P
age
1
of
10
s
b3
-
5/2526
PR
E
SC
R
IPTIO
N
DR
U
G
A
F
F
O
R
DAB
ILI
TY
S.B.
3
-
5
:
SU
MMA
R
Y
O
F
IN
TRODU
CE
D BIL
L
IN C
O
MMIT
TE
E
Sena
t
e
Bi
l
l
s
3
t
h
r
o
u
g
h
5
(
as
i
n
t
r
o
d
u
ce
d
1
-
8
-
25
)
Sp
o
n
so
r
:
S
e
n
at
o
r
Dar
r
i
n
Cami
l
l
eri
(
S.
B.
3)
S
e
n
at
o
r
Ve
r
o
n
i
ca
K
l
i
n
e
fe
l
t
(S
.B.
4)
S
e
n
at
o
r
Su
e
S
h
i
n
k
(
S.B.
5)
Co
mm
i
t
t
e
e
:
F
i
n
an
ce
,
In
suran
c
e
,
an
d
C
o
n
sum
e
r
P
r
o
t
e
cti
o
n
Dat
e
C
o
mp
l
e
t
e
d
:
4
-
2
2
-
25
I
N
T
RO
D
U
CT
I
O
N
Sena
t
e
Bi
l
l
3
wo
u
l
d
c
r
e
at
e
t
h
e
Pr
e
s
cr
i
p
t
i
o
n
Dr
u
g
Aff
o
r
d
ab
i
l
i
t
y
B
o
ar
d
(
B
o
ar
d
)
an
d
t
h
e
Pr
e
sc
r
i
p
t
i
o
n
D
r
u
g
Aff
o
r
d
ab
i
l
i
t
y
St
ake
h
o
l
d
e
r
Co
u
n
cil
(
Co
u
n
cil
)
.
Th
e
Bo
a
r
d
wo
u
l
d
h
ave
t
o
se
l
e
ct
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
cts
b
as
e
d
o
n
s
p
e
cifi
e
d
c
r
i
t
e
r
i
a
an
d
d
e
t
e
r
mi
n
e
w
h
e
t
h
e
r
t
o
c
o
n
d
u
ct c
o
st
an
d
aff
o
r
d
ab
i
l
i
t
y
r
e
vi
e
w
s
fo
r
t
h
o
s
e
p
r
o
d
u
cts
b
a
se
d
o
n
t
h
e
i
r
ave
r
ag
e
c
o
st
t
o
p
at
i
e
n
t
s
.
Up
o
n
r
e
vi
e
w
,
t
h
e
Bo
a
r
d
c
o
u
l
d
d
e
cid
e
t
o
e
stab
l
i
sh
an
u
p
p
e
r
p
aym
e
n
t
l
i
mi
t
o
n
a
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct,
wh
i
ch
is
a
cap
o
n
th
e
am
o
u
n
t
t
h
at
a
pr
e
sc
r
i
p
t
i
o
n
dr
u
g
pu
r
cha
s
e
r
o
r
pay
e
r
co
u
l
d
p
a
y
fo
r
t
h
e
p
r
o
d
u
ct.
Th
e
b
i
l
l
al
so
w
o
u
l
d
al
l
o
w
t
h
e
A
t
t
o
r
n
e
y
G
e
n
e
r
al
t
o
p
u
r
s
u
e
ci
vi
l
acti
o
n
s
fo
r
a
vi
o
l
at
i
o
n
o
f
an
u
p
p
e
r
p
ayment
l
i
mi
t
an
d
sub
j
e
ct
t
h
e
b
i
l
l
s'
p
r
o
vi
sion
s
t
o
ap
p
r
o
p
r
i
at
i
o
n
.
Th
e
o
t
h
e
r
t
wo
b
i
l
l
s
w
o
u
l
d
r
e
q
u
i
r
e
i
n
sur
e
r
s
i
n
t
h
e
St
at
e
an
d
t
h
e
H
e
al
t
h
y
Mi
c
h
i
g
an
Pl
an
t
o
c
o
mp
l
y
wi
t
h
up
p
e
r
paym
e
n
t
li
m
i
t
s
o
n
p
r
e
sc
r
i
p
t
i
o
n
dr
u
g
p
r
o
d
u
cts
.
Sena
t
e
Bi
l
l
4
an
d
Se
n
at
e
Bi
l
l
5 a
r
e
ti
e
-
b
a
r
r
e
d
to
Se
n
at
e
bi
l
l
3
.
BRI
E
F
FI
SC
A
L
I
M
P
A
C
T
Th
e
b
i
l
l
s
wo
u
l
d
h
ave
a
s
i
g
n
i
fican
t
fisc
al
i
mp
act
o
n
St
at
e
g
o
ve
r
n
ment
an
d
n
o
fisc
al
i
mp
act
o
n
l
o
cal
un
i
t
s
o
f
g
o
ve
r
n
m
e
n
t
.
Th
e
cr
e
at
i
o
n
o
f
t
h
e
Bo
ar
d
un
d
e
r
th
e
D
e
p
ar
t
ment
o
f
In
suran
c
e
an
d
F
i
n
an
cia
l
Se
r
vi
ce
s
(
DIF
S
)
wo
u
l
d
r
e
q
u
i
r
e
sig
n
i
fica
n
t
app
r
o
p
r
i
at
i
o
n
s
e
sti
m
at
e
d
at ab
o
u
t
$4.0
to
$5
.0
mi
l
l
i
o
n
p
e
r
y
e
a
r
,
i
n
clu
d
i
n
g
a
p
p
r
o
xi
ma
t
e
l
y
3.0
F
u
l
l
-
Ti
me
E
q
u
i
val
e
n
t
s
(
F
TE
s
)
.
Th
e
De
p
ar
t
m
e
n
t
o
f
At
t
o
r
n
e
y
G
e
n
e
r
al
,
DIF
S,
an
d
t
h
e
D
e
p
ar
t
m
e
n
t
o
f
Tr
e
a
s
u
r
y
e
a
ch
w
o
u
l
d
i
n
cur
mi
n
o
r
o
n
g
o
i
n
g
co
sts
d
u
e
t
o
ad
mi
n
i
str
at
i
v
e
a
n
d
r
e
g
u
l
at
o
r
y
acti
vi
t
i
e
s
r
e
q
u
i
r
e
d
u
n
d
e
r
b
i
l
l
;
h
o
we
v
e
r
,
t
h
e
se
a
cti
vi
t
i
e
s
l
i
ke
l
y
wo
u
l
d
n
o
t
r
e
q
u
i
r
e
an
y
sig
n
i
fican
t
i
n
cr
e
a
se
i
n
ap
p
r
o
p
r
i
at
i
o
n
s.
Th
e
bi
l
l
s
w
o
u
l
d
ha
v
e
an
i
n
d
e
t
e
r
mi
n
at
e
f
i
s
cal
im
p
act o
n
th
e
De
p
a
r
t
m
e
n
t
o
f
H
e
al
t
h
an
d
H
u
ma
n
Ser
vi
ce
s
(
D
H
H
S)
,
d
e
p
e
n
d
e
n
t
on
t
h
e
e
f
fe
cts
o
f
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
i
c
e
s
an
d
r
e
i
mb
u
r
s
e
m
e
n
t
s
o
n
M
e
d
i
cai
d
e
xpe
n
d
i
t
u
r
e
s.
Pr
o
p
o
s
e
d
M
CL
50
0
.340
6
z
(S
.B.
4)
Le
g
i
sla
t
i
v
e
An
al
y
st:
Nat
h
an
L
e
am
an
Pr
o
p
o
s
e
d
M
CL
40
0
.109
o
(S
.B.
5)
F
i
sc
al
An
al
ys
t
:
J
o
h
n
P
.
Maxwe
l
l
E
l
i
z
ab
e
t
h
Racz
ko
ws
ki
P
age
2
of
10
s
b3
-
5/2526
CO
N
T
E
N
T
Sen
a
te
Bi
l
l
3
w
oul
d
e
na
ct
t
he
"
P
r
es
c
r
i
pti
o
n
Dr
ug
C
ost
a
n
d
A
ffo
r
da
b
i
l
i
ty
R
evi
ew
A
ct
"
to
do
the
fo
l
l
o
w
i
ng
:
--
E
sta
b
l
i
sh
the
Bo
a
r
d
a
nd
th
e
Cou
nci
l
a
nd
p
r
es
cr
i
be
th
ei
r
me
mbe
r
sh
i
p
a
nd
dut
i
e
s.
