Information for Vermont Prescribers of Prescription Drugs (Long Form)

Information for Vermont Prescribers of Prescription Drugs (Long Form) Beyaz (Drospirenone-Ethinyl Estradiol-Levomefolate Calcium) This list does not imply that the products on this chart are interchangeable or have the same efficacy or safety. Please refer to each product s FDA-approved label and indication for further information. The prices listed below are Average Wholesale s ("AWP") as established and made available to the public by a third party publisher or as calculated from data made available to the public by a third party publisher. The price paid by consumers may be higher or lower than the prices listed below. Information about AWP of these drugs is being provided to Vermont prescribers pursuant to Vermont law, to give you information about the relative prices of marketed drugs and other drugs in the same therapeutic class. The prices listed here do not necessarily reflect price per dosage, price per course of treatment, or the cost effectiveness of all the products listed. For simplicity, only the smallest package sizes available for each product are included. Marketed Product: Product Name Manufacturer NDC Beyaz Oral Tablet 3-0.02-0.451 Pkg Size PHARMA 50419040701 28 180.66 $6.45 Other Products: Product Name Manufacturer NDC Size Aftera Oral Tablet 1.5 TEVA/WOMENS HEALTH 51285010388 1 $16.20 $16.20 Altavera Oral Tablet 0.15-30 SANDOZ 00781558315 28 $92.76 $1.10 Alyacen 1/35 Oral Tablet 1-35 Alyacen 7/7/7 Oral Tablet 0.5/0.75/1-35 PHARMACEUTICALS 68462039429 28 $93.10 $1.11 PHARMACEUTICALS 68462055629 28 $101.50 $1.21 Amethia Lo Oral Tablet 0.1-0.02 & 0.01 ACTAVIS PHARMA 52544022891 91 $268.55 $2.95 Amethia Oral Tablet 0.15-0.03 &0.01 ACTAVIS PHARMA 52544026884 91 $268.55 $2.95 Amethyst Oral Tablet 90-20 ACTAVIS PHARMA 52544029528 28 $59.40 $2.12 Apri Oral Tablet 0.15-30 - Aranelle Oral Tablet 0.5/1/0.5-35 Ashlyna Oral Tablet 0.15-0.03 &0.01 USA 00555904358 28 $183.10 $1.09 USA 00555906667 28 $118.05 $1.41 PHARMACEUTICALS 68462064691 91 $304.94 $3.35 Aubra Oral Tablet 0.1-20 - AFAXYS 50102012001 28 $35.16 $1.26 Aviane Oral Tablet 0.1-20 - USA 00555904558 28 $210.96 $1.26 1

