Exhibit 99.1

Contact:
Jeff Hall, Chief Financial Officer
David Myers, Vice President, Investor Relations
(314) 810-3115
investor.relations@express-scripts.com

Express Scripts Announces Record Third Quarter Earnings and 2011 Guidance

          ST. LOUIS, October 27, 2010 — Express Scripts, Inc. (Nasdaq: ESRX) announced 2010 third quarter net income from continuing operations of $307.1 million, or $0.57 per diluted share. Third quarter adjusted earnings per share, as detailed in Table 4, was $0.65 per diluted share, an increase of 55% over 2009.

Third Quarter 2010 Review (2010 data reflected on an adjusted basis. See Tables 2 and 3)

	•		Total adjusted claims of 186.9 million, up 48% from 2009
	•		Gross profit of $807.7 million, up 32% from 2009
	•		EBITDA of $617.1 million, up 45% from 2009
	•		EBITDA per adjusted claim of $3.30, up from $3.10 in the second quarter
	•		Year to date net cash flow from operations of $1.8 billion, up 99% from 2009
	•		Repaid remaining outstanding balance of term loan facility
	•		Repurchased 16.4 million shares for $747.5 million

          “Through our business model of alignment, we lower costs for clients, improve health outcomes for members, and generate exceptional shareholder value,” stated George Paz, chief executive officer and chairman. “Our third quarter results demonstrate our commitment to enabling better health and value — one consumer at a time.”

          The Company has now successfully implemented 90% of NextRx membership onto Express Scripts’ IT systems. The migration of the remaining membership is expected to be completed by the end of the year. The Company expects to complete the integration, including retirement of NextRx IT systems and rationalization of operational footprint during the first quarter of 2011.

          “As we near the completion of the NextRx integration, we can turn our focus to the potential of this strategic alliance, which will open new horizons for improving healthcare outcomes for members while lowering overall costs through development of innovative product and service offerings,” said Paz.

2010 Guidance

          The Company previously provided 2010 adjusted earnings per diluted share guidance of $2.45 to $2.50. Based on year-to-date performance and strong underlying fundamentals, the

Company now believes its 2010 adjusted earnings per share will be in a range of $2.48 to $2.50. Adjusted earnings per share excludes items as detailed in Table 5.

2011 Guidance

          The Company expects to achieve adjusted 2011 earnings per share in the range of $3.15 to $3.25. Adjusted earnings per share excludes items as detailed in Table 6.

	•		Total adjusted claims are expected to be in a range of 750 to 780 million
	•		Adjusted EBITDA per claim is expected to be in a range of $3.70 to $3.90
	•		Cash flow from operations is expected to be in a range of $2.2 billion to $2.4 billion

          “The fundamentals of our business and realization of the expected synergies allow us to deliver solid earnings while making significant investments to continue our growth and position us as a leader in the evolving healthcare landscape,” said Jeff Hall, chief financial officer.

About Express Scripts

          Express Scripts, Inc., one of the largest pharmacy benefit management companies in North America, is leading the way toward creating better health and value for patients through Consumerology®, the advanced application of the behavioral sciences to healthcare. This approach is helping millions of members realize greater healthcare outcomes and lowering cost by assisting in influencing their behavior. Headquartered in St. Louis, Express Scripts provides integrated PBM services including network-pharmacy claims processing, home delivery services, specialty benefit management, benefit-design consultation, drug-utilization review, formulary management, and medical and drug data analysis services. The company also distributes a full range of biopharmaceutical products and provides extensive cost-management and patient-care services. More information can be found at http://www.express-scripts.com/ and http://www.consumerology.com/.

SAFE HARBOR STATEMENT

          This press release contains forward-looking statements, including, but not limited to, statements related to the Company’s plans, objectives, expectations (financial and otherwise) or intentions. Actual results may differ significantly from those projected or suggested in any forward-looking statements. Factors that may impact these forward-looking statements can be found in the Management’s Discussion and Analysis of Financial Condition and Results of Operations in the Company’s Form 10-Q filed with the SEC on October 27, 2010. A copy of this form can be found at the Investor Relations section of Express Scripts’ web site at http://www.express-scripts.com.

          We do not undertake any obligation to release publicly any revisions to such forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events.