--
Requ
i
r
e
the
Bo
a
r
d,
i
n
cons
ul
t
a
tio
n
w
i
th
t
h
e
Cou
nci
l
,
to
se
l
ect
p
r
es
c
r
i
pt
i
on
dr
ug
pr
od
uct
s
b
a
s
ed
o
n
sp
eci
f
i
ed
c
r
i
te
r
i
a
a
nd
co
sts
a
nd
dete
r
mi
ne
w
h
ether
to
con
duct
cost
a
nd
a
ffo
r
d
a
bi
l
i
t
y
r
ev
i
e
w
s
fo
r
th
em
ba
s
ed
o
n
a
ve
r
a
ge
pa
t
i
e
n
t cos
t
sh
a
r
e.
--
Speci
fy
the
i
nfo
r
ma
t
i
on
t
ha
t
th
e
Bo
a
r
d
co
u
l
d,
a
nd
w
o
ul
d
ha
ve
to
,
con
si
der
w
he
n
conduct
i
ng
a
co
st
a
n
d
a
ffor
da
bi
l
i
ty
r
evi
ew
for
a
p
r
es
c
r
i
pti
o
n
d
r
ug
p
r
od
uct
.
--
A
l
l
o
w
th
e
Bo
a
r
d
to
es
ta
bl
i
s
h
uppe
r
pa
y
men
t
l
i
mits
on
p
r
es
c
r
i
pti
o
n
d
r
ug
pr
oduct
s
i
f
i
t
det
er
m
i
ne
d
th
a
t
spe
n
di
ng
o
n
a
p
r
es
c
r
i
pti
on
dr
ug
pr
od
uct
h
a
d
o
r
w
ou
l
d
l
e
a
d
to
a
ffo
r
d
a
bi
l
i
ty
c
ha
l
l
e
nges
to
h
ea
l
th
c
a
r
e
sy
stems
o
r
hi
gh
out
-
of
-
pock
et
cost
s
f
or
pa
ti
ent
s
i
n
t
he
Stat
e.
--
A
l
l
o
w
the
A
tt
o
r
n
ey
G
ene
r
a
l
to
i
nv
es
ti
ga
t
e
a
v
i
ol
a
ti
on
o
f
a
n
u
pp
er
p
a
ym
ent
l
i
m
i
t
a
nd
com
m
enc
e
a
c
i
vi
l
a
ct
i
on
a
cc
or
d
i
ng
l
y
.
--
E
sta
b
l
i
sh
the
Pr
es
cr
i
p
tio
n
Dru
g
A
ff
or
d
a
b
i
l
i
t
y
Fu
nd
for
s
uppo
r
t o
f
the
Bo
a
r
d.
--
Requ
i
r
e
t
he
Bo
a
r
d
t
o
con
duct
a
o
ne
-
t
i
me
study
co
ncer
ni
ng
pr
e
scr
i
pti
o
n
dr
ugs
a
nd
the
i
r
co
sts
a
nd
r
e
por
t
i
ts
fi
nd
i
ng
s
to
th
e
Le
gi
s
l
a
tur
e.
--
Requ
i
r
e
t
he
B
oa
r
d
t
o
p
r
ov
i
de
a
n
a
n
nu
a
l
r
epo
r
t
t
o
the
L
egi
s
l
a
tu
r
e
d
eta
i
l
i
n
g
spe
c
i
fi
ed
i
nf
or
m
a
ti
on
r
el
a
te
d
to
pr
es
c
r
i
pt
i
o
n
d
r
ug
cost
s.
--
A
l
l
o
w
th
e
Bo
a
r
d
to
pr
omul
ga
t
e
r
ul
es
a
nd
t
o
ent
er
cont
r
a
ct
s
w
i
t
h
th
i
r
d
-
pa
r
ti
es
t
o
a
s
si
st
th
e
Bo
a
r
d
i
n
c
a
r
r
y
i
ng
out
i
t
s
r
eq
ui
r
e
d
fu
nct
i
o
ns
.
--
Subj
ect t
he
bi
l
l
'
s
i
m
pl
ement
a
ti
on
t
o
a
pp
r
op
r
i
a
tio
n.
Sen
a
te
B
i
l
l
4
w
o
ul
d
a
me
nd
th
e
I
ns
u
r
a
nce
Code
t
o
r
e
qu
i
r
e
a
n
i
ns
u
r
er
t
ha
t
off
er
e
d
hea
l
th
i
ns
ur
a
nc
e
po
l
i
ci
es
i
n
the
State
to
com
pl
y
w
i
t
h
up
p
er
p
a
yme
nt
l
i
mit
s
es
ta
bl
i
sh
ed
un
der
Se
na
te
B
i
l
l
3
.
Sen
a
te
Bi
l
l
5
w
o
ul
d
a
mend
t
he
S
oci
a
l
W
el
f
a
r
e
A
ct
t
o
r
e
qu
i
r
e
the
M
edi
c
a
l
A
ss
i
st
a
nce
Progr
a
m
(Med
i
ca
i
d)
t
o
com
pl
y
w
i
th
uppe
r
pa
ym
ent
l
i
m
i
ts
e
st
a
bl
i
sh
ed
u
nde
r
Se
na
t
e
Bi
l
l
3
.
Sena
t
e
Bi
l
l
3
i
s
d
e
s
cr
i
b
e
d
in
gr
e
at
e
r
de
t
ai
l
b
e
l
o
w
.
Sen
a
te
Bi
l
l
3
"Pr
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct"
wo
u
l
d
m
e
an
a
b
r
a
n
d
-
n
am
e
d
r
u
g
,
a
g
e
n
e
r
i
c
d
r
u
g
,
b
i
o
l
o
g
i
c,
o
r
b
i
o
sim
i
l
ar
.
"
Bi
o
l
o
g
i
c"
wo
u
l
d
me
an
a
dr
u
g
th
at
is
p
r
o
d
u
c
e
d
o
r
di
st
r
i
b
u
t
e
d
i
n
ac
c
o
r
d
an
c
e
wi
t
h
a
b
i
o
l
o
g
i
cs
l
i
c
e
n
s
e
s
ap
p
l
i
c
at
i
o
n
ap
p
r
o
v
e
d
b
y
t
h
e
Un
i
t
e
d
St
at
e
s
F
o
o
d
an
d
D
r
u
g
Ad
mi
n
i
str
at
i
o
n
(
F
DA)
.
"Bi
o
sim
i
l
a
r
"
wo
u
l
d
mean
a
d
r
u
g
t
h
at
i
s
p
r
o
d
u
c
e
d
an
d
d
i
str
i
b
u
t
e
d
i
n
acc
o
r
d
an
ce
wi
t
h
a
b
i
o
l
o
g
i
cs
l
i
c
e
n
se
s
ap
p
l
i
c
at
i
o
n
ap
p
r
o
ve
d
u
n
d
e
r
4
2
US
C
26
2(
K
)
,
wh
i
ch
g
e
n
e
r
al
l
y
p
r
e
sc
r
i
b
e
s
t
h
e
r
e
q
u
i
r
e
m
e
n
t
s
f
o
r
a
p
e
r
so
n
ap
p
l
yi
n
g
fo
r
l
i
ce
n
s
u
r
e
o
f
a
b
i
o
l
o
g
i
cal
p
r
o
d
u
ct
an
d
sp
e
cifi
e
s
t
h
e
r
e
q
u
i
r
e
m
e
n
t
s
o
f
such
a
p
r
o
d
u
ct.
"G
e
n
e
r
i
c
d
r
u
g
"
w
o
u
l
d
me
an
an
y
o
f
t
h
e
f
o
l
l
o
wi
n
g
:
--
A
r
e
t
ai
l
d
r
u
g
t
h
at
i
s
ma
r
ke
t
e
d
o
r
d
i
str
i
b
u
t
e
d
i
n
a
cc
o
r
d
an
c
e
wi
t
h
an
ab
b
r
e
vi
at
e
d
n
e
w
d
r
u
g
ap
p
l
i
cati
o
n
un
d
e
r
21
US
C 35
5.
--
An
y
d
r
u
g
so
l
d
,
l
i
c
e
n
s
e
d
,
o
r
ma
r
ke
t
e
d
u
n
d
e
r
t
h
e
n
e
w
d
r
u
g
ap
p
l
i
cati
o
n
ap
p
r
o
v
e
d
b
y
t
h
e
F
DA
o
f
t
h
e
F
e
d
e
r
al
F
o
o
d
,
Dr
u
g
,
an
d
Co
sm
e
t
i
c
A
ct
t
h
at
i
s
ma
r
k
e
t
e
d
,
s
o
l
d
,
o
r
d
i
str
i
b
u
t
e
d
u
n
d
e
r
a
d
i
ff
e
r
e
n
t
l
ab
e
l
e
r
c
o
d
e
,
p
r
o
d
u
ct
co
d
e
,
t
r
ad
e
n
am
e
,
t
r
ad
e
ma
r
k,
o
r
p
a
ck
ag
i
n
g
t
h
a
n
t
h
e
b
r
an
d
na
me
d
r
u
g
.
