Cancer Drugs Emerging as Top Driver of Specialty Drug Spending

-- Deep pipeline, new targeted therapies to drive oncology drug spending

FRANKLIN LAKES, N.J., Oct. 8 /PRNewswire-FirstCall/ -- Cancer treatments are
on track to become the biggest driver of specialty pharmacy spending as its
contribution to overall drug spending hit five percent for the first time in
the first half of 2009, according to Medco Health Solutions, Inc. (NYSE: MHS).
Oncology specialty drug spending increased 15.1 percent last year, trailing
only medications for autoimmune conditions and multiple sclerosis as a
specialty drug growth driver. Driven by medications that can cost tens of
thousands of dollars per course of therapy and a deep pipeline of new targeted
products with fewer side effects than traditional chemotherapy, worldwide
sales of these medications are expected to reach $80 billion by 2012.

"Targeted cancer therapies have dramatically reshaped oncology and greatly
benefited cancer patients," said Dr. Robert S. Epstein, Medco's chief medical
officer. "The newer cancer drugs improve survival rates since they target
what fuels the cancer's growth. As some may extend life, they may be used for
longer periods of time and improve quality of life for millions of patients.
Due to the higher costs of these treatments, however, proper selection and
dosing is extremely important."

Combinations of oral oncology drugs and injectable monoclonal antibodies from
the biotech industry are big drivers of drug spending and this trend is likely
to continue as existing treatments gain additional approvals and new drugs
reach the market.

Presently more than 800 drugs are under investigation for treatment of cancer,
which is expected to be diagnosed 1.48 million times this year. Early
detection and more effective, well-tolerated medications are allowing some
cancers to behave like chronic diseases. According to the American Cancer
Society, cancer patients today are living longer than a generation ago with
the five-year relative survival rate for all cancers combined between
1996-2004 reaching 66 percent, up from 50 percent between 1975-77.

Nearly all the cancer drugs approved by the Food and Drug Administration in
the last four years have cost more than $20,000 for a twelve-week course of
therapy, while some individual treatments can cost $10,000 per month.
Oncology drugs are projected to account for 9 percent of all prescription
pharmaceutical spending growth between 2009 and 2011.

To help manage the drug spend in the biotech drug category, in which many of
the cancer treatments reside, a regulatory pathway to make lower-cost, generic
versions - biosimilars - of these drugs is now under consideration in
Congress. If approved, generic biotech drugs could lead to significant
savings once the original brand drug loses patent.

Breast cancer drugs to hit market
Many oncology agents in late stage clinical development and several expected
to receive approval in 2010 or 2011 will likely have a significant effect on
specialty drug spending. Breast cancer could have an array of new treatments,
including vandetanib (Zactima(TM)), motesanib, lonafarnib (Sarasar®), and
pazopanib. Several of these drugs may be initially approved for other forms
of cancer.

Supportive Care
Supportive care therapies that help manage the side effects of other cancer
treatments represent a considerable share of cancer-related drug costs. In
the case of side effects from breast cancer treatment, several treatments that
suppress estrogen can contribute to the risk for osteoporosis, and oral or
injectable osteoporosis drugs can reduce the risk of skeletal problems and
bony metastasis. Chemotherapy and radiation treatments can create additional
side effects and new drugs have entered the market to treat those problems.
Drugs to treat anemia and neutropenia, both side effects associated with
chemotherapy, have been on the market for years. However, supportive care
therapies need special attention. Clinicians and patients need to be aware of
the safety concerns associated with anemia treatments that require close
attention to hemoglobin levels, and consideration of the risk of thrombosis or
growth of some tumor types.

Medco Opens Specialized Oncology Care Center
Marking October as the 25th Anniversary of Breast Cancer Awareness Month,
Medco is making a major commitment to advancing cancer care with the opening
of the oncology Medco Therapeutic Resource Center® (TRC) in its new
Indianapolis pharmacy. The oncology TRC will focus on the specialized
treatment of patients with common cancers such as leukemia, breast, lung,
prostate and colon, as well as pediatric cancers. In addition, Medco's new
oncology TRC will assist those who are prescribed specialty drugs to maintain
or improve their quality of life.

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

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.

Ann Smith, Medco Health Solutions, +1-201-269-5984, Ann_Smith@medco.com; Janet
Schiller or Bill Borden, Coyne Public Relations, +1-973-316-1665, both for
Medco Health Solutions