Medco 2015 Annual Report Download

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PHARMACY.SMARTER.
Clients and members are at the center
of everything we do.
Caring for millions, one patient at a time
ANNUAL
REPORT
2015

Table of contents

  • Page 1
    ANNUAL REPORT 2015 PHARMACY.SMARTER. Clients and members are at the center of everything we do. Caring for millions, one patient at a time

  • Page 2
    ...network-pharmacy claims processing, home delivery pharmacy care, specialty pharmacy care, benefit-design consultation, drug utilization review, formulary management, and medical and drug data analysis services. Express Scripts also distributes a full range of biopharmaceutical products and provides...

  • Page 3
    ...treated by experts from our Accredo® specialty pharmacy; or a parent picking up a prescription at a retail pharmacy counter for their child, Express Scripts is there, standing with our patients and clients to ensure they get the most value from their medicine. 1 Express Scripts 2015 Annual Report

  • Page 4
    ... whether we do our job well: did we help someone live better through our work? John's mother would say Accredo and Liz most certainly did. Aligned with our more than 3,000 clients, we take bold actions that change healthcare. In 2015, nearly 50,000 Express Scripts patients received curative therapy...

  • Page 5
    ... chain management expertise; the specialized care offered by Accredo; the digital and high-touch member experience delivered by our home delivery pharmacy; and the diverse opportunities within UBC and our pharma services business. For 30 years, Express Scripts has successfully helped clients and...

  • Page 6
    ...shows changes over the past five-year period in the value of $100 invested (assuming reinvestment of dividends) in: (1) Our Common Stock; (2) S&P 500 Index; (3) S&P 500 Health Care Index $260 Express Scripts $200 S&P 500 Index* $140 S&P 500 - Healthcare* $0 2010 2011 2012 2013 2014 2015 Years...

  • Page 7
    ...12b-2 of the Exchange Act). The aggregate market value of Registrant's voting stock held by non-affiliates as of June 30, 2015, was $59,987,373,540 based on 674,470,132 shares held on such date by non-affiliates and a closing sale price for the Common Stock on such date of $88.94 as reported on the...

  • Page 8
    ...contracted network of retail pharmacies, our home delivery pharmacies and our specialty pharmacies. Revenues from the delivery of prescription drugs to our members represented 98.0% of our revenues in 2015, 98.4% in 2014 and 98.8% in 2013. Revenues from services, such as Express Scripts 2015 Annual...

  • Page 9
    ...com. Information included on our website is not part of this annual report. Products and Services Pharmacy Benefit Management Services Overview. Our core PBM services involve management of prescription drug utilization to drive high quality, costeffective pharmaceutical care. We consult with clients...

  • Page 10
    ... clinically appropriate, moving drug coverage from medical to pharmacy benefit and to lower-cost sites of care. Retail Network Pharmacy Administration. We contract with retail pharmacies to provide prescription drugs to members of the pharmacy benefit plans we manage. In the United States, Puerto...

  • Page 11
    ... medical and Medicare drug benefits to a number of Medicare plan sponsors. As a PBM supporting health plans, we provide prescription adjudication services in addition to a suite of required programmatic offerings such as a Medication Therapy Management program, an Explanation of Benefits for members...

  • Page 12
    ... Center services home delivery pharmacy services specialty pharmacy, including the distribution of fertility pharmaceuticals, requiring special handling or packaging retail network pharmacy administration benefit design consultation drug utilization review Express Scripts 2015 Annual Report 10

  • Page 13
    ... to managed care organizations, health insurers, third-party administrators, employers, union-sponsored benefit plans, workers' compensation plans, government health programs, providers, clinics, hospitals and others. Express Scripts provides pharmacy network services and home delivery and specialty...

  • Page 14
    ... services. The team also produces the Express Scripts Drug Trend Report which examines trends in pharmaceutical utilization and cost, the factors triggering those trends and new solutions our clients can implement to lower their pharmacy spend while improving the health of their members. Information...