P
age
3
of
10
s
b3
-
5/2526
--
A
d
r
u
g
t
h
at
e
n
t
e
r
e
d
t
h
e
ma
r
k
e
t
b
e
f
o
r
e
19
62
t
h
at
was
n
o
t
o
r
i
g
i
n
al
l
y
ma
r
k
e
t
e
d
u
n
d
e
r
a
n
e
w
d
r
u
g
app
l
i
cati
o
n
.
"Pe
r
s
o
n
"
w
o
u
l
d
me
an
a
n
in
d
i
vi
d
u
al
an
d
wo
u
l
d
in
clu
d
e
a
b
o
d
y
p
o
l
i
t
i
c
an
d
c
o
r
p
o
r
at
e
.
"Pr
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
p
u
r
cha
s
e
r
"
wo
u
l
d
mean
an
e
n
t
i
t
y
t
h
at
p
u
r
cha
s
e
s
an
d
t
ak
e
s
o
wn
e
r
shi
p
o
f
a
pr
e
sc
r
i
p
t
i
o
n
dr
u
g
pr
o
d
u
ct
fo
r
r
e
s
al
e
o
r
p
r
o
vi
d
i
n
g
to
pat
i
e
n
t
s.
"Thi
r
d
p
ar
t
y
p
a
ye
r
"
w
o
u
l
d
mean
a
h
e
al
t
h
i
n
sure
r
,
a
St
at
e
d
e
p
a
r
t
ment
o
r
a
g
e
n
cy
ad
mi
n
i
ste
r
i
n
g
a
p
l
an
o
f
Me
d
i
cal
A
ss
i
s
t
an
ce
u
n
d
e
r
t
h
e
So
cia
l
W
e
l
fa
r
e
Act
,
a
p
e
r
s
o
n
ad
mi
n
i
ste
r
i
n
g
a
s
e
l
f
-
fun
d
e
d
pl
an
,
o
r
a
ph
ar
m
acy
b
e
n
e
fit
man
ag
e
r
.
"H
e
al
t
h
i
n
sure
r
"
w
o
u
l
d
mean
an
i
n
sur
e
r
au
t
h
o
r
i
z
e
d
u
n
d
e
r
t
h
e
In
suran
c
e
Co
d
e
t
o
d
e
l
i
v
e
r
,
i
ss
u
e
,
fo
r
d
e
l
i
v
e
r
y,
o
r
r
e
n
e
w
i
n
t
h
e
St
at
e
a
h
e
al
t
h
i
n
suran
ce
p
o
l
i
cy
o
r
a
h
e
al
t
h
ma
i
n
t
e
n
an
ce
o
r
g
an
i
z
at
i
o
n
u
n
d
e
r
t
h
e
I
n
suran
ce
Co
d
e
.
(
G
e
n
e
r
a
l
l
y,
a
h
e
al
t
h
ma
i
n
t
e
n
an
c
e
o
r
g
a
n
i
z
at
i
o
n
mean
s
a
p
e
r
s
o
n
t
h
at
,
am
o
n
g
o
t
h
e
r
t
h
i
n
g
s,
d
e
l
i
v
e
r
s
h
e
al
t
h
i
n
suran
c
e
s
e
r
vi
c
e
s
t
h
at
a
r
e
m
e
d
i
cal
l
y
n
e
ce
ss
a
r
y
t
o
e
n
r
o
l
l
e
e
s
u
n
d
e
r
t
h
e
t
e
r
ms
o
f
i
t
s
h
e
al
t
h
ma
i
n
t
e
n
an
ce
co
n
t
r
a
ct
an
d
i
s
r
e
sp
o
n
sib
l
e
fo
r
th
e
a
vai
l
ab
i
l
i
t
y,
ac
ce
ss
i
b
i
l
i
t
y,
an
d
qu
al
i
t
y
o
f
t
h
e
hea
l
t
h
s
e
r
vi
c
e
s
p
r
o
vi
d
e
d
.)
"H
e
al
t
h
e
q
u
i
t
y"
wo
u
l
d
mean
at
t
ai
n
i
n
g
t
h
e
h
i
g
h
e
st
l
e
v
e
l
o
f
h
e
al
t
h
f
o
r
al
l
i
n
d
i
vi
d
u
al
s,
i
n
wh
i
ch
an
in
d
i
vi
d
u
al
ha
s
fai
r
an
d
ju
st o
p
p
o
r
t
u
n
i
t
y
t
o
att
ai
n
th
e
in
d
i
vi
d
u
al
'
s
o
p
t
i
ma
l
heal
t
h
r
e
g
a
r
d
l
e
ss
o
f
r
ac
e
,
e
t
h
n
i
cit
y,
d
i
s
ab
i
l
i
t
y,
se
xu
al
o
r
i
e
n
t
at
i
o
n
,
g
e
n
d
e
r
i
d
e
n
t
i
t
y,
s
o
cio
e
co
n
o
mi
c
stat
u
s
,
g
e
o
g
r
ap
h
y,
p
r
e
fe
r
r
e
d
l
a
n
g
u
ag
e
,
o
r
o
t
h
e
r
fac
t
o
r
t
h
at
aff
e
ct
s
ac
ce
ss
t
o
h
e
al
t
h
car
e
an
d
h
e
al
t
h
o
u
t
co
m
e
s
.
"Man
u
fac
t
u
r
e
r
"
wo
u
l
d
m
e
an
an
e
n
t
i
t
y
t
h
at
m
e
e
t
s
an
y
o
f
t
h
e
f
o
l
l
o
wi
n
g
:
--
O
wn
s
t
h
e
p
at
e
n
t
t
o
a
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
o
r
e
n
t
e
r
s
i
n
t
o
a
l
e
ase
wi
t
h
an
o
t
h
e
r
ma
n
u
fac
t
u
r
e
r
t
o
ma
r
k
e
t
an
d
d
i
str
i
b
u
t
e
a
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
u
n
d
e
r
t
h
e
e
n
t
i
t
y'
s
o
wn
n
am
e
.
--
Is
t
h
e
l
ab
e
l
e
d
e
n
t
i
t
y,
o
f
a
g
e
n
e
r
i
c
d
r
u
g
at
t
h
e
p
o
i
n
t
o
f
ma
n
u
fac
t
u
r
e
an
d
t
h
e
e
n
t
i
t
y
s
e
t
s
o
r
cha
n
g
e
s
t
h
e
wh
o
l
e
sal
e
acc
u
sati
o
n
c
o
st
o
f
a
b
r
a
n
d
-
n
am
e
dr
u
g
th
at
it
m
an
u
fac
t
u
r
e
s
o
r
ha
s
l
e
as
e
d
t
h
e
r
i
g
h
t
t
o
ma
r
k
e
t
o
r
t
h
e
e
n
t
i
t
y
s
e
t
s
o
r
cha
n
g
e
s
t
h
e
wh
o
l
e
sal
e
acqu
i
s
i
t
i
o
n
co
st
o
f
a ge
n
e
r
i
c
d
r
u
g
th
at
it
m
an
u
fac
t
u
r
e
s.
"Wh
o
l
e
sal
e
acqu
i
sit
i
o
n
c
o
st"
wo
u
l
d
mean
,
wi
t
h
r
e
spe
ct
t
o
a
d
r
u
g
o
r
b
i
o
l
o
g
i
cal
,
t
h
e
ma
n
u
fac
t
u
r
e
r
’
s
l
i
st
p
r
i
c
e
fo
r
t
h
e
d
r
u
g
o
r
b
i
o
l
o
g
i
c
al
t
o
wh
o
l
e
sal
e
r
s
o
r
d
i
r
e
ct
p
u
r
cha
s
e
r
s
i
n
t
h
e
Un
i
t
e
d
St
at
e
s,
n
o
t
i
n
clu
d
i
n
g
p
r
o
mp
t
p
ay
o
r
o
t
h
e
r
d
i
sc
o
u
n
t
s,
r
e
b
at
e
s
o
r
r
e
d
u
cti
o
n
s
i
n
p
r
i
c
e
,
f
o
r
t
h
e
m
o
st
r
e
c
e
n
t
m
o
n
t
h
fo
r
wh
i
ch
t
h
e
i
n
fo
r
ma
t
i
o
n
i
s
avai
l
ab
l
e
,
a
s
r
e
p
o
r
t
e
d
i
n
wh
o
l
e
sal
e
p
r
i
c
e
g
u
i
d
e
s
o
r
o
t
h
e
r
pu
b
l
i
cati
o
n
s
o
f
d
r
u
g
o
r
bi
o
l
o
g
i
cal
pr
i
cin
g
dat
a.
