Study Links Rheumatoid Arthritis Drug Adherence to Improved Medical Outcomes and Lower Costs

Study Links Rheumatoid Arthritis Drug Adherence to Improved Medical Outcomes
and Lower Costs
Specialty pharmacy management leads to fewer ER visits and reduced medical
expenditure for RA patients

PHILADELPHIA, Oct. 19 /PRNewswire-FirstCall/ -- Rheumatoid arthritis (RA)
patients who regularly adhere to their prescription drug regimen have fewer
emergency room and doctor visits and incur lower medical costs, according to
research presented today by Medco Health Solutions, Inc. (NYSE: MHS) at the
American College of Rheumatology's Annual Meeting in Philadelphia. The study
examined differences in RA patient medication adherence, use of medical
services, and treatment costs when patients using either adalimumab (Humira®)
or etanercept (Enbrel®) obtained these medications through specialty or retail
pharmacies.

"This study fills a research void for patients with rheumatoid arthritis.
While many studies have shown an association between increased adherence,
better clinical outcomes, and lower costs in non-specialty medications, this
study is one of the first to show a link between specialty pharmacy management
in patients with RA and these outcomes." said Dr. Jane F. Barlow, lead author
and vice president of Medical Strategy and Clinical Quality at Medco. "The
research also showed that specialty pharmacy patients used fewer medical
services suggesting better control of the disease."

The study compared the medical and pharmacy claims of 4,388 patients with RA
who filled their prescriptions for adalimumab or etanercept through a
specialty pharmacy or through a retail pharmacy from 2006 to 2008. After 2
years, patients who used a specialty pharmacy had a 16.0 percent higher
adherence rate and on average, had $1,534 lower annual medical costs than
those using a retail pharmacy. The reductions in medical service costs were
tied to physician and ER visits. The study also found that because of the
more consistent use of medications by specialty patients, medication costs
adjusted to average wholesale price were higher.

"The study only measured direct medical costs, but indirect costs of RA from
disability and absenteeism are a big factor for employers when they have
employees with RA," Barlow said. "Specialty pharmacies can mitigate medical
and indirect costs, which can offset the cost of the medications." The
indirect costs for RA patients from lost productivity can be as much or more
as the direct medical costs.

RA afflicts 1.3 million
Approximately 1.3 million patients have RA, which is characterized by pain and
swelling in the joints driven by the body's immune system attacking the lining
of the joints. Joint destruction for RA patients can occur within two years
of the onset of the disease. The condition can strike at any age, but most
commonly begins between 35-50 years of age. Women are more than twice as
likely to be affected by the condition as men. RA is the leading cause of
disability in the US and severely disables about 10 percent of all patients.
It decreases life expectancy by three to seven years with heart disease,
infection, and gastro-intestinal bleeding accounting for most of those deaths.
Improved treatment has slowed the progression of the disease and allows the
vast majority of patients to live normal lives. TNF inhibitors, which are
commonly prescribed for the condition, help interfere with inflammation
associated with RA and other autoimmune disorders, such as Crohn's disease and
moderate-to-severe cases of plaque psoriasis.

For more information about this study and other Medco research efforts, please
visit www.medcoresearch.com.

About Accredo Health
Accredo Health Group, Inc., a wholly-owned subsidiary of Medco Health
Solutions, Inc., is the nation's largest specialty pharmacy dedicated to
providing an enhanced level of personalized service to patients with chronic
and complex disease. Drugs dispensed by Accredo, which are often biotechnology
drugs, frequently require special handling and clinical services to ensure the
drugs are properly administered to promote patient safety and health.

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

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