  • Page 15
    ... drug coverage and services to Medicare Part D beneficiaries. Through our core PBM business, we also provide Medicare Part D-related products and services to other Medicare Part D sponsors, Medicare Advantage Prescription Drug Plans and other employers and clients offering Medicare Part D benefits...

  • Page 16
    ...under certain circumstances. Prompt Pay Laws. Under Medicare Part D and certain state laws, some of which also govern the Public Exchanges, PBMs and many of our health plan clients, we may be obligated to pay retail pharmacy providers within established time periods that may be shorter than existing...

  • Page 17
    ... to certain of our clients, such as managed care organizations and health insurers. If such legislation were to become widely adopted and broad in scope, it could have the effect of limiting the economic benefits achievable through pharmacy benefit management. 15 Express Scripts 2015 Annual Report

  • Page 18
    ... of the product to be sold, to fill mail orders within thirty days and to provide clients with refunds when appropriate. The United States Postal Service also has significant statutory authority to restrict the delivery of drugs and medicines through the mail. Express Scripts 2015 Annual Report 16

  • Page 19
    ... PBMs and certain types of managed care organizations and insurance companies, including, but not limited to, preferred provider organizations, third-party administrators and companies that provide utilization review services. The scope of these laws differs from state to state, and the application...

  • Page 20
    ... Care Pharmacists; International Union of Operating Engineers; and Retail, Wholesale and Department Store Union, United Food and Commercial Workers. Four collective bargaining agreements covering these employees will expire at various dates through December 2016. Express Scripts 2015 Annual Report...

  • Page 21
    ... 2014 and has also served as a director of the Company since June 2015. From April 2012 to February 2014 he served as Senior Vice President and President, Sales and Account Management. Mr. Wentworth joined Express Scripts when the Company merged with Medco in April 2012. At Medco, he served as Group...

  • Page 22
    ... April 2010 to April 2012. Prior to joining Express Scripts in March 2008, Mr. McGinnis held various legal and business development roles with American Water Works Company, Inc. Available Information We make available through our website (www.express-scripts.com) access to our annual report on Form...

  • Page 23
    ... providers changes to the healthcare industry designed to manage healthcare costs or alter healthcare financing practices or changes to government policies in general a significant failure or disruption in service within our operations or the operations of our vendors changes relating to Medicare...

  • Page 24
    ... many PBMs, including us, to reduce the prices charged for core products and services while sharing a greater portion of the formulary fees and related revenues received from pharmaceutical manufacturers with clients. We cannot assume positive trends would offset these pressures in the future. Our...

  • Page 25
    ... network contracts • wholesale distributor laws • legislation imposing benefit plan design restrictions and requirements, which limit how our clients can design their drug benefit plans • various licensure laws, such as managed care and third-party administrator licensure laws • drug pricing...

  • Page 26
    ... 1 above (see "Part I - Item 1 - Business - Clients"), we have long-term contracts with Anthem and the United States Department of Defense ("DoD"). These two clients collectively represented 29.4% and 25.9% of our revenues during 2015 and 2014, respectively. Express Scripts 2015 Annual Report 24

  • Page 27
    ... or totally eliminate our ability to process and dispense prescriptions and provide products and services to our clients and members, which could have a material adverse effect on our business and results of operations. Regulatory changes relating to Medicare Part D, our failure to comply with...

  • Page 28
    ...-related costs which could adversely impact our business and our results of operations. In addition, due to the availability of Medicare Part D, some of our employer clients may stop providing pharmacy benefit coverage to retirees, instead allowing retirees to choose their own Medicare Part D plans...

  • Page 29
    ... of drugs from our home delivery pharmacies and through pharmacies in our retail networks administrative fees for managing rebate programs, including the development and maintenance of formularies which include the particular manufacturer's products access to limited distribution specialty...

  • Page 30
    ... services of these executives will continue to be available to us. Changes in drug pricing or industry pricing benchmarks could materially impact our financial performance. Contracts in the prescription drug industry, including our contracts with retail pharmacy networks and with PBM and specialty...

