PROCESS. EACH OF THE PARTIES IRREVOCABLY
SUBMITS TO THE NON-EXCLUSIVE JURISDICTION OF THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF NEW YORK, FOR THE PURPOSES OF ANY SUIT, ACTION OR OTHER PROCEEDING ARISING OUT OF THIS AGREEMENT, ANY RELATED AGREEMENT OR ANY TRANSACTION
CONTEMPLATED HEREBY OR THEREBY. EACH OF THE PARTIES HERETO FURTHER AGREES THAT SERVICE OF ANY PROCESS, SUMMONS, NOTICE OR DOCUMENT BY U.S. REGISTERED MAIL TO SUCH PARTY’S RESPECTIVE ADDRESS SET FORTH ABOVE SHALL BE EFFECTIVE SERVICE OF PROCESS
FOR ANY ACTION, SUIT OR PROCEEDING WITH RESPECT TO ANY MATTERS TO WHICH IT HAS SUBMITTED TO JURISDICTION IN THIS PARAGRAPH. EACH OF THE PARTIES HERETO IRREVOCABLY AND UNCONDITIONALLY WAIVES ANY OBJECTION TO THE LAYING OF VENUE OF ANY ACTION, SUIT OR
PROCEEDING ARISING OUT OF THIS AGREEMENT, ANY RELATED DOCUMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY AND THEREBY IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF DELAWARE, AND HEREBY AND THEREBY FURTHER IRREVOCABLY AND UNCONDITIONALLY
WAIVES AND AGREES NOT TO PLEAD OR CLAIM IN ANY SUCH COURT THAT ANY SUCH ACTION, SUIT OR PROCEEDING BROUGHT IN ANY SUCH COURT HAS BEEN BROUGHT IN AN INCONVENIENT FORUM. 
 (k) No Recourse. Notwithstanding anything to the contrary in this Agreement, the Company and each holder of Registrable Securities agrees and acknowledges that no recourse under this Agreement or
any documents or instruments delivered in connection with this Agreement, shall be had against any current or future director, officer, employee, general or limited partner or member of any holder of Registrable Securities or of any Affiliate or
assignee thereof, whether by the enforcement of any assessment or by any legal or equitable proceeding, or by virtue of any statute, regulation or other applicable law, it being expressly agreed and acknowledged that no personal liability whatsoever
shall attach to, be imposed on or otherwise be incurred by any current or future officer, agent or employee of any holder of Registrable Securities or any current or future member of any holder of Registrable Securities or any current or future
director, officer, employee, partner or member of any holder of Registrable Securities or of any Affiliate or assignee thereof, as such for any obligation of any holder of Registrable Securities under this Agreement or any documents or instruments
delivered in connection with this Agreement for any claim based on, in respect of or by reason of such obligations or their creation. 

  
 -24-

 (l) Descriptive Headings; Interpretation. The descriptive headings of this Agreement
are inserted for convenience only and do not constitute a part of this Agreement. The use of the word “including” in this Agreement shall be by way of example rather than by limitation. 

(m) No Strict Construction. The language used in this Agreement shall be deemed to be the language chosen by the parties hereto to
express their mutual intent, and no rule of strict construction shall be applied against any party. 
 (n) Counterparts.
This Agreement may be executed in multiple counterparts, any one of which need not contain the signature of more than one party, but all such counterparts taken together shall constitute one and the same agreement. 

(o) Electronic Delivery. This Agreement, the agreements referred to herein, and each other agreement or instrument entered into in
connection herewith or therewith or contemplated hereby or thereby, and any amendments hereto or thereto, to the extent executed and delivered by means of a photographic, photostatic, facsimile or similar reproduction of such signed writing using a
facsimile machine or electronic mail shall be treated in all manner and respects as an original agreement or instrument and shall be considered to have the same binding legal effect as if it were the original signed version thereof delivered in
person. At the request of any party hereto or to any such agreement or instrument, each other party hereto or thereto shall re-execute original forms thereof and deliver them to all other parties. No party hereto or to any such agreement or
instrument shall raise the use of a facsimile machine or electronic mail to deliver a signature or the fact that any signature or agreement or instrument was transmitted or communicated through the use of a facsimile machine or electronic mail as a
defense to the formation or enforceability of a contract and each such party forever waives any such defense. 
 (p) Further
Assurances. In connection with this Agreement and the transactions contemplated hereby, each holder of Registrable Securities shall execute and deliver any additional documents and instruments and perform any additional acts that may be
necessary or appropriate to effectuate and perform the provisions of this Agreement and the transactions contemplated hereby. 

