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                                                                     EXHIBIT 2.2

                      FIRST AMENDMENT TO PURCHASE AGREEMENT

         This First Amendment (this "Amendement") to that certain Purchase
Agreement dated July 30, 2001 among NEOFORMA GAR, INC., NEOFORMA.COM, INC.,
MED-XS SOLUTIONS, INC. AND MED-XS ASSET SERVICES, INC. (the "Purchase
Agreement") is hereby entered into between the parties as of September 5, 2001.
Capitalized terms not otherwise defined herein shall be accorded the meaning
given them in the Purchase Agreement.

         1. Section 2.1(a)(i) of the Purchase Agreement shall be replaced in its
entirety with the following:

                  "(A) One Hundred and Fifty Thousand Dollars ($150,000) in cash
                  in the form of a certified check delivered at the closing or
                  by wire transfer payment at the Closing, and (B) One Hundred
                  Thousand Dollars ($100,000) (the "October Payment") in cash in
                  the form of a certified check delivered on October 31, 2001 or
                  by wire transfer payment on October 31, 2001, subject to
                  Section 2.4."

         2. A new Section 2.4 shall be added to the Purchase Agreement as
follows:

                  "The October Payment shall be subject to a credit equal to 50%
                  of the Gross Profits received by Sellers with respect to each
                  Acquired Contract for which a required consent to assignment
                  was not received by October 30, 2001, for the 12 month period
                  prior to Closing."

         3. Section 5.3 of the Purchase Agreement shall be replaced in its
entirety with the follows:

                  "Sellers shall use their best efforts to obtain written
                  consents to assignment of all Acquired Contracts that require
                  consent."

         4. All other terms of the Purchase Agreement shall remain in full force
and effect.



                             SIGNATURE PAGE FOLLOWS


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         IN WITNESS WHEREOF, the undersigned parties have duly executed this
Amendment as of this 5th day of September, 2001.

NEOFORMA.COM, INC.                       NEOFORMA GAR, INC.
a Delaware corporation                   a Delaware corporation

By: /s/  Daniel Eckert                   By:  /s/  Daniel Eckert
    -------------------                       ------------------
    Name:                                     Name:
    Title:                                    Title:


MED-XS ASSET SERVICES, INC.              MED XS SOLUTIONS, INC.
an Ohio corporation                      an Ohio corporation

By:  /s/  Kevin Tenkku                   By: /s/ Kevin Tenkku
     -----------------                       ----------------
      Name: Kevin Tenkku                     Name: Kevin Tenkku
      Title: President                       Title:  President