EXPRESS SCRIPTS, INC.
Unaudited Consolidated Statement of Operations

		Three Months Ended								Nine Months Ended
		September 30,								September 30,
(in millions, except per share data)		2010				2009				2010				2009
Revenues(1)		$	11,251.8			$	5,613.0			$	33,679.0			$	16,525.3
Cost of revenues (1)			10,487.7				5,001.9				31,494.2				14,789.0
Gross profit			764.1				611.1				2,184.8				1,736.3
Selling, general and administrative			236.1				252.7				671.8				642.4
Operating income			528.0				358.4				1,513.0				1,093.9
Other (expense) income:
Interest income			2.2				2.0				4.4				4.1
Interest expense			(42.2	)			(48.0	)			(127.0	)			(142.7	)
			(40.0	)			(46.0	)			(122.6	)			(138.6	)
Income before income taxes			488.0				312.4				1,390.4				955.3
Provision for income taxes			180.9				115.6				515.4				351.8
Net income from continuing operations			307.1				196.8				875.0				603.5
Net (loss) income from discontinued operations, net of tax			(5.6	)			0.8				(23.4	)			0.8
Net income		$	301.5			$	197.6			$	851.6			$	604.3
Weighted average number of common shares outstanding during the period:
Basic			531.7				549.0				541.9				519.4
Diluted			537.0				554.4				547.5				524.2
Basic earnings per share:
Continuing operations		$	0.58			$	0.36			$	1.61			$	1.16
Discontinued operations			(0.01	)			—				(0.04	)			—
Net earnings			0.57				0.36				1.57				1.16
Diluted earnings per share:
Continuing operations		$	0.57			$	0.35			$	1.60			$	1.15
Discontinued operations			(0.01	)			—				(0.04	)			—
Net earnings			0.56				0.36				1.56				1.15

EXPRESS SCRIPTS, INC.
Unaudited Consolidated Balance Sheet

		September 30,				December 31,
(in millions, except share data)		2010				2009
Assets
Current assets:
Cash and cash equivalents		$	267.5			$	1,070.4
Restricted cash and investments			10.9				9.1
Receivables, net			1,795.5				2,516.4
Inventories			315.8				313.0
Deferred taxes			119.2				135.0
Prepaid expenses and other current assets			45.1				94.2
Current assets of discontinued operations			—				5.4
Total current assets			2,554.0				4,143.5
Property and equipment, net			353.7				347.1
Goodwill			5,490.7				5,497.1
Other intangible assets, net			1,764.5				1,880.8
Other assets			31.8				31.7
Noncurrent assets of discontinued operations			—				31.0
Total assets		$	10,194.7			$	11,931.2
Liabilities and Stockholders’ Equity
Current liabilities:
Claims and rebates payable		$	2,597.5			$	2,850.7
Accounts payable			686.1				706.4
Accrued expenses			682.9				549.2
Current maturities of long-term debt			0.1				1,340.1
Current liabilities of discontinued operations			—				10.4
Total current liabilities			3,966.6				5,456.8
Long-term debt			2,493.4				2,492.5
Other liabilities			514.7				430.1
Total liabilities			6,974.7				8,379.4
Stockholders’ Equity:
Preferred stock, 5,000,000 shares authorized, $0.01 par value per share; and no shares issued and outstanding			—				—
Common stock, 1,000,000,000 shares authorized, $0.01 par value per share; shares issued: 690,243,000 and 345,279,000, respectively; shares outstanding: 526,211,000 and 275,007,000, respectively			6.9				3.5
Additional paid-in capital			2,314.3				2,260.0
Accumulated other comprehensive income			17.4				14.1
Retained earnings			5,040.2				4,188.6
			7,378.8				6,466.2
Common stock in treasury at cost, 164,032,000 and 70,272,000 shares, respectively			(4,158.8	)			(2,914.4	)
Total stockholders’ equity			3,220.0				3,551.8
Total liabilities and stockholders’ equity		$	10,194.7			$	11,931.2

