Document:

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                                                                 Exhibit 10.65

                                 FIRST AMENDMENT
                                       TO
                           LOAN AND SECURITY AGREEMENT

         This First Amendment to Loan and Security Agreement is entered into as
of March 16, 2004 (the "Amendment"), by and between COMERICA BANK ("Bank"), and
GENAISSANCE PHARMACEUTICALS, INC. ("Borrower").

                                    RECITALS

         Borrower and Bank are parties to that certain Loan and Security
Agreement dated as of September 30, 2003, as amended (collectively, the
"Agreement"). The parties desire to amend the Agreement in accordance with the
terms of this Amendment.

         NOW, THEREFORE, the parties agree as follows:

         1. Section 6.7 of the Agreement is hereby amended in its entirety to
read as follows:

                  6.7 ACCOUNTS. Borrower shall maintain at all times and shall
         cause each of its Subsidiaries to maintain at all times its depository,
         operating, and investment accounts with Bank and/or, if securities
         account control agreements acceptable to Bank have been entered into,
         Comerica Securities, Inc. Notwithstanding the foregoing and provided
         Borrower is in compliance with all its other obligations under this
         Agreement including, without limitation, its obligations under Sections
         6.9 and 7.3, (i) Borrower may maintain an aggregate amount not to
         exceed One Million Dollars ($1,000,000) at any time with financial
         institutions other than Bank and/or Comerica Securities, Inc., and (ii)
         Borrower shall have up to thirty (30) days following the consummation
         of a merger or acquisition to transfer any depository, operating, and
         investment accounts to Bank and/or Comerica Securities, Inc. which
         Borrower acquires pursuant to such merger or acquisition (other than an
         account contemplated by subsection (i) hereof). Notwithstanding the
         foregoing, in the event the balance of the account contemplated in
         subsection (i) hereof exceeds $1,000,000, Borrower shall have five (5)
         Business Days (the "Section 6.7 Cure Period") starting on the day on
         which such noncompliance first occurs in which to cause such account to
         be in compliance with this Section 6.7 provided that, at the end of
         such five day period, Borrower must be in compliance with this Section
         6.7 and that no new Section 6.7 Cure Period may begin until Borrower is
         in such compliance.

         2. Unless otherwise defined, all initially capitalized terms in this
Amendment shall be as defined in the Agreement. The Agreement, as amended
hereby, shall be and remain in full force and effect in accordance with its
respective terms and hereby is ratified and confirmed in all respects. Except as
expressly set forth herein, the execution, delivery, and performance of this
Amendment shall not operate as a waiver of, or as an amendment of, any right,
power, or remedy of Bank under the Agreement, as in effect prior to the date
hereof. Borrower ratifies and reaffirms the continuing effectiveness of all
promissory notes, guaranties, security agreements,

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mortgages, deeds of trust, environmental agreements, and all other instruments,
documents and agreements entered into in connection with the Agreement.

         3. Borrower represents and warrants that the representations and
warranties continued in the Agreement are true and correct as of the date of
this Amendment, and that no Event of Default has occurred and is continuing.

         4. This Amendment may be executed in two or more counterparts, each of
which shall be deemed an original, but all of which together shall constitute
one instrument.

         5. This Agreement shall be governed by, and construed in accordance
with, the internal laws of the State of California, without regard to principles
of conflicts of law.

         6. As a condition to the effectiveness of this Amendment, Bank shall
have received, in form and substance satisfactory to Bank, the following:

            (a) this Amendment, duly executed by Borrower; and

            (b) such other documents, and completion of such other matters,
as Bank may reasonably deem necessary or appropriate.

         IN WITNESS WHEREOF, the undersigned have executed this Amendment as of
the first date above written.

                                        GENAISSANCE PHARMACEUTICALS, INC.

                                        By: /s/ Ben D. Kaplan
                                            -----------------------------
                                        Title: SVP & CFO

                                        COMERICA BANK

                                        By: /s/ Kristen Kosofsky
                                            -----------------------------

                                        Title: VP Life Sciences<Page>

                                                                   Exhibit 10.17

                     Summary of 2005 Executive Compensation

On March 9, 2005, the Compensation Committee of the Board of Directors of Keane,
Inc. (the "Company") approved the 2005 Incentive Compensation Plan for the
Company's executive officers.