Azurette Oral Tablet 0.15-0.02/0.01 (21/5) ACTAVIS PHARMA 52544094028 28 $359.88 $2.14 Balziva Oral Tablet 0.4-35 - USA 00555903458 28 $269.01 $1.60 Bekyree Oral Tablet 0.15-0.02/0.01 (21/5) LUPIN PHARMACEUTICALS 68180088011 28 $59.98 $2.14 Beyaz Oral Tablet 3-0.02-0.451 PHARMA 50419040701 28 $180.66 $6.45 Blisovi 24 Fe Oral Tablet 1-20 (24) LUPIN PHARMACEUTICALS 68180086411 28 $89.54 $3.20 Blisovi Fe 1.5/30 Oral Tablet 1.5-30 LUPIN PHARMACEUTICALS 68180086611 28 $28.94 $1.03 Blisovi FE 1/20 Oral Tablet 1-20 LUPIN PHARMACEUTICALS 68180086511 28 $28.66 $1.02 Brevicon (28) Oral Tablet 0.5-35 ACTAVIS PHARMA 52544025428 28 $223.82 $2.66 Briellyn Oral Tablet 0.4-35 - Camila Oral Tablet 0.35 Camrese Lo Oral Tablet 0.1-0.02 & 0.01 Camrese Oral Tablet 0.15-0.03 &0.01 PHARMACEUTICALS 68462031629 28 $134.50 $1.60 USA 00555071558 28 $221.49 $1.32 USA 00093614882 91 $537.10 $2.95 USA 00093313491 91 $268.55 $2.95 Caziant Oral Tablet 0.1/0.125/0.15-0.025 ACTAVIS PHARMA 52544095931 28 $100.93 $1.20 Chateal Oral Tablet 0.15-30 AFAXYS 50102013001 28 $30.93 $1.10 Cryselle-28 Oral Tablet 0.3-30 USA 00555904958 28 $183.12 $1.09 Cyclafem 1/35 Oral Tablet 1-35 PAR PHARMACEUTICALS 00603752149 28 $93.11 $1.11 Cyclafem 7/7/7 Oral Tablet 0.5/0.75/1-35 PAR PHARMACEUTICALS 00603752549 28 $101.73 $1.21 Cyclessa Oral Tablet 0.1/0.125/0.15-0.025 PRASCO LABORATORIES 76388028301 28 $69.19 $2.47 Cyred Oral Tablet 0.15-30 - AFAXYS 50102015401 28 $35.22 $1.26 Dasetta 1/35 Oral Tablet 1-35 NORTHSTAR RX 16714034801 28 $29.49 $1.05 Dasetta 7/7/7 Oral Tablet 0.5/0.75/1-35 NORTHSTAR RX 16714034601 28 $32.22 $1.15 Daysee Oral Tablet 0.15-0.03 &0.01 LUPIN PHARMACEUTICALS 68180084611 91 $268.55 $2.95 2

Deblitane Oral Tablet 0.35 NORTHSTAR RX 16714044001 28 $49.47 $1.77 Delyla Oral Tablet 0.1-20 - OHM LABS 51660057286 28 $35.16 $1.26 Desogen Oral Tablet 0.15-30 ORGANON 00052026108 28 $57.18 $2.04 Desogestrel-Ethinyl Estradiol Oral Tablet 0.15-0.02/0.01 (21/5) MYLAN 00378729653 28 $179.94 $2.14 Desogestrel-Ethinyl Estradiol Oral Tablet 0.15-30 NORTHSTAR RX 16714036701 28 $36.39 $1.30 Drospirenone-Ethinyl Estradiol Oral Tablet 3-0.02 Drospirenone-Ethinyl Estradiol Oral Tablet 3-0.03 PHARMACEUTICALS 68462072084 28 $101.31 $3.62 PHARMACEUTICALS 68462073329 28 $230.05 $2.74 Drospirenone-Ethinyl Estradiol Oral Tablet 3-0.03 LUPIN PHARMACEUTICALS 68180090211 28 $76.68 $2.74 Drospirenone-Ethinyl Estradiol Oral Tablet 3-0.03 MYLAN 00378730053 28 $230.05 $2.74 EContra EZ Oral Tablet 1.5 AFAXYS 50102011101 1 $36.56 $36.56 Elinest Oral Tablet 0.3-30 - NORTHSTAR RX 16714036501 28 $30.52 $1.09 Ella Oral Tablet 30 AFAXYS 50102091101 1 $42.90 $42.90 Emoquette Oral Tablet 0.15-30 PAR PHARMACEUTICALS 00603754049 28 $117.90 $1.40 Enpresse-28 Oral Tablet USA 00555904758 28 $164.92 $0.98 Enpresse-28 Oral Tablet TEVA/WOMENS HEALTH 51285051428 28 $164.92 $0.98 Enskyce Oral Tablet 