EXPRESS SCRIPTS, INC.
Unaudited Condensed Consolidated Statement of Cash Flows

		Nine Months Ended
		September 30,
(in millions)		2010				2009
Cash flows from operating activities:
Net income		$	851.6			$	604.3
Net loss (income) from discontinued operations, net of tax			23.4				(0.8	)
Net income from continuing operations			875.0				603.5
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization			180.9				70.9
Non-cash adjustments to net income			140.7				77.1
Deferred financing fees			4.1				59.0
Changes in operating assets and liabilities:
Accounts receivable			706.6				(108.3	)
Claims and rebates payable			(253.2	)			20.2
Other net changes in operating assets and liabilities			175.6				186.2
Net cash provided by operating activities — continuing operations			1,829.7				908.6
Net cash provided by operating activities — discontinued operations			12.3				17.9
Net cash flows provided by operating activities			1,842.0				926.5
Cash flows from investing activities:
Purchases of property and equipment			(84.6	)			(89.5	)
Purchase of short-term investments			(10.0	)			(1,198.9	)
Other			15.8				5.4
Net cash used in investing activities — continuing operations			(78.8	)			(1,283.0	)
Net cash used in investing activities — discontinued operations			(0.8	)			(1.0	)
Net cash used in investing activities			(79.6	)			(1,284.0	)
Cash flows from financing activities:
Repayment of long-term debt			(1,340.1	)			(240.1	)
Treasury stock acquired			(1,276.2	)			—
Tax benefit relating to employee stock compensation			32.9				7.7
Net proceeds from employee stock plans			19.3				7.1
Deferred financing fees			(3.9	)			(69.5	)
Proceeds on long-term debt, net of discounts			—				2,491.6
Net proceeds from stock issuance			—				1,569.1
Net cash (used in) provided by financing activities			(2,568.0	)			3,765.9
Effect of foreign currency translation adjustment			2.7				3.3
Net (decrease) increase in cash and cash equivalents			(802.9	)			3,411.7
Cash and cash equivalents at beginning of period			1,070.4				530.7
Cash and cash equivalents at end of period		$	267.5			$	3,942.4

Table 1
Unaudited Consolidated Selected Information
(in millions)

		Three Months Ended								Nine Months Ended
		September 30,								September 30,
		2010				2009				2010				2009
Claims Volume
Network			148.9				95.2				448.9				284.1
Home Delivery & Specialty (1)			13.6				11.2				40.5				32.8
Total claims			162.5				106.4				489.4				316.9
Total adjusted claims(2)			186.9				126.3				562.6				376.0
Depreciation and Amortization (D&A):
Revenue amortization(3)		$	28.5			$	—			$	85.5			$	—
Cost of revenues depreciation			10.3				5.4				28.2				16.9
Selling, general and administrative depreciation			12.7				9.2				36.7				28.3
Selling, general and administrative amortization			10.2				8.5				30.5				25.7
Total D&A		$	61.7			$	23.1			$	180.9			$	70.9
Generic Fill Rate
Network			73.3	%			69.6	%			72.4	%			69.2	%
Home Delivery			60.5	%			58.3	%			60.0	%			57.5	%
Overall			72.1	%			68.3	%			71.2	%			67.9	%

Table 2
Calculation of Adjusted Gross Profit and SG&A
(in millions)

		Three Months Ended								Nine Months Ended
		September 30,								September 30,
		2010				2009				2010				2009
Gross profit, as reported		$	764.1			$	611.1			$	2,184.8			$	1,736.3
Amortization of NextRx-related intangible assets (1)			28.5				—				85.5				—
Non-recurring integration-related costs (2)			15.1				—				62.7				—
Non-recurring benefit related to client contract amendment (3)			—				—				(30.0	)			—
Adjusted gross profit		$	807.7			$	611.1			$	2,303.0			$	1,736.3
Selling, general and administrative expenses, as reported		$	236.1			$	252.7			$	671.8			$	642.4
Amortization of legacy intangible assets (4)			8.6				8.5				25.7				25.7
Amortization of NextRx-related intangible assets (5)			1.6				—				4.8				—
Non-recurring integration-related costs (2)			12.3				—				22.7				—
Non-recurring transaction-related costs (6)			—				9.6				—				21.3
Non-recurring benefit related to insurance recovery (7)			—				—				—				(15.0	)
Non-recurring legal settlement(8)			—				35.0				—				35.0
Adjusted selling, general and administrative expenses		$	213.6			$	199.6			$	618.6			$	575.4

The Company is providing adjusted gross profit and selling, general and administrative expenses excluding the impact of non-recurring charges and amortization of intangible assets in order to compare the underlying financial performance to prior periods.

