Meducom International Inc. 18 Macdonell Street, Suite 200 Guelph, ON N1H 2Z3 (519) 767-6644 (519) 767-2542 [email protected] Copyright © 2008. The contents

Meducom International Inc.18 Macdonell Street, Suite 200

Guelph, ON N1H 2Z3 (519) 767-6644

(519) [email protected]

Copyright © 2008. The contents of this Proposal & Estimate are proprietary.

Proposal & Estimate

Interactive Multimedia CHE Program

on Non-Small Cell Lung Cancer: Histology Matters

Prepared on August 15, 2008 for:Shannon Simoneau, Julie GibbonsEli Lilly Canada Inc.


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Meducom International Inc.® is pleased to present a Proposal & Estimate for services associated with the development of an accredited education program on Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer . Our proposed CMEPak™ deliverable will incorporate patient case studies and evidence/information derived from the clinical literature and pertinent guidelines.

Meducom has extensive experience with the development of case-based and simulation-based medical education programs for healthcare professionals. This experience includes the development of accredited medical education programs, and use of powerful electronic media channels including PowerPoint-based rep-delivered programs and Flash-enabled audio/visual programs delivered on the Internet World Wide Web.

In summary, Meducom International Inc.® is able to provide products and services specified within this Proposal & Estimate for an investment of $107,621 (excluding taxes). Through this investment, Eli Lilly Canada Inc. will further its presence as a preferred supplier of education for Canadian physicians. Finally, Appendix A outlines a number of program options, not accounted for in the total project budget, that can expand the reach and power of this important CHE initiative.

Executive Summary


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Introduction 4

CHE Services 5

Recent CHE Examples 6

Therapeutic Area Experience 8

Objectives 9

Program Elements 10

Needs Assessment - Description 11

CHE Program Development and Accreditation Process Management 12

CMEPak™ - Description 13

RapiCard™ - Description 14

Investment Summary 15

Needs Assessment – Specifications 16

CHE Program Development and Accreditation Process Management – Specifications 17

CMEPak™ - Specifications 18

RapiCard™ - Specifications 19

Costs Not Included 20

Conditions of Engagement 21

Expectations 22

Completion and Payment Schedule 23

Work Authorization 24

References 25

Appendix A: Optional Components 26

Table of ContentsPage


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Meducom International is a full service healthcare communications agency with a history of delighted clients and successful platforms and programs that deliver results. Our diverse experience, gained through more than 14 years of innovation and service, includes areas such as professional relations and opinion leader development, journal publications, advertising, direct targeted marketing, continuing health education, needs assessment and e-media. In all areas of our work, we craft high-quality solutions that are effective and influential, delivered with efficiency, warmth and style.

As a healthcare communications agency, Meducom is recognized for its strategic, editorial, creative and technical capabilities among pharmaceutical, biotech, diagnostic and medical clients. Our strengths include needs assessment, program development, education design, accreditation, program management and execution and outcome evaluation. Our goal is to create and sustain strong working relationships with key medical audiences on behalf of our clients. Our core competency is the execution of successful programs from conceptualization through to completion.

We have worked on a wide range of brands, large and small, and stay in close touch with market trends and developments so that we can develop and deliver novel programs and value for our client partners. Our clients have established long-term partnerships with Meducom for the simple reason that we provide better ideas, better design and better implementation, all managed within a commitment to a “no fuss, no worries” customer experience. Our clients have established long-term partnerships with Meducom for the simple reason that we provide better ideas, better design and better implementation, all managed within a commitment to a “no fuss, no worries” customer experience.

Introduction


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CHE Services

Through experience across numerous therapeutic areas, Meducom has developed a portfolio of many diverse and successful programs. In conceiving, developing and implementing these programs, Meducom has demonstrated a high level of competency in core areas such as:

Strategic DevelopmentWith our extensive industry backgrounds, Meducom’s senior account directors provide strategic input into program design and development. They understand the role of CHE and professional relations in marketing and ensure that key brand messages are integrated into every program.

Instructional Design/Adult Education/Evaluation:Meducom participates in the CACHE and ACME associations and has works with many of Canada’s CHE leaders. Senior staff are trained in development and delivery of adult learning programs.

CHE Accreditation:Meducom has enjoyed success in developing numerous MAINPRO and Royal College of Physicians and Surgeons of Canada (RCPSC) accredited programs across many therapeutic areas. These encompass both traditional and novel delivery channels including i-media learning platforms such as CMEHub™ and on-demand learning at MDgroove.com™.

Medical Writing/Abstract/Poster/Journal Submissions:Meducom has developed publications and articles for submission to peer-review journals, in addition to publishing under numerous well-recognized proprietary banners.

Collaboration and Liaison with KOLsMeducom has a strong reputation for quality and integrity in dealing with KOLs across a wide variety of therapeutic areas. Meducom has a comprehensive network and established relationships with numerous general practitioners and specialist physicians across Canada.

Meeting Coordination and Execution/Logistical Planning (Domestic and International)On average, Meducom develops and implements approximately 50 “meetings” per year, ranging from advisory boards (10-15 participants) to symposia (with more than 250 participants). Clients can select from a menu of meeting services: e.g. comprehensive planning and logistics, or focus purely on the strategic elements.

