INVESTORS’ MEETING — ORLANDO, FL

1. INVESTORS’ MEETING — ORLANDO, FL April 28, 2005

2. Forward-Looking Statements 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.

3. Agenda Express Scripts’ Value Proposition Express Scripts’ Value Proposition Engaging the Market Multi-Faceted Growth Managing the Supply Chain Providing a Cost-Effective Solution for Specialty Drugs Break Adding Value Through Service Performance Medicare: An Opportunity for Our Clients Delivering Superior Financial Results and ROIC Positioning for the Future George Paz Larry Zarin Ed Ignaczak Chip Casteel Dom Meffe David Lowenberg, Doug Porter Patrick McNamee Agnès Rey-Giraud Ed Stiften George Paz

4. Express Scripts’ Value Proposition George Paz President and CEO

5. What We Do We Make the Use of Prescription Drugs Safer and More Affordable But more importantly …

6. … Is How We Do It • Supported by Best in Class • People • Service • Technology A Business Model Based on An Unwavering Commitment to Alignment

7. 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

8. What Are the Savings? Retail, Clinical. Formulary And Rebate Savings 24% Paid by Cash Customer at Pharmacy Retail Pharmacy Cash Price Mail Savings 6% Express Scripts Client Savings Express Scripts Client Costs C O S T Paid by Express Scripts Clients Total Savings 30% Availability of Proven PBM Cost Management Tools Will Produce 20%–25% Savings (CBO)

9. Moving to preferred brands, mail and generics Moving to preferred brands, mail and generics Moving to preferred brands, mail and generics Why This Model Works Increased Savings Opportunities: Client Member Increased Profit Opportunities: Express Scripts Retail Non-Preferred Brand Retail Preferred Brand Home Delivery Generics We Make Money by Saving Clients and Members Money

10. Strong Management Team Executive Role Tom Boudreau Chip Casteel Ed Ignaczak David Lowenberg Patrick McNamee Dom Meffe Chris Pawlowicz Doug Porter Agnès Rey-Giraud Ed Stiften Larry Zarin Legal Supply Chain Management Sales and Account Management Operations Information Technology Specialty Pharmacy Human Resources Patient and Client Services Research and Product Management Finance Marketing & Corporate Communications

11. Recent Additions to Strong Corporate Governance Gary Benanav Frank Borelli Maura Breen Nicolas Lahowchic Thomas Mac Mahon John Parker George Paz Samuel Skinner Seymour Sternberg Barrett Toan Howard Waltman Norman Zachary* Board Member Principal Occupation Vice Chairman, New York Life Insurance Ret. CFO, Marsh & McLennan Senior Vice President, Verizon President & CEO, Limited Logistics Services Chairman & CEO, LabCorp Chairman, Care Capital, LLC President & CEO, Express Scripts Ret. Chairman, President & CEO, USF Corp Chairman, President & CEO, New York Life Insurance Ret. CEO, Express Scripts Director, Chairman of the Corp. Governance Cmtte. Ret. President, Logica Data Architects *Director Emeritus

12. Express Scripts’ Value Proposition Engaging the Market Larry Zarin Vice President Marketing and Corporate Communications

13. Common Cause • Keeping the prescription-drug benefit off the endangered list • Member buy-in versus fear of member disruption

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

15. Value Proposition: Complete Alignment • Reduce pharmacy costs … eliminate waste … drive generics, low-cost brands and home delivery • No compromise to health outcomes … no cost shifting • Maximize member satisfaction

16. “Tell me and I’ll forget. Show me and I may not remember. Involve me and I will understand.” — Native American Saying

17. The Express Scripts Way • Face-to-face • Workshops, symposiums, seminars • AKA “Business Theater” Great for brand, relationships, retention and new sales.