0.15-30 LUPIN PHARMACEUTICALS 68180088211 28 $39.34 $1.41 Errin Oral Tablet 0.35 USA 00555034458 28 $221.49 $1.32 Estarylla Oral Tablet 0.25-35 SANDOZ 00781405815 28 $96.69 $1.15 Estrostep Fe Oral Tablet 1-20/1-30/1-35 ACTAVIS 00430000531 28 $575.94 $6.86 Fallback Solo Oral Tablet 1.5 LUPIN PHARMACEUTICALS 68180085313 1 $36.56 $36.56 Falmina Oral Tablet 0.1-20 - NORTHSTAR RX 16714035901 28 $35.16 $1.26 Femcon Fe Oral Tablet Chewable 0.4-35 ACTAVIS 00430001005 28 $836.96 $5.98 3

Generess FE Oral Tablet Chewable 0.8-25 ACTAVIS PHARMA 52544020431 28 $470.45 $5.60 Gianvi Oral Tablet 3-0.02 USA 00093542328 28 $70.81 $2.53 Gildagia Oral Tablet 0.4-35 - PAR PHARMACEUTICALS 00603359049 28 $134.52 $1.60 Gildess 1.5/30 Oral Tablet 1.5-30 PAR PHARMACEUTICALS 00603760602 21 $28.94 $1.38 Gildess 1/20 Oral Tablet 1-20 PAR PHARMACEUTICALS 00603760702 21 $28.66 $1.36 Gildess 24 FE Oral Tablet 1-20 (24) PAR PHARMACEUTICALS 00603761049 28 $268.62 $3.20 Gildess FE 1.5/30 Oral Tablet 1.5-30 PAR PHARMACEUTICALS 00603760817 28 $173.60 $1.03 Gildess FE 1/20 Oral Tablet 1-20 PAR PHARMACEUTICALS 00603760917 28 $171.93 $1.02 Heather Oral Tablet 0.35 PHARMACEUTICALS 68462030329 28 $110.75 $1.32 Introvale Oral Tablet 0.15-0.03 SANDOZ 00781558436 91 $481.95 $1.77 Jencycla Oral Tablet 0.35 LUPIN PHARMACEUTICALS 68180087711 28 $36.92 $1.32 Jolessa Oral Tablet 0.15-0.03 USA 00555912366 91 $482.02 $1.77 Jolivette Oral Tablet 0.35 ACTAVIS PHARMA 52544089228 28 $221.52 $1.32 Juleber Oral Tablet 0.15-30 - NORTHSTAR RX 16714046401 28 $34.93 $1.25 Junel 1.5/30 Oral Tablet 1.5-30 Junel 1/20 Oral Tablet 1-20 - Junel FE 1.5/30 Oral Tablet 1.5-30 Junel FE 1/20 Oral Tablet 1-20 Junel Fe 24 Oral Tablet 1-20 (24) USA 00555902742 21 $86.81 $1.38 USA 00555902542 21 $85.97 $1.36 USA 00555902858 28 $173.61 $1.03 USA 00555902658 28 $171.94 $1.02 USA 00093532828 28 $89.54 $3.20 Kaitlib Fe Oral Tablet Chewable 0.8-25 LUPIN PHARMACEUTICALS 68180090311 28 $122.13 $4.36 Kariva Oral Tablet 0.15-0.02/0.01 (21/5) Kelnor 1/35 Oral Tablet 1-35 USA 00555905058 28 $359.88 $2.14 USA 00555906458 28 $179.28 $1.07 4

Kimidess Oral Tablet 0.15-0.02/0.01 (21/5) PAR PHARMACEUTICALS 00603751249 28 $179.94 $2.14 Kurvelo Oral Tablet 0.15-30 LUPIN PHARMACEUTICALS 68180084411 28 $30.93 $1.10 Larin 1.5/30 Oral Tablet 1.5-30 NORTHSTAR RX 16714040701 21 $28.94 $1.38 Larin 1/20 Oral Tablet 1-20 - NORTHSTAR RX 16714040801 21 $28.66 $1.36 Larin 24 FE Oral Tablet 1-20 (24) NORTHSTAR RX 16714041601 28 $89.54 $3.20 Larin Fe 1.5/30 Oral Tablet 1.5-30 NORTHSTAR RX 