anaging prescription drug care for employers, Blue Cross and Blue Shield organizations, labor unions, government health plans and managed care companies always has been an intensely competitive business. Now, with the vast majority of Americans covered by managed pharmacy plans, rapid growth in the nation’s senior population, and an ever greater reliance on prescription drugs to treat disease, the battle to retain customers and win new ones is more competitive than ever.

To succeed takes innovative clinical programs, effective cost-management capabilities, advanced information technology, highly trained customer service and account management teams and a platform for timely communication with patients and providers.

Those characteristics define Merck-Medco Managed Care . Working closely with patients, physicians and pharmacists, Merck-Medco is improving the safety, effectiveness and affordability of prescription drug therapy, and meeting the evolving needs of our more than 1,100 plan sponsor clients and their 51 million members.

Solid Growth Across the Board
We are not only meeting the needs of our existing customers, but are winning important new accounts in all key market segments. Major new clients gained during 1998 included IBM Corporation, United HealthCare, the State of Texas Employee Retirement System, the National Labor Alliance of Health Care Coalition, Travelers Group, Chevron Corporation, National Steel and employees of the State of Iowa.

Our continued growth resulted in significant increases in the number of prescriptions we managed in 1998, which grew 11 percent to over 322 million. Similarly, we managed more than $14 billion in drug spending on behalf of our clients, up 20 percent.

Investing and Innovating to Meet Evolving Market Needs
While the market continues to demand that we execute on the basics – clinical and cost management of prescription drug benefits and responsive customer service – plan sponsors increasingly want prescription drug care more fully integrated in the overall health care of their members.
Since developing our first health management program for diabetes in 1993, Merck-Medco has moved aggressively to meet this need. We significantly expanded our clinical staff and developed a suite of Optimal Outcomes health management programs to help our clients improve care for patients with high-risk, high-cost conditions. The programs are designed in keeping with recognized best practice standards and are reviewed by panels of independent health care experts.

Increasingly, plan sponsors are recognizing the value of these programs. Currently, more than 60 Merck-Medco clients take advantage of Optimal Outcomes health management programs. To date, more than a quarter of a million patients have enrolled in our programs for asthma, congestive heart failure, depression, diabetes, gastrointestinal diseases, high cholesterol, hypertension and smoking cessation.

The dedication of Merck-Medco’s more than 11,000 employees, together with our ongoing commitments to clinical excellence, the most advanced information technology systems, and responsive client and customer service operations, are keeping us at the forefront of meeting the need for high-quality, affordable prescription drug care.