The incentive awards are based on the Company's pre-established performance
objectives, primarily financial measures to be achieved for the year ended
December 31, 2005. These financial measures at the Company wide level include
cash earnings per share (CEPS)(1), revenues, days sales outstanding (DSO)(2) and
at the business unit level, revenues and operating income. The pre-established
performance objectives also include non-financial measures that are based upon
the executive's individual objectives, such as leadership initiatives,
organizational effectiveness, brand development and compliance.

Each executive was assigned a pre-established incentive target expressed as a
percentage ranging from 50% to 100% of his or her base salary. Current salary of
each of the executive officers is as follows:

<Table>
<Caption>
EXECUTIVE OFFICER                                                             BASE SALARY
--------------------------------------------------------------------------   -------------
<S>                                                                          <C>
Brian T. Keane - President and Chief Executive Officer                       $     525,000

John J. Leahy - Senior Vice President - Finance and Administration and
Chief Financial Officer                                                      $     430,000

Robert B. Atwell, Senior Vice President - North American Branch Operations   $     430,000

Russell Campanello, Senior Vice President - Human Resources                  $     300,000

Georgina Fisk, Vice President - Marketing                                    $     215,000

Raymond W. Paris, Senior Vice President - Healthcare Solutions Division      $     320,000

Laurence Shaw, Senior Vice President - International Operations              L     225,000
</Table>

L -- amount in British Pounds.

Each executive is eligible for reimbursement of Financial Planning services up
to $12,000 per year. In addition, under the Company's 401(K) deferred profit and
sharing plan, after one-year of employment, the Company contributes $.50 for
each pre-tax dollar deferred, up to 6.0% of the executive's annual salary
contributed. Lastly, each executive is eligible for awards under the Company's
stock incentive plans.

(1) Keane's management believes that cash performance is the primary driver of
long-term per share value and, accordingly, views diluted cash earnings per
share (CEPS) as an important indicator of performance. CEPS excludes
amortization of intangible assets, stock-based compensation, restructuring
charges, net, and in 2003, an arbitration award. CEPS includes the weighted
average impact of the shares issuable upon conversion of the debentures. CEPS is
not a measurement in accordance with Generally Accepted Accounting Principles
(GAAP).

(2) DSO is calculated using trailing three months total revenue divided by the
number of days in the period to determine daily revenue. The average accounts
receivable balance for the three-month period is then divided by daily revenue.<Page>

                                                                   EXHIBIT 10.18

SUMMARY OF DIRECTOR COMPENSATION

The compensation of the non-employee members of the Board of Directors is as
follows:

<Table>
<Caption>
COMPENSATION                                                               AMOUNT
----------------------------------------------------   --------------------------------------------------
<S>                                                    <C>
Annual retainer                                                          $   20,000
Additional compensation:
Fee per Board Meeting                                                         2,000
Annual fee for Chairperson of Nominating and                                  5,000
Corporate Governance Committee
Annual fee for Chairperson of Compensation Committee                         15,000
Annual fee for Chairperson of Audit Committee                                25,000

Committee meetings and telephonic meetings of the      No additional fee (part of annual retainer)
Board

Initial stock option grant for a new Director          10,000 shares of common stock to be granted
                                                       on the date of election. These options vest
                                                       in three equal annual installments and have
                                                       an exercise price equal to the closing price
                                                       of our common stock on the NYSE on the date
                                                       of grant.

Annual stock option grant                              5,000 shares of common stock to be granted on
                                                       the date of each Annual Meeting. These options
                                                       vest in three equal annual installments and have
                                                       an exercise price equal to the closing price of
                                                       our common stock on the NYSE on the date of grant.
</Table>

     The compensation of our non-employee directors is determined on an
approximate 52-week period (the "Annual Directors Term") that runs from annual
meeting date to annual meeting date rather than on a calendar year. A director
may elect to receive his or her annual fee or meeting attendance fees for an
Annual Directors Term in the form of shares of common stock in lieu of cash
payments. If a director elects to receive shares of common stock in lieu of cash
as payment for the annual fee or meeting attendance fees, the number of shares
to be received by the director will be determined by dividing the dollar value
of the annual fee or the meeting attendance fees owed by the closing price of
our common stock as reported on the NYSE on the last day of the Annual Directors
Term.

     Directors generally make their elections as to the form of compensation for
his or her annual fee or meeting attendance fees in July of each year and such
election is valid for the Annual Directors Term beginning in the calendar year
in which the election is made.

     Non-employee directors are also eligible to receive stock options under our
stock incentive plans. Directors who are officers or employees of Keane do not
receive any additional compensation for their services as directors.

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