16714040501 28 $28.94 $1.03 Larin Fe 1/20 Oral Tablet 1-20 NORTHSTAR RX 16714040601 28 $28.66 $1.02 Layolis FE Oral Tablet Chewable 0.8-25 ACTAVIS PHARMA 52544006431 28 $366.39 $4.36 Leena Oral Tablet 0.5/1/0.5-35 ACTAVIS PHARMA 52544021928 28 $236.10 $1.41 Lessina Oral Tablet 0.1-20 - USA 00555901467 28 $104.89 $1.25 Levonest Oral Tablet NORTHSTAR RX 16714034001 28 $27.49 $0.98 Levonorgest-Eth Estrad 91-Day Oral Tablet 0.1-0.02 & 0.01 LUPIN PHARMACEUTICALS 68180084811 91 $268.55 $2.95 Levonorgest-Eth Estrad 91-Day Oral Tablet 0.15-0.03 &0.01 MYLAN 00378728590 91 $537.10 $2.95 Levonorgest-Eth Estrad 91-Day Oral Tablet 0.15-0.03 PHARMACEUTICALS 68462067295 91 $482.09 $1.77 Levonorgest-Eth Estrad 91-Day Oral Tablet 0.15-0.03 LUPIN PHARMACEUTICALS 68180084311 91 $160.70 $1.77 Levonorgest-Eth Estrad 91-Day Oral Tablet 0.15-0.03 MYLAN 00378728153 91 $482.09 $1.77 Levonorgestrel Oral Tablet 1.5 PHARMACIST PHARMACEUTICAL LLC 63704000901 1 $36.56 $36.56 Levonorgestrel-Ethinyl Estrad Oral Tablet 0.1-20 LUPIN PHARMACEUTICALS 68180085411 28 $35.16 $1.26 Levonorgestrel-Ethinyl Estrad Oral Tablet 0.1-20 MYLAN 00378728785 28 $35.16 $1.26 Levonorgestrel-Ethinyl Estrad Oral Tablet 0.15-30 MYLAN 00378655053 28 $92.79 $1.10 Levonorgestrel-Ethinyl Estrad Oral Tablet 90-20 PHARMACEUTICALS 68462063784 28 $59.40 $2.12 Levonorg-Eth Estrad Triphasic Oral Tablet LUPIN PHARMACEUTICALS 68180085711 28 $27.49 $0.98 5

Levora 0.15/30 (28) Oral Tablet 0.15-30 ACTAVIS PHARMA 52544027928 28 $185.58 $1.10 Lo Loestrin Fe Oral Tablet 1-10 / 10 ACTAVIS 00430042014 28 $646.02 $4.61 Loestrin 1.5/30 (21) Oral Tablet 1.5-30 TEVA/WOMENS HEALTH 51285012797 21 $606.13 $5.77 Loestrin 1/20 (21) Oral Tablet 1-20 TEVA/WOMENS HEALTH 51285013197 21 $606.13 $5.77 Loestrin Fe 1.5/30 Oral Tablet 1.5-30 TEVA/WOMENS HEALTH 51285012870 28 $606.13 $4.33 Loestrin Fe 1/20 Oral Tablet 1-20 TEVA/WOMENS HEALTH 51285012570 28 $606.13 $4.33 Lomedia 24 FE Oral Tablet 1-20 (24) AMNEAL PHARMACEUTICALS 65162031684 28 $268.61 $3.20 Loryna Oral Tablet 3-0.02 SANDOZ 00781565615 28 $212.43 $2.53 LoSeasonique Oral Tablet 0.1-0.02 & 0.01 TEVA/WOMENS HEALTH 51285009287 91 $704.77 $3.87 Low-Ogestrel Oral Tablet 0.3-30 ACTAVIS PHARMA 52544084728 28 $183.12 $1.09 Lutera Oral Tablet 0.1-20 - ACTAVIS PHARMA 52544094928 28 $210.96 $1.26 Lyza Oral Tablet 0.35 AFAXYS 50102010001 28 $36.92 $1.32 Marlissa Oral Tablet 0.15-30 PHARMACEUTICALS 68462038884 28 $30.92 $1.10 Microgestin 1.5/30 Oral Tablet 1.5-30 ACTAVIS PHARMA 52544029021 21 $154.74 $1.23 Microgestin 1/20 Oral