Express Scripts Specialty PBM Improves Health and Lower Costs.

Business Editors/Health/Medical Writers

ST. LOUIS--(BUSINESS WIRE)--July 28, 2003

New drugs emerging from the world's biotechnology labs hold great promise for patients, but at a price that's causing heartburn for the employers, unions, governments and health plans that provide pharmacy benefits to millions of Americans.

Costs for individual therapies average approximately $15,000 annually, but can range up to $150,000 annually. And, spending on biotech and specialty injectable drugs is projected to grow 20 percent to 40 percent this year alone.

Express Scripts (Nasdaq:ESRX), one of the nation's largest pharmacy benefit management firms, dispensed 90 percent more specialty prescriptions in 2002 than in 2001, as reported in the company's annual Drug Trend report, which included a review of specialty drugs this year:

(http://www.express-scripts.com/other/news_views/2002drugtrend/ specialty_injectables.pdf). (Due to the length of this URL, it may be necessary to copy and paste this hyperlink into your Internet browser's URL address field.)

Express Scripts Specialty PBM program provides members with access to valuable but expensive drugs, building on Express Scripts' experience developing specialty distribution services and specialty mail pharmacy services.

"Biotech and specialty injectable drugs give new hope to people with chronic ailments and conditions," said Barrett Toan, chairman and chief executive officer of Express Scripts. "We want the Express Scripts Specialty PBM program to serve a leading role in making the use of these important drugs safer and much more affordable."

"Specialty pharmacy therapies have great potential to fundamentally change healthcare treatment regimens and the overall health status of the nation's population," said Craig Kephart, vice president and general manager of specialty pharmacy benefit services. "Through Express Scripts Specialty PBM program, we can take an active role in helping our clients manage the benefits and costs associated with these new treatments and provide the same type of value in specialty pharmacy that we provide in the pharmacy benefit management (PBM) arena."

Express Scripts Specialty PBM program is focused on developing strategies that assist payers in managing their overall specialty drug cost trend. The emphasis on this effort will be to focus on the highest cost disease states including, hemophilia, rheumatoid arthritis, multiple sclerosis, infertility growth hormones, hepatitis C and soon, psoriasis.

The new unit will also offer cost savings for many drugs typically covered in the medical benefit. "By incorporating specialty drugs in both the pharmacy and the medical benefit, the Express Scripts Specialty PBM program offers a total management solution," said Kephart.

Typically, specialty drugs are used by small patient populations with chronic, often complex, diseases that require challenging regimens and a high level of clinical expertise. Currently, the Express Scripts Specialty PBM program is offering a cost-effective hemophilia program designed to significantly lower the high cost of drug therapy associated with this genetic disorder. The program includes discounted drugs and free supplies available through mail service, as well as dosing management, clinical tracking and individualized patient support.

Express Scripts, Inc. (Nasdaq:ESRX) is one of the largest pharmacy benefit management (PBM) companies in North America. Express Scripts provides integrated PBM services, including network pharmacy claims processing, mail pharmacy services, benefit design consultation, drug utilization review, formulary management, disease management, medical and drug data analysis services and medical information management services. The company also provides distribution services for specialty pharmaceuticals through its Specialty Distribution subsidiary. Express Scripts is headquartered in St. Louis, Missouri. More information can be found at http://www.express-scripts.com, which includes expanded investor information and resources.