Summary of MEDCO HEALTH SOLUTIONS INC

Item 7.01 Regulation FD Disclosure.
On November 21, 2008, Medco Health Solutions, Inc. (the "Company") will hold its 2008 Analyst Day conference. As previously announced by the Company through a press release issued on November 13, 2008, the Company is also hosting a live webcast of its Analyst Day conference in listen-only mode today beginning at 8:00 am EST. Listeners may log on to the webcast on the Company's investor relations website at www.medco.com/investor.
A copy of the presentation related to the conference is attached as Exhibit 99.1 hereto and is incorporated into this Current Report on Form 8-K (this "Current Report") by reference solely for purposes of this Item 7.01 disclosure. These materials are also available on the Company's investor relations website at www.medco.com/investor.
The information in this Current Report, including the exhibit attached hereto, is being furnished and shall not be deemed "filed" for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the "Exchange Act"), or otherwise subject to the liabilities of such section. The information in this Current Report, including the exhibit, shall not be incorporated by reference into any registration statement or other document pursuant to the Securities Act of 1933, as amended, or the Exchange Act, regardless of any incorporation by reference language in any such filing.
Cautionary Language Concerning Forward-Looking Statements This Current Report 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 are not historical facts, but rather are based on current expectations, estimates, assumptions and projections about the business and future financial results of the pharmacy benefit management ("PBM") and specialty pharmacy industries, and other legal, regulatory and economic developments. We use words such as "anticipates," "believes," "plans," "expects," "projects," "future," "intends," "may," "will," "should," "could," "estimates," "predicts," "potential," "continue," "guidance" and similar expressions to identify these forward-looking statements. Medco's actual results could differ materially from the results contemplated by these forward-looking statements due to a number of factors. These factors include:
Х Competition in the PBM, specialty pharmacy and the broader healthcare industry is intense and could impair our ability to attract and retain clients;

Х Failure to retain key clients could result in significantly decreased revenues and could harm our profitability;

Х If we do not continue to earn and retain purchase discounts and rebates from manufacturers at current levels, our gross margins may decline;

Х Our acquisition activity increased recently and if we are unable to effectively integrate acquired businesses into ours, our operating results may be adversely affected. Even if we are successful, the integration of these businesses has required, and will likely

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continue to require, significant resources and management attention;

Х If we fail to comply with complex and rapidly evolving laws and regulations, we could suffer penalties, or be required to pay substantial damages or make significant changes to our operations;

Х Government efforts to reduce healthcare costs and alter healthcare financing practices could lead to a decreased demand for our services or to reduced profitability;

Х Failure to execute our Medicare Part D prescription drug benefits strategy could adversely impact our business and financial results;

Х PBMs could be subject to claims under ERISA if they are found to be a fiduciary of a health benefit plan governed by ERISA;

Х Pending litigation could adversely impact our business practices and have a material adverse effect on our business, financial condition, liquidity and operating results;

Х We are subject to corporate integrity agreements and noncompliance may impede our ability to conduct business with the federal government;

Х Legislative or regulatory initiatives that restrict or prohibit the PBM industry's ability to use patient identifiable medical information could limit our ability to use information that is critical to the operation of our business;

Х Our specialty pharmacy business is highly dependent on our relationships with a limited number of biopharmaceutical suppliers and the loss of any of these relationships could significantly impact our ability to sustain or increase our revenues;

Х Our ability to grow our specialty pharmacy business could be limited if we do not expand our existing base of drugs or if we lose patients;

Х Our specialty pharmacy business, Medicare Part D offerings and certain revenues from diabetes testing supplies expose us to increased credit risk;

Х Changes in industry pricing benchmarks could adversely affect our financial performance;

Х The terms and covenants relating to our existing indebtedness could adversely impact our financial performance;

Х Prescription volumes may decline, and our net revenues and profitability may be negatively impacted, if products are withdrawn from the market, if prescription drugs transition to over-the-counter products, or if increased safety risk profiles of specific drugs result in utilization decreases;

Х We may be subject to liability claims for damages and other expenses that are not covered by insurance;

Х The success of our business depends on maintaining a well-secured pharmacy operation and technology infrastructure and failure to execute could adversely impact our business;

Х We could be required to record a material non-cash charge to income if our recorded intangible assets or goodwill are impaired, or if we shorten intangible asset useful lives;

Х Changes in reimbursement rates, including competitive bidding for durable medical equipment suppliers, could negatively affect our PolyMedica diabetes testing supplies revenues and profits under our Liberty brand; and

Х Anti-takeover provisions of the Delaware General Corporation Law ("DGCL"), our certificate of incorporation and our bylaws could delay or deter a change in control and make it more difficult to remove incumbent officers and directors.

The foregoing list of factors is not exhaustive. You should carefully consider the foregoing factors and the other risks and uncertainties that affect our business described in our Annual

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Report on Form 10-K, Quarterly Reports on Form 10-Q and other documents filed from time to time with the Securities and Exchange Commission. Item 9.01 Financial Statements and Exhibits.

Exhibit No. Description
99.1 Slide Presentation dated November 21, 2008

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