McKesson Pharmaceutical 2014-2015 Flu Vaccine Pre

McKesson Pharmaceutical 2014-2015 Flu Vaccine Pre-Order Form
All pre-orders must be submitted through McKesson Connect. Contact [email protected] for assistance or fax completed form to 916-2676424 and a customer service representative will call you to complete your pre-order.
YOU MUST RECEIVE AN EMAIL CONFIRMATION OR YOUR PRE-ORDER IS NOT COMPLETE.
By placing a pre-order you are committing to purchasing the doses below. See Special Terms. FLU VACCINES ARE NOT RETURNABLE.
McKesson Account #: _______________________ Name: _____________________________________________ Phone: ____________________________
Trivalent
Flu Vaccines
Ref
Mfr
Age
Description
T1
CSL
9 yrs+1
T2
CSL
9 yrs+1
T3
GSK
3 yrs+
T4
Novartis
4 yrs+
T5
Novartis
4 yrs+
T6
Novartis
18 yrs+
Afluria® IIV3
0.5mL prefilled syringes
Afluria® IIV3
5mL multidose vial
Flulaval® IIV3
5mL multidose vial
Fluvirin® IIV3
0.5mL prefilled syringes
Fluvirin® IIV3
5mL multidose vial
Flucelvax® RIV3
0.5mL prefilled syringes
Fluzone® IIV3
0.5mL prefilled syringes
Fluzone® IIV3
5mL multidose vial
Fluzone® IIV3 High-Dose
0.5mL prefilled syringes
Fluzone® Intradermal IIV3
0.1mL prefilled syringes
Sanofi
Pasteur
Sanofi
Pasteur
Sanofi
Pasteur
Sanofi
Pasteur
T7
T8
T10
T11
Quadrivalent
Q12
GSK
Sanofi
Pasteur
Sanofi
Pasteur
Sanofi
Pasteur
MedIm
mune
Q13
Q14
Q15
Q16
3 yrs+
3 yrs+
65 yrs+
18-64
yrs
3 yrs+
3 yrs+
3 yrs+
6-35 mo
2-49 yrs
Flulaval® IIV4
5mL multidose vial
Fluzone® IIV4
0.5mL prefilled syringes
Fluzone® IIV4
5mL multidose vial
Fluzone® IIV4 Pediatric
0.25mL prefilled syringes
FluMist ® Intranasal LAIV4
0.2mL prefilled sprays
Doses per
box/ Doses
per vial
Preservativefree?
PreOrder
Price
Federal
Excise
Tax
Total
Price
10/box of PFS
Yes
$90.00
$7.50
$97.50
10/MDV
No
$80.00
$7.50
$87.50
10/MDV
No
$69.00
$7.50
$76.50
10/box of PFS
No (1mcg/
0.5mL dose)
$101.76
$7.50
$109.26
10/MDV
No
$89.44
$7.50
$96.94
10/box of PFS
Yes
$117.02
$7.50
$124.52
10/box of PFS
Yes
$94.90
$7.50
$102.40
10/MDV
No
$83.97
$7.50
$91.47
10/box of PFS
Yes
$277.36
$7.50
$284.86
10/box of PFS
Yes
$139.96
$7.50
$147.46
10/MDV
No
$137.50
$7.50
$145.00
10/box of PFS
Yes
$151.31
$7.50
$158.81
10/MDV
No
$142.83
$7.50
$150.33
10/box of PFS
Yes
$189.09
$7.50
$196.59
10/box of
sprays
Yes
$219.50
$7.50
$227.002
Total # of
Boxes or
Vials
Total # of
Doses
* Total price includes Federal Excise Tax in effect at the time of purchase order (currently $0.75 per dose) and is subject to increase in the event of a tax increase. Early-Bird price listed above is effective for pre-orders
received on or before Mar 31, 2014. Standard pre-order pricing is valid from April 1, 2014 through June 30, 2014. All pre-orders can be cancelled or modified on or before June 30, 2014. After June 30, 2014, customers
who meet a minimum order of 100 doses of one brand are eligible to modify up to 30 percent of their pre-order commitment on or before December 15, 2014. Note that once flu vaccines are delivered to the customer,
they are NOT eligible for returns. If you have a contract price that is different from the price indicated above, please contact [email protected] to verify your eligibility.
1
2
FDA approved for 5 years and older.
2014 Flumist PLUS program offered to licensed physicians, physician groups, and hospitals for pre-orders placed before April 18, 2014.
Safety Needles & Syringes for AUTOSHIP in July
Ref
Mfr
Item #
Description
N17
BD
1967223
N18
McKesson
Private Label
BD
1490135
BD SafetyGlideTM Needle
25G x 1”
McKesson Private Label Safety Needle
25Gx1”
BD IntegraTM Retracting Syringe
3mL, 25G x 1”
McKesson Private Label Safety Needle w/ Syringe
3mL, 25Gx1”
BD Sharps Container
5.4Qt
Sharps Compliance MAIL BACK Sharps Container
2G
N19
N20
N21
N22
McKesson
Private Label
BD
Sharps
Compliance
1328707
1490127
1945146
1288422
Units/
box
50/box
For use with Multidose vial
(MDV) or Prefilled Syringe (PFS)
PFS
100/box
PFS
50/box
MDV
100/box
MDV
1 unit
N/A
1 unit
N/A
Qty
Special Terms
McKesson reserves the right to restrict some product sales to specific classes of trade, due to manufacturer request or contractual obligations. Shipment is based on availability from the manufacturer. McKesson reserves
the right to substitute any other 2014-2015 FDA licensed and approved influenza vaccine for any or all of the influenza vaccine described herein. Neither McKesson Corporation ("McKesson") nor any of its affiliates guarantee any specific delivery date or quantity, nor will McKesson or any of its affiliates be held liable for any delays or product shortages. You agree that this is a binding order and you may not cancel the order after June 30,
2014. You agree to purchase all of the Flu Vaccine pre-ordered by you no later than January 31, 2015 or upon delivery, whichever earlier, pursuant to the terms and conditions of your pharmaceutical distribution agreement with McKesson Corporation, as it may be amended, and such terms of sale apply to purchases made pursuant to this form; but notwithstanding any provision therein, the Flu Vaccine purchased hereunder (a) may
not be returned to McKesson except for expiring Flumist; (b) shall not be included in any service level calculation or subject to any service level guarantee; (c) will be counted towards volume discount tiers as applicable in
your pharmaceutical agreement with McKesson; and (d) shall be net-billed and shall not be subject to the Cost of Goods pricing or any rebates, credits, allowances or other discounts provided for therein; and further, that
any Flu Vaccine not purchased by Customer by January 31, 2015, shall be shipped to Customer on that date and any amount due and owing for such product shall be due and payable to McKesson upon receipt.
IN NO EVENT SHALL MCKESSON OR ITS AFFILIATES BE LIABLE TO CUSTOMER OR ANY OTHER PERSON OR ENTITY FOR ANY INCIDENTAL, SPECIAL, PUNITIVE, EXEMPLARY, INDIRECT OR CONSEQUENTIAL DAMAGES
(INCLUDING LOST PROFITS) FROM ANY CAUSE, INCLUDING, WITHOUT LIMITATION, DAMAGES RESULTING FROM ANY UNAVAILABILITY OF, DEFECT IN, OR MISSHIPMENT OF THESE PRODUCTS, HOWEVER CAUSED, ON ANY
THEORY OF LIABILITY AND WHETHER OR NOT MCKESSON HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.

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