PowerPoint®/Presentation ExcellenceMembers of Meducom’s team have expertise with Microsoft PowerPoint®, ensuring that presentations are impressive yet academic, while following key the principles and practices of multimedia learning.

Meducom has developed proprietary add-in and Internet-based tools for PowerPoint®, including e-Carousel® (assists in building presentations via a key word search), SlideStation™ (an online tool for managing slide libraries) and CaseBuilder™ (a wizard that helps physicians to build a case study presented via well-formatted PowerPoint® slides).


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Recent CHE Examples

Recent examples of accredited CME programs delivered by Meducom include:

Practical Applications of AECOPD Treatment Guidelines (for Bayer Healthcare)

• MAINPRO-M1 accredited• Format: Kit packages including participant guides, facilitator’s guide, slides on CD-ROM, novel

recruitment materials and printed implementation materials• Delivery: Representative-implemented CHE• Steering Committee: Meyer Balter, MD, FRCPC; Guy Deslauriers, MD, FRCPC; Gerald Evans,

MD, FRCPC; Ashvini Gursahaney, MD, CM, FRCPC; Alan Kaplan, MD CCFP(EM); Andrew McIvor, MD, MSc, FRCPC; Jeremy Road, MD, FRCPC; Coleman Rotstein, MD, FRCPC

Adjuvant Endocrine Therapy in Early Breast Cancer

• RCPSC Section 1 with University of Montreal• Format: Clinician Education Package containing slide presentation on CD-ROM, Facilitator’s Guide

and meeting support materials• Delivery: Representative-implemented CHE• Planning Committee: John Mackey, MD, FRCPC; André Robidoux, MD, FRCSC

Emerging Trends in the Management of Parkinson’s Disease

• MAINPRO-M1 accredited• Format: Kit packages including participant guides, facilitator’s guide, slides on CD-ROM,

recruitment materials and implementation materials• Delivery: Agency- and representative-implemented regional CHE• Steering Committee: Sylvain Chouinard, MD, FRCPC; Peter Lin, MD, CCFP; Stephen McKenzie,

MD, FRCPC; France Parent, MD, CCFP

ADHD: At the Leading Edge

• RCPSC Section 1 with McGill University• Format: CMEPak™ containing case studies and support slides on CD-ROM and facilitator’s guide• Delivery: Representative-implemented CHE• Planning Committee: Emmett Francoeur, MD, FRCPC; Samuel Chang, MD, FRCPC; Grazyna

Jackiewicz, MD FRCPC

Achieving Asthma Control with Confidence (3 Modules)

• MAINPRO-M1 and C accredited• Format: Kit packages including participant guides, facilitator’s guide, slides on CD-ROM,

recruitment materials and implementation materials• Delivery: Representative-implemented CHE• Planning Committee: Alan Kaplan, MD, CCFP (EM); Meyer Balter, MD, CM, ABIM, FACP, FCCP,

FRCPC; Ashvini Gursahaney, MDCM, FRCPC; Coleman Rotstein, MD, FRCPC, FACP, FIDSA


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Recent CHE Examples

Evidence Beyond Blood Pressure Control (4 Modules)

• MAINPRO-M1 accredited• Format: Case-based multimedia learning program• Delivery: Representative-implemented CHE with CMEHub™ online materials deployment interface• Planning Committee: Sheldon Tobe, MD, FRCPC; Jonathan Howlett, MD, FACC, FRCPC; Zahra

Bardai, MD, CCFP

Migraine Mastery: Head of the Class

• MAINPRO-M1 accredited• Format: CMEPak™ containing case studies and support slides on CD-ROM and facilitator’s guide• Delivery: Representative-implemented CHE, i-learning delivery at www.MDgroove.com• Steering Committee: Werner Becker, MD, FCCP; Guy-Pierre Boudreau, MD; Elizabeth Callahan,

MD, CCFP; Teresa Cavett, MD, CCFP; Ethel Cooper-Rosen, MD, CCFP; Thomas Gabruch, MD, CCFP; Gregory McAnulty, MD, CCFP, FCFP, ABFP, AAMA; Sharon Northorp, MD, CFPC; Laurie Pereles, MD, CCFP; Gary Shapero, MD, CCFP

Straight From the Heart: Managing the Cardiovascular Risk Continuum

• RCPSC Section 1 with the Canadian Cardiovascular Society• Format: Case based, interactive talk show style symposium• Delivery: Meducom-organized Satellite Symposium at Canadian Cardiovascular Congress• Planning Committee: George Honos, MD, FRCPC, FACC; Andrew Pipe, CM, MD, LLD(Hon),DSc

(Hon); Larry Leiter, MD, FACP, FRCPC

PAH Pathways to Progress

• RCPSC Section 1 with Canadian Thoracic Society• Format: CMEPak™ containing case studies and support slides on CD-ROM and facilitator’s guide• Delivery: Representative-implemented CHE• Planning Committee: Robert Levy, MD, FRCPC, Michael Connelly, MD, MRC, John Granton, MD,

FRCPC, Sanjay Mehta, MD, ABIM, FRCPC, Janet Pope, MD, MPH, FRCPC, Steeve Provencher, MD, FRCPC, James Tam, MD, FRCPC, FACC

