FIRST AMENDMENT TO THE DISTRIBUTION AND MANUFACTURING SERVICES AGREEMENT BETWEEN LEVPHARMA AND SANQUIN

EXHIBIT 10.3.1

FIRST AMENDMENT TO THE

DISTRIBUTION

AND

MANUFACTURING SERVICES AGREEMENT

BETWEEN

LEVPHARMA

AND

SANQUIN

THIS FIRST AMENDMENT is entered into effective as of the latest of the dates of signatures hereunder by and between the Parties to the DISTRIBUTION AND MANUFACTURING SERVICES AGREEMENT BETWEEN LEVPHARMA AND SANQUIN dated January 16, 2004 (the “AGREEMENT”): LEV PHARMACEUTICALS, INC., a corporation formed under the laws of the state of Delaware, having an address at 236 Old Lancaster Road, Merion Station, Pennsylvania 19066 (“LEVPHARMA”) and the SANQUIN BLOOD SUPPLY FOUNDATION, a not-for-profit organization formed under the laws of The Netherlands, having an address at Plesmanlaan 125, 1066 CX, Amsterdam, The Netherlands, acting for the purposes of the AGREEMENT through its Plasma Products Division, (“SANQUIN”).