"Co
n
sum
e
r
Pr
i
ce
In
d
e
x"
(
CPI)
w
o
u
l
d
m
e
an
t
h
e
Un
i
t
e
d
St
at
e
s
C
o
n
sum
e
r
Pr
i
ce
In
d
e
x
f
o
r
al
l
u
r
b
an
c
o
n
sum
e
r
s
a
s
d
e
f
i
n
e
d
an
d
r
e
p
o
r
t
e
d
b
y
t
h
e
Un
i
t
e
d
St
at
e
s
D
e
p
ar
t
ment
o
f
Lab
o
r
,
Bu
r
e
au
o
f
Labo
r
St
at
i
sti
c
s.
"34
0B
Pr
o
g
r
am
e
n
t
i
t
y"
wo
u
l
d
mean
an
e
n
t
i
t
y
a
u
t
h
o
r
i
z
e
d
t
o
p
ar
t
i
cip
at
e
i
n
t
h
e
F
e
d
e
r
al
34
0B
Pr
o
g
r
am
u
n
d
e
r
t
h
e
Pu
b
l
i
c
H
e
al
t
h
S
e
r
vi
c
e
Ac
t
.
(
G
e
n
e
r
al
l
y,
t
h
e
34
0
B
P
r
o
g
r
am
r
e
q
u
i
r
e
s
p
h
ar
ma
ce
u
t
i
cal
ma
n
u
fa
ctu
r
e
r
s
p
a
r
t
i
cip
at
i
n
g
i
n
Me
d
i
cai
d
t
o
se
l
l
o
u
t
p
at
i
e
n
t
d
r
u
g
s
at
d
i
sc
o
u
n
t
e
d
p
r
i
ce
s
t
o
h
e
al
t
h
ca
r
e
o
r
g
an
i
z
at
i
o
n
s
t
h
at
ca
r
e
f
o
r
l
o
w
i
n
c
o
m
e
o
r
u
n
i
n
s
u
r
e
d
p
at
i
e
n
t
s,
am
o
n
g
o
t
h
e
r
th
i
n
g
s.
(S
e
e
BA
C
KG
RO
U
N
D
))
Pr
e
sc
r
i
p
t
i
o
n
D
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g
Aff
o
r
d
ab
i
l
i
t
y
Bo
ar
d
Th
e
bi
l
l
w
o
u
l
d
c
r
e
at
e
th
e
B
o
ar
d
as
an
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o
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o
m
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t
i
t
y
wi
t
h
i
n
DIFS
.
P
age
4
of
10
s
b3
-
5/2526
Th
e
B
o
ar
d
w
o
u
l
d
co
n
sist
o
f
fiv
e
m
e
mb
e
r
s
ap
p
o
i
n
t
e
d
b
y
t
h
e
G
o
ve
r
n
o
r
wi
t
h
ad
vi
ce
an
d
c
o
n
s
e
n
t
o
f
t
h
e
S
e
n
at
e
.
Th
e
m
e
mb
e
r
s
w
o
u
l
d
h
av
e
t
o
i
n
clu
d
e
i
n
d
i
vi
d
u
al
s
wh
o
h
ad
e
xpe
r
t
i
se
i
n
h
e
al
t
h
car
e
e
co
n
o
mi
cs
,
h
e
al
t
h
p
o
l
i
cy
,
h
e
al
t
h
e
q
u
i
t
y,
a
n
d
cli
n
i
cal
medi
cin
e
.
Th
e
G
o
v
e
r
n
o
r
c
o
u
l
d
n
o
t
ap
p
o
i
n
t
an
i
n
d
i
vi
d
u
al
i
f
t
h
e
i
n
d
i
vi
d
u
al
we
r
e
a
ff
i
l
i
a
t
e
d
wi
t
h
a
ma
n
u
fac
t
u
r
e
r
o
r
a
t
r
ad
e
as
so
cia
t
i
o
n
fo
r
a
ma
n
u
fa
ctu
r
e
r
o
r
o
t
h
e
r
wi
s
e
h
ad
a
p
e
r
s
o
n
al
o
r
fin
an
cia
l
i
n
t
e
r
e
st
t
h
at
h
ad
t
h
e
p
o
t
e
n
t
i
al
t
o
b
i
as
o
r
ha
v
e
th
e
app
e
a
r
an
ce
o
f
b
i
a
sin
g
th
e
in
d
i
vi
d
u
al
'
s
d
e
cisi
o
n
s
o
n
th
e
Bo
a
r
d
.
Th
e
G
o
ve
r
n
o
r
al
so
co
u
l
d
not
app
o
i
n
t
a
r
e
g
i
ste
r
e
d
lobb
yi
st i
n
th
e
St
at
e
.
Th
e
G
o
v
e
r
n
o
r
wo
u
l
d
h
av
e
t
o
ap
p
o
i
n
t
t
wo
o
f
t
h
e
f
i
r
st
m
e
mb
e
r
s
t
o
o
n
e
-
y
e
ar
t
e
r
ms
an
d
t
h
r
e
e
o
f
t
h
e
fi
r
st
memb
e
r
s
t
o
t
wo
-
y
e
ar
t
e
r
ms
.
A
fte
r
t
h
e
fi
r
st
ap
p
o
i
n
t
ment
s
,
memb
e
r
s
wo
u
l
d
b
e
ap
p
o
i
n
t
e
d
f
o
r
f
o
u
r
-
y
e
a
r
t
e
r
ms
o
r
u
n
t
i
l
a
succ
e
s
so
r
wa
s
ap
p
o
i
n
t
e
d
,
wh
i
che
v
e
r
wa
s
l
at
e
r
.
If
a
vac
an
cy
o
c
cur
r
e
d
o
n
t
h
e
B
o
ar
d
,
t
h
e
G
o
v
e
r
n
o
r
wo
u
l
d
h
ave
t
o
ap
p
o
i
n
t
an
i
n
d
i
vi
d
u
al
t
o
fil
l
t
h
e
vac
an
cy
t
o
t
h
e
b
al
an
c
e
o
f
t
h
e
t
e
r
m.
Th
e
G
o
ve
r
n
o
r
c
o
u
l
d
r
e
m
o
v
e
a
m
e
mb
e
r
o
f
t
h
e
Bo
a
r
d
fo
r
i
n
co
mp
e
t
e
n
c
e
,
d
e
r
e
l
i
cti
o
n
o
f
d
u
t
y
,
ma
l
f
e
asan
ce
,
mi
sf
e
a
san
c
e
,
o
r
n
o
n
f
e
as
an
ce
i
n
o
ff
i
ce
,
o
r
an
y
o
t
h
e
r
go
o
d
c
au
se
.
Th
e
G
o
ve
r
n
o
r
wo
u
l
d
h
av
e
t
o
cal
l
t
h
e
fir
st
m
e
e
t
i
n
g
o
f
t
h
e
Bo
a
r
d
.
At
t
h
e
fir
st
me
e
t
i
n
g
,
t
h
e
B
o
ar
d
memb
e
r
s
w
o
u
l
d
h
ave
t
o
e
l
e
ct
a
memb
e
r
as
ch
ai
r
p
e
r
s
o
n
an
d
o
t
h
e
r
o
ff
i
ce
r
s
as
i
t
c
o
n
sid
e
r
e
d
n
e
ce
ss
a
r
y
o
r
ap
p
r
o
p
r
i
at
e
.
Aft
e
r
t
h
e
fir
st
me
e
t
i
n
g
,
t
h
e
Bo
a
r
d
wo
u
l
d
h
ave
t
o
me
e
t
at
l
e
a
st
q
u
ar
t
e
r
l
y,
o
r
mo
r
e
f
r
e
q
u
e
n
t
l
y
at
t
h
e
cal
l
o
f
t
h
e
cha
i
r
p
e
r
s
o
n
o
r
i
f
r
e
q
u
e
ste
d
b
y
at
l
e
ast
t
h
r
e
e
memb
e
r
s
.
A
ma
j
o
r
i
t
y
o
f
t
h
e
memb
e
r
s
w
o
u
l
d
c
o
n
sti
t
u
t
e
a
q
u
o
r
u
m.
A
ma
j
o
r
i
t
y
o
f
t
h
e
m
e
mb
e
r
s
p
r
e
se
n
t
an
d
se
r
vi
n
g
wo
u
l
d
b
e
r
e
q
u
i
r
e
d
f
o
r
o
ff
i
cia
l
acti
o
n
u
n
l
e
ss
o
n
e
o
r
mo
r
e
m
e
mb
e
r
s
r
e
cus
e
d
t
h
e
mse
l
ve
s
;
i
n
t
h
at
cas
e
t
w
o
t
h
i
r
d
s
o
f
t
h
e
m
e
mb
e
r
s
p
r
e
se
n
t
an
d
s
e
r
v
i
n
g
wo
u
l
d
b
e
r
e
q
u
i
r
e
d
fo
r
o
ff
i
cia
l
a
cti
o
n
o
f
t
h
e
Bo
ar
d
.