(q) No Inconsistent Agreements. The Company shall not hereafter enter into any agreement with respect to its securities which is
inconsistent with or violates the rights granted to the holders of Registrable Securities in this Agreement. 

*    *    *    *    * 

  
 -25-

 IN WITNESS WHEREOF, the parties have executed this Second Amended and Restated Registration
Rights Agreement as of the date first written above. 
  

					
	U.S. Healthcare I, L.L.C.
		
	By:	 	 /s/ Kevin Fusco

		 	Name:	 	Kevin Fusco
		 	Title:	 	Authorized Person
	
	U.S. Healthcare II, L.L.C.
		
	By:	 	 /s/ Kevin Fusco

		 	Name:	 	Kevin Fusco
		 	Title:	 	Authorized Person
	
	K-V Pharmaceutical Company
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President and CEO

  
 [Second
Amended and Restated Registration Rights Agreement] 

 SCHEDULE OF USH INVESTORS 

U.S. Healthcare I, L.L.C. 
 c/o Kirkland & Ellis LLP 
 601 Lexington Avenue 

New York, New York 10022 
 Attn: Leonard Klingbaum, Esq. 
 Fax: 212-446-6460 

U.S. Healthcare II, L.L.C. 
 c/o Kirkland & Ellis LLP 
 601 Lexington Avenue 

New York, New York 10022 
 Attn: Leonard Klingbaum, Esq. 
 Fax: 212-446-6460 

  
 A-1Second Amended and Restated Registration Rights Agreement

 Exhibit 10.7 
 AMENDMENT NO. 2 TO CREDIT AGREEMENT 
 This AMENDMENT NO. 2 TO CREDIT
AGREEMENT (this “Agreement”), dated as of March 2, 2011, is entered into by and among K-V PHARMACEUTICAL COMPANY, a Delaware corporation (the “Borrower”), certain of the Borrower’s subsidiaries, as
guarantors (collectively, the “Guarantors”), U.S. HEALTHCARE I, L.L.C., as Administrative Agent and Collateral Agent (the “Agent”) and the LENDERS listed on the signature pages hereto, and U.S. Healthcare I, L.L.C.
(“USH I”) and U.S. Healthcare II, L.L.C. (“USH II”) and is made with reference to that certain CREDIT AND GUARANTY AGREEMENT, dated as of November 17, 2010 (as amended by that certain Amended and Restated
Amendment No. 1 to Credit Agreement dated as of January 6, 2011, the “Credit Agreement”) by and among the Borrower, the Guarantors, the Lenders from time to time party thereto and the Agent. Unless otherwise stated,
capitalized terms used herein without definition shall have the same meanings herein as set forth in the Credit Agreement. 

WHEREAS, the Credit Parties have failed to comply with the requirement set forth in Section 6.7(b) of the Credit Agreement with
respect to the calendar months of December 2010 and January 2011, and, solely as a result of such non-compliance, Events of Default under Section 8.1(b) have occurred and are continuing (the “Covenant Defaults”); 

WHEREAS, the Credit Parties have failed to comply with the requirements set forth in Section 5.14 of the Credit Agreement insofar as
they have failed to cause there to be effective a Control Agreement with respect to account no. 5590011846 at Bank of America, N.A. and, solely as a result of such non-compliance, an Event of Default under 8.1(b) has occurred and is continuing (the
“Control Agreement Default”); 
 WHEREAS, the Credit Parties have failed to comply with the requirements set
forth in Section 5.16(b) of the Credit Agreement and, solely as a result of such non-compliance, an Event of Default under Section 8.1(b) has occurred and is continuing (together with the Covenant Defaults and Control Agreement Default,
the “Waived Defaults”); 
 WHEREAS, the Credit Parties, the Agent and the Lenders entered into, among other
agreements, that certain Waiver Agreement dated as of February 27, 2011 (the “Waiver Agreement”) pursuant to which the Lenders waived the Waived Defaults until 5:00 p.m. (New York City time) on March 2, 2011; 

WHEREAS, the Borrower has requested that the Agent and the Lenders agree to waive the Waived Defaults on a permanent basis, and amend
certain terms and provisions set forth in the Credit Agreement; and 
 WHEREAS, the Agent and the Lenders are willing to amend
the Credit Agreement on the terms and subject to the conditions specified herein. 

  
 1 

 NOW, THEREFORE in consideration of the foregoing and for other good and valuable
consideration, the receipt and sufficiency of which is hereby acknowledged, the parties hereto agree as follows: 
 1.
Confirmation of Obligations. The Borrower and the other Credit Parties acknowledge and agree that the aggregate principal balance of the outstanding Obligations under the Credit Agreement as of February 28, 2011 was not less than
$48,091,152.00. The foregoing amount does not include any of the interest, fees, costs, and expenses to which Agent and Lenders are entitled under the Credit Agreement or other Credit Documents. All of the foregoing Obligations are outstanding, and
the Borrower and the other Credit Parties agree and acknowledge that (a) they are jointly and severally liable for the Obligations, and (b) they have no right of offset, defense, or counterclaim with respect to any of the Obligations or
Liens securing same, and any such offset, defense, or counterclaim is hereby waived. 
 2. Representations, Warranties and
Acknowledgments by Credit Parties. To induce the Agent, the Lenders and the Commitment Parties to execute this Agreement, as of the Effective Date (as defined below), each Credit Party hereby acknowledges, stipulates, represents, warrants and
agrees as follows: 
 (a) After giving effect to this Agreement, no Defaults or Events of Default have occurred
and are continuing as of the date hereof. 
 (b) Each of the Borrower and the other Credit Parties has the full
power, authority and legal right to enter into this Agreement and all documents, acknowledgments and instruments delivered in connection herewith, and this Agreement and such other documents, acknowledgments and instruments have been duly authorized
by the board of directors or other governing body of the applicable Credit Party. 
 (c) This Agreement, all
documents, acknowledgments and instruments delivered in connection herewith, the Credit Agreement, and the other Credit Documents constitute the legal, valid and binding obligations of the Borrower and the other Credit Parties and are enforceable
against the Borrower and the other Credit Parties in accordance with their respective terms. 
 (d) Neither the
execution, delivery and performance of this Agreement and all documents, acknowledgments and instruments delivered in connection herewith nor the consummation of the transactions contemplated hereby or thereby does or shall contravene, result in a
breach of, or otherwise violate (i) any provision of the Borrower’s or any other Credit Party’s corporate charter or bylaws or other Organizational Documents or governing documents, and (ii) any law or regulation, any order or
decree of any court or government instrumentality, or any agreement or document by which such party is bound, except in the case of clause (ii) to the extent as such conflict, breach or violation could not reasonably be expected to
result in a Material Adverse Effect. 
 (e) The Liens of the Agent and each Lender in and on the Collateral are
and continue to be valid, binding, perfected and enforceable first priority Liens (other than as may be permitted in the Credit Documents) which secure the Obligations, and no tax or judgment liens are currently of record against the Borrower or any
other Credit Party (other than such tax or judgment liens that constitute Permitted Liens). 

  
 2 

 3. Amendments to Credit Documents. Upon the Effective Date: 

(a) The Credit Agreement is hereby amended by inserting each of the provisions which appear with computerized underscoring
and by deleting each of the provisions which appear with computerized strike-through in the document annexed hereto as Exhibit A, in each case in the appropriate and applicable places as shown therein. 

(b) The form of Initial Approved Budget (Exhibit J to the Credit Agreement) is amended and replaced in its entirety with
Exhibit J hereto. 
 (c) Item number seven (7) of Schedule 5.22 to the Credit Agreement is
hereby amended by deleting the clause “90 days following the Closing Date” and inserting in lieu thereof the clause “May 2, 2011”. 
 4. Waiver. Upon the Effective Date, the Lenders hereby permanently waive the Waived Defaults. 
 5. Conditions Precedent. This Agreement shall be effective on the date when each of the following conditions precedent shall have been satisfied (such date, the “Effective Date”):