  • Page 31
    ... and five mail order dispensing pharmacies. We also have seven Specialty Pharmacy home delivery pharmacies and 35 specialty branch pharmacies. We believe our facilities generally have been well maintained, are in good operating condition and have adequate capacity to meet our current business needs...

  • Page 32
    ... of Justice, District of Rhode Island, pursuant to 18 U.S.C. Section 24(a), requesting information regarding the Company's contractual arrangements with Pfizer, Bayer EMD Serono and biogen idec concerning the following drugs: Betaseron, • • • Express Scripts 2015 Annual Report 30

  • Page 33
    ... predict with certainty the timing or outcome of this matter. On April 8, 2014, the Company received a subpoena from the United States Department of Labor, Employee Benefits Security Administration requesting information regarding ESI's and Medco's client relationships from 2009 to the present. The...

  • Page 34
    ... future. Recent Sales of Unregistered Securities None. Issuer Purchases of Equity Securities There were no repurchases of the Company's common stock during the fourth quarter of 2015. In December 2015, the Board of Directors of the Company approved an increase in the authorized number of shares...

  • Page 35
    ... per share data) 2015 2014 2013 2012(1) 2011 Statement of Operations Data (for the Year Ended December 31): Revenues(2) Cost of revenues(2) Gross profit Selling, general and administrative Operating income Other expense, net Income before income taxes Provision for income taxes Net income from...

  • Page 36
    ..., 2014, 2013, 2012 and 2011 have been adjusted to reflect net financing costs related to our senior notes and term loans as a reduction in the carrying value of debt in conjunction with the adoption of ASU 2015-03 during 2015. (6) Prior to the acquisition of Medco, Express Scripts, Inc. ("ESI") and...

  • Page 37
    ... to Express Scripts per adjusted claim, are each affected by the changes in claims volume between retail and home delivery and the relative representation of brand-name, generic and specialty pharmacy drugs, as well as the level of efficiency in the business. 35 Express Scripts 2015 Annual Report

  • Page 38
    ... integrated PBM services include clinical solutions to improve health outcomes, specialized pharmacy care, home delivery pharmacy services, specialty pharmacy services, retail network pharmacy administration, benefit design consultation, drug utilization review, drug formulary management, Medicare...

  • Page 39
    ... Group, claims volume and related revenues and cost of revenues decreased throughout 2013. PBM OPERATING INCOME Year Ended December 31, (in millions) 2015 2014 2013 Product revenues: Network revenues(1) Home delivery and specialty revenues(2) Service revenues Total PBM revenues Cost of PBM revenues...

  • Page 40
    ... $129.4 million of revenues for the year ended December 31, 2014 related to a client contract as compared to $108.2 million for the year ended December 31, 2013, as well as better management of ingredient costs and formulary and cost savings from the increase in the generic fill rate. SG&A decreased...

  • Page 41
    ... millions) 2015 2014 2013 Product revenues Service revenues Total Other Business Operations revenues Cost of Other Business Operations revenues Other Business Operations gross profit Other Business Operations SG&A Other Business Operations operating income Claims Home delivery, specialty and other...

  • Page 42
    ... in accruals. Employee stock-based compensation expense decreased $53.7 million in 2014 from 2013 due to acceleration of stock-based compensation expense and award vesting associated with the termination of certain Medco employees following the Merger. Express Scripts 2015 Annual Report 40

  • Page 43
    ... the year ended December 31, 2014. These net outflows are compared to $4,055.2 million related to treasury share repurchases, $1,300.0 million related to senior note redemptions and $631.6 million of quarterly term facility payments during the year ended December 31, 2013. At December 31, 2015, our...

  • Page 44
    ....3 million during the years ended December 31, 2015, 2014 and 2013, respectively. In December 2015, the Board of Directors of the Company approved an increase in the authorized number of shares that may be repurchased under our share repurchase program, originally announced in 2013, by an additional...