Th
e
Bo
a
r
d
wo
u
l
d
h
av
e
t
o
co
mp
l
y
wi
t
h
t
h
e
O
p
e
n
Me
e
t
i
n
g
s
Act
an
d
t
h
e
F
r
e
e
d
o
m
o
f
In
fo
r
ma
t
i
o
n
Act
(
F
O
IA
)
.
Th
e
sal
a
r
i
e
s
an
d
o
t
h
e
r
e
xp
e
n
s
e
s
o
f
t
h
e
B
o
a
r
d
wo
u
l
d
b
e
sub
j
e
ct
t
o
an
n
u
al
ap
p
r
o
p
r
i
at
i
o
n
.
M
e
mb
e
r
s
o
f
t
h
e
Bo
a
r
d
w
o
u
l
d
b
e
sub
j
e
ct
t
o
Pu
b
l
i
c
Act
31
7
o
f
19
68
,
wh
i
ch
g
o
ve
r
n
s
t
h
e
c
o
n
d
u
ct
o
f
p
u
b
l
i
c
se
r
van
t
s
r
e
g
ar
d
i
n
g
go
v
e
r
n
m
e
n
t
al
de
ci
sio
n
s
an
d
c
o
n
t
r
acts
.
Pr
e
sc
r
i
p
t
i
o
n
D
r
u
g
Aff
o
r
d
ab
i
l
i
t
y
St
ake
h
o
l
d
e
r
Co
u
n
cil
Th
e
b
i
l
l
w
o
u
l
d
cr
e
at
e
t
h
e
Co
u
n
cil
wi
t
h
i
n
DIF
S.
Th
e
C
o
u
n
cil
w
o
u
l
d
c
o
n
sist
o
f
21
m
e
mb
e
r
s.
Sev
e
n
o
f
t
h
e
m
e
mb
e
r
s
wo
u
l
d
be
ap
p
o
i
n
t
e
d
b
y
t
h
e
G
o
v
e
r
n
o
r
as
fo
l
l
o
ws:
--
O
n
e
in
d
i
vi
d
u
al
r
e
p
r
e
se
n
t
i
n
g
man
u
fac
t
u
r
e
r
s
o
f
b
r
an
d
-
n
am
e
dr
u
g
s
.
--
O
n
e
in
d
i
vi
d
u
al
r
e
p
r
e
se
n
t
i
n
g
man
u
fac
t
u
r
e
r
s
o
f
g
e
n
e
r
i
c
d
r
u
g
s.
--
O
n
e
in
d
i
vi
d
u
al
r
e
p
r
e
se
n
t
i
n
g
e
mp
l
o
y
e
r
s.
--
O
n
e
in
d
i
vi
d
u
al
r
e
p
r
e
se
n
t
i
n
g
ph
ar
ma
cy
b
e
n
e
fit
ma
n
ag
e
r
s
.
--
O
n
e
in
d
i
vi
d
u
al
r
e
p
r
e
se
n
t
i
n
g
ph
ar
ma
cists.
--
O
n
e
in
d
i
vi
d
u
al
r
e
p
r
e
se
n
t
i
n
g
a
mu
t
u
al
in
suran
ce
co
mp
an
y.
--
O
n
e
m
e
mb
e
r
o
f
th
e
pu
b
l
i
c.
"Br
an
d
-
n
am
e
d
r
u
g
"
wo
u
l
d
mean
a
d
r
u
g
o
t
h
e
r
t
h
an
an
au
t
h
o
r
i
z
e
d
g
e
n
e
r
i
c
t
h
at
i
s
p
r
o
d
u
ce
d
o
r
d
i
str
i
b
u
t
e
d
i
n
a
cc
o
r
d
an
c
e
wi
t
h
an
o
r
i
g
i
n
al
n
e
w
d
r
u
g
ap
p
l
i
cati
o
n
ap
p
r
o
ve
d
u
n
d
e
r
21
US
C
35
5,
wh
i
ch
g
e
n
e
r
al
l
y
spe
cifi
e
s
t
h
e
ap
p
l
i
cati
o
n
p
r
o
c
e
s
s
an
d
r
e
q
u
i
r
e
m
e
n
t
s
f
o
r
a
p
e
r
s
o
n
t
o
i
n
t
r
o
d
u
c
e
an
o
r
i
g
i
n
al
new
dr
u
g
.
Th
e
mu
t
u
al
i
n
suran
ce
c
o
mp
an
y
c
o
u
l
d
n
o
t
b
e
an
e
n
t
i
t
y
t
h
at
d
i
r
e
ctl
y,
o
r
i
n
d
i
r
e
ctl
y
,
t
h
r
o
u
g
h
o
n
e
o
r
m
o
r
e
i
n
t
e
r
m
e
d
i
ar
i
e
s
co
n
t
r
o
l
l
e
d
,
o
r
wa
s
c
o
n
t
r
o
l
l
e
d
b
y
,
o
r
was
u
n
d
e
r
c
o
mm
o
n
c
o
n
t
r
o
l
wi
t
h
a
ma
n
ag
e
d
c
a
r
e
o
r
g
an
i
z
at
i
o
n
de
s
cr
i
b
e
d
b
e
l
o
w
.
P
age
5
of
10
s
b3
-
5/2526
Th
e
C
o
u
n
cil
al
so
wo
u
l
d
h
ave
t
o
co
n
sist
o
f
s
e
v
e
n
memb
e
r
s
ap
p
o
i
n
t
e
d
b
y
t
h
e
G
o
v
e
r
n
o
r
fr
o
m
a
l
i
st
o
f
n
o
mi
n
e
e
s
sub
mi
t
t
e
d
b
y
t
h
e
Sp
e
a
ke
r
o
f
t
h
e
H
o
u
se
o
f
R
e
p
r
e
s
e
n
t
at
i
ve
s.
Th
e
l
i
st
o
f
n
o
mi
n
e
e
s
w
o
u
l
d
ha
ve
to
in
clu
d
e
in
d
i
vi
d
u
al
s
wh
o
r
e
p
r
e
s
e
n
t
e
d
th
e
f
o
l
l
o
wi
n
g
:
--
A stat
e
wi
d
e
o
r
g
an
i
z
at
i
o
n
th
at
advo
cat
e
d
f
o
r
s
e
n
i
o
r
c
i
t
i
z
e
n
s.
--
A stat
e
wi
d
e
o
r
g
an
i
z
at
i
o
n
th
at
advo
cat
e
d
f
o
r
he
al
t
h
c
ar
e
.
--
A stat
e
wi
d
e
o
r
g
an
i
z
at
i
o
n
th
at
advo
cat
e
d
f
o
r
di
v
e
r
sit
y
wi
t
h
i
n
c
o
mm
u
n
i
t
i
e
s.
--
A l
ab
o
r
un
i
o
n
.
--
R
e
s
e
ar
che
r
s
wh
o
spe
cia
l
i
z
e
d
in
pr
e
sc
r
i
p
t
i
o
n
dr
u
g
pr
o
d
u
ct
s.
--
Th
e
pu
b
l
i
c.
Th
e
fin
al
s
e
v
e
n
m
e
mb
e
r
s
w
o
u
l
d
h
ave
t
o
b
e
ap
p
o
i
n
t
e
d
b
y
t
h
e
G
o
v
e
r
n
o
r
f
r
o
m
a
l
i
st
o
f
n
o
mi
n
e
e
s
sub
mi
t
t
e
d
b
y
t
h
e
Sen
at
e
Maj
o
r
i
t
y
Le
ad
e
r
.
T
h
e
l
i
st
o
f
n
o
mi
n
e
e
s
w
o
u
l
d
h
ave
t
o
i
n
clu
d
e
i
n
d
i
vi
d
u
al
s
wh
o
r
e
p
r
e
s
e
n
t
e
d
th
e
f
o
l
l
o
wi
n
g
:
--
Ph
ys
i
cia
n
s.
--
Nu
r
s
e
s.
--
H
o
spi
t
al
s.
--
Man
ag
e
d
c
a
r
e
o
r
g
an
i
z
at
i
o
n
s.
--
Th
e
D
e
p
ar
t
m
e
n
t
o
f
T
e
ch
n
o
l
o
g
y,
Man
ag
e
m
e
n
t
an
d
Bu
d
g
e
t
.
--
Cl
i
n
i
cal
R
e
s
e
ar
che
r
s
.
--
Th
e
pu
b
l
i
c.