 (a) The Agent shall have received (i) a counterpart signature page of this Agreement duly executed by
each of the Credit Parties and (ii) a counterpart signature page of this Agreement duly executed by the Lenders. 
 (b) The Agent shall have received a duly executed and delivered amended registration rights agreement relating to the Existing Warrants (as defined below) and the Additional Warrants (as defined below),
in form and substance satisfactory to the Borrower, USH I and USH II. 
 (c) The Agent shall have received all
fees and other amounts due and payable to the Agent on or prior to the date hereof, including to the extent invoiced, reimbursement or other payment of all out-of-pocket expenses required to be reimbursed or paid by the Borrower hereunder or under
any other Credit Document. 
 (d) Each Credit Party shall have obtained all material consents necessary or
advisable in connection with the transactions contemplated by this Agreement. 
 (e) The Agent shall have
received: (a) (i) an original duly executed and delivered amended and restated Stock Purchase Warrant, in form and substance satisfactory to the Borrower, USH I and USH II, amending and restating that certain Stock Purchase Warrant
(Certificate No. W-1) dated as of November 17, 2010 issued to USH I and USH II, in exchange for the originally issued Warrant and (ii) an original duly executed and delivered amended and restated Stock Purchase Warrant, in form and
substance satisfactory to the Borrower, USH I and USH II, amending and restating that certain Stock Purchase Warrant (Certificate No. W-2) dated as of November 30, 2010 issued to USH I and USH II, in exchange for the originally issued Warrant
(the warrants referred to in clauses (i) and (ii), together, the “Existing Warrants”); and (b) (i) an original counterpart signature page of the Stock Purchase Warrant (the “Additional

  
 3 

 
Warrants”) in form and substance satisfactory to the Borrower, USH I and USH II, delivery of such Additional Warrants to be in full substitution for the delivery of, and in
satisfaction of the requirement to deliver such, Additional Warrants pursuant to that certain Waiver Agreement dated as of February 9, 2011, duly executed by the Borrower and (ii) copies of the favorable written opinions of counsel to the
Credit Parties, each in form and substance reasonably satisfactory to the Agent (and each Credit Party hereby instructs such counsel to deliver such opinions to the Agent) with respect to the Existing Warrants (as amended), Additional Warrants and
the transactions contemplated thereby (it being agreed that such opinions shall be satisfactory to the Agent to the extent that such opinions are substantially the same as the opinions delivered to the Agent in connection with the Warrants issued on
or about the Closing Date). Upon delivery to the Agent of the Additional Warrants and the Existing Warrants, (as amended), all such warrants shall be in full force and effect and shall have been duly issued and delivered to USH I and USH II.

 (f) The Agent and Lenders shall have received such other documents, information or agreements regarding Credit
Parties as Agent or Collateral Agent may reasonably request. 
 6. Limited Effect of Agreement. Except as expressly
provided in this Agreement, the Credit Agreement and each other Credit Document shall continue to be, and shall remain, in full force and effect. This Agreement shall not be deemed or otherwise construed to be a commitment or any other undertaking
or expression of any willingness to engage in any further discussion with any Credit Party or any other Person with respect to any waiver, amendment, modification or any other change to the Credit Agreement or any other Credit Document, or any
rights or remedies arising in favor of the Agent and the Lenders under or with respect to any such documents. Any failure by the Credit Parties to comply with the terms hereof within the time period specified (including with respect to the
requirements included in Section 6 of this Agreement) shall constitute an immediate Event of Default under the Credit Agreement (with any purported grace periods or notice requirements hereby waived by the Credit Parties). 

7. Cash Flow Forecast. Attached as Exhibit C hereto is a 13-week cash flow forecast that constitutes a Cash Flow Forecast
required to be delivered pursuant to Section 5.1(e) as of the first Wednesday in the month of March, 2011. 
 8.
Amendment. No term of this Agreement (or the exhibits and schedules attached hereto) may be waived, modified or amended except in a writing signed by the Agent, the Lenders and the Credit Parties. 

9. No Waiver. Except as expressly provided to the contrary in this Agreement, all the terms, conditions and provisions of the
Credit Agreement and other Credit Documents shall continue in full force and effect. 
 10. Release of Obligations. The
Credit Parties hereby waive, release, remise and forever discharge the Agent, Lenders, the Commitment Parties (as defined below) and each other Indemnitee from any and all actions, causes of action, suits or other claims of any kind or character,
known or unknown, which any Credit Party ever had, now has or might hereafter have 

  
 4 

 
against the Agent, any Lender or any other Indemnitee which relate, directly or indirectly, to any acts or omissions of the Agent, any Lender or any other Indemnitee on or prior to the date
hereof arising out of, in connection with, or otherwise relating to, the Credit Documents or any matter in connection therewith. The Credit Parties agree and confirm that the Commitment Letter dated as of November 17, 2010 provided by U.S.
Healthcare I, L.L.C. and U.S. Healthcare II, L.L.C. (the “Commitment Parties”) in favor of the Borrower has been terminated, and that neither of the Commitment Parties has any further obligation whatsoever thereunder. 

