- To: [RECIPIENTS REDACTED — header contains multiple recipients]
- Cc: [RECIPIENTS REDACTED]
- From: [SENDER REDACTED]
- Sent: Fri 4/6/2018 4:42:50 PM
- Subject: Re: [EXTERNAL] Injectable medication

Notes: multiple names and email addresses are redacted in the image (black bars).

Great. HI Mary...May we please schedule a CTA scan for Jeffrey Epstein On Tues. April 10 or Wed. April 11? You may coordinate with me today...if we do not confirm something today, you will need to coordinate with. who will be sitting in for me next week when I am on holiday. At the moment Jeffrey is available anytime Tuesday accept f

On Apr 6, 2018, at 12:39 PM, Kaw, Kristine <blackened out> wrote:

Mary helps us schedule CTAs. She is cc'd here and will contact you. Please provide best contact info Thanks, KK

From: I

Sent: Friday, April 06, 2018 12:35 PM

To: Kaw, Kristine

Cc: Shimony, Rony

Subject: Re: [EXTERNAL] Injectable medication

HI ICK...Thanks for following up! Jeffrey says Dr. Shimony wants to do a scan first....can we schedule the scan for Tues April 10 or Wed. April 11?

On Apr 6, 2018, at 11:48 AM, Kaw, Kristine
> 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...I received an email from Repatha to "learn 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 I need to do something!???

## From: (cont.)

<change><s>On Jan 19,</s></change> 2018, <change><s>at 7:30</s></change> AM,
wrote:

Ok super

Sent from my !Phone

On Jan 18. 2018, at 5:26 PM, Kaw. Kristine ‹ > wrote:

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

<u>From:</u>

Sent: Thursday, January 18, 2018 3:58 PM

To: Kaw, Kristine

Subject: Re: [EXTERNAL] Injectable medication

The nurse just left...they had a uood talk...hoping Jeffrey will decide <u>how he</u> wishes to proceed soon! thanks,

Key information from the image:

*   **Date:** Jan 17, 2018
*   **Time:** 10:42 AM
*   **From:** Kristine Kaw
*   **To:** lesley.jee@gmail.com
*   **Subject:** Re: \[EXTERNAL] Injectable medication
*   **Message:** Ok sounds good.


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

## From: (cont.)

train without it. He has still yet
to answer RE self pay or
insurance.

## Sent from my iPhonc

- Date/time: Jan 16, 2018, 10:47 AM
- Header: "[name/email redacted] wrote:"
- Message body: "Great. Just didn't want to delay the process since I know it is difficult to find time in his very busy schedule. KK"
- Footer/From line: "[name/email redacted] (mailto: [email redacted])"

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 minute I hear something.

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

c

## Sent from my iPhonc (cont.)



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

## Sent from my iPhonc (cont.)

know
so I can
prescri
be
accordi
ngly.
KK

<u>From:</u>

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

Hi Kristin e. Thank you for this! I actuall y sent jeffrey a note about this earlier but still ha e not heard back from him. He is been in consta nt meetin gs himself . I will

## Sent from my iPhonc (cont.)

ask him again howev er and use your much more well versed paragr aph tomorr ow mornin g early! Hope to have an answer soon. Thanks and have a great evenin

<u>g.</u>

Sent from my iPhone

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

<kristine.kaw@mou
ntsinai.
org> wrote:

Sorry for the late response. Just finished with
patients.

-Looking a labs sent from early this month, Lipids

## Sent from my iPhonc (cont.)

done was calculated as opposed to direct LDL. Insurance companies look for the direct LDL when approving medications because this is a more accurate count, therefore, representing a more accurate cardiovascular risk equivalent.

When the triglycerides is high, such as in the case of Mr. Epstein, the lab cannot provide an accurate LDL count. As you can see there was no 101value given

-If you want to proceed with insurance approval, he will need to re-take labs with direct 101. He cannot start Repatha prior to rechecking labs because it will not be an accurate reflection of his baseline without medications.

-If he wants to self a , Century Specialty Pharmacy is willing to give him a 10% discount if he purchases minimum of 6 months. They will ship the medication over as soon as it's ordered and have it virtually the next day.

-Here is the breakdown of cost:

For the once a month injection $1,250/month (with 10% discount if he buys minimum of 6 months)

For the twice a month injection $1,150/month (with 10% discount if he buys minimum of 6 months)

Hope that answers all your questions. I will be available tomorrow if you have any questions. Please let me know what his decision is prescription to the pharmacy is pending his ok. Thanks

KK



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

Hello Kristine! I wanted to let you know I DID get Jeffrey's approval confirmed with Rcpatha and have been able to speak with a nurse on Jeffrey's behalf! A registered nurse is to call me within 1-2 business days to set up his training...truly hoping for next We, Th or

## Sent from my iPhonc (cont.)

Fri! I will be sure to let you know.

Some more questions:

-I understood from Dr. Shimony you will be contacting Jeffrey's insurance to find out about coverage and getting the $5 co-pay card?

-Once insurance approves the medication, when will Jeffrey receive his meds? Hoping he can get 3 months of the medication at a time....let me know ifhis insurance approves this or how many months we can receive at a time...maybe it is more!? -will you order Jeffrey 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 <u>et ick</u> to me when you can!! Thank you!

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

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

Sent: Wednesday, January 10, 2018 2:43
PM

## Sent from my iPhonc (cont.)

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 M, Jeffrey Epstcin'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. <u>Thanks,</u> 

On Jan 9, 2018, at 5:37 PM, Kaw, Kristine <blackened out> 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

<u>From:</u>

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

## Sent from my iPhonc (cont.)

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

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 1-844-REPATHA 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