Th
e
man
ag
e
d
ca
r
e
o
r
g
a
n
i
z
at
i
o
n
co
u
l
d
n
o
t
b
e
an
e
n
t
i
t
y
t
h
at
d
i
r
e
ctl
y
o
r
i
n
d
i
r
e
ctl
y
,
t
h
r
o
u
g
h
o
n
e
o
r
m
o
r
e
i
n
t
e
r
m
e
d
i
ar
i
e
s,
c
o
n
t
r
o
l
l
e
d
,
was c
o
n
t
r
o
l
l
e
d
b
y,
o
r
wa
s
u
n
d
e
r
c
o
m
mon
c
o
n
t
r
o
l
wi
t
h
t
h
e
mu
t
u
al
in
suran
ce
co
mp
an
y
d
e
s
cr
i
b
e
d
ab
o
v
e
.
Th
e
G
o
v
e
r
n
o
r
wo
u
l
d
h
av
e
t
o
e
n
sur
e
t
h
at
t
h
e
me
mb
e
r
s
ap
p
o
i
n
t
e
d
t
o
t
h
e
Co
u
n
cil
h
ad
kn
o
wl
e
d
g
e
i
n
at l
e
ast
o
n
e
o
f
th
e
f
o
l
l
o
wi
n
g
ar
e
as:
--
Th
e
ph
ar
ma
ce
u
t
i
cal
bu
si
n
e
ss
mo
d
e
l
.
--
Su
p
p
l
y
cha
i
n
bu
sin
e
ss
mode
l
.
--
Th
e
p
r
acti
c
e
o
f
m
e
d
i
cin
e
o
r
cli
n
i
cal
tr
ai
n
i
n
g
.
--
Co
n
sum
e
r
o
r
pat
i
e
n
t
pe
r
sp
e
cti
v
e
s.
--
H
e
al
t
h
ca
r
e
c
o
st t
r
e
n
d
s
.
--
Cl
i
n
i
cal
an
d
heal
t
h
s
e
r
vi
ce
s
r
e
s
e
a
r
ch.
Th
e
G
o
ve
r
n
o
r
w
o
u
l
d
ha
ve
t
o
app
o
i
n
t
s
e
v
e
n
o
f
t
h
e
f
i
r
st m
e
mb
e
r
s
t
o
o
n
e
-
ye
ar
te
r
ms
,
s
e
v
e
n
o
f
t
h
e
fir
st
m
e
mb
e
r
s
t
o
t
w
o
-
ye
a
r
t
e
r
m
s,
an
d
s
e
v
e
n
o
f
t
h
e
fi
r
st
m
e
mb
e
r
s
t
o
t
h
r
e
e
-
y
e
a
r
t
e
r
ms
.
Aft
e
r
t
h
e
fi
r
st
ap
p
o
i
n
t
ment
,
me
mb
e
r
s
wo
u
l
d
b
e
ap
p
o
i
n
t
e
d
fo
r
t
h
r
e
e
-
ye
a
r
t
e
r
ms
o
r
u
n
t
i
l
a
succ
e
ss
o
r
was
ap
p
o
i
n
t
e
d
,
wh
i
ch
e
v
e
r
wa
s
l
at
e
r
.
If
a
vac
an
cy
o
cc
u
r
r
e
d
,
t
h
e
G
o
v
e
r
n
o
r
w
o
u
l
d
h
ave
t
o
ap
p
o
i
n
t
an
i
n
d
i
vi
d
u
al
t
o
fil
l
t
h
e
va
can
c
y
f
o
r
t
h
e
b
al
an
c
e
o
f
t
h
e
t
e
r
m.
Th
e
G
o
ve
r
n
o
r
co
u
l
d
r
e
m
o
v
e
a
m
e
mb
e
r
o
f
t
h
e
Co
u
n
cil
f
o
r
i
n
co
mp
e
t
e
n
c
e
,
d
e
r
e
l
i
cti
o
n
o
f
d
u
t
y,
ma
l
f
e
asan
c
e
,
mi
sf
e
a
san
c
e
,
o
r
non
f
e
as
an
ce
in
o
ff
i
ce
,
o
r
an
y
o
t
h
e
r
g
o
o
d
c
au
s
e
.
At
th
e
f
i
r
st
me
e
t
i
n
g
,
t
h
e
Co
u
n
cil
wo
u
l
d
e
l
e
ct a
c
h
ai
r
p
e
r
so
n
an
d
o
t
h
e
r
o
ff
i
ce
r
s
a
s
i
t
c
o
n
sid
e
r
e
d
n
e
ce
ss
a
r
y
o
r
ap
p
r
o
p
r
i
at
e
.
Aft
e
r
t
h
e
fi
r
st
m
e
e
t
i
n
g
,
t
h
e
Co
u
n
cil
wo
u
l
d
h
ave
t
o
m
e
e
t
at
l
e
a
st
q
u
ar
t
e
r
l
y.
Th
e
Co
u
n
cil
c
o
u
l
d
me
e
t
m
o
r
e
f
r
e
q
u
e
n
t
l
y
at
t
h
e
cal
l
o
f
t
h
e
cha
i
r
p
e
r
so
n
o
r
i
f
r
e
q
u
e
ste
d
b
y
at
l
e
ast
s
e
v
e
n
m
e
m
b
e
r
s.
A
ma
j
o
r
i
t
y
o
f
t
h
e
memb
e
r
s
wo
u
l
d
c
o
n
sti
t
u
t
e
a
q
u
o
r
u
m
an
d
a
ma
j
o
r
i
t
y
o
f
t
h
e
memb
e
r
s
p
r
e
s
e
n
t
an
d
se
r
vi
n
g
wo
u
l
d
b
e
r
e
q
u
i
r
e
d
f
o
r
o
ff
i
cia
l
acti
o
n
o
f
t
h
e
Co
u
n
cil
.
P
age
6
of
10
s
b3
-
5/2526
Th
e
Co
u
n
cil
w
o
u
l
d
h
ave
t
o
co
mp
l
y
wi
t
h
t
h
e
O
p
e
n
Me
e
t
i
n
g
s
Act
an
d
F
O
IA
.
Co
u
n
cil
memb
e
r
s
wo
u
l
d
not be
e
n
t
i
t
l
e
d
t
o
c
o
mp
e
n
sati
o
n
f
o
r
se
r
vi
ce
o
n
th
e
Co
u
n
cil
bu
t
c
o
u
l
d
be
r
e
i
mb
u
r
se
d
fo
r
actu
al
an
d
nec
e
s
sar
y
e
x
p
e
n
se
s
i
n
cur
r
e
d
in
s
e
r
vi
n
g
.
Co
st an
d
A
ff
o
r
d
ab
i
l
i
t
y
R
e
vi
e
w
Wi
t
h
i
n
18
m
o
n
t
h
s
o
f
t
h
e
b
i
l
l
’
s
e
ff
e
cti
v
e
d
at
e
,
t
h
e
Bo
ar
d
,
i
n
c
o
n
sul
t
at
i
o
n
wi
t
h
t
h
e
C
o
u
n
cil
,
w
o
u
l
d
h
ave
to
s
e
l
e
ct at
l
e
ast
o
n
e
pr
e
s
cr
i
p
t
i
o
n
d
r
u
g
pr
o
d
u
ct base
d
o
n
an
y
o
f
th
e
f
o
l
l
o
wi
n
g
cr
i
t
e
r
i
a:
--
Th
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
was
a
b
r
an
d
-
n
am
e
d
r
u
g
o
r
b
i
o
l
o
g
i
c
t
h
at
,
as
ad
j
u
st
e
d
an
n
u
al
l
y
fo
r
i
n
fla
t
i
o
n
i
n
acc
o
r
d
an
c
e
wi
t
h
t
h
e
C
PI,
h
ad
a
wh
o
l
e
sal
e
ac
q
u
i
sit
i
o
n
co
st
o
f
at
l
e
ast
$6
0
,000
p
e
r
y
e
ar
o
r
co
u
r
s
e
o
f
t
r
e
at
ment
o
r
h
ad
a
wh
o
l
e
sal
e
acqu
i
sit
i
o
n
c
o
st
i
n
cr
e
as
e
o
f
at
l
e
ast $3
,000
in
an
y
12
-
mon
t
h
pe
r
i
o
d
.
--
Th
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
wa
s
a
b
i
o
sim
i
l
ar
t
h
at
h
ad
a
wh
o
l
e
sal
e
acq
u
i
sit
i
o
n
co
st
t
h
at
was le
ss
th
an
15%
l
o
w
e
r
th
an
th
e
r
e
fe
r
e
n
ce
d
b
r
an
d
bi
o
l
o
g
i
c.