18. Ed IgnaczakSenior Vice PresidentSales and Account Management Express Scripts’ Value Proposition Multi-Faceted Growth

19. Capturing New Business Service Improvements New Highest Programs to Generic Fill Meet Market Rate Demands Capturing New Business Medicare D Formulary Support Mgmt and Services Flexibility Transparency and Client Alignment

20. Client Satisfaction Steadily Improving • Service and satisfaction metrics have increased consistently quarter over quarter since 2003 with an early spike in 2005 100% 95% 2003 90% 2004 85% 80% 1q05 75% 70% 65% 60% ESI Performance Exceed Likelihood to Likelihood to Expectations Recommend Renew

21. Renewals • Service and Satisfaction have contributed to strong retention rates in ’04 and YTD ’05 Top 100 Accounts Through 2006 (# of Clients) Secured 90 Pending 6 Loss 4

22. 2006 Upsell Pipeline is Strong 10,000 • 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 Sold Weighted Pipeline 9,000 8,000 7,000 6,000 ('000 Lives) 5,000 4,000 3,000 2,000 1,000 0 Home Delivery Three Tier Generic Enforcement Specialty/CuraScript New Clinical Products Narrowing Formularies

23. Capturing New Business 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 12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0 Total Pipeline 2003 Wins 2004 Wins

24. Why Express Scripts? • Alignment With Clients • Our People • Generics • Specialty Exceeding Client Expectations

25. Chip CasteelSenior Vice PresidentSupply Chain Express Scripts’ Value Proposition Managing the Supply Chain

26. 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

27. Harness Forces “Preferred Savings Grid” Reward Winners Strengthen benefit designs Narrow formularies Move market share Reinvigorate Competition Rebid every 2 years Traditional Approach to Suppliers Pharma

28. Improvement in PSG Benefit Design Restricted (3-Tier / Closed) Standard 75% of PSG utilization occurs within Restricted Benefit Designs

29. 2003-05 Formulary Analysis Count of Brand Drugs on Formulary Within Competitive Product Categories Brand Formulary Drugs in CPC Structure • Narrower formularies provide greater value to clients • Focus on lower net cost drugs — 16% of brand drugs • removed from formulary

30. 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 Traditional Approach to Suppliers Pharma Retail

31. Retail Strategy For the Future It’s not all about locations anymore ... Its about good access and client savings.

32. Express Scripts’ Broadest Network

33. Broad Network Without Two Large Chains

34. Network Management Greater Management

35. 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

36. 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

37. 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

38. 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 Express Scripts’ Value Proposition Providing a Cost-Effective Solution 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. National Specialty Product Mix Hemophilia 3% IVIG 1% RSV 10% Growth Hormone Deficiency 3% Chemotherapy 32% Hepatitis C 7% $12.53 PMPM Psoriasis 12% Chemotherapy Supportive Care 15% Rheumatoid Arthritis 8% Multiple Sclerosis 9%

44. Biotech - Rapid Growth Traditional Spend $210 Billion Specialty Spend $35 Billion 2004 Total Outpatient Pharmacy Spend $190 Billion Specialty Spend $73 Billion 26% 18% 2008 Projected Outpatient Pharmacy Spend $283 Billion Traditional Spend $155 Billion Sources: IMS Data through November 2004 Wall Street Equity Research, 2004 CMS National Healthcare Expenditure Projection: 2003 – 2013 Data on file: CuraScript. 600 600 500 Biotech Drugs in Development Biotech Drugs on the Market 369 400 Number of Drugs 300 240 Source: PhRMA, International Federation of Pharmaceutical Wholesalers & Biotech Industry Organization 197 200 100 92 100 29 10 0 2000 2005 Estimated 1990 1995

45. Routes of Administration Specialty Drug Pipeline • Late-stage development; Phase II or later • Majority are injectable Source: Express Scripts data

46. Current Distribution ChannelsToday’s Wild, Wild West Typical Payer Injectable Spend Retail Pharmacy 15%-20% Mail Order Pharmacy 5%-10% Specialty Pharmacy 5%-25% Physician Office 40%-60% Outpatient Hospital 15%-20% Home Care & Infusion 5%-10% • 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

47. Our Specialty Solution CARE The CuraScript Difference Making specialty drug therapy more effective and affordable, one patient at a time COST SAVINGS CONVENIENCE

48. CuraScript Value Proposition: A Legacy of Results Current cost 100%

49. CuraScript Value Proposition: A Legacy of Results Lower unit costs Current cost 100% 7.2% savings

50. CuraScript Value Proposition: A Legacy of Results Clinical based utilization savings Lower unit costs Current cost 100% 7.2% savings 8.2% savings