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Exhibit 10.5

Confidential Treatment has been requested for portions of this exhibit. The copy filed herewith omits the information subject to the confidentiality request. Omissions are designated as “***”. A complete version of this exhibit has been filed separately with the Securities and Exchange Commission.

June 18, 2009

Dr. Robert Tiebout

The Sanquin Blood Supply Foundation

Plesmanlaam 125

1 066CX Amsterdam

The Netherlands

Dear Dr. Tiebout

Reference is made to the Distribution and Manufacturing Services Agreement between Lev Pharmaceuticals Inc. (“Lev”) and Sanquin Blood Supply Foundation (“Sanquin) dated January 16, 2004, as amended through the date hereof (the “DMS Agreement”). ViroPharma Biologics, Inc. (“ViroPharma”) is the successor to Lev under the DMS Agreement. All capitalized terms used in this letter agreement (this “Agreement”) that are not defined below shall have the meanings ascribed to them in the DMS Agreement.

Parties have evaluated the requirements made by *** and pursuant to supplements submitted to the BLA for Cinryze. It was concluded that additional resources are needed to meet such requirements and that a revision of the purchase price for Cinryze is warranted.

Below you will find a brief description of the additional resources as discussed and the understanding between the parties in this respect.

 

1.

Equipment Purchase.

Part of the additional resources that were not foreseen before relate to equipment.

Sanquin and ViroPharma agree that it is in the best interests of the parties for Sanquin to purchase a *** and to *** to the *** for *** (“***”) system as well as to the *** system (“***”) (collectively, the “Equipment”) for use in manufacturing Cinryze for ViroPharma.

Sanquin shall purchase the Equipment, install it and qualify it for use in accordance with the timelines described in the Work Plan (defined below).

2.

Hiring of Additional Employees.

Another part of the additional resources needed relate to staffing.

(a) Sanquin shall hire approximately *** additional full time equivalent employees (FTEs). The FTE’s shall include persons hired in the following capacities: