Popular Breast Cancer Drug Used with Certain Antidepressants Puts New Jersey Women...

Popular Breast Cancer Drug Used with Certain Antidepressants Puts New Jersey
Women at Risk

FRANKLIN LAKES, N.J., July 30 /PRNewswire-FirstCall/ -- A new analysis finds
that women in New Jersey who take the breast cancer drug tamoxifen in
conjunction with certain popular antidepressants may be at a higher risk for a
breast cancer recurrence.

In May, Medco Health Solutions, Inc. (NYSE: MHS) and Indiana University School
of Medicine released a study revealing that women using tamoxifen to prevent a
recurrence of breast cancer who also use certain selective serotonin reuptake
inhibitors (SSRI), for example Prozac(R) (fluoxetine), Paxil(R) (paroxetine)
and Zoloft(R) (sertraline), have up to twice the chance of having a recurrence
of the disease.

In a separate New Jersey-specific analysis, Medco found that among nearly
2,000 tamoxifen patients in the state during 2008, 12 percent were also taking
SSRIs, including those that could put them in the at-risk population.

"We've been aware that certain antidepressants, known as CYP2D6 inhibitor
drugs, block the activation of tamoxifen chemically, but this evidence shows
that these drugs are putting women in New Jersey and across the nation at a
much higher risk for recurrent breast cancer," said Dr. Milayna Subar,
National Practice Leader for Medco's Oncology Therapeutic Resource Center
located at Medco's Willingboro, N. J. pharmacy. "Women taking tamoxifen along
with an SSRI should speak with their doctor immediately to discuss
modifications to their medication regimen to ensure they are getting the full
benefit of their tamoxifen therapy."

Approximately 500,000 women take tamoxifen in the U.S., with 80,000 new
patients starting on the treatment annually. Nearly 30 percent of women
taking tamoxifen also use an antidepressant. Based on estimates from the
Centers for Disease Control and Prevention, New Jersey is among the states
with the highest breast cancer incidence and death rate in the country.

The study by Medco and Indiana University School of Medicine that was
presented at the 2009 Annual Meeting of the American Society of Clinical
Oncology (ASCO). It was the largest study to-date looking at how these drugs
impact breast cancer recurrence rates when taken with tamoxifen.

Antidepressants are often prescribed when women receiving tamoxifen are
depressed, or to treat hot flashes -- a common side effect of the breast
cancer drug. Paxil, Prozac and Zoloft are among a group of antidepressant
drugs known as CYP2D6 inhibitors. These drugs prevent the CYP2D6 enzyme from
working properly, and cause less of the active form of tamoxifen, called
endoxifen, from being produced, making the drug less effective at preventing
breast cancer. Women taking tamoxifen along with certain SSRIs have a 2-fold
increased risk of breast cancer recurrence compared to women not taking these
drugs together.

Tamoxifen
Tamoxifen is one of the oldest and most widely used treatments for reducing
the risk of breast cancer recurrence among women with estrogen-dependent
tumors. The drug works by blocking the estrogen receptors in the breast cells
and can reduce the risk of a breast cancer recurrence by up to 50 percent.
It's the only anti-estrogen available for prevention of breast cancer
recurrence in pre-menopausal women and is one of several anti-estrogens used
to treat post-menopausal breast cancer patients.

Medco Therapeutic Resource Center(R) in Willingboro, N.J.
Willingboro, New Jersey is home to the world's largest automated pharmacy and
is the current site of the Medco Therapeutic Resource Center (TRC) for
oncology patients. Medco's TRCs focus on the specialized treatment of patients
with chronic and complex conditions, including centers for cardiovascular
diseases, diabetes, immunologic and pulmonary conditions. Nearly half of the
company's 2,600 pharmacists are specialists deployed across the TRCs where
they provide disease-specific therapy management for those patients who
account for 96 percent of pharmacy spending and 75 percent of this country's
medical costs.

About Medco
Medco Health Solutions, Inc. (NYSE: MHS) is pioneering the world's most
advanced pharmacy(R) and its clinical research and innovations are part of
Medco making medicine smarter(TM) for more than 60 million Americans.

With more than 20,000 employees dedicated to improving patient health and
reducing costs for a wide range of public and private sector clients, and 2008
revenue exceeding $51 billion, Medco ranks 45th on the Fortune 500 list and is
named among the world's most innovative, most admired and most trustworthy
companies.

For more information, go to http://www.medcohealth.com.

This press release contains "forward-looking statements" as that term is
defined in the Private Securities Litigation Reform Act of 1995. These
statements involve risks and uncertainties that may cause results to differ
materially from those set forth in the statements. No forward-looking
statement can be guaranteed, and actual results may differ materially from
those projected. We undertake no obligation to publicly update any
forward-looking statement, whether as a result of new information, future
events, or otherwise. Forward-looking statements in this press release should
be evaluated together with the risks and uncertainties that affect our
business, particularly those mentioned in the Risk Factors section of the
Company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q filed
with the Securities and Exchange Commission.

SOURCE Medco Health Solutions, Inc.

Jennifer Luddy of Medco, +1-201-269-6402, jennifer_luddy@medco.com; or Erin
Drelick of Coyne Public Relations, +1-973-316-1665, edrelick@coynepr.com