Exhibit

We hereby consent to the incorporation by reference in the Registration Statements on Form S-8 (Nos. 333-211133 and 333-180507) and Form S-3 (No. 333-221565) of Express Scripts Holding Company of our report dated February 27, 2018 relating to the financial statements, financial statement schedule, and the effectiveness of internal control over financial reporting, which appears in this Form 10-K.