Table 3
EBITDA Reconciliation
(in millions, except per claim data)

The following is a reconciliation of net income from continuing operations to EBITDA⁽¹⁾ from continuing operations. The Company believes net income is the most directly comparable measure calculated under U.S. GAAP.

		Three Months Ended								Nine Months Ended
		September 30,								September 30,
		2010				2009				2010				2009
Net income from continuing operations, as reported		$	307.1			$	196.8			$	875.0			$	603.5
Provision for income taxes			180.9				115.6				515.4				351.8
Depreciation and amortization			61.7				23.1				180.9				70.9
Interest expense, net			40.0				46.0				122.6				138.6
EBITDA from continuing operations, as reported			589.7				381.5				1,693.9				1,164.8
Non-recurring integration-related costs (2)			27.4				—				85.4				—
Non-recurring benefit related to client contract amendment (3)			—				—				(30.0	)			—
Non-recurring transaction-related costs (4)			—				9.6				—				21.3
Non-recurring benefit related to insurance recovery (5)			—				—				—				(15.0	)
Non-recurring legal settlement(6)			—				35.0				—				35.0
Adjusted EBITDA from continuing operations		$	617.1			$	426.1			$	1,749.3			$	1,206.1
Total adjusted claims			186.9				126.3				562.6				376.0
Adjusted EBITDA per adjusted claim		$	3.30			$	3.37			$	3.11			$	3.21

The Company is providing EBITDA excluding the impact of non-recurring charges in order to compare the underlying financial performance to prior periods.

Table 4
Calculation of Adjusted EPS

		Three Months Ended								Nine Months Ended
		September 30,								September 30,
		2010				2009				2010				2009
						(per diluted share)
EPS from continuing operations, as reported		$	0.57			$	0.35			$	1.60			$	1.15
Non-recurring items:
Integration-related costs (1)			0.03				—				0.10				—
Benefit related to client contract amendment (2)			—				—				(0.03	)			—
Transaction-related costs (3)			—				0.02				—				0.03
Benefit related to insurance recovery (4)			—				—				—				(0.02	)
Termination of bridge financing (5)			—				—				—				0.07
Legal settlement (6)			—				0.04				—				0.04
Amortization of:
Legacy intangible assets (7)			0.01				0.01				0.03				0.03
NextRx-related intangible assets (8)			0.04				—				0.10				—
EPS from continuing operations, adjusted		$	0.65			$	0.42			$	1.80			$	1.30
EPS from discontinued operations, as reported		$	(0.01	)		$	—			$	(0.04	)		$	—
Non-recurring items:
Impairment and other charges (9)			0.01				—				0.04				—
EPS from discontinued operations, adjusted		$	—			$	—			$	—			$	—
Total EPS, adjusted		$	0.65			$	0.42			$	1.79			$	1.30

The Company is providing diluted earnings per share excluding the impact of non-recurring charges and intangibles amortization in order to compare the underlying financial performance to prior periods.

Table 5
2010 Guidance Information

		Estimated
		Year Ended
		December 31, 2010
		(per diluted share)
Revised adjusted EPS guidance		$2.48			to	$	2.50
GAAP items not included in guidance:
Non-recurring charges related to the NextRx integration (1)		0.14			to		0.17
Amortization of legacy intangible assets (2)			0.04				0.04
Amortization of NextRx-related intangible assets (3)			0.14				0.14
Non-recurring benefit related to client contract amendment (4)			(0.03	)			(0.03	)
Impairment charge (5)			0.04				0.04

Table 6
2011 Guidance Information

		Estimated
		Year Ended
		December 31, 2011
		(per diluted share)
Adjusted EPS guidance		$3.15			to	$	3.25
GAAP items not included in guidance:
Amortization of legacy intangible assets (1)			0.04				0.04
Amortization of NextRx-related intangible assets (2)			0.15				0.15
Non-recurring charges related to the NextRx integration (3)			To be determined