Echocardiographic Assessment of Pulmonary Hypertension and Right Ventricular Function

• RCPSC Section 1 with McGill University• Format: Case-based online learning program employing Flash delivery technologies• Delivery: Online i-CHE (On-Demand Learning) at www.MDgroove.com• Planning Committee: George Honos, MD, FRCPC, FACC, James W. Tam, MD, FRCP(C), FACC


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Therapeutic Area Experience

Meducom is a fully integrated, independent and Canadian-owned agency that has developed a leadership position in healthcare communications since its inception in 1994. Our team of professionals has a multidisciplinary background in pharmaceutical sales, marketing, CHE, research, professional relations, medical publishing and medical e- and i-media, which gives us an intimate understanding of the needs of our clients and the key stakeholders who impact their business. Meducom has established a reputation as strategic consultants and innovative marketers who excel at delivering medical communications and professional relations programs that influence MD behaviour and brand success.

Meducom continues to be a strategic partner to several major pharmaceutical, biotech, diagnostic and medical device/technology companies. We develop and execute educational and communications programs that cover all aspects of a brand’s life cycle, from pre-launch to well beyond product launch. The following is a list of some of the therapeutic areas in which Meducom has recently worked:

Acne ADHD Allergy Alzheimer’s disease

Anemia Angina Arthritis Asthma

Bipolar Disorder BPH Breast Cancer CHE

Crohn’s Disease Colorectal cancer COPD Dementia

Depression Diabetes Diagnostics Dyslipidemia

Epilepsy Erectile Dysfunction GERD Glaucoma

HIV/AIDS HPV Hypertension Intra-abdominal Infection

IVG Kidney Transplant Liver Transplant Lung cancer

Migrane Multiple Sclerosis Obesity Osteoporosis

Overactive Bladder PAH Pain Prostate cancer

Psoriasis RTI Rheumatoid arthritis Schizophrenia

Smoking cessation Stroke Tremor UTI


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Objectives

Market Objectives

• Expand clinician understandings of the assessment and staging of NSCLC

• Expand clinician understandings of the management of NSCLC, including clinical goals, guideline statements and new horizons emerging from expanded indications of therapies

• Position for action the clinical evidence for targeted first-line therapies in the treatment of NSCLC, including the importance of the use of histology to guide treatment selection

• Provoke attitudinal and behavioural change by engaging clinicians with realistic patient presentations, diagnosis and treatment options through interactive clinical cases and thought provoking questions

Program Objectives

• Establish a dialogue between Lilly representatives and medical oncologists that will assess learning/educational needs of the target marketing audience with respect to NSCLC, histology as a key factor in selecting therapeutic options and the use of Alimta® as a treatment option

• Develop educational content about NSCLC treatments that is:

– balanced and respectful of the evidence and the audience – accurate, focused and credible– grounded in identified learning and clinical needs– consistent with adult-learning principles, as outlined in the Rx&D Code of

Conduct– accredited at the Maintenance of Certification level

• Develop educational materials that activate many different learning styles through use of different media and modalities

• Develop educational materials that are enduring and scaleable for current and future learning needs/issues

• Integrate current education content (i.e. provided by key opinion leaders) into this new CHE program

• Develop educational materials that are easily used/deployed by representatives and that have an electronic component

• Develop materials to enhance participation in and support recruitment of participants for the CHE program

• Develop evaluation materials/models for participants who complete the CHE program


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Program Elements

Meducom proposes to deliver the following products and services in this project:

• CHE Needs Assessment

• CHE program development, including content development, management of the accreditation process and production of a CMEPak™ on Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer

• RapiCard™ to support representatives as they market the program to medical oncologists

Several optional components and their associated investment requirements are also proposed:

• Online deployment of materials for faculty and representatives through Meducom’s proprietary CMEHub™ technology

• Creation and deployment of an On-Demand Learning program at www.MDgroove.com

• Train-the-Faculty development program for opinion leaders who will serve as presenters/faculty for live-group CHE meetings

• Program Quick Guide® to facilitate program enrichment and/or representative follow-up

• Post-program survey of CHE participants to assess knowledge to action translation

CD-ROMCD-ROMCD-ROMCD-ROM Facilitator Facilitator GuideGuide

Facilitator Facilitator GuideGuide

Rep Implementation Rep Implementation GuideGuide

Rep Implementation Rep Implementation GuideGuide

CMEHub™CMEHub™CMEHub™CMEHub™ On-Demand On-Demand LearningLearning

On-Demand On-Demand LearningLearning Train-the-FacultyTrain-the-FacultyTrain-the-FacultyTrain-the-Faculty Quick GuideQuick Guide®®Quick GuideQuick Guide®®

Core Proposed Platform:

Optional Program Components:

Program RapiCard™Program RapiCard™Program RapiCard™Program RapiCard™


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Needs Assessment - Description

All CHE programs, whether accredited or not, rely on the assessment of the needs and interests of the target healthcare professional audience. A comprehensive Needs Assessment will precede program development in order to guide content creation. This Needs Assessment will be created by Meducom with collaboration from Eli Lilly Canada Inc. in order to ensure that key areas for learning development will be addressed.

Participants in Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer will also be asked to complete a Personal Learning Assessment; they will be asked to contribute to their own learning by identifying, from the menu of available content, which topic(s) they would like to address. Content delivery can focus on the needs identified by the participant(s).