  • Page 45
    ... in exchange for those goods or services. In July 2015, the FASB delayed the effective date of the standard by one year. The new guidance is effective for financial statements issued for annual reporting periods beginning after December 15, 2017 and early 43 Express Scripts 2015 Annual Report

  • Page 46
    ... reflect current market conditions as well as management judgment. We base our fair values on projected financial information which we believe to be reasonable. However, actual results may differ from those projections and those differences may be material. Express Scripts 2015 Annual Report 44

  • Page 47
    ... be impacted by changes in economic and market conditions as well as changes to our customers' financial condition. We record reserves for clients based on known adjustments to adjudicated claims and historical discounts issued as a percentage of revenue. SELF-INSURANCE ACCRUALS ACCOUNTING POLICY...

  • Page 48
    .... Our cost of revenues includes the cost of drugs dispensed by our home delivery pharmacies or retail network for members covered under our Medicare Part D PDP product offerings and is recorded at cost as incurred. SPECIALTY DRUG REVENUES We operate specialty pharmacies that dispense medications for...

  • Page 49
    ... that our audits provide a reasonable basis for our opinions. As discussed in Note 1 to the financial statements, the Company changed the manner in which it classifies deferred taxes in 2015. A company's internal control over financial reporting is a process designed to provide reasonable assurance...

  • Page 50
    EXPRESS SCRIPTS HOLDING COMPANY CONSOLIDATED BALANCE SHEET December 31, (in millions) 2015 2014 Assets Current assets: Cash and cash equivalents Receivables, net Inventories Deferred taxes Prepaid expenses and other current assets Total current assets Property and equipment, net Goodwill Other ...

  • Page 51
    ..., except per share data) 2015 2014 2013 Revenues Cost of revenues(1) Gross profit Selling, general and administrative Operating income Other (expense) income: Interest income and other Interest expense and other Income before income taxes Provision for income taxes Net income from continuing...

  • Page 52
    EXPRESS SCRIPTS HOLDING COMPANY CONSOLIDATED STATEMENT OF COMPREHENSIVE INCOME Year Ended December 31, (in millions) 2015 2014 2013 Net income Other comprehensive loss: Foreign currency translation loss Comprehensive income Less: Comprehensive income attributable to non-controlling interest ...

  • Page 53
    ... 31, 2013 Net income Other comprehensive loss Treasury stock acquired Common stock issued under employee plans, net of forfeitures and stock redeemed for taxes Amortization of unearned compensation under employee plans Exercise of stock options Tax benefit relating to employee stock compensation...

  • Page 54
    ... long-term debt Net proceeds from employee stock plans Excess tax benefit relating to employee stock-based compensation Other, net Net cash used in financing activities Effect of foreign currency translation adjustment Less cash decrease attributable to discontinued operations Net increase (decrease...

  • Page 55
    ... integrated PBM services include clinical solutions to improve health outcomes, specialized pharmacy care, home delivery pharmacy services, specialty pharmacy services, retail network pharmacy administration, benefit design consultation, drug utilization review, drug formulary management, Medicare...

  • Page 56
    ...-for-sale securities are reported at fair value, which is based upon quoted market prices, with unrealized holding gains and losses reported through other comprehensive income, net of applicable taxes. We held no securities classified as available-for-sale at December 31, 2015 or 2014. Impairment...

  • Page 57
    ... of the fair values of our financial instruments. Revenue recognition. Revenues from our PBM segment are earned by dispensing prescriptions from our home delivery and specialty pharmacies, processing claims for prescriptions filled by retail pharmacies in our networks, and providing services to drug...

  • Page 58
    ... in conjunction with claims processing and home delivery services provided to clients, are recorded as a reduction of cost of revenues and the portion of the rebate and administrative fees payable to customers is treated as a reduction of revenues. The Express Scripts 2015 Annual Report 56

  • Page 59
    ...payments derived from providing PBM services, as a component of revenues on the consolidated statement of operations. Our cost of revenues includes the cost of drugs dispensed by our home delivery pharmacies or retail network for members covered under our Medicare Part D PDP product offerings. These...

