X0306 4 2018-04-26 0001532063 Express Scripts Holding Co. ESRX 0001235678 LAHOWCHIC NICHOLAS C/O EXPRESS SCRIPTS HOLDING COMPANY ONE EXPRESS WAY ST. LOUIS MO 63121 1 0 0 0 Common Stock 2018-04-26 4 M 0 7466 57.59 A 39026 D Non-Qualified Stock Option (Right-to-Buy) 57.59 2018-04-26 4 M 0 7466 D 2018-05-04 Express Scripts Holding Company Common Stock 7466 0 D The transaction was completed in connection with and prior to the scheduled expiration of the options. Grant of Stock Options pursuant to Express Scripts, Inc. 2000 Long-Term Incentive Plan. Vested in three (3) equal installments on May 1, 2012, May 1, 2013, and May 1, 2014. /s/ Nick H. Varsam, as Attorney-in-Fact for Nicholas J. LaHowchic 2018-04-30