For this program, a Needs Assessment will be conducted using one or more of the following methodologies:• Faxed questionnaire

• E-mailed questionnaire

• Web-based questionnaire

Needs Assessment surveys developed by Meducom International Inc. usually incorporate suggestions from both the sponsor and from one or more members of the Program Steering Committee for a CHE program. Where possible, they are distributed under the auspices of a healthcare professional to enhance credibility and encourage professional courtesy.


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CHE Program Development and Accreditation Process Management

Meducom will provide services associated with the development and support of a Program Steering Committee that will control and contribute to the CHE program content, including up to two patient case studies. The Program Steering Committee will consist of six key opinion leaders in lung cancer. The program content will be developed to meet relevant criteria for accreditation and accreditation will be sought.

Meducom will engage with the Canadian Association of Medical Oncologists (CAMO) in order to secure that organization’s commitment to serve as accreditation sponsor for Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer. Section 1 accreditation (Maintenance of Certification CPD program, Royal College of Physicians and Surgeons of Canada) will be sought from CAMO, and Meducom will develop/secure the collateral elements required for accreditation (learning objectives, program agenda, evaluation strategy, financial disclosures, etc.).


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CMEPak™ - Description

A CMEPak™ is Meducom’s proprietary, multifunctional, interactive multimedia CHE platform.

Each CMEPak™ is designed to:

• Facilitate discussion among target clinicians about the therapeutic area covered

• Support delivery of Lunch & Learn programs through its modular platform design

• Provide a value-added education platform for self-learning purposes

• Enable no-fuss deployment of CHE content to MDgroove.com™ (web channel) to reach different market segments including no-see or difficult-to-see MDs

The CMEPak™ for this program will include:

• PowerPoint slides and accompanying notes – Includes modular design with hyperlinks (Figure 1)

• Up to two patient case studies (using Meducom’s proprietary case presentation format)

• Representative Implementation Guide to help company representatives in program setup and execution using the CMEPak™

• Printed Facilitator’s Guide with slide images, notes, discussion questions and facilitation suggestions

• A customized silk-screened CD-ROM containing PowerPoint and administration files in English and French, housed in a DVD case

Meducom will additionally grant license to Eli Lilly Canada Inc. to deliver and use copies of its proprietary add-in for PowerPoint called e-Carousel®. This add-in expands the capabilities of PowerPoint by:

1. Allowing presenters to rapidly select slides for use in a custom presentation based on slide numbers, visual selection or search by key words/phrases

2. Allowing presenters to easily create supplementary slides using a slide creation wizard

3. Facilitating “in-presentation” search for slides by key words

Figure 1: CMEPak™ Main Menu

Histology MattersMain Menu

Epidemiology & Epidemiology & Impact of NSCLC Impact of NSCLC

Diagnosis Diagnosis of NSCLCof NSCLC

Treatment Selection Treatment Selection ConsiderationsConsiderations

for NSCLC for NSCLC

Clinical Evidence Clinical Evidence for Targeted for Targeted

Therapy of NSCLCTherapy of NSCLC

Patient & Caregiver Patient & Caregiver CounsellingCounselling

& Support& Support

Case StudiesCase Studies

11

22

33

44

55

66


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RapiCard™ - Description

Meducom will develop a compelling marketing RapiCard™, for representative distribution, that will be used to entice target healthcare audiences to participate in a live-group (and/or online) CHE program using Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer .

Effort will be made to design this RapiCard™ so that it adds value to clinical practice; in this way, it will create motivation not only to participate in the program (as a supplement to the formal program invitation), but to promote retention because of compelling and useful content on at least one face of the card. This RapiCard™ will help position Eli Lilly Canada Inc. as a partner committed to better healthcare outcomes for Canadians.


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Investment Summary

Our estimates for the completion of the project described in this Proposal & Estimate are:

• Needs Assessment services amounting to $9,000, excluding applicable taxes

• CHE Program Development services amounting to $48,075, excluding applicable taxes

• CMEPak™ services and product amounting to $47,046, excluding applicable taxes

• RapiCard™ services and product amounting to $3,500, excluding applicable taxes

excluding optional components (where designated) and other expenses described below.


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Needs Assessment - Specifications

Format and Specifications:

Fax/Online Needs Assessment Questionnaire/Survey

• Question Number: Not to exceed 15 questions or 2 pages

• Medium: Fax or online by either email or at MDgroove.com™

• Sample Size: Entire audience of ~ 300 medical oncologists

– Includes question design and survey layout in English and French– Production in English and French

• Reporting: In one of either PowerPoint slides or Word document

Investment:

Needs Assessment $9,000 + GST


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CHE Program Development - Specifications

Specifications:

• Recruit, support and act on behalf of/in concert with Program Steering Committee of 6 members to develop program outline and approach

• Co-ordinate program development with accreditation co-sponsor (Section 1 accreditation, Maintenance of Certification CPD program, RCPSC)

• Prepare and submit program elements for accreditation to accreditation co-sponsor

• Disburse honoraria (to amounts listed in our budget) to members of Program Steering Committee

Investment:

