INVESTORS’ MEETING — ORLANDO, FL

1 2005 Express Scripts, Inc.All Rights Reserved

INVESTORS’ MEETING — ORLANDO, FLApril 28, 2005


Statements included in this presentation or in the oral comments made as part of this presentation may contain forward-looking statements, including but not limited to statements of the Company’s plans, objectives, expectations or intentions, that involve risk and uncertainties.

The Company’s actual results may differ significantly from those projected or suggested in any forward-looking statement due to a variety of factors, which are discussed in detail in the Company’s filings with the Securities and Exchange Commission.

Forward-Looking Statements


AgendaExpress Scripts’ Value Proposition

Express Scripts’ Value Proposition

Engaging the Market

Multi-Faceted Growth

Managing the Supply Chain

Providing a Cost-EffectiveSolution for Specialty Drugs

Break

Adding Value ThroughService Performance

Medicare: An Opportunity for Our

Clients

Delivering Superior FinancialResults and ROIC

Positioning for the Future

George Paz

Larry Zarin

Ed Ignaczak

Chip Casteel

Dom Meffe

David Lowenberg, Doug

PorterPatrick McNamee

Agnès Rey-Giraud

Ed Stiften

George Paz


George PazPresident and CEO



What We Do

We Make the Use of Prescription Drugs Safer and More Affordable

But more importantly …


… Is How We Do It

• Supported by Best in Class‐ People‐ Service‐ Technology

A Business Model Based on An Unwavering

Commitment to Alignment


What Are the Results?

• High Client and Patient Satisfaction• Superior Trend Management• The Validation of Our Business Model• Innovative Culture• State-of-the-Art Facilities• Outstanding Track Record


What Are the Savings?

Availability of Proven PBM Cost Management Tools Will Produce 20%–25% Savings (CBO)

Paid byCash Customer

at Pharmacy

Retail, Clinical.Formulary

And RebateSavings 24% Mail Savings

6%

Paid byExpress ScriptsClients

Total Savings 30%

COST

Retail Pharmacy Cash Price

Express Scripts Client Savings

Express Scripts Client Costs


Why This Model Works

Retail Non-Preferred

Brand

Retail Preferred

Brand

GenericsHome Delivery

Increased Savings

Opportunities:

Client

Member

Increased

Profit

Opportunities:

Express Scripts

Moving to preferred brands, mail and generics



We Make Money by Saving Clients and Members Money


Tom BoudreauChip CasteelEd IgnaczakDavid LowenbergPatrick McNameeDom MeffeChris PawlowiczDoug PorterAgnès Rey-

GiraudEd StiftenLarry Zarin

LegalSupply Chain ManagementSales and Account ManagementOperationsInformation TechnologySpecialty PharmacyHuman ResourcesPatient and Client ServicesResearch and Product ManagementFinanceMarketing & Corporate Communications

Executive Role

Strong Management Team


Gary BenanavFrank BorelliMaura BreenNicolas LahowchicThomas Mac MahonJohn ParkerGeorge PazSamuel SkinnerSeymour SternbergBarrett ToanHoward WaltmanNorman Zachary*

Vice Chairman, New York Life InsuranceRet. CFO, Marsh & McLennanSenior Vice President, VerizonPresident & CEO, Limited Logistics ServicesChairman & CEO, LabCorpChairman, Care Capital, LLCPresident & CEO, Express ScriptsRet. Chairman, President & CEO, USF CorpChairman, President & CEO, New York Life InsuranceRet. CEO, Express Scripts Director, Chairman of the Corp. Governance Cmtte.Ret. President, Logica Data Architects

Board Member Principal Occupation

Recent Additions to Strong Corporate Governance

*Director Emeritus


Larry ZarinVice President

Marketing and Corporate Communications


Engaging the Market


Common Cause

• Keeping the prescription-drug benefit off the endangered list

• Member buy-in versus fear of member disruption


Fact

• We have the strategies and tools to control drug spend with no compromise to health outcomes.


Value Proposition: Complete Alignment

• Reduce pharmacy costs… eliminate waste

• No compromise to health outcomes… drive generics, low-cost brands and home delivery

• Maximize member satisfaction… no cost shifting


“Tell me and I’ll forget. Show me and I may not remember. Involve

me and I will understand.”— Native American Saying


The Express Scripts Way

• Face-to-face

• Workshops, symposiums, seminars– AKA “Business Theater”

Great for brand, relationships, retention and new sales.


