To: Dr. Rony + Catherine Shimony
Cc: Shimony, Rony
From: 
Sent: Fri 4/6/2018 4:35:10 PM
Subject: Re: [EXTERNAL] Injectable medication

HI K.K...Thanks for following up! Jeffrey says Dr. Shimony wants to do a scan first....can we schedule this for Tues April 10 or Wed. April 11 of this coming week? (April 10 or 11)

On Apr 6, 2018, at 11:48 AM, Kaw, Kristine <redacted> wrote:

Good morning= It's been a while since I heard from you. Any update on what Mr. Epstein has decided for Repatha, self pay or try insurance approval which means he needs new set of lipid profile. Please let us know so we can help him with the process of getting medication that will help him lower risk for cardiac events. KK

From:

Sent: Thursday, January 25, 2018 5:37 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

Hi Kristine...1 received an email from Repatha to "lean how to fill your Repatha prescription"...did Jeffrey finally decide what he wanted to do? He has not been back to me with any news, but certainly doesn't mean he hasn't spoken to Dr. Shimony or you about it! Just wondering if 1 need to do something!???

On Jan 19, 2018, at 7:30 AM,
wrote:

Oftsuper
Sent from my iPhone
On Jan 18, 2018, at 5:28 PM, Kaw, Kristine > wrote:

Great thank you for the update. Dr. Shimony communicated
with him
KK

From
Sent: Thursday, January 18, 2018 3:58 PM
To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable medication

the nurse just left...they had a good talk...hoping Jeffrey

will decide how he wishes to proceed soon! thanks, Lesley

- Timestamp in image: On Jan 17, 2018 at 10:42 AM
- Header line: “[name and email redacted] wrote:”
- Message text: “Ok sounds good”
- Additional header/footer: “From:” followed by a redacted block
- Surrounding context (provided): Sent: Wednesday, January 17, 2018 8:11 AM; To: [recipient redacted]; Subject: Re: [EXTERNAL] Injectable medication
- Additional surrounding line: “will decide how he wishes to proceed soon! thanks, [name redacted]”

Sent: Wednesday, January 17, 2018 8:11 AM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

Morning! Jeffrey has said yes to training tomorrow with Nurse Kristine. Do we know for sure if Jeffrey will be doing one dose a month or two? It should hopefully be one right? The nurse knows Jeffrey won't have the actual drug but says she can train without it. He has still yet to answer RE self pay or insurance.

## Sent from my iPhone

On Jan 16, 2018, at 10:47 AM, Kaw, Kristine <blackened out> wrote:
Great. Just didn't want to delay the process since I know it is difficult to find time in his very busy schedule.
KK

From: <blackened out>
Sent: Tuesday, January 16, 2018 10:46 AM
To: Kaw, Kristine
Subject: Re: [EXTERNAL] Injectable medication

Morning Kristine! Thank you so much for following up...I am still waiting for Jeffrey's response on all of this...Hoping to hear today but he is traveling...will let you know the

## Sent from my iPhone (cont.)

minute I hear something.

On Jan 16, 2018, at
10:38 AM, Kaw,
Kristine

wrote:

Good morning. Just
following up
regarding Mr.
Epstein's decision on
how to proceed. I
believe the nurse is
scheduled to come in
this week for
teaching and ideally
it would be great if
she can teach and
observe his first
medication
administration.
Please let me know
so I can prescribe
accordingly.
KK

From:

Sent: Thursday, January 11, 2018 6:10 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

Hi Kristine. Thank
you for this! I
actually sent Jeffrey
a note about this
earlier but still ha c
not heard back
from him. He is
been in constant
meetings himself. I
will ask him again
however and use
your much more

## Sent from my iPhone (cont.)

well versed
paragraph
tomorrow morning
early! Hope to
have an answer
soon. Thanks and
have a great
evening.

Sent from my
iPhone

On Jan 11, 2018, at 6:03 PM, Kaw, Kristine

wrote:

Sorry for the late response. Just finished with patient s.
-
Looking a labs sent from early this month, Lipids done was calculated as oppose d to direct LDL.
Insurance companies look for the

## Sent from my iPhone (cont.)

<table><tr><th>direct
LDL
when
approvi
ng
medica
tions
becaus
e this is
a more
accurat
e count,
therefo
re,
represe
nting a
more
accurat
e
cardiov
ascular
risk
equival
ent.
When
the
triglyce
rides is
high,
such as
in the
case of
Mr.
Epstein,
the lab
cannot
provide
an
accurat
e LDL
count.
As you
can see
there
was no
LDL
value
given</th></tr></table>

## Sent from my iPhone (cont.)

<table><tr><th>-If you
want to
procee
d with
insuran
ce
approv
al, he
will
need to
re-take
labs
with
direct
LDL. He
cannot
start
Repath
a prior
to
recheck
ing labs
becaus
e it will
not be
an
accurat
e
reflecti
on of
his
baselin
e
without
medica
tions.
-If he
wants
to self
pay,
Century
Specialt
y
Pharma
cy [ ]

is
willing</th></tr></table>

## Sent from my iPhone (cont.)

<table><tr><th>to give
him a
10%
discoun
t if he
purchas
es
minimu
m of 6
months
. They
will
ship the
medica
tion
over as
soon as
it's
ordered
and
have it
virtuall
y the
next
day.
-Here is
the
breakd
own of
cost:
For the
once a
month
injectio
n
$1,250/
month (
with
10%
discoun
t if he
buys
minimu
m of 6
months
)
For the
twice a</th></tr></table>

