National Survey by American Medical Association and Medco Shows Physicians See Value in Genetic Testing; Cite Need for Greater Education to Put it into Practice

National Survey by American Medical Association and Medco Shows Physicians See
Value in Genetic Testing; Cite Need for Greater Education to Put it into
Practice
98 percent of physicians agree that knowing a patient's genetic profile may
help them better prescribe medications

HONOLULU, Oct. 23 /PRNewswire-FirstCall/ -- Medco Health Solutions, Inc.(NYSE:
MHS) and the American Medical Association (AMA) today announced the findings
of a national benchmark survey on physicians' acceptance, use and education
regarding pharmacogenomic testing. The survey revealed that physicians almost
unanimously recognize the role that genes play in affecting a patient's drug
response; however, few felt they had the necessary training and education to
prescribe genetic tests that could provide valuable information to guide the
prescribing and dosing of medications.

Pharmacogenomic tests analyze a person's genetic make-up to determine how they
metabolize certain medications; using this genetic information can help
improve the safety and effectiveness of drug therapies.

The survey findings, based on responses from more than 10,000 physicians
nationwide, were presented at the 59th Annual American Society of Human
Genetics (ASHG) Conference. Results from the survey found that only 26
percent (about one in four) of physicians have had any type of education in
the field known as pharmacogenomics (PGx), and only 10 percent of physicians
currently believe they have the necessary information and training to put
pharmacogenomics testing to use. In addition, while the survey found that
only 13 percent of physicians had ordered or recommended PGx testing for their
patients in the preceding six months, more than 26 percent planned to do so
within the next six months. Among total respondents, 10 percent reported that
PGx tests had benefited their patients by improving drug effectiveness, and
another 10 percent said their patients benefited from reduced drug toxicity
due to testing.

"This research generates important insight about where physicians stand on
pharmacogenomic testing," said Dr. Robert Epstein, Medco's chief medical
officer. "It's clear that there is wide acceptance that genetic testing has a
role in patient care, but the need for formal training and education among
physicians is necessary to obtain greater adoption and implementation of these
tests in clinical practice. This survey with the AMA is the first to identify
the role that education can play in physician use of these tests to improve
patient care; and with the number of new drugs coming to market with a
companion diagnostic, it's paramount that this education take place."

Other survey findings show that physicians who feel well-informed about PGx
testing are more than twice as likely to recommend or order a genetic test.
Physicians who currently use genetic tests tend to be older males who have
been out of medical school for 15 to 29 years and oncologists.

"The ability of genetic technology to assist in diagnosis and appropriate
therapy is well-recognized, and the AMA has been involved in assisting
physicians in integrating genetic technology into routine clinical practice
for several years," said AMA Board of Trustees Member Joseph P. Annis, M.D.
"The AMA is committed to providing education and resources to physicians in
this growing and important area of medical science so that they can
appropriately use genetically-based technology, such as pharmacogenomic
testing."

The Present and Future of Genetic Testing

About one of every four patients in the United States were prescribed
medications with PGx information in the label of the drug in 2006. These
medications include antidepressants, analgesics, cancer treatments,
cardiovascular drugs and gastrointestinal medicines. For example, one enzyme
- CYP2D6 (part of the cytochrome p450 system of liver enzymes) - may be
involved in the metabolism of 30 percent of all drugs used today. In a case
showing a genetic connection to drug metabolism, a test is recommended for
patients using the blood thinner warfarin since they can experience serious
bleeds or blood clots if given the wrong dose; a genetic test can help
determine the accurate dosage based on the patient's genetic profile and
prevent these potentially life-threatening incidents. Genetic testing is also
important for breast cancer patients on tamoxifen since about 10 percent of
those women won't respond well to the medication because of their genetic
make-up. Provided with this information, physicians can find the appropriate
treatment that will be effective for individual breast cancer patients.
Variations in numerous other genes beyond those regulating liver enzymes have
also been found to be important in determining the safe and effective use of
drugs.

In the future, even more drugs may be linked to genetic tests. From the
second half of 2009 through the first half of 2010, seven drugs paired with
genetic tests are expected to be up for FDA approval, as well as approximately
10 to 20 percent of new drugs being labeled with PGx-related information over
the next five-to-ten years. In particular, the field of oncology will see
many more of these drugs in the coming years, with roughly 50 percent of
cancer drugs in the pipeline expected to be orally administered by 2013 and 85
percent of those will rely on a genetic biomarker.

For more information about the survey and ASHG presentation, please visit
www.medcoresearch.com.

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, Inc., +1-201-675-3709, ann_smith@medco.com;
or Janet Schiller, or Nicole Klein, both of Coyne Public Relations,
+1-973-316-1665