  • Page 60
    ... million related to our senior notes and term loans have been reclassified from "Other intangible assets, net" to a reduction in the carrying value of our long-term debt, and net financing costs of $3.7 million related to our 2011 revolving facility have been Express Scripts 2015 Annual Report 58

  • Page 61
    ...the company expects to receive in exchange for those goods or services. In July 2015, the FASB delayed the effective date of the standard by one year. The new guidance is effective for financial statements issued for annual reporting periods beginning after December 15, 2017 and early application is...

  • Page 62
    ... and $664.9 million at December 31, 2015 and 2014, respectively. We capitalized $172.8 million of internally developed software during 2015. Under certain of our operating leases for facilities in which we operate home delivery and specialty pharmacies, we are required to remove improvements and...

  • Page 63
    ...and ASU 2015-15, as described in Note 1 - Summary of significant accounting policies. Following is a summary of the change in the net carrying value of goodwill by reportable segment: (in millions) PBM Other Business Operations Total Balance at December 31, 2013 Purchase price allocation adjustment...

  • Page 64
    ... and 2015 two-year term loan, of which $4,925.0 million was outstanding as of December 31, 2015, had average interest rates of 1.45% and 1.33%, respectively, as of December 31, 2015. The 2011 term loan had an average interest rate of 1.90% as of December 31, 2014. Express Scripts 2015 Annual Report...

  • Page 65
    ...2014 credit facility. The credit facilities require interest to be paid at LIBOR plus an agreed upon rate at the time of borrowing. Financing costs. As of December 31, 2015, we adopted ASU 2015-03 and ASU 2015-15. As a result, net financing costs of $50.6 million related to our senior notes and term...

  • Page 66
    ... 2013 Statutory federal income tax rate State taxes, net of federal benefit Non-controlling interest Investment in foreign subsidiaries Other, net Effective tax rate 35.0% 0.7 (0.2) - (0.2) 35.3% 35.0% 2.0 (0.3) - (3.1) 33.6% 35.0% 2.6 (0.3) (0.7) (0.2) 36.4% Express Scripts 2015 Annual Report...

  • Page 67
    ...recorded through the allocation of Medco's purchase price. (2) Amounts for 2014 and 2013 include reductions and additions related to a claimed loss in 2012 on the disposition of PolyMedica Corporation (Liberty). All but an immaterial amount of our unrecognized tax benefits of $1,038.4 million, would...

  • Page 68
    ... our prior year tax positions by $56.8 million, which impacted our effective tax rate. The Internal Revenue Service ("IRS") is currently examining ESI's 2010 and 2011 and Express Scripts's combined 2012 consolidated United States federal income tax returns. Our federal income tax audit uncertainties...

  • Page 69
    ... are settled by issuance of new shares. The maximum term of stock options, restricted stock units and performance shares is generally 10 years. The tax benefit related to employee stock compensation recognized during the years ended December 31, 2015, 2014 and 2013 was $41.3 million, $37.3 million...

  • Page 70
    ...We have issued stock options to certain officers, directors and employees to purchase shares of our common stock at fair market value on the date of grant. Stock options generally have three-year graded vesting. As of December 31, 2015 and 2014, unearned compensation related to stock options was $31...

  • Page 71
    ... of the following components: Year Ended December 31, (in millions) 2015 2014 2013 Interest cost Actual loss (gain) on plan assets Net actuarial loss (gain) Net expense (benefit) $ $ 0.3 1.5 - 1.8 $ 0.4 $ (6.3) 0.1 (5.8) $ $ 0.5 (15.3) (0.4) (15.2) 69 Express Scripts 2015 Annual Report

  • Page 72
    ... are priced using fair value pricing sources and techniques. The pension plan may redeem its shares quarterly at the stated NAV after a one year lockup. As of December 31, 2015 and 2014, the pension plan does not hold any investments classified as Level 1. Express Scripts 2015 Annual Report 70

  • Page 73
    ... millions) Hedge Fund Balance at December 31, 2013 Net purchases, sales and issuances Unrealized gains Balance at December 31, 2014 Net purchases, sales and issuances Unrealized gains Balance at December 31, 2015 $ 42.9 (10.0) 1.5 34.4 (6.0) 1.4 29.8 $ $ 71 Express Scripts 2015 Annual Report