## Sent from my iPhone (cont.)

<table><tr><th>month</th></tr><tr><td>injectio</td></tr><tr><td>n</td></tr><tr><td>$1,150/</td></tr><tr><td>month (</td></tr><tr><td>with</td></tr><tr><td>10%</td></tr><tr><td>discoun</td></tr><tr><td>t if he</td></tr><tr><td>buys</td></tr><tr><td>minimu</td></tr><tr><td>m of 6</td></tr><tr><td>months</td></tr><tr><td>)</td></tr></table>

<table><tr><th>Hope
that
answer
sall
your
questio
ns. I
will be
availabl
e
tomorr
ow if
you
have
any
questio
ns.
Please
let me
know
what
his
decisio
n is
prescri
ption to
the
pharma
cy is
pendin
g his
ok.
Thanks</th></tr></table>

## Sent from my iPhone (cont.)

<u>From:</u>

Sent: Thursday, January 11, 2018 12:34 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

Hello Kristin e! I wanted to let you know I DID get Jeffrey's approval confir med with Repath a and have been able to speak with a nurse on Jeffrey's behalf! A register ed nurse is to

## Sent from my iPhone (cont.)

<table><tr><th>call me
within
1-2
busines
s days
to set
up his
trainin
g...trul
y
hoping
for
next
We, Th
or Fri!
I will
be sure
to let
you
know.

Some
more
questio
ns:
-I
underst
ood
from
Dr.
Shimo
ny you
will be
contact
ing
Jeffrey'
S
insuran
ce to
find
out
about
covera
ge and
getting
the $5</th></tr></table>

## Sent from my iPhone (cont.)

<table><tr><th>co-pay
card?
-Once
insuran
ce
approv
es the
medica
tion,
when
will
Jeffrey
receive
his
meds?
Hopin
g he
can get
3
months
of the
medica
tion at
a
time....
let me
know
if his
insuran
ce
approv
es this
or how
many
months
we can
receive
at a
time...
maybe
it is
more!?
-will
you
order
Jeffrey</th></tr></table>

## Sent from my iPhone (cont.)

a Sharps Container? The nurse was asking me with type of injection he will be getting and I do not know ...she said there are 3 different ones...

I know
you are
busy
and
will get
back to
me
when
you
can!!
Thank
you!

On Jan 10, 2018, at 4:08 PM, Kaw, Kristine
<██████████████████████> wrote:

I am so sorry if I can't respond right away since I
am seeing patients with Dr. Shimony. I am on

## Sent from my iPhone (cont.)

the phone now with Repatha. It must have been a misunderstanding, they need the patient, Mr. Epstein, to give permission for you to set up his appointment. Repatha needs to be called again and choose reimbursement services for Mr. Epstein to give you permission moving forward with his training. I will also be faxing you a form to fill out and for Mr. Epstein to sign. This gives Repatha permission to assist him. Are you free to talk to avoid misunderstandings? Thanks KK

<u>From:</u> 

Sent: Wednesday, January 10, 2018 2:43 PM To: Kaw, Kristine Subject: Re: [EXTERNAL] Injectable medication

Hi Kristine.

-I found Erica Peltz so no worries there! :)
-I called REPATHA to organize training, but they do not have him registered (which I did) and they tell me you must call them to give me permission to schedule the appointment?!
Sounds like silliness to me, but what can I do!? She let me register Jeffrey so when you call give them his Acct #PP02BW57 and tell them  Jeffrey Epstein's personal assistant, may coordinate the training session for him. Once you do this let me know and I will call them back. Would greatly appreciate it.

Thanks,

On Jan 9, 2018, at 5:37 PM, Kaw,
Kristine
<██████████████████████> wrote:

Great thank you. Dr. Shimony states he had recent labs just don't know what his definition of "recent" is. Should be within the past 30 days. Please let me know if any issues and contact by email or office number.

KK

## Sent from my iPhone (cont.)

<u>From:</u>

Sent: Tuesday, January 09, 2018 5:27 PM
To: Kaw, Kristine
Subject: [EXTERNAL] Re: Injectable
medication

Hi Kristine. Thank you so much for this. Let me find out from Jeffrey if he has lab work that includes cholesterol within past 30 days. I don't think he does but he has gone without me knowing before A. I'll call the number below to set up training. Have a good evening.

Sent from my iPhone

On Jan 9, 2018, at 5:10 PM, Kaw, Kristine c > wrote: Hi=. Before we get started with the process, I need a copy of Mr. Epstein's recent labs including cholesterol with in the past 30 days. Please let me know if he does not have one so I can send an rx to get it done. We will try to get approval for his medication to avoid paying out of pocket and the company is willing to provide samples while working on his approval. Please call to set up a training session and also $5 copay card if medication approved. Please let me know if you have any questions. Thank you Kristine