Tablet 1-20 ACTAVIS PHARMA 52544027621 21 $171.94 $1.36 Microgestin 24 Fe Oral Tablet 1-20 ACTAVIS PHARMA 52544016741 28 $89.54 $3.20 Microgestin FE 1.5/30 Oral Tablet 1.5-30 ACTAVIS PHARMA 52544023328 28 $173.61 $1.03 Microgestin FE 1/20 Oral Tablet 1-20 ACTAVIS PHARMA 52544024928 28 $171.94 $1.02 Minastrin 24 Fe Oral Tablet Chewable 1-20 (24) ACTAVIS 00430053595 28 $0.00 $0.00 Mircette Oral Tablet 0.15-0.02/0.01 (21/5) TEVA/WOMENS HEALTH 51285012058 28 $759.29 $4.52 Modicon (28) Oral Tablet 0.5-35 JANSSEN 50458017115 28 $419.86 $2.50 Mono-Linyah Oral Tablet 0.25-35 NORTHSTAR RX 16714036001 28 $32.23 $1.15 6

MonoNessa Oral Tablet 0.25-35 ACTAVIS PHARMA 52544024728 28 $204.60 $1.22 My Way Oral Tablet 1.5 GAVIS PHARMACEUTICALS 43386062230 1 $36.56 $36.56 Myzilra Oral Tablet PAR PHARMACEUTICALS 00603762549 28 $82.47 $0.98 Natazia Oral Tablet 3/2-2/2-3/1 PHARMA 50419040901 28 $180.66 $6.45 Necon 0.5/35 (28) Oral Tablet 0.5-35 ACTAVIS PHARMA 52544055028 28 $192.84 $1.15 Necon 1/35 (28) Oral Tablet 1-35 ACTAVIS PHARMA 52544055228 28 $176.81 $1.05 Necon 1/50 (28) Oral Tablet 1-50 ACTAVIS PHARMA 52544024531 28 $88.41 $1.05 Necon 10/11 (28) Oral Tablet 35 ACTAVIS PHARMA 52544055428 28 $192.84 $1.15 Necon 7/7/7 Oral Tablet 0.5/0.75/1-35 ACTAVIS PHARMA 52544016528 28 $193.18 $1.15 Next Choice One Dose Oral Tablet 1.5 ACTAVIS PHARMA 52544006554 1 $36.56 $36.56 Nikki Oral Tablet 3-0.02 LUPIN PHARMACEUTICALS 68180088611 28 $70.81 $2.53 Nora-BE Oral Tablet 0.35 ACTAVIS PHARMA 52544062928 28 $221.52 $1.32 Norethin Ace-Eth Estrad-FE Oral Tablet 1-20 MYLAN 00378728353 28 $85.97 $1.02 Norethin Ace-Eth Estrad-FE Oral Tablet 1-20 (24) MYLAN 00378730153 28 $268.61 $3.20 Norethindrone Acet-Ethinyl Est Oral Tablet 1-20 PHARMACEUTICALS 68462013281 21 $85.98 $1.36 Norethindrone Acet-Ethinyl Est Oral Tablet 1-20 MYLAN 00378728053 21 $85.97 $1.36 Norethindrone Oral Tablet 0.35 PHARMACEUTICALS 68462030529 28 $110.75 $1.32 Norethindrone Oral Tablet 0.35 LUPIN PHARMACEUTICALS 68180087611 28 $36.92 $1.32 Norethindrone Oral Tablet 0.35 MYLAN 00378727253 28 $110.76 $1.32 Norethindrone Oral Tablet 0.35 NORTHSTAR RX 16714007301 28 $36.92 $1.32 Norethin-Eth Estradiol-Fe Oral Tablet Chewable 0.8-25 - MYLAN 00378730853 28 $365.98 $4.36 Norgestimate-Eth Estradiol Oral Tablet 0.25-35 PHARMACEUTICALS 68462030984 28 $36.50 $1.30 7