CHE Program Development $48,075 + GSTDetail:Honoraria $16,000Strategic Services/Liaison with Client/Agency Fee $14,500Liaison with/Support of Program Committee $9,750Accreditation Fees $6,000Projected Agency Costs (couriers, telephone, fax, etc.) $1,825


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CMEPak™ - Specifications


40 program packages, will be produced with the following specifications:

• Up to 90 specific PowerPoint slides (50 content slides, up to 2 case studies (~40 slides)) developed and formatted in modular design

• Supporting notes and navigation elements

• Custom hard-cover DVD case with 4-colour cover insert*

• CD-ROM label in full colour with bilingual graphics*

• Printed Facilitator’s Guide (up to 32 pages, 4/4 colour print, saddle-stitched, finished size 4.875” x 7.375”) with slide thumbnails, speaker notes and interaction guidance to support program delivery*

• Simultaneous production of English and French versions (E/F split: 70%/30%)

• Up to 3 royalty free art images/graphics included

Included files on CD-ROM:

• Program administration materials, including printable invitations (letter and flyer types) with registration forms, program agenda and learning objectives, program confirmation letter, attendance sheet, certificate of attendance, evaluation forms

• Pre- and post-program questionnaires/quizzes

• Inclusion of 40 licenses (one per package) of e-Carousel®

• Inclusion of Meducom’s What’s HIP? reflection form and, if desired, online methodology

Investment:

CMEPak™ $47,046 + GSTDetail:Program Content Development $22,338Program Creative Development $16,675Program Production $8,033

* one round of layout revisions included


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RapiCard™ - Specifications


• Finished Size: Not to exceed 8.5” x 5.5”

• Material: 10 pt card stock

• Bundling: Shipped shrink-wrapped in 25 or 50 units (per client guidance)

• Colour: 4-colour process on both sides

• Finishing: Coated on both sides for durability

• Quantity: 500 units (English/French split: 70%/30%)

– Design and layout included*– Printing and finishing included

• Submitted with CMEPak™ for review by accreditation sponsor

Investment:

RapiCard™ $3,500 + GST

* one round of layout revisions included


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Costs Not Included

Costs Not Included

• Honoraria for members of the Program Steering Committee exceeding a total budget of $16,000 and honoraria for participants in any Train-the-Faculty program

• French translation for program and support materials

• Printing of any materials not explicitly specified in the proposal

• Additional royalty-free images beyond the estimated number (3), or any rights-managed or custom images/graphics

• Projected agency costs (justifiable by receipts) exceeding the amounts listed

• Revisions to layouts or designs requested by clients after the allowed one round of revisions


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Conditions of Engagement

• All quotations submitted are based on pricing as of August 13, 2008 in Canadian dollars and are subject to change. These estimates may vary by 15%.

• All taxes and incidentals are not included in these quotes but will be applied where applicable upon final billing.

• Agency expenses for the duration of the program will be submitted separately, including long distance phone, fax and courier charges, etc.

• Agency services and fees are limited to those listed within the cost estimate. Additional services requested by client both pre- and post-program are subject to additional costs and fees.

• All costs and fees are subject to change with additional participants/faculty, upon mutual agreement of the parties.

• Client-initiated revisions to layouts that occur after the included one round of layout revisions may be billed as additional fees at the discretion of Meducom International Inc.®

• Meducom shall not be financially responsible for any failure of performance due to Acts of God, war, disaster, terrorism, legal or non-legal strikes, accidents or governmental acts which make performance impossible.

• Work on this project will begin upon client approval and receipt of Purchase Order from the client. Meducom is not responsible for delays stemming from review processes internal to the client, including editorial and production changes. Should these delays impact on project time lines and/or production costs, Meducom reserves the right to invoice for additional costs upon discussion with the client.

• A signature approving this Proposal & Estimate is binding and authorizes initiation of the work described in this document and enacts all terms and conditions herein.

• In the event that any part of this contract is cancelled for any reason, Meducom International Inc. will invoice for those services rendered to date, as well as any costs committed which cannot be cancelled.

• This estimate is valid 21 days from date issued.


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Expectations

Due to the complex and innovative nature of this proposed program, a close working partnership between employees of Meducom and Eli Lilly Canada Inc. will be required. This collaboration will require timely response to questions and concerns raised by both parties, since there are complex logistics associated with working with multiple media and faculty.

The involvement of 6 faculty in the production of materials in multiple media can create disagreements and time delays in project timelines. Meducom commits to advising the client when these situations will impact the timing of deliverables.

Since the Program Steering Committee is actively involved in guiding content and accreditation sponsors require program submissions which treat therapeutic options with balance and without commercial bias, it is likely that there will be substantial effort to create balance in all presentations pertaining to therapeutic options. It is further identified that components of the program which focus on the client’s product may not be deemed suitable for accreditation by an accrediting sponsor approached by Program Steering Committee and Meducom; Meducom will not be held liable for delays in accreditation or for requirements to alter contents mandated by an accreditation sponsor. All efforts will be made by Meducom, during program development, to promote content development that will lead to successful accreditation.