11. WAIVER OF JURY TRIAL. EACH OF THE PARTIES TO THIS AGREEMENT HEREBY IRREVOCABLY WAIVES ALL RIGHT TO A TRIAL BY JURY IN ANY
ACTION, PROCEEDING OR COUNTERCLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR THE TRANSACTIONS CONTEMPLATED HEREBY. 
 12.
Severability. Wherever possible, each provision of this Agreement shall be interpreted in such a manner as to be effective and valid under applicable law, but if any provision of this Agreement shall be prohibited by or invalid under
applicable law, such provision shall be ineffective to the extent of such prohibition or invalidity, without invalidating the remainder of such provision or the remaining provisions of this Agreement. 

13. GOVERNING LAW. THIS AGREEMENT AND THE RIGHTS AND OBLIGATIONS OF THE PARTIES HEREUNDER SHALL BE GOVERNED BY, AND SHALL BE
CONSTRUED AND ENFORCED IN ACCORDANCE WITH, THE LAWS OF THE STATE OF NEW YORK, WITHOUT REGARD TO CONFLICTS OF LAWS PRINCIPLES THEREOF. 
 14. Survival. All representations, warranties, covenants and agreements made herein shall survive the execution, delivery and consummation of this Agreement. 

15. Section Headings. Section headings in this Agreement are included herein for convenience of reference only and shall not
constitute a part of this Agreement for any other purposes. 
 16. Lender Co-operation. The Lenders agree to reasonably
cooperate with the Borrower and its advisers in connection with the publicly announced refinancing transaction, including aspects relating to an orderly release of collateral security in a manner consistent with customary market practices. The
foregoing notwithstanding, cooperation shall not include, and, as a result of the foregoing agreement, the Lenders shall not be under obligation to enter into, any agreement by the Lenders to any waivers, amendments, forbearance or similar
arrangements, or the waiver or deviation by the Loan Parties to any of the terms and provisions of the Credit Documents, or an exercise of remedies by the Agents and Lenders in accordance with the terms of the Credit Documents. 

  
 5 

 17. Counterparts; Electronic Execution. This Agreement may be executed in any number
of counterparts and by different parties on separate counterparts, each of which when so executed shall be deemed to be an original and all of which taken together shall constitute but one and the same agreement. Delivery of an executed counterpart
of this Agreement by electronic or facsimile transmission shall be as effective as delivery of a manually executed counterpart of this Agreement. 
 [REMAINDER OF PAGE LEFT INTENTIONALLY BLANK] 

  
 6 

 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their
respective officers thereunto duly authorized as of the date first above written. 
  

					
	K-V Pharmaceutical Company, as the Borrower
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President and CEO
	
	Zeratech Technologies USA, Inc., as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President
	
	DrugTech Corporation, as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President
	
	ETHEX Corporation, as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President
	
	FP1096, Inc., as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President
	
	Nesher Pharmaceuticals Inc., as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President

  
 [Signature
Page to Amendment No. 2] 

 
					
	Nesher Solutions USA, Inc., as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President
	
	Nesher Discovery Solutions, Inc., as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President
	
	Ther-Rx Corporation, as a Guarantor
		
	By:	 	 /s/ Gregory J. Divis

		 	Name:	 	Gregory J. Divis
		 	Title:	 	President

  
 [Signature
Page to Amendment No. 2] 

 
					
	U.S. HEALTHCARE I, L.L.C.,
	as Agent and a Lender
		
	By:	 	 /s/ Kevin Fusco

		 	Name:	 	Kevin Fusco
		 	Title:	 	Authorized Person
	
	 U.S. HEALTHCARE II, L.L.C.,
 as a Lender

		
	By:	 	 /s/ Kevin Fusco

		 	Name:	 	Kevin Fusco
		 	Title:	 	Authorized Person

  
 [Signature
Page to Amendment No. 2] 

 EXHIBIT A 

Amendments to Credit Agreement 

 EXHIBIT B 

Cash Flow Forecast 

 EXHIBIT J

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