  • Page 74
    ... and current business plans. These future purchase commitments as of December 31, 2015 are summarized below (in millions): Year Ended December 31, Future Purchase Commitments 2016 2017 2018 2019 2020 Thereafter Total $ $ 166.8 46.1 19.8 8.1 1.5 - 242.3 Express Scripts 2015 Annual Report 72

  • Page 75
    ... of a bi-annual survey of retail drug prices. In March 2014, the Ninth Circuit Court of Appeals remanded the case to the district court for further proceedings. (i) Brady Enterprises, Inc., et al. v. Medco Health Solutions, Inc., and (ii) North Jackson Pharmacy, Inc., et al. v. Express Scripts, Inc...

  • Page 76
    ... acquisition of Medco Health Solutions, Inc. by Express Scripts Holding Company. • • We have received and intend to cooperate with various subpoenas from government agencies requesting information. In addition, we are currently in discussions with Anthem regarding the periodic pricing review...

  • Page 77
    ... of the contract. (2) Includes retail pharmacy co-payments of $9,170.0 million, $10,272.7 million and $12,620.3 million for the years ended December 31, 2015, 2014 and 2013, respectively. (3) Includes home delivery and specialty, including drugs we distribute to other PBMs' clients under limited...

  • Page 78
    ...medicines. PBM service revenues include administrative fees associated with the administration of retail pharmacy networks contracted by certain clients, informed decision counseling services and specialty pharmacy services. Other Business Operations service revenues include revenues related to data...

  • Page 79
    ... attributable to Express Scripts Basic earnings per share attributable to Express Scripts Diluted earnings per share attributable to Express Scripts Fiscal 2014 Revenues(2) Cost of revenues(2) Gross profit Selling, general and administrative Operating income Net income Less: Net income attributable...

  • Page 80
    ... between ESI and Medco in the condensed consolidating statement of operations for the year ended December 31, 2015. These events had no impact on our consolidated balance sheet, consolidated statement of operations or consolidated statement of cash flows. Express Scripts 2015 Annual Report 78

  • Page 81
    Condensed Consolidating Balance Sheet Express Scripts Holding Company Express Scripts, Inc. Medco Health Solutions, Inc. NonGuarantors (in millions) Guarantors Eliminations Consolidated As of December 31, 2015 Cash and cash equivalents Receivables, net Other current assets Total current assets ...

  • Page 82
    ...Express Scripts Holding Company Express Scripts, Inc. Medco Health Solutions, Inc. NonGuarantors (in millions) Guarantors Eliminations Consolidated As of December 31, 2014 Cash and cash equivalents Receivables, net....4 - 4,923.2 782.1 9.8 20,054.2 53,748.3 Express Scripts 2015 Annual Report 80

  • Page 83
    ... Express Scripts Holding Company Express Scripts, Inc. Medco Health Solutions, Inc. NonGuarantors (in millions) Guarantors Eliminations Consolidated For the year ended December 31, 2015 Revenues Operating expenses Operating income Other (expense) income: Interest (expense) income and other, net...

  • Page 84
    ... Holding Company Express Scripts, Inc. Medco Health Solutions, Inc. NonGuarantors (in millions) Guarantors Eliminations Consolidated For the year ended December 31, 2013 Revenues Operating expenses Operating income Other (expense) income, net Income (loss) before income taxes Provision (benefit...

  • Page 85
    ... Repayment of long-term debt Net proceeds from employee stock plans Excess tax benefit relating to employee stock-based compensation Other, net Net intercompany transactions Net cash (used in) provided by financing activities Effect of foreign currency translation adjustment Net increase in cash and...

  • Page 86
    ... Express Scripts Holding Company Express Scripts, Inc. Medco Health Solutions, Inc. NonGuarantors (in millions) Guarantors Eliminations Consolidated For the year ended December 31, 2014 Net cash flows provided by (used in) operating activities $ Cash flows from investing activities: Purchases...