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Completion and Payment Schedule

COMPLETION & DELIVERY

• January 2009 of all components − based on sponsorship approval by August 29, 2008

PAYMENT TERMS: NET 30 DAYS

Interim Payment 1: Due at signing of contract

• CHE Program Development (50%)

• CMEPak™ (50%)

• Program Marketing RapiCard™ (50%)

Interim Payment 2: Due on engagement of Program Steering Committee



Interim Payment 3: Due on receipt by Eli Lilly Canada Inc. of content for CMEPak™ and RapiCard™ for internal review


• CMEPak™ (40%)


Final Payment: Due on delivery of completed


• CMEPak™ (10%)



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Work AuthorizationWork on this project will begin upon client approval and receipt of Purchase Order from Eli Lilly Canada Inc. Meducom is not responsible for delays stemming from review processes internal to Eli Lilly Canada Inc., including editorial and production changes. Should these delays impact on project time lines and/or production costs, Meducom reserves the right to invoice for additional costs upon discussion with client.

A signature approving this Proposal & Estimate is binding and authorizes initiation of the work described in this document.

This document has been researched and developed by Meducom International Inc.® with the assistance of a written brief provided by the client and other written sources. The information and executional elements in this proposal are considered proprietary and should not be otherwise discussed or reproduced (internally or externally) without the prior knowledge and consent of Meducom.

Should the elements of this proposal not be accepted, the information and content presented within remains the property of Meducom, and is deemed confidential as defined in agreements in place between Eli Lilly Canada Inc. and Meducom International Inc.®

Meducom International Inc.® retains copyright, editorial control and distribution rights to programs in this Proposal & Estimate identified as trademarks of Meducom International Inc.® No part of these programs, either in whole or in part, may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the written permission of Meducom International Inc. ® Copyright© 2008.

e-Carousel® and Quick Guide® are registered trademarks of Meducom International Inc.(r). All rights reserved.

CMEPak™, RapiCard™, CaseBuilder™, SlideStation™ and MDgroove.com™ are trademarks of Meducom International Inc. All rights reserved.

Investment Synopsis and Approval

Signature Date PO#Eli Lilly Canada Inc.

Investment:

Needs Assessment $9,000 + GST

CHE Program Development $48,075 + GST

CMEPak™ $47,046 + GST

RapiCard™ $3,500 + GST

TOTAL: $107,621 + GST


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References

Ms. Ursula Mann,

Sr. Medical Education Associate, ADHD, Western Canada

Eli Lilly Canada Inc.

Toll Free: 1-800-268-4446 Ext. 9985

Home Office: 403-241-7413

Email: [email protected]

Mr. Mark Preston,

Senior Product Manager

Nycomed Canada

Toll Free: 1 888 831 7999 x 4148


Ms Tessa Trasler,

Health Education Manager

Merck Frosst Canada Ltd.

Phone: 514-428-2688



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Proposal & Estimate

Appendix A:Optional Components

=Additional Reach and Success!

Optional Components


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CMEHub™ - Description

CMEHub™ is an internet portal solution that facilitates the creation of online communities for Canadian healthcare professionals who have interest in a CHE program, either as faculty or as participants. This unique portal is a secure space at which clinicians who are involved with the delivery of a CHE program or who have participated in a CHE program can continue their association with the CMEHub™ program sponsor.

A CMEHub™ portal incorporates some of the best of the emerging web technologies and features, which, depending on investment levels, may include web forums and chat, “invite a friend” viral marketing and polls and surveying instruments. This secure and dynamic portal program is an ideal way to build loyalty and sustain communication with a community of CHE faculty/participants on an ongoing basis.

CMEHub™ sponsorship is for a minimum of 12 months. During that sponsorship period, Meducom will:• Create an CMEHub™ portal branded for Histology Matters: Navigating

Treatment Options for Non-small Cell Lung Cancer, including installing all standard CMEHub™ components on the world wide web at a unique web address

• Provide ongoing technical support

• Manage registration requests and permissions

• Purge any components of spam or indecent messages, should these occur, and revoke the membership(s) of any users who violate CMEHub™ guidelines

• Install software upgrades as relevant

• Ensure availability, in an archive, of all meeting minutes, transcripts or recordings generated by or for the participants in the CMEHub™

• Provide a marketing program to support the awareness of the program to potential users

A unique CMEHub™ web portal can be developed for this program. The portal includes strict permissions control, presented as a registration gate, in order to deter those who should not belong to the community. A CMEHub™ portal is a secure space in which invited clinicians may access relevant slides and resources to support the delivery of a CHE program. This is an ideal solution for modular CHE programs that build content over time. As well, the CMEHub™ web portal also serves as a repository of all program administration tools (viewable only by the sponsor’s representatives) and can serve as a communication conduit between Health Education and Marketing management and field representatives.


