PRESS RELEASE: Younger Adults Increasingly Treated for Heart Disease-related Conditions

Younger Adults Increasingly Treated for Heart Disease-related Conditions

Increase in use of cholesterol and hypertension medications largest among people ages 20 to 44

Drop in the age of women using heart disease medications greater than men

FRANKLIN LAKES, N.J., Oct. 30 -- Heart disease, high blood pressure and hardening of the arteries - conditions that are usually associated with the senior population - are creeping into young adulthood. According to new research conducted by Medco Health Solutions, Inc. (NYSE: MHS), prescription drug use by younger adults for heart disease- related conditions is increasing at a rapid rate, far outpacing older adults and offering a glimpse into the forthcoming clinical and financial challenges facing the nation's health care system.

The analysis shows that between 2001 and 2006, the number of 20-44 year olds taking prescription medications to treat high cholesterol increased 68 percent, and use of antihypertensives jumped 21 percent.

Based on this new analysis, the estimated number of 20-44 year olds nationwide on lipid-lowering drugs surged from 2.5 million in 2001 to 4.2 million in 2006, while the number of people of that age taking antihypertensives spiked from 7 million to 8.5 million in the six-year period.

"This may be both a good news, bad news story," said Dr. Robert Epstein, Medco's chief medical officer. "The good news is that younger patients are taking medications that control conditions that, if left untreated, could lead to heart attacks and strokes - indicating that physicians are screening patients more regularly and treating these precursors more aggressively than in the past. The bad news is that these conditions are showing up in patients at younger ages, which could be the result of the growing obesity epidemic and various lifestyle factors."

Not only were the increases among 20-44 year olds significant, but so too were the rates of increase when compared to age groups more traditionally associated with these categories of medications. The increase in the number of 20-44 year-olds on lipid-lowering medications was 37 percent higher than it was for 45 to 64 year olds; the growth in prevalence of those on antihypertensives was 52 percent greater. When compared with patients 65 years or older, the increase in usage of lipid-lowering medications was 31 percent higher in the 20-44 group, and among those on antihypertensives it was more than double.

Decline Seen in Age of Patients on Drug Treatment

The analysis also found a significant shift downward in the age of patients using these drug treatments. In 2006, half of all patients on lipid- lowering drugs were 61 years old or younger; the median age of women fell more sharply than men, dropping from 67 to 62 in the six-year span, as compared to 62 to 59 for men.

The median age of those using antihypertensives declined four years over the six-year period, with half of all patients on these drugs being 60 years or younger in 2006; again women had the greatest decline, dropping from 65 to 60 versus men whose median age fell from 63 to 60.

"There is a history of women being under-diagnosed and under-treated for heart conditions," said Epstein. "The fact that more women at a younger age are receiving medication treatment for high cholesterol and hypertension is a sign that the medical community is recognizing that heart disease is a serious threat to women as well as men."

Heart Disease Risks

High cholesterol and high blood pressure are two of the leading risk factors for heart disease, heart attack and stroke. High LDL cholesterol can cause atherosclerosis, a narrowing and hardening of the arteries that feed the heart and brain. High blood pressure, or hypertension, can weaken the arterial walls and make them more prone to atherosclerosis. Both conditions can lead to blood clots that can block blood flow and result in a heart attack or stroke.

For some people with high cholesterol and hypertension, lifestyle changes such as weight loss, dietary changes and exercise can control the conditions. For others, medications may be needed. The most common medications used to treat high cholesterol are statins. To treat hypertension, diuretics, beta- blockers and ACE inhibitors are often prescribed.

Medco's Specialist Pharmacists

Medco has developed an innovative approach to help improve and advance pharmacy care through condition-specific resource centers that are staffed with hundreds of pharmacists who receive training and certification in specific chronic conditions and have expertise in the drugs used to treat them. With this training and concentrated practice, Medco's specialist pharmacists can offer deeper, more specific guidance when a medication safety issue arises.

Medco's specialist pharmacists focus on some of the most common chronic conditions Americans face including heart disease, high blood pressure, and high cholesterol. Aided by advanced, integrated databases that provide real- time prescription medication history, and medical diagnoses (when available), specialist pharmacists can collaborate with doctors and their patients on drug safety issues. Specialist pharmacists may also consult with physicians to help ensure that members receive the most affordable medications.

About Medco

Medco Health Solutions, Inc. (NYSE: MHS) is the nation's leading pharmacy benefit manager based on its 2006 total net revenues of more than $42 billion. Medco's prescription drug benefit programs are designed to drive down the cost of pharmacy health care for private and public employers, health plans, labor unions and government agencies of all sizes, and for individuals served by the Medicare Part D Prescription Drug Program. Medco's technologically advanced mail-order pharmacies and award-winning Internet pharmacy have been recognized for setting new industry benchmarks for pharmacy dispensing quality. Medco serves the needs of patients with complex conditions requiring sophisticated treatment through its specialty pharmacy operation, which became the nation's largest with the 2005 acquisition of Accredo Health, Incorporated. Medco is the highest-ranked independent pharmacy benefit manager on the 2007 Fortune 500 list. On the Net:

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 filed with the Securities and Exchange Commission.