  • Page 87
    ... Express Scripts Holding Company Express Scripts, Inc. Medco Health Solutions, Inc. NonGuarantors (in millions) Guarantors Eliminations Consolidated For the year ended December 31, 2013 Net cash flows provided by (used in) operating activities $ Cash flows from investing activities: Purchases...

  • Page 88
    ... 13a-15(f) and 15d-15(f) under the Exchange Act) occurred during the quarter ended December 31, 2015 that has materially affected, or is reasonably likely to materially affect, our internal control over financial reporting. Item 9B - Other Information None. Express Scripts 2015 Annual Report 86

  • Page 89
    ... and Related Party Transactions" and "Corporate Governance." Item 14 - Principal Accounting Fees and Services The information required by this item will be incorporated by reference from the Proxy Statement under the heading "Principal Accountant Fees." 87 Express Scripts 2015 Annual Report

  • Page 90
    ... for the years ended December 31, 2015, 2014 and 2013 All other schedules are omitted because they are not applicable or the required information is shown in the consolidated financial statements or the notes thereto. (3) List of Exhibits See Index to Exhibits on the pages below. The Company agrees...

  • Page 91
    ... February 16, 2016 February 16, 2016 February 16, 2016 February 16, 2016 February 16, 2016 February 16, 2016 February 16, 2016 February 16, 2016 89 Express Scripts 2015 Annual Report

  • Page 92
    ... 46.0 130.8 103.9 - - - $ 202.2 165.1 87.3 66.9 87.5 92.4 Year ended 12/31/13 Year ended 12/31/14 Year ended 12/31/15 $ $ $ $ $ (1) Except as otherwise described, these deductions are primarily write-offs of receivable amounts, net of any recoveries. Express Scripts 2015 Annual Report 90

  • Page 93
    ... Scripts Pharmacy, Inc. and U.S. Bank Trust National Association, as Trustee, incorporated by reference to Exhibit 4.7 to Express Scripts Holding Company's Annual Report to Form 10-K filed February 20, 2014. Fourth Supplemental Indenture, dated as of February 2, 2015, among Medco Health Solutions...

  • Page 94
    ... Holding Company's Current Report on Form 8-K filed April 6, 2012. Ninth Supplemental Indenture, dated as of May 29, 2012, among Express Scripts, Inc., Express Scripts Holding Company, Medco Health Solutions, Inc., the other subsidiaries of Express Scripts Holding Company party thereto and Wells...

  • Page 95
    ... Company's Quarterly Report on Form 10Q for the quarter ended June 30, 2012. Form of Restricted Stock Unit Grant Notice for Non-Employee Directors used with respect to grants of restricted stock units by Express Scripts Holding Company under the Express Scripts, Inc. 2011 Long-Term Incentive Plan...

  • Page 96
    ...to Express Scripts Holding Company's Quarterly Report on Form 10Q for the quarter ended June 30, 2012. Form of terms and conditions for director stock option and restricted stock unit awards, incorporated by reference to Exhibit 10.2 to Medco Health Solutions, Inc.'s Current Report on Form 8-K filed...

  • Page 97
    ... contract or compensatory plan or arrangement. Certain portions of this exhibit have been omitted and filed separately with the Securities and Exchange Commission pursuant to a confidential treatment order of the Securities and Exchange Commission. 2 3 4 95 Express Scripts 2015 Annual Report

  • Page 98
    Intentionally left blank Express Scripts 2015 Annual Report 96

  • Page 99
    ... exhibits to Express Scripts' Annual Report on Form 10-K for the fiscal year ended December 31, 2015. These and other exhibits will be furnished by the Investor Relations department upon request. Investor Relations Contact 314.810.3115 [email protected] Board of Directors Gary...

  • Page 100
    ... stewardship by printing our Annual Report on recycled stocks that are certified by the Forest Stewardship Council® (FSC®). The cover and financial pages are printed on paper stock that has 10% post-consumer waste content. © 2016 Express Scripts Holding Company. All Rights Reserved. 16EME33981