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CMEHub™ - Specifications

Functionality Specifications:*

• SlideStation™ Slide Library tool

• FeedbackHub™

• Calendar of Events

• ExpertHub™ question and answer forum (with question-hold/adjudication technology)

• Web forum/bulletin board

• ChatHub™ invokable text chat room service

• PublicationHub™

• System e-mailer

AVAILABLE COMPONENTS (with additional investments required):

• TrainingHub™• Desktop Update Notifier application• What’s H.I.P.? i-platform• Program Management Hub• Online journal club software• PracticalHub™• Medical tools (i.e. creatinine, BMI and dosage calculators);• CaseBuilder™ program, which allows members to build and deploy their

own patient case studies• Quiz widget

Investment:

CMEHub™ (for 1 module deployed) $12,500 + GST*

Monthly Technical Support and Reporting Fee (12X$169) $2,028

Additional Module Deployment Fees $2,699 per module

* Pricing does not include development of website text or posted content


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Train-the-Faculty Program: Description

Meducom can provide support for the development and implementation of two online Train-the-Faculty (TTF) meetings with an anticipated total of 25 targeted physician faculty members. This support includes:

• Management of the faculty recruitment process (i.e. development and delivery to a list of target physicians, provided by the sponsor, of program recruitment materials; management of confirmations of attendance; provision of instructions regarding technology connection to confirmed faculty; reminder letters to faculty the week of the event)

• Development of agenda and learning objectives for TTF meetings

• Development, in association with TTF trainers, of any slides or materials to support their efforts in training their colleagues during the web sessions

• Management of technical support for web and phone conferencing logistics (using Meducom or the sponsor’s web and telephone tools)

• Disbursement of funds to TTF program participants

• Provision of weekly recruitment reports and a final report to the program sponsor

• Development (excluding services associated with deployment to an online site) of a video and audio archive (as permitted by the technology used) of one or both TTF meetings


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Train-the-Faculty - Specifications

Specifications:

• Recruit, on behalf of Program Steering Committee, a total of 25 faculty members who will be trained to deliver the CHE program in up to two webconference sessions

• Co-ordinate recruitment process, including development and use of invitation letter, registration forms, agenda and learning objectives and phone message reminders to target faculty

• Provide weekly recruitment progress reports

• Provide technology access instructions to all confirmed TTF participants

• Support development of TTF support materials, including up to 10 additional slides for use by TTF Chair/Presenter and related handouts (by email or for download)

• Disburse honoraria (honoraria costs not included) to TTF participants

• Provide access/use of Meducom’s web conferencing and teleconferencing technology for up to two 1.5 hour sessions

• Develop a web archive of the TTF program (excluding costs of web deployment)

Investment:

Train-the-Faculty $26,900 + GSTDetail:Web Services (including technology, archive development) $8,500Recruitment Management and Reporting $12,400Development of TTF Support Materials $6,000


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On-Demand [email protected]™ -

DescriptionOn-Demand Learning @MDgroove.com™ provides Canadian physicians with powerful and rapid i-learning programs integrating both audio and visual streams, animations, and personal assessment tools. At the heart of the MDgroove.com™ system, On-Demand Learning presents patient case studies and evidence-informed and guideline-supported medicine through the familiar “slides” paradigm. This learning methodology incorporates reflection opportunities, program assessment, and future planning to address uncovered learning needs.

Meducom proposes to create one On-Demand Learning CHE program @MDgroove.com™, derived directly from the content of the CMEPak™ created as part of this CHE initiative. This program would be accredited as a Section 1 learning program and eligible for 1.5 Section 1 Maintenance of Certification credits.

The full On-Demand Learning framework at MDgroove.com™ includes:• Pre-engagement practice reflection exercise

• Pre-engagement learning quiz (optional)

• Multimedia program delivery (narrated slides in Flash format)

• Unique Participant Toolbar, including note-taking feature, SlideStation™ PowerPoint® presentation builder*, glossary and immediate link to Ask the Experts

• Ask the Experts

• What’s H.I.P.? learning summary

• Program evaluation summary

• Opt-in sponsor follow-up engagementTo assist with the marketing of an On-Demand Learning program @MDgroove.com™, Meducom also develops an attractive invitation card for distribution by representatives, and can offer an attractive package (not quoted) of marketing services to its database of:• more than 19,000 Canadian physician e-mail addresses

• more than 40,000 Canadian physician fax numbers

* The SlideStation presentation builder on the Participant Toolbar allows users to flag slides from the program they are interested in downloading for personal study or use after the program.


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On-Demand Learning @MDgroove.com - Specifications

Media Specifications:

• Program Format: Flash multimedia program, with narrated slides derived from the content of the CMEPak™, deployed to MDgroove.com™

• Interactions: Up to three interactive graphics and an interactive program glossary

Hosting Environment:

• Hosted in an interactive web environment with sequenced program components which include reflection and pre-test, program multimedia, program web forum and/or chat room, What’s HIP? interaction, Program Evaluation Form and post-test.

• “Refer a Friend” feature and permission for sponsor follow-up will be enabled if desired by client. Provision of periodic reports of program performance included.

Investment:

On-Demand Learning @MDgroove.com™ $17,450 + GST*

Marketing Card for ODL Program (500 units) $2,850 + GST*

*This price depends on the completion by Meducom International Inc.® and availability of the CMEPak™ entitled Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer.

To understand the power and promise of On-Demand Learning, an example is available online at the client

demonstration site for MDgroove.com™.To access this example:• Navigate, using a web browser, to demo.mdgroove.com (no www in front of this web address)• In the login panel on the left of the screen, enter LillyCME as your username and CMEgroovy as your

password. • Click program badge “Echocardiographic Assessment of Pulmonary Hypertension and Right Ventricular

Function” in the Easy Links panel on the right of the screen.• Access available components of this program through the “Scoreboard”, click on the button to the right of

“Opening Questions” to access a pre-work activity (you may enter dummy data); click Submit when you have completed this screen.