Norgestim-Eth Estrad Triphasic Oral Tablet 0.18/0.215/0.25-25 PHARMACEUTICALS 68462071984 28 $161.03 $5.75 Norgestim-Eth Estrad Triphasic Oral Tablet 0.18/0.215/0.25-25 MYLAN 00378727753 28 $439.57 $5.23 Norgestim-Eth Estrad Triphasic Oral Tablet 0.18/0.215/0.25-35 PHARMACEUTICALS 68462056529 28 $117.96 $1.40 Norinyl 1+35 (28) Oral Tablet 1-35 ACTAVIS PHARMA 52544025928 28 $447.49 $2.66 Norlyroc Oral Tablet 0.35 OHM LABS 51660012786 28 $110.76 $3.96 Nor-QD Oral Tablet 0.35 ACTAVIS PHARMA 52544023528 28 $447.42 $2.66 Nortrel 0.5/35 (28) Oral Tablet 0.5-35 Nortrel 1/35 (21) Oral Tablet 1-35 Nortrel 1/35 (28) Oral Tablet 1-35 Nortrel 7/7/7 Oral Tablet 0.5/0.75/1-35 USA 00555900867 28 $96.52 $1.15 USA 00555900942 21 $88.50 $1.40 USA 00555901058 28 $176.99 $1.05 USA 00555901258 28 $193.38 $1.15 Ocella Oral Tablet 3-0.03 USA 00555913179 28 $76.68 $2.74 Ogestrel Oral Tablet 0.5-50 - ACTAVIS PHARMA 52544084828 28 $134.77 $1.60 Opcicon One-Step Oral Tablet 1.5 SUN PHARMACEUTICALS 62756071860 1 $24.00 $24.00 Orsythia Oral Tablet 0.1-20 - PAR PHARMACEUTICALS 00603763449 28 $105.48 $1.26 Ortho Micronor Oral Tablet 0.35 JANSSEN 50458019416 28 $331.68 $1.97 Ortho Tri-Cyclen (28) Oral Tablet 0.18/0.215/0.25-35 JANSSEN 50458019115 28 $303.16 $1.80 Ortho Tri-Cyclen Lo Oral Tablet 0.18/0.215/0.25-25 JANSSEN 50458025115 28 $1,074.73 $6.40 Ortho-Cyclen (28) Oral Tablet 0.25-35 JANSSEN 50458019700 28 $50.53 $1.80 Ortho-Novum 1/35 (28) Oral Tablet 1-35 JANSSEN 50458017615 28 $510.90 $3.04 Ortho-Novum 7/7/7 (28) Oral Tablet 0.5/0.75/1-35 JANSSEN 50458017820 28 $45.82 $1.64 Pimtrea Oral Tablet 0.15-0.02/0.01 (21/5) NORTHSTAR RX 16714040401 28 $59.98 $2.14 8

Pirmella 1/35 Oral Tablet 1-35 LUPIN PHARMACEUTICALS 68180089311 28 $29.47 $1.05 Pirmella 7/7/7 Oral Tablet 0.5/0.75/1-35 LUPIN PHARMACEUTICALS 68180089211 28 $32.23 $1.15 Plan B One-Step Oral Tablet 1.5 TEVA/WOMENS HEALTH 51285014619 1 $39.00 $39.00 Portia-28 Oral Tablet 0.15-30 USA 00555902058 28 $185.58 $1.10 Previfem Oral Tablet 0.25-35 PAR PHARMACEUTICALS 00603764217 28 $193.38 $1.15 Quartette Oral Tablet 42-21-21-7 DAYS TEVA/WOMENS HEALTH 51285043165 91 $422.02 $4.64 Quasense Oral Tablet 0.15-0.03 ACTAVIS PHARMA 52544096691 91 $482.09 $1.77 React Oral Tablet 1.5 WOCKHARDT USA 64679005002 1 $36.56 $36.56 Reclipsen Oral Tablet 0.15-30 ACTAVIS PHARMA 52544095428 28 $236.10 $1.41 Safyral Oral Tablet 3-0.03-0.451 PHARMA 50419040303 28 $541.98 $6.45 Seasonique Oral Tablet 0.15-0.03 &0.01 TEVA/WOMENS HEALTH 51285008787 91 $704.77 $3.87 Setlakin Oral Tablet 0.15-0.03 NORTHSTAR RX 16714036601 91 $160.68 $1.77 Sharobel Oral Tablet 0.35 NORTHSTAR RX 16714044101 28 $37.49 $1.34 Sprintec 28 Oral Tablet 0.25-35 USA 00555901658 28 $193.38 $1.15 Sronyx Oral