Ed IgnaczakSenior Vice President

Sales and Account Management


Multi-Faceted Growth

19

2005 Express Scripts, Inc.All Rights Reserved

Capturing New Business

New Programs to Meet Market

Demands

Medicare D Support Services

Transparency and Client

Alignment

Formulary Mgmt and Flexibility

Highest Generic Fill

Rate

Service Improvements

Capturing New

Business

20


Client Satisfaction Steadily Improving

• Service and satisfaction metrics have increased consistently quarter over quarter since 2003 with an early spike in 2005

Exceed60%

65%

70%

75%

80%

85%

90%

95%

100%

ESI PerformanceExpectations

Likelihood toRecommend

Likelihood toRenew

2003

2004

1q05

21


Renewals• Service and Satisfaction have contributed to strong retention rates in ’04 and YTD ’05

Top 100 AccountsThrough 2006 (# of Clients)

Pending 6

Loss 4

Secured 90

22


2006 Upsell Pipeline is Strong

• Significant potential to continue to manage client trends in key product categories

• New products continue to be developed and rolled out

• Strong track record of success

10,000

('000

Liv

es)

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

Hom

e Del

iver

y

Gener

ic E

nfor

cem

ent

Nar

rowin

g Fo

rmul

arie

s

New

Clin

ical

Pro

duct

s

Spec

ialty

/Cur

aScr

ipt

Thre

e Ti

er

Sold Weighted Pipeline

23


Capturing New Business

• Excellent new business growth for 2003 & 2004

• Pipeline for 2005/2006 is strong with more than $9 Billion in revenues

• Managed care ‘jumbo’ pipeline down as MCO’s focus on Medicare

New Business

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

2003 Wins 2004 Wins Total Pipeline

24


Why Express Scripts?

• Alignment With Clients• Our People• Generics• Specialty

Exceeding Client

Expectations


Chip CasteelSenior Vice President

Supply Chain


Managing the Supply Chain


How Do We Get the Best Value

From Our Suppliers?• By enhancing and harnessing the forces of

competition

• By rewarding “winners”

• By reinvigorating competition at regular intervals


Traditional Approach to Suppliers

Harness Forces– “Preferred Savings Grid”

Reward Winners– Strengthen benefit

designs– Narrow formularies– Move market share

Reinvigorate Competition– Rebid every 2 years

Pharma


Improvement in PSG Benefit Design

44% 50%59%

70% 71% 75%

50%41%

30% 29% 25%

56%

0%

20%

40%

60%

80%

100%

1999 2000 2001 2002 2003 2004

StandardRestricted

(3-Tier / Closed)

75% of PSG utilization occurs within

Restricted Benefit Designs


275

328

0

50

100

150

200

250

300

350

2003 National Preferred 2005 National Preferred

2003-05 Formulary Analysis

BrandFormularyDrugs in

CPC Structure

Count of Brand Drugs on FormularyWithin Competitive Product Categories

• Narrower formularies provide greater value to clients

• Focus on lower net cost drugs — 16% of brand drugs removed from formulary


Traditional Approach to Suppliers

Harness Forces– “Preferred Savings

Grid”

Reward Winners– Narrow formularies– Strengthen Benefit

Designs– Move Market Share

Reinvigorate Competition– Rebid every 2 years

Harness Forces?– Broad networks for

maximum locations

Reward Winners?– No “Losers”

– No market share movement

Reinvigorate Competition?– Custom Networks – value

for specific clients

Pharma Retail


Retail Strategy For the Future

It’s not all about locations anymore ...

Its about good access and client savings.


Express Scripts’ Broadest Network


Broad Network Without Two Large Chains


States

Available Pharmacie

s

Most Inclusive Network

Most Restrictive Network

TRICARE Access

Minimum

CA 5,644 5,071 3,881 283NY 4,444 4,224 1,829 300TX 4,236 3,821 1,827 579FL 4,020 3,670 1,966 469PA 2,970 2,825 1,687 432

Network ManagementGreater Management


Home Delivery Wholesale Suppliers

• Brand Pharmaceuticals: All purchased from licensed wholesalers ($4.1B in 2004)

• Generic Pharmaceuticals: 95+% purchased direct from manufacturers ($250M in 2004)

• Express Scripts does not purchase from repackagers or from alternate source suppliers


Wholesaler Purchases (Brand Pharmaceuticals)

• Product delivered twice daily to all Express Scripts Pharmacies

• 99% service level for top 200 drugs, 98% for all other products

• Sites keep approximately 5-6 days supply on hand


Generic Pharmaceutical Purchasing

• Express Scripts purchases direct from about 45 generic manufacturers

• Substantial savings compared to purchase through wholesalers

• Sites keep approximately 30-day supply on hand


Annual Generic Bid Process

• All generic contracted products put out to bid annually

• All generic manufacturers participate, covering more than 2000 NDCs

• Annual bid process savings average 8%–10%

39


Dom MeffePresident and CEO, CuraScriptSenior Vice President, Specialty

Pharmacy


Providing a Cost-EffectiveSolution for Specialty Drugs

40


Specialty Pharmacy — The Gathering Storm

Payers’ Dilemma: Looming Costs for Chronic Conditions

Biotechnology Healthcare, April 2005

Biologics’ Looming Price Tag Has Payers Retooling Pharmacy Coverage

Biotechnology Healthcare, April 2005

41


What are Specialty Medications?

• High-cost oral, injectable, infused

or inhaled medications

• Self-administered or administered

by a healthcare provider

• Outpatient or a home setting

42


Characteristics of Specialty Medications

• Frequent dosage adjustments

• More severe side-effects than traditional drugs

• Specialized storage, handling and distribution requirements

• Narrow therapeutic range

• Require periodic laboratory or

diagnostic testing

• Cost in excess of $1,300 per 30 day supply

43


Chemotherapy 32%

ChemotherapySupportive Care 15%

Multiple Sclerosis 9%

Rheumatoid Arthritis 8%

Psoriasis 12%

Hepatitis C 7%

Growth Hormone Deficiency 3%

RSV10%

IVIG 1% Hemophilia 3%

National Specialty Product Mix

$12.53 PMPM

44


Biotech - Rapid Growth

Sources:IMS Data through November 2004Wall Street Equity Research, 2004CMS National Healthcare Expenditure Projection: 2003 – 2013Data on file: CuraScript.

2004 Total Outpatient Pharmacy Spend $190 Billion

2008 Projected Outpatient Pharmacy Spend $283 Billion

Source:PhRMA, International Federation of Pharmaceutical Wholesalers & Biotech Industry Organization

26%26%18%18%

Traditional SpendTraditional Spend$210 Billion$210 Billion

Specialty SpendSpecialty Spend$73 Billion$73 Billion

Specialty SpendSpecialty Spend$35 Billion$35 Billion

Traditional SpendTraditional Spend$155 Billion$155 Billion

Biotech Drugs in DevelopmentBiotech Drugs on the Market

2005Estimated

200019951990

600

500

400

300

200

100

0

600

197

369

92

240

29100

10

Nu

mb

er

of

Dru

gs

45


Routes of Administration Specialty Drug Pipeline

• Late-stage development; Phase II or later

• Majority are injectable

Oncology

1746

26 15* 4**

Rheumatoid Arthritis

520

8 7 5

Hepatitis C

59

8 1

Crohn’s Disease

210

1 7 2

Psoriasis8

2 3 1 2

Multiple Sclerosis

77

5 2

Oral

Injectable

IV

SQ

IM

Unknown

Source: Express Scripts data

46


Current Distribution ChannelsToday’s Wild, Wild West

Typical Payer Injectable SpendTypical Payer Injectable Spend

Retail Pharmacy15%-20%

Retail Pharmacy15%-20%

Mail Order Pharmacy5%-10%

Mail Order Pharmacy5%-10%

Specialty Pharmacy5%-25%

Specialty Pharmacy5%-25%

PhysicianOffice

40%-60%

PhysicianOffice

40%-60%

OutpatientHospital15%-20%

OutpatientHospital15%-20%

Home Care& Infusion5%-10%

Home Care& Infusion5%-10%

Unmanaged injectables result in:

• Inappropriate utilization• Inconsistent clinical

management• Variable reimbursement

Unmanaged injectables result in:

• Inappropriate utilization• Inconsistent clinical

management• Variable reimbursement

• Higher cost for payer• Reduced effectiveness of

treatment• Reduced patient care• Reduced member satisfaction• Physician panel frustration

• Higher cost for payer• Reduced effectiveness of

treatment• Reduced patient care• Reduced member satisfaction• Physician panel frustration

47


Our Specialty Solution

CARE

COST SAVINGS

CONVENIENCE

The CuraScript Difference

Making specialtydrug therapy

more effective and affordable,

one patient at a time

48


Current cost

100%

CuraScript Value Proposition: A Legacy of Results

49


Current cost

Lower unit costs

7.2% savings

100%


50


Current cost

Lower unit costs

7.2% savings

Clinical based

utilization savings

8.2% savings

100%


51


Current cost

Lower unit costs

7.2% savings

Clinical-based

utilization savings

8.2% savings

5.9% savings

100%


Lower administrati

ve costs

52


Current cost

Lower unit costs

7.2% savings

Clinical based

utilization savings

8.2% savings

5.9% savings

100%

21.3%

savings

overall


Lower administrati

ve costs

53


CARELogic™ Patient Care Management

Tools of the program include:• Patient assessment and risk stratification• Integration of diagnostic and medical data • Dedicated clinical patient support team• Critical pathway management• Intense patient education• Adherence support for medication regimen

compliance• Psychosocial assessment and counseling• Utilization and dose management• Delivery coordination of medication• Outcomes reporting

Care management programs designed to specifically manage a disease state and the related drug therapy

54


CARELogic™ Clinical Management

Initial Clinical Assessment

Initial Clinical Assessment

Disease Specific Clinical Pathway

Initiated

Disease Specific Clinical Pathway

Initiated

Ongoing Clinical Assessment and

Interventions

Ongoing Clinical Assessment and

Interventions

Patient Care CoordinationPatient Care Coordination

Three follow-up

interventions in the first six

months

High risk Clinical assessment and on-going interventions

Patient AdmissionPatient Admission

01/11/05

55


The Value of Clinical Management

2003 Annualized Healthplan Savings

Total Plan Claims CARELogic Savings

Savings as a %

of Claims

Q1 $3,557,786.20 $148,058.43 4.2%

Q2 $3,837,958.59 $324,653.25 8.5%

Q3 $4,041,100.73 $407,177.25 10.1%

Q4 $4,149,502.00 $363,805.78 8.8%

$15,755,208.51 $1,243,694.71 7.9%

410,000 Lives Healthplan 2003 Annual Clinical Management Summary — Exclusive program with UM 01/11/05

Case Study

56


Proven Clinical Outcomes ...CuraScript’s MSLogic™ Case Study

2004 Client Savings Avoided Exacerbation

Expenses:

$ 719,175.53

01/11/05

Average CuraScript

National

Exacerbations Per Patient

0.67 1.0

Rate of Compliance

92.2% 54%

2004 Results of a 410,000 Life Health plan managed by CuraScriptMarks, A.S., Johnson, KE; Value in Health, 2002;5.O'Brien et al, BMC Health Services Research, Sept. 2003

Clinical Management Strategies

Goal: Reduce number and severity of relapses by improving patient compliance with their drug therapy

Interventions: Patient assessment, education, utilization management, side effect management, physician consultation

Translates into substantial impact on patient's quality of life and medical costs savings

57


Implementation Expertise

• Program and Benefit Design Consultation• Communication Strategy

• Ongoing Account Management

Ongoing Account Management

• Patient satisfaction• Implement new programs

• Support to the client’s initiatives• Continuous communication strategies

Client satisfaction

58


CuraScript Client Network Mix

Preferred10%

Mix 7%

Open 43%

Exclusive40%

As Percent of Total Revenue

Source: Data on file

59


CuraScript Penetration intoExpress Scripts

Retail

CuraScript

Mail

82% 73%

70% 69% 66%

2%13%

17% 20%25%

16%14%

13% 11%

9%

100

90

80

70

60

50

40

30

20

10

0Q1 2004Q2 2004Q3 2004 Q4 2004 Q1 2005

Express Scripts Enterprise Book of Specialty Medications

Perc

en

tag

e o

f P

lan

Costs

60


BREAK

61


David LowenbergChief Operating Officer

Doug PorterSenior Vice President, Client and Patient Services

Patrick McNamee Senior Vice President and CIO


Adding Value Through Service Performance

62


Win-Win Solution for Clients, Patients and Stockholders

Client RetentionClient Retention

EXPRESS SCRIPTS’ PROFITABILITY

Client ImplementationClient Implementation

Home Delivery GrowthHome Delivery Growth Generic PromotionGeneric Promotion Cost EfficienciesCost Efficiencies