--
Th
e
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
was
a
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
t
h
at
co
u
l
d
cr
e
at
e
aff
o
r
d
ab
i
l
i
t
y
cha
l
l
e
n
g
e
s
fo
r
h
e
al
t
h
sy
st
e
ms
i
n
t
h
e
St
at
e
an
d
p
at
i
e
n
t
s,
i
n
clu
d
i
n
g
a
p
r
e
sc
r
i
p
t
i
o
n
dr
u
g
p
r
o
d
u
ct n
e
e
d
e
d
t
o
add
r
e
ss
a
p
u
b
l
i
c
h
e
al
t
h
e
m
e
r
g
e
n
c
y.
Ad
d
i
t
i
o
n
al
l
y,
t
h
e
B
o
ar
d
,
i
n
co
n
sul
t
at
i
o
n
wi
t
h
t
h
e
C
o
u
n
cil
,
c
o
u
l
d
cho
o
s
e
a
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
b
as
e
d
o
n
i
f
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
w
e
r
e
a
g
e
n
e
r
i
c
d
r
u
g
t
h
at
,
ad
j
u
ste
d
an
n
u
al
ly
fo
r
i
n
fla
t
i
o
n
i
n
a
cc
o
r
d
an
ce
wi
t
h
t
h
e
CPI,
h
ad
a
wh
o
l
e
s
al
e
acqu
i
sit
i
o
n
co
st
t
h
at
was
i
n
c
r
e
a
se
d
b
y
20
0%
o
r
mo
r
e
d
u
r
i
n
g
t
h
e
i
mm
e
d
i
at
e
l
y
p
r
e
c
e
d
i
n
g
12
-
mon
t
h
p
e
r
i
o
d
,
as
d
e
t
e
r
mi
n
e
d
b
y
t
h
e
d
i
ff
e
r
e
n
c
e
b
e
t
we
e
n
t
h
e
r
e
sul
t
i
n
g
wh
o
l
e
sal
e
a
cqu
i
sit
i
o
n
co
st
an
d
t
h
e
av
e
r
ag
e
wh
o
l
e
sal
e
acqu
i
sit
i
o
n
c
o
st
r
e
p
o
r
t
e
d
o
v
e
r
t
h
e
i
mm
e
d
i
at
e
l
y
p
r
e
c
e
d
i
n
g
12
-
mon
t
h
s
a
n
d
was
at
l
e
a
st
$1
00
o
r
mo
r
e
f
o
r
an
y
o
f
t
h
e
f
o
l
l
o
wi
n
g
:
--
A
30
d
ay
-
sup
p
l
y
t
h
at
l
aste
d
a
p
at
i
e
n
t
a
p
e
r
i
o
d
o
f
30
c
o
n
se
cut
i
ve
d
a
ys
b
as
e
d
o
n
t
h
e
r
e
co
mm
e
n
d
e
d
do
sag
e
a
p
p
r
o
v
e
d
f
o
r
la
b
e
l
i
n
g
by
t
h
e
FDA
.
--
A
sup
p
l
y
t
h
at
l
aste
d
a
p
at
i
e
n
t
fe
w
e
r
t
h
an
30
c
o
n
se
cut
i
v
e
d
ay
s
b
as
e
d
o
n
t
h
e
r
e
co
mm
e
n
d
e
d
d
o
sag
e
f
o
r
la
b
e
l
i
n
g
by
t
h
e
FDA
.
--
O
n
e
u
n
i
t
o
f
t
h
e
d
r
u
g
i
f
t
h
e
l
ab
e
l
i
n
g
ap
p
r
o
v
e
d
b
y
t
h
e
F
DA
d
i
d
n
o
t
r
e
c
o
mm
e
n
d
a
fin
i
t
e
d
o
sag
e
.
Th
e
B
o
ar
d
w
o
u
l
d
n
o
t
h
ave
t
o
i
d
e
n
t
i
fy
e
ach
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
t
h
at
met
t
h
e
c
r
i
t
e
r
i
a
l
i
ste
d
ab
o
ve
.
Th
e
B
o
a
r
d
wo
u
l
d
ha
ve
to
de
t
e
r
mi
n
e
wh
e
t
h
e
r
to
c
o
n
d
u
ct a
co
st
an
d
af
f
o
r
d
ab
i
l
i
t
y
r
e
vi
e
w
f
o
r
e
a
ch
se
l
e
c
t
e
d
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
wi
t
h
i
n
p
u
t
fr
o
m
t
h
e
Co
u
n
cil
an
d
co
n
sid
e
r
at
i
o
n
o
f
t
h
e
a
ve
r
ag
e
pat
i
e
n
t
c
o
st
cha
r
e
fo
r
e
a
ch p
r
e
s
cr
i
p
t
i
o
n
dr
u
g
pr
o
d
u
ct.
If
t
h
e
B
o
ar
d
c
o
n
d
u
cte
d
a
c
o
st
aff
o
r
d
ab
i
l
i
t
y
r
e
vi
e
w
o
f
a
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct,
t
h
e
Bo
a
r
d
co
u
l
d
c
o
n
sid
e
r
an
y
d
o
c
u
ment
o
r
r
e
s
e
ar
ch
r
e
l
a
t
e
d
t
o
t
h
e
m
an
u
fac
t
u
r
e
r
'
s
se
l
e
cti
o
n
o
f
t
h
e
i
n
t
r
o
d
u
cto
r
y
p
r
i
ce
o
r
p
r
i
c
e
i
n
cr
e
as
e
o
f
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
i
n
clu
d
i
n
g
l
i
fe
cy
cl
e
ma
n
ag
e
ment
,
n
e
t
a
ve
r
a
g
e
p
r
i
ce
i
n
t
h
e
St
at
e
,
m
ar
k
e
t
c
o
mp
e
t
i
t
i
o
n
,
p
r
o
j
e
cte
d
r
e
ve
n
u
e
,
an
d
t
h
e
e
sti
ma
t
e
d
c
o
st
e
ff
e
cti
v
e
n
e
ss
o
f
t
h
e
p
r
e
s
cr
i
p
t
i
o
n
dr
u
g
p
r
o
d
u
ct
.
In
t
h
e
r
e
v
i
e
w,
t
h
e
Bo
a
r
d
w
o
u
l
d
h
ave
t
o
d
e
t
e
r
mi
n
e
wh
e
t
h
e
r
t
h
e
u
se
o
f
a
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
t
h
at
was
ful
l
y
c
o
n
sist
e
n
t
wi
t
h
t
h
e
l
ab
e
l
i
n
g
ap
p
r
o
v
e
d
b
y
t
h
e
F
DA
o
r
stan
d
ar
d
m
e
d
i
cal
p
r
acti
c
e
f
o
r
t
h
e
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
h
ad
l
e
d
t
o
o
r
wo
u
l
d
l
e
ad
t
o
aff
o
r
d
ab
i
l
i
t
y
cha
l
l
e
n
g
e
s
t
o
h
e
al
t
h
ca
r
e
s
ys
t
e
ms
i
n
t
h
e
St
at
e
o
r
hi
g
h
o
u
t
-
of
-
p
o
ck
e
t
c
o
sts
f
o
r
pat
i
e
n
t
s
i
n
th
e
St
at
e
.
Th
e
B
o
a
r
d
w
o
u
l
d
ha
ve
t
o
c
o
n
sid
e
r
an
y
i
n
f
o
r
ma
t
i
o
n
th
at
a
ma
n
u
fa
ctu
r
e
r
chos
e
t
o
p
r
o
vi
d
e
an
d
al
l
th
e
f
o
l
l
o
wi
n
g
f
a
cto
r
s
t
o
th
e
e
xt
e
n
t
po
s
sib
l
e
in
maki
n
g
a
d
e
t
e
r
mi
n
at
i
o
n
:
--
Th
e
wh
o
l
e
s
al
e
a
cqu
i
sit
i
o
n
c
o
st
f
o
r
th
e
pr
e
s
cr
i
p
t
i
o
n
dr
u
g
p
r
o
d
u
ct
so
l
d
in
t
h
e
St
at
e
.
P
age
7
of
10
s
b3
-
5/2526
--
Th
e
a
ve
r
ag
e
m
o
n
e
t
a
r
y
p
r
i
c
e
c
o
n
ce
ss
i
o
n
,
d
i
sc
o
u
n
t
,
o
r
r
e
b
at
e
t
h
at
t
h
e
ma
n
u
fac
t
u
r
e
r
p
r
o
vi
d
e
d
t
o
h
e
al
t
h
i
n
sure
r
s
an
d
p
h
ar
ma
cy
b
e
n
e
fit
ma
n
ag
e
r
s
i
n
t
h
e
St
at
e
,
e
xpr
e
s
s
e
d
as
a
p
e
r
ce
n
t
o
f
t
h
e
wh
o
l
e
sal
e
ac
q
u
i
sit
i
o
n
c
o
st f
o
r
th
e
pr
e
sc
r
i
p
t
i
o
n
dr
u
g
p
r
o
d
u
ct u
n
d
e
r
r
e
vi
e
w
.