Tablet 0.1-20 - ACTAVIS PHARMA 52544096728 28 $210.96 $1.26 Syeda Oral Tablet 3-0.03 SANDOZ 00781565815 28 $230.04 $2.74 Take Action Oral Tablet 1.5 TEVA/WOMENS HEALTH 51285010088 1 $39.00 $39.00 Tarina FE 1/20 Oral Tablet 1-20 AFAXYS 50102012801 28 $28.66 $1.02 Tilia Fe Oral Tablet 1-20/1-30/1-35 ACTAVIS PHARMA 52544005431 28 $171.47 $2.04 Tri-Estarylla Oral Tablet 0.18/0.215/0.25-35 SANDOZ 00781406015 28 $117.96 $1.40 Tri-Legest Fe Oral Tablet 1-20/1-30/1-35 USA 00555903270 28 $285.76 $2.04 Tri-Linyah Oral Tablet 0.18/0.215/0.25-35 NORTHSTAR RX 16714036301 28 $39.32 $1.40 9

Tri-Lo-Estarylla Oral Tablet 0.18/0.215/0.25-25 SANDOZ 00781406215 28 $184.68 $2.20 Tri-Lo-Marzia Oral Tablet 0.18/0.215/0.25-25 LUPIN PHARMACEUTICALS 68180083711 28 $146.68 $5.24 Tri-Lo-Sprintec Oral Tablet 0.18/0.215/0.25-25 USA 00093214028 28 $146.68 $5.24 TriNessa (28) Oral Tablet 0.18/0.215/0.25-35 ACTAVIS PHARMA 52544024828 28 $235.92 $1.40 TriNessa Lo Oral Tablet 0.18/0.215/0.25-25 ACTAVIS PHARMA 52544008741 28 $32.60 $1.16 Tri-Norinyl (28) Oral Tablet 0.5/1/0.5-35 ACTAVIS PHARMA 52544027428 28 $487.87 $2.90 Tri-Previfem Oral Tablet 0.18/0.215/0.25-35 PAR PHARMACEUTICALS 00603766317 28 $235.92 $1.40 Tri-Sprintec Oral Tablet 0.18/0.215/0.25-35 USA 00555901858 28 $235.94 $1.40 Trivora (28) Oral Tablet ACTAVIS PHARMA 52544029128 28 $164.92 $0.98 Velivet Oral Tablet 0.1/0.125/0.15-0.025 USA 00555905167 28 $100.93 $1.20 Vestura Oral Tablet 3-0.02 ACTAVIS PHARMA 52544098228 28 $70.81 $2.53 Vienva Oral Tablet 0.1-20 - SANDOZ 00781557515 28 $88.30 $1.05 Viorele Oral Tablet 0.15-0.02/0.01 (21/5) PHARMACEUTICALS 68462031884 28 $59.98 $2.14 Vyfemla Oral Tablet 0.4-35 - LUPIN PHARMACEUTICALS 68180087513 28 $134.51 $1.60 Wera Oral Tablet 0.5-35 - NORTHSTAR RX 16714037001 28 $16.09 $0.57 Wymzya Fe Oral Tablet Chewable 0.4-35 LUPIN PHARMACEUTICALS 68180089913 28 $365.89 $2.61 Yasmin 28 Oral Tablet 3-0.03 YAZ Oral Tablet 3-0.02 PHARMA 50419040201 28 $123.84 $4.42 PHARMA 50419040501 28 $123.84 $4.42 Zarah Oral Tablet 3-0.03 ACTAVIS PHARMA 52544098131 28 $230.05 $2.74 Zenchent FE Oral Tablet Chewable 0.4-35 AMNEAL PHARMACEUTICALS 65162034784 28 $268.61 $3.20 Zenchent Oral Tablet 0.4-35 ACTAVIS PHARMA 52544095328 28 $269.02 $1.60 Zovia 1/35E (28) Oral Tablet 1-35 ACTAVIS PHARMA 52544038328 28 $179.27 $1.07 10

Zovia 1/50E (28) Oral Tablet 1-50 ACTAVIS PHARMA 52544038428 28 $199.74 $1.19 Source: Medispan Release date: July 2016 For additional price comparison information see: http://www.compliance.bayerweb.com/vermontawp.htm 11