PeoplePeople Service Service Technology Technology

63


Our Success Starts With Our People

ResultsResults

CompetenciesCompetencies

OrganizationOrganization

PeoplePeople

64


0

100

200

300

400

500

600

Jun-92

'92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04

Adju

sted C

laim

s* (m

illions)

Network claims MailClaims*

Focus on the Customer

•* Represents 3 times home delivery claims; home delivery claims are 90 days versus 30 days in the network

IPO

Organic

Growth

Acquisitions

Integration

Service Service

ServiceImprovement

65


Technology Investment Portfolio

Low

High

Expected Value High

Profit

Cost Efficiencies

Generic PromotionHome Delivery Growth

Client Implementation

Technology Technology

66


Client and Patient Services Alignment

Personal, specific service drives higher patient satisfaction and ensures client

retention

Personal provider for pharmacy home delivery

Focused investments to reduce costs and improve service

Saving money for clients and patients

Industry leading team and track record for new clients and patients

Client Retention

Home Delivery Growth

Cost Efficiencies

Generics Promotion


67


Client Retention Through Service

• Specific Attention, Personalization and Care

• Deliver Value — Service, Savings and Lower Cost

• Accepting Nothing Less Than Very Satisfied

68


Service Enhancements

― Situational scripting

― Decision trees and case-based reasoning

― Client-specific messaging

Knowledge Management

• Integrating Critical Information Into Single Source― Prescription history

― Patient-specific information― Plan benefits and features

― Client-specific requirements

• Proactively Pushing Information to Advocate’s Desktop

Improved First Call Resolution

+ Specific,

Patient-Focused Outcomes

=Patient Satisfaction

and Savings

69


Optimal Configuration for Home Delivery Growth

Patient Scripts

Order Processi

ngFulfillme

nt

Former Configuration

Current Configuration

Patient Scripts

Order Processi

ngFulfillme

nt

Harrisburg

Troy

Harrisburg

Troy

Harrisburg

Troy

BensalemBensalem

Regional Model

70


Investment in Accuracy and Cost Efficiencies

• Enterprise Contact Center Model– High-quality, low-cost labor market– Reduce attrition levels– Create a service-centric environment

• St. Marys, GA - Q3 2004• Pueblo, CO – Q3 2005

• Home Delivery Pharmacy Model– Proprietary dispensing technology– Engineered workflow– Proactive, caring and trusted patient consultation

71


• Exclusive focus on patient savings through generics

• Physician and patient-friendly process

• Extend our industry leading conversion rate, enhancing our bottom line

Generic Penetration Growth

72


Successful Client Implementations

“I really appreciate all that you and your team are doing for us. Express Scripts is really going the extra mile …”

“Way to start things off for 2005!”

“I've done more of these implementations than I care to count, and this one has been the smoothest by far.”

“I'm impressed with how responsive you guys are … very refreshing!”

“This has been by far the easiest transition I have gone through ...”

1/1/05 CLIENT IMPLEMENTATION COMMENTS

• Unparalleled experience• Proven processes and tools• Client customization• Invaluable results for client retention and

attracting new accounts

73


Information Systems Role

Deliver efficient and highly available systems in support of business vision,

clients and patients

Technology

Patients

Clients

Knowledge Management

74


Operational Excellence• Knowledge Management Tool

– Single-source solution for advocates to retrieve critical client, plan and contact-specific information

– Automatic, personal presentation of patient information

Client Retention


Generics Promotion

75


Patient Interface


Cost Efficiencies

Generics Promotion

• Express-Scripts.com for Members– Promotes self-service, which drives cost efficiencies– Vehicle to facilitate home delivery and generics outcomes – Direct involvement from patients in their prescription drug benefit

76


Client-Focused Tools• Trend Central

– Delivers claims experience to optimally manage trend

– Facilitates client transparency into our business


Client Retention


SM

77


Win-Win Solution for Clients, Patients and Stockholders

Client RetentionClient Retention

EXPRESS SCRIPTS’ PROFITABILITY

Client ImplementationClient Implementation

Home Delivery GrowthHome Delivery Growth Generic PromotionGeneric Promotion Cost EfficienciesCost Efficiencies

PeoplePeople Service Service Technology Technology

78


Agnès Rey-GiraudSenior Vice President

Research and Product Management


Medicare: An Opportunity for Our Clients

79


Medicare Part D 2006 Strategy

Grow with our clients by becoming the most trusted Part D advisor for both employers and health plans.