• On the program scoreboard, click on the button “Learning Program” to activate an example of how On-Demand Learning content is delivered though video/audio.


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Quick Guide® - Description

A Quick Guide® is a pocket-sized spiral-bound guide that captures current opinions, consensus and recommendations in a given therapeutic area. Emphasis is placed on including practical, actionable content within the Quick Guide® - algorithms, quick clinical tests, and risk factor tools are common content. Recent Quick Guides® have included Reality Checks, which are practical guidance/comments from experts about how to translate knowledge to action. The Quick Guide® can highlight the relationship of associated medical conditions or drug interactions to a therapeutic area.

Meducom’s Quick Guide® series is among the most successful of its publications over its 14 years of operations as a healthcare communications agency. Quick Guides® are enduring, retained and remembered; Meducom continues to receive phone calls and messages from physicians and university professors asking for copies of Quick Guide® titles, some dating back 5 or more years! A Quick Guide® is a powerful and conveniently-sized reminder of basic tools and information to enable the clinician’s work.

Meducom can enrich the experiences of those healthcare professionals who participate in Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer by developing, concurrent with program development, a Quick Guide® related to Non-small Cell Lung Cancer.


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Quick Guide® - Specifications

Format and Specifications:• Finished Size: 5.0” x 3.5” - 16 cards/set

• Material: 10 pt card stock with lamination on both sides

• Binding: 3/8” spiral binding

• Bundling: Shipped loose, banded or shrink-wrapped in 25 or 50 units (per client guidance)

• Colour: 4-colour graphics throughout

• Quantity: 500 units (English/French split: 70%/30% )

• Written by the Meducom editorial team

• MD editor to be determined

Submitted with CMEPak™ for review by accreditation sponsor

Investment:Quick Guide® - Non-small Cell Lung Cancer $60,400 + GST


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Post-CHE Survey - Description

Meducom can more comprehensively evaluate the learning outcomes from Histology Matters: Navigating Treatment Options for Non-small Cell Lung Cancer by implementing a formal post-event questionnaire or survey. Each randomly-selected program graduate will be contacted approximately 6 to 8 weeks following their participation in the CHE program for further assessment of learning outcomes, with an offer to assist in the development of a Personal Learning Program (eligible for Section 4 credits, Maintenance of Certification program). These surveys measure recall and impressions about the topics discussed and explore knowledge acquisition and translation to practice change.

Meducom will conduct the following services as part of this program:• Compile and manage data on program participants (provided by representatives of Eli Lilly Canada Inc.)

• Develop survey instrument and media strategy (i.e., fax, mail, email, telephone)

• Conduct survey

• Prepare report for Eli Lilly Canada Inc.

• Provide assistance, as requested, to physicians interested in developing a Personal Learning Plan for NSCLC format and specifications


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Post-CHE Survey - Specifications


Print/Fax/Online Questionnaire/Survey

• Question Number: Not to exceed 12 questions or 2 pages

• Medium: Fax, paper (through mail), or online by either email or at MDgroove.com™

• Sample Size: To be determined


Phone Questionnaire/Survey

• Question Number: Not to exceed 6 questions

• Medium: Telephone contact with representative sample of program participants

• Sample Size: Options for n=60, n=150, n=500


Personal Learning Plan Support

• Develop and provide a Personal Learning Form to interested physicians

• Provide assistance, as warranted, in the development of a Personal Learning Plan

Investment:

Post-CHE Survey $To be determined based on media strategy and sample size


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Options Investment Summary

Our estimates for the development of the project options described in this Appendix are:

• CMEHub™ services (including monthly fees for 12 month period) amounting to $14,528, excluding applicable taxes

• Train-the-Faculty services amounting to $26,900, excluding applicable taxes

• On-Demand Learning @MDgroove.com™ services and marketing card amounting to $20,300, excluding applicable taxes (with conditions described in this Appendix)

• Quick Guide™ services and product amounting to $60,400, excluding applicable taxes

• Post-CHE Survey services and reporting – pricing to be determined

excluding optional components (where designated).

This document has been researched and developed by Meducom International Inc. with the assistance of a written brief provided by the client and other written sources. The information and executional elements in this proposal are considered proprietary and should not be otherwise discussed or reproduced (internally or externally) without the prior knowledge and consent of Meducom.

Should the elements of this proposal not be accepted, the information and content presented within remains the property of Meducom, and is deemed confidential as defined in agreements in place between Eli Lilly Canada Inc. and Meducom International Inc.®

Meducom International Inc.® retains copyright, editorial control and distribution rights to programs in this Appendix A identified as trademarks of Meducom International Inc.® No part of these programs, either in whole or in part, may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the written permission of Meducom International Inc. ® Copyright© 2008.

e-Carousel® and the Quick Guide® are registered trademarks of Meducom International Inc.®. All rights reserved.

CMEHub™ and associated trademarks, CaseBuilder™, CMEPak™, MDgroove.com™, SlideStation™ , and What’s H.I.P?™ are trademarks of Meducom International Inc.® All rights reserved.

Documents

Meducom International Inc. 18 Macdonell Street, Suite 200 Guelph, ON N1H 2Z3 (519) 767-6644 (519) 767-2542 [email protected] Copyright © 2008. The contents