-----BEGIN PRIVACY-ENHANCED MESSAGE-----
Proc-Type: 2001,MIC-CLEAR
Originator-Name: webmaster@www.sec.gov
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 TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB
MIC-Info: RSA-MD5,RSA,
 DgU7Sob+iy0hme37fHQ6TERWQQzYm1mB+xS+SpksthuokitGmV/DxvlLIf6OZ2FD
 Tywl+u5JGradNU599JyFOA==

<SEC-DOCUMENT>0000885721-04-000054.txt : 20040212
<SEC-HEADER>0000885721-04-000054.hdr.sgml : 20040212
<ACCEPTANCE-DATETIME>20040212154811
ACCESSION NUMBER:		0000885721-04-000054
CONFORMED SUBMISSION TYPE:	5
PUBLIC DOCUMENT COUNT:		1
CONFORMED PERIOD OF REPORT:	20031231
FILED AS OF DATE:		20040212

ISSUER:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			EXPRESS SCRIPTS INC
		CENTRAL INDEX KEY:			0000885721
		STANDARD INDUSTRIAL CLASSIFICATION:	RETAIL-DRUG STORES AND PROPRIETARY STORES [5912]
		IRS NUMBER:				431420563
		STATE OF INCORPORATION:			DE
		FISCAL YEAR END:			1202

	BUSINESS ADDRESS:	
		STREET 1:		13900 REIVERPORT DRIVE
		CITY:			MARYLAND HEIGHTS
		STATE:			MO
		ZIP:			63043
		BUSINESS PHONE:		3147701666

	MAIL ADDRESS:	
		STREET 1:		13900 REIVERPORT DRIVE
		CITY:			MARYLAND HEIGHTS
		STATE:			MO
		ZIP:			63043

REPORTING-OWNER:	

	OWNER DATA:	
		COMPANY CONFORMED NAME:			MAC MAHON THOMAS P
		CENTRAL INDEX KEY:			0001168580

	FILING VALUES:
		FORM TYPE:		5
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	000-20199
		FILM NUMBER:		04591525

	BUSINESS ADDRESS:	
		STREET 1:		430 S SPRING STREET
		CITY:			BURLINGTON
		STATE:			NC
		ZIP:			27215
</SEC-HEADER>
<DOCUMENT>
<TYPE>5
<SEQUENCE>1
<FILENAME>macmahon-123103_ex.xml
<TEXT>
<XML>
<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0201</schemaVersion>

    <documentType>5</documentType>

    <periodOfReport>2003-12-31</periodOfReport>

    <notSubjectToSection16>0</notSubjectToSection16>

    <form3HoldingsReported>0</form3HoldingsReported>

    <form4TransactionsReported>1</form4TransactionsReported>

    <issuer>
        <issuerCik>0000885721</issuerCik>
        <issuerName>EXPRESS SCRIPTS INC</issuerName>
        <issuerTradingSymbol>ESRX</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001168580</rptOwnerCik>
            <rptOwnerName>MAC MAHON THOMAS P</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>1 DEER RIDGE DRIVE</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>MORRISTOWN</rptOwnerCity>
            <rptOwnerState>NJ</rptOwnerState>
            <rptOwnerZipCode>07960</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>1</isDirector>
            <isOfficer>0</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
        </reportingOwnerRelationship>
    </reportingOwner>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Non-Qualified Stock Option (right to buy)</value>
                <footnoteId id="F1"/>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>65.94</value>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2003-05-23</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>A</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>6000</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0</value>
                    <footnoteId id="F1"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <value>2010-05-23</value>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                    <footnoteId id="F3"/>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>6000</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>6000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeTransaction>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">Employee stock option granted pursuant to Express Scripts, Inc. 2000 Long-Term Incentive Plan.</footnote>
        <footnote id="F2">Options vest in three equal installments on the first three anniversaries of the grant date.</footnote>
        <footnote id="F3">Express Scripts, Inc. Common Stock</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>Thomas P. Mac Mahon</signatureName>
        <signatureDate>2004-02-12</signatureDate>
    </ownerSignature>
</ownershipDocument>

</XML>
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
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