--
Th
e
p
r
i
c
e
at
wh
i
ch
t
h
e
r
a
p
e
u
t
i
c
al
t
e
r
n
at
i
v
e
s
f
o
r
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
h
ad
b
e
e
n
s
o
l
d
i
n
th
e
St
at
e
.
--
Th
e
a
ve
r
ag
e
m
o
n
e
t
a
r
y
p
r
i
c
e
c
o
n
ce
ss
i
o
n
,
d
i
sc
o
u
n
t
,
o
r
r
e
b
at
e
t
h
at
t
h
e
ma
n
u
fac
t
u
r
e
r
p
r
o
vi
d
e
d
to
heal
t
h
in
sur
e
r
s
an
d
ph
ar
ma
cy
b
e
n
e
f
i
t
man
ag
e
r
s
i
n
th
e
St
at
e
o
r
was
e
xp
e
ct
e
d
t
o
pr
o
vi
d
e
to
h
e
al
t
h
in
sure
r
s
an
d
ph
ar
ma
cy
b
e
n
e
fit
man
ag
e
r
s
i
n
th
e
St
at
e
f
o
r
th
e
r
ap
e
u
t
i
c
al
t
e
r
n
at
i
ve
s.
--
Th
e
c
o
st
t
o
h
e
al
t
h
i
n
s
u
r
e
r
s
b
as
e
d
o
n
p
at
e
n
t
acc
e
ss
c
o
n
si
ste
n
t
wi
t
h
t
h
e
F
DA
l
ab
e
l
e
d
i
n
d
i
cati
o
n
s
o
r
r
e
co
g
n
i
z
e
d
s
t
an
d
ar
d
m
e
d
i
cal
p
r
ac
t
i
ce
.
--
Th
e
i
mp
act
o
n
p
at
i
e
n
t
acc
e
ss
t
h
at
r
e
sul
t
e
d
f
r
o
m
t
h
e
co
st
o
f
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
r
e
l
at
i
v
e
t
o
in
suran
c
e
b
e
n
e
fit
de
sig
n
.
--
Th
e
cur
r
e
n
t
o
r
e
xp
e
ct
e
d
d
o
l
l
ar
val
u
e
o
f
d
r
u
g
-
s
p
e
cifi
c
p
at
i
e
n
t
ac
ce
ss
p
r
o
g
r
am
s
t
h
at
we
r
e
sup
p
o
r
t
e
d
by
t
h
e
man
u
f
actu
r
e
r
.
--
Th
e
r
e
l
at
i
v
e
fin
an
cia
l
i
m
p
act
t
o
h
e
al
t
h
,
medi
cal
,
o
r
s
o
cia
l
s
e
r
vi
ce
c
o
st
s
a
s
c
o
u
l
d
b
e
n
o
t
i
fi
e
d
an
d
c
o
mp
a
r
e
d
t
o
ba
se
l
i
n
e
e
ff
e
cts
o
f
e
xi
sti
n
g
th
e
r
ap
e
u
t
i
c
al
t
e
r
n
at
i
ve
s.
--
Th
e
av
e
r
ag
e
p
at
i
e
n
t
c
o
-
p
ay
o
r
o
t
h
e
r
c
o
st
-
sha
r
i
n
g
fo
r
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
i
n
t
h
e
St
at
e
.
--
An
y
o
t
h
e
r
f
a
cto
r
e
stab
l
i
she
d
by
th
e
B
o
ar
d
,
b
y
r
u
l
e
.
If
t
h
e
B
o
ar
d
co
n
sid
e
r
e
d
t
h
e
e
sti
ma
t
e
d
c
o
st
e
ff
e
cti
ve
n
e
ss
o
f
a
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct,
t
h
e
Bo
ar
d
wo
u
l
d
ha
v
e
t
o
c
o
mp
l
y
wi
t
h
th
e
f
o
l
l
o
wi
n
g
:
--
Th
e
B
o
ar
d
c
o
u
l
d
n
o
t
u
se
a
c
o
st
-
p
e
r
-
q
u
al
i
t
y
a
d
j
u
ste
d
l
i
fe
y
e
ar
,
o
r
si
mi
l
ar
m
e
asu
r
e
,
t
o
i
d
e
n
t
i
fy
a
sub
p
o
p
u
l
at
i
o
n
fo
r
wh
i
ch
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
w
o
u
l
d
b
e
l
e
ss
c
o
st
e
ff
e
cti
v
e
du
e
to
s
e
v
e
r
i
t
y
o
f
i
l
l
n
e
ss
,
ag
e
,
o
r
pr
e
e
x
i
sti
n
g
di
sabi
l
i
t
y.
--
If
t
h
e
Bo
ar
d
u
se
d
a
c
o
st
-
e
ff
e
cti
v
e
n
e
s
s
an
al
y
sis
fo
r
a
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
t
h
at
e
xte
n
d
e
d
an
i
n
d
i
vi
d
u
al
'
s
l
i
fe
,
t
h
e
Bo
a
r
d
wo
u
l
d
h
ave
t
o
u
s
e
a
c
o
st
-
e
ff
e
cti
ve
n
e
ss
an
al
y
sis
t
h
at
we
i
g
h
e
d
t
h
e
val
u
e
o
f
al
l
ad
d
i
t
i
o
n
al
l
i
f
e
t
i
me
g
ai
n
e
d
e
q
u
al
l
y
f
o
r
an
y
i
n
d
i
vi
d
u
a
l
,
n
o
ma
t
t
e
r
t
h
e
s
e
v
e
r
i
t
y
o
f
il
l
n
e
ss
,
a
g
e
,
o
r
pr
e
e
xi
sti
n
g
di
sabi
l
i
t
y.
E
stab
l
i
shi
n
g
Up
p
e
r
P
a
y
ment
L
i
mi
t
s
If
t
h
e
B
o
ar
d
d
e
t
e
r
mi
n
e
d
t
h
at
spe
n
d
i
n
g
o
n
a
p
r
e
s
cr
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
h
a
d
l
e
d
t
o
o
r
w
o
u
l
d
l
e
ad
t
o
af
fo
r
d
ab
i
l
i
t
y
cha
l
l
e
n
g
e
s
to
heal
t
h
c
ar
e
sy
st
e
ms in
th
e
St
at
e
o
r
hi
g
h
o
u
t
-
of
-
p
o
ck
e
t
c
o
st
s
fo
r
p
at
i
e
n
t
s
i
n
t
h
e
St
at
e
,
t
h
e
Bo
a
r
d
c
o
u
l
d
e
stab
l
i
sh
b
y
r
u
l
e
,
an
u
p
p
e
r
p
ayment
l
i
mi
t
fo
r
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct.
In
e
stab
l
i
shi
n
g
t
h
e
u
p
p
e
r
p
aym
e
n
t
l
i
mi
t
,
t
h
e
Bo
a
r
d
wo
u
l
d
h
a
ve
t
o
co
n
sid
e
r
t
h
e
r
e
l
e
van
t
a
d
mi
n
i
str
at
i
ve
co
sts
r
e
l
a
t
e
d
t
o
sup
p
l
yi
n
g
o
r
sto
ck
i
n
g
t
h
e
p
r
e
sc
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
an
d
t
h
e
i
mp
act
o
f
an
u
p
p
e
r
p
ay
ment
l
i
mi
t
fo
r
t
h
e
p
r
e
s
c
r
i
p
t
i
o
n
d
r
u
g
p
r
o
d
u
ct
o
n
34
0B
Pr
o
g
r
am
e
n
t
i
t
i
e
s.
Th
e
u
p
p
e
r
p
aym
e
n
t
l
i
mi
t
co
u
l
d
n
o
t
i
n
clu
d
e
a
p
r
o
f
e
ss
i
o
n
al
d
i
spe
n
sin
g
fe
e
.
Th
e
up
p
e
r
paym
e
n
t
li
mi
t
wo
u
l
d
tak
e
e
ff
e
ct
o
n
th
e
dat
e
p
r
e
sc
r
i
b
e
d
b
y
t
h
e
B
o
a
r
d
,
b
y
r
u
l
e
,
b
u
t
c
o
u
l
d
not ta
k
e
e
ff
e
c
t
wi
t
h
i
n
s
i
x
mon
t
h
s
o
f
i
t
s
e
stab
l
i
shm
e
n
t
.
E
xc
e
p
t
as
o
t
h
e
r
wi
s
e
p
r
o
vi
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