80


The Most Trusted Advisor on Part D …

• Express Scripts — the Part D PBM of choice for our managed care and carrier clients

• World class consulting, modeling and education for our employers and labor clients

• Flawless execution in 2006 and beyond

81


As the Dust is Settling, HMOs and Carriers Have Clarity on Key Objectives• Protect current business

(Medicare Supplement, Medicare Advantage, employer retirees)

• Maximize growth on MA-PD, PDP

• Manage adverse selection

• Maintain flexibility for future

Protect and grow clients’ business by managing risk and positioning for 2007 and beyond

82


We’ll Help Our Clients Be Competitive

•Plan Management– Manage to lowest net cost while meeting Medicare standards

•Quality and Coordination– Assure quality care, driving out fraud and ensuring coordination with other Medicare coverage

•Senior-Focused Solutions– Communicate effectively to members and actively managing those with high spend

83


• Reduce spend

• Minimize retiree disruption

• Minimize administrative burden

• Avoid inherent risks of first year

• Maintain flexibility for future

Generate certain and significant savings today with little or no changes, while positioning for 2007 and beyond.

Employers and Unions Are Also Gaining Clarity on Key Objectives

84


Minimize retiree disruption

Minimize administrative burden

Avoid risk of first-year program

Maintain flexibility for future

Employers Have Evaluated Options Versus Objectives

SubsidyEmployer

PDP Wrap

Reduce spend

Express Scripts

Dedicated PDP

√

√

√

√

√

√ √ √

√√

EXPRESS SCRIPTS’ RECOMMENDATIONS FOR 2006

1. If you qualify for the subsidy, TAKE IT.

2. If you don’t qualify, UPDATE or take a Wrap.

3. Regardless, position yourself for possible changes in 2007.

85


The Market Responded FavorablyTo Our Approach• Current Book

―Managed care and carrier clients: 36 MA-PDs and 14 PDPs

―Completed a Subsidy analysis for nearly 2,000 employer and union clients

―Two employer clients considering becoming their own PDP

• New Business– 2006

• Three new managed care clients won — 125,000 Medicare lives

• Six prospective managed care prospects — 300,000 Medicare lives

– 2007• Current pipeline growing as we speak

86


Getting Ready For 2006

• Clients’ PDP applications• Benefit design consulting and

implementation• Supply chain and client contracting• People, technology, service• CMS compliant policies and procedures• Senior-focused communications and

education

87


Summary

• Well positioned for 2006

• Our 2006 offensive strategy is to help our managed care and carrier clients profitably grow their MA-PDs and PDPs

• We are building the foundation for 2007

88


Ed StiftenSenior Vice President and CFO


Delivering Superior Financial Results and ROIC

89


Financial Overview

• 1Q EPS $1.14 — up 28% from last year• Cash flow from operations of $138.1

million versus $97.8 million last year• Record adjusted claims of 142 million,

up 16% from last year• Record generic utilization of 54%

versus 49% last year• Gross profit per adjusted claim of $1.87

versus $1.77 last year (excluding non-recurring gain last year)

• Increased 2005 EPS guidance

Q1 2005 Highlights

90


Financial Overview

$0.00

$0.20

$0.40

$0.60

$0.80

$1.00

$1.20

$1.40

$1.60

Q1'01

Q2'01

Q3'01

Q4'01

Q1'02

Q2'02

Q3'02

Q4'02

Q1'03

Q2'03

Q3'03

Q4'03

Q1'04

Q2'04

Q3'04

Q4'04

Q1'05

Pe

r s

ha

re

EPS Free cash flow per share*

(1) Reflects a $70-$75 million reduction in Q2 2003 due to one-time impact of implementing a new wholesale purchase agreement

(2) Excludes a $0.10 per share charge for the early retirement of debt(3) Excludes a $0.20 charge to increase legal reserves for the cost of defense.

Quality of Earnings

(1)(1)(2)(2)

* Reflects a 12-month moving average of free cash flow (cash from operations less CapX)

(3)(3)

91


Peer Group Comparison - YTD 2005

12/31/2004 4/22/2005 % Incr Gain

ESRX $ 76.44 $ 88.20 15.4% 15.4%

Stock Price

12/31/2004 4/22/2005 % Incr*

PBM

Medco $ 41.60 $ 52.02 25.0%

Caremark $ 39.43 $ 39.41 -0.1%

Avg 12.5% 33.4% 4.2%

MCD

Wellpoint $ 115.00 $ 117.77 2.4%

Cigna $ 81.57 $ 88.00 7.9%

Aetna $ 62.38 $ 69.86 12.1%

Avg 7.5% 33.3% 2.5%

Retail

Walgreens $ 38.37 $ 41.87 9.4%

CVS $ 45.07 $ 50.50 12.3%

Avg 10.9% 33.3% 3.6%

Peer Group 10.3%

Peer Group Total Return

*Reflects dividend yield

Our Job Is to Outperform This Peer Group Median Over the

Long Term

92


Components of EPS Growth — 2004

0%

5%

10%

15%

20%

25%

Express Scripts*

Rx Growth EBITDA/ Rx Growth Cap Structure/ Other

* Excluding $25 million charge to increase legal reserves for the cost of defense and $5.5 million termination payment received

6%6%

7%7%

8%8%

93


U.S. Prescription Growth

1.6%3.2%

5.7% 5.2% 4.8%

7.6%9.1%

6.2%5.4%

4.7%3.1% 3.5%

15.0%

18.0%

3.8%

-3.5%

19.2%

11.0%

8.9%10.1%

5.4%

3.7%

13.8%

0.8%

4.6%

11.9%

7.2%8.3%

-1.4%

18.0%

-5%

0%

5%

10%

15%

20%

25%

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

U.S. Scripts

Medco

Caremark

Express Scripts

Caremark

Medco

Express Scripts

Note: Rx growth for Medco, Caremark and Express Scripts reflect as configured today

94


Financial Overview

$0.68

$0.80$0.88

$1.03

$1.12

$1.05

$0.50

$0.70

$0.90

$1.10

1999 2000 2001 2002 2003 2004**

EBITDA* per adjusted claim

* A reconciliation of EBITDA to net income and to net cash provided by operating activities can be found in the Investor Relations

section of Express Scripts’ Web site, www.express-scripts.com under Presentations.

** Excluding $25 million charge to increase legal reserves for the cost of defense and $5.5 million termination payment received.

Pricing can be lowered as clients tighten formulary compliance, increase home delivery, utilize generics and restrict retail networks. These changes result in lower prices to our clients and greater profits to Express Scripts.

10.5% CAGR

95


Gross Profit/SGA/EBITDA per Adj. Rx

$0.50

$0.70

$0.90

$1.10

$1.30

$1.50

$1.70

$1.90

1999 2000 2001 2002 2003 2004*

Gross Profit per Adj Rx SGA per Adj Rx EBITDA per Adj Rx

Future EBITDA per Adj. Rx Must Come From Gross Profit per Adj. Rx•* Excluding $25 million charge to increase legal reserves for the cost of defense and $5.5 million termination payment received.

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Focus on Return on Invested Capital (ROIC)

Express Scripts ROIC*

0%2%

4%6%

8%10%

12%14%

16%18%

20%

2000

2001

2002

2003

2004

**

ROIC is our Preferred Performance Metric

* Reflects operating income less tax divided by average invested capital, which consists of stockholder’s equity, plus interest

bearing liabilities plus long-term deferred income taxes, net. ** Excludes $25 million charge to increase legal reserves for the cost of defense and 5.5 million termination payment received

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Why Express Scripts? Industry-Leading ROIC

Comparison of Peer Group ROIC - 2004

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Expr

ess

Scri

pts

Cig

na

Wal

gree

ns

Car

emar

k

Aet

na

CVS

Med

co

Wel

lpoi

nt

We Lead Our Peer Group in ROIC Performance

Source: Express Scripts Analysis

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Our Financial Goals

• 15% + EBITDA growth

• Increase gross profit per claim

• Maintain ROIC leadership 0%

5%

10%

15%

20%

25%

Express Scripts

EBITDA Growth Cap Structure/ Other

5%-7%5%-7%

14%-16%14%-16%


George PazPresident and CEO


Positioning Us for the Future


• Our 'Golden Rule' of Alignment

• The People To Grow the Business

• Technologies Second to None

• Operational and Service Excellence

Why Express Scripts?A Strong Value Proposition


• New Sales• Upsells and Retention• Generics, Home Delivery and Specialty• Innovative Product Development• Strategic Deployment of Capital

Why Express Scripts?All the Right Growth Levers


INVESTORS’ MEETING — ORLANDO, FLApril 28, 2005

INVESTORS’ MEETING — ORLANDO, FL

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