President, chair, and chief executive officer, Express Scripts
Born: 1947, in Briarcliff Manor, New York.
Education: Kenyon College, BA, 1969; Wharton School of Finance and Commerce at the University of Pennsylvania, MPA, 1974.
Family: Married Polly (maiden name unknown); children: two.
Career: State of Illinois, c. 1970–1973, budget analyst; state of Pennsylvania, c. 1973–1974, budget analyst; PriceWaterhouse, consultant to state and local governments, c. 1974–1979; campaign office of Arkansas gubernatorial candidate Bill Clinton, 1979, budget adviser; state of Arkansas, 1979–1981, commissioner of social services; Missouri Department of Social Services, 1981–1985; director; Sanus Health Plan of St. Louis, 1985–1991, executive director and chief operating officer; Express Scripts, 1986–1989, manager; 1989–, president and chief executive officer, 2000–, chairman of the board.
Awards: Named Entrepreneur of the Year, Inc. , 1994.
Address: Express Scripts, 13900 Riverport Dr., Maryland Heights, Missouri 63043; http://www.expressscripts.com.
■ Barrett A. Toan helped make Express Scripts into one of the leading pharmacy-benefits management (PBM) companies in the United States. Thanks to savvy acquisitions and the changing prescription drug market, Toan's Missouri company posted revenues of $13.3 billion in 2003, with earnings of $249.5 million. It was the third-largest PBM company in the United States and was poised to take a lucrative share of the new Medicare prescription-discount card.
Toan was born in 1947 and grew up in Briarcliff Manor, New York. He was schooled at Kenyon College in Ohio and at the University of Pennsylvania's Wharton School of Finance and Commerce, from which he earned a master's degree in public business administration. His first job was with the state of Illinois in its Bureau of the Budget. He also held a similar post in Pennsylvania's capital and then worked as a public-policy consultant in Washington, D.C.
Toan's Beltway experience led to a position on the campaign staff of an Arkansas gubernatorial candidate in 1979. When the Democratic candidate, a young attorney general named Bill Clinton, won the election, Toan was named to his cabinet as commissioner of Arkansas's division of social services. After two years in Little Rock, Toan moved on to a post as the director of the Missouri Department of Social Services. He left the public sector in 1985 to take a position at a new company, Sanus Health Plan in St. Louis, a health maintenance organization. He served as its executive director and chief operating officer for the next six years. In 1986 he took a third position, running a mail-order pharmacy company within Sanus called Express Scripts, which was a joint venture between Sanus and a St. Louis–based retail drugstore chain.
Express Scripts struggled during its first few years in business. It changed hands more than once but eventually became a stand-alone company in the early 1990s. At that point Toan was serving as president and chief executive officer. The company went public in 1992, and only when Toan decided to branch out into the new field of PBM did Express Scripts begin to turn a profit. "We created the first, to our knowledge, national program that had uniform pricing for retailers and for mail order in all 50 states," he told Pam Droog in an interview with St. Louis Commerce (August 2001).
Revenues at Express Scripts grew steadily during the 1990s, and Toan's company quickly became a leader in the field. Its clients were government agencies or employers that offered prescription drug coverage in their employee health insurance plans. Express Scripts then negotiated discounts with drug-makers to lower the prices of prescriptions purchased at the retail level. Its dual goal was to save the employers and employees money and to ensure that drugmakers would be able to profit from steady sales of its products in return.
Other PBMs came onto the playing field in the 1990s but later merged with the drugmakers themselves, which some viewed as potential conflict of interest. Toan, however, was committed to keeping Express Scripts independent. He later made several savvy acquisitions of competitors when the drug-makers decided to unload them, including a 1999 purchase of Diversified Pharmaceutical Services from SmithKline Beecham. The $715 million price paid was far less than Smith-Kline Beecham had paid for it some years earlier.
In 1998 Forbes magazine named Toan one of America's most underpaid executives, based on his salary over a five-year period in relation to the excellent performance of Express Scripts stock, which is traded on the NASDAQ under the ticker ESRX. When one of the original backers, New York Life, sold its stake in the company in 2000, Toan was given the title chairman of the board and received a $7.9 million bonus package of stock and retirement benefits.
Toan kept abreast of Express Scripts' rivals in the PBM field—Medco Health Solutions, AdvancePCS, and Care-mark—from his office at company headquarters in Maryland Heights, Missouri. His company also became involved in the new prescription drug card feature of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Although by the early 2000s he was no longer considered one of corporate America's most undercompensated CEOs, he still kept a modest office of just one hundred square feet, comparable to the many of the workspaces of the five thousand other Express employees. The dean of the graduate business school at Washington University in St. Louis, Stuart Greenbaum, told Droog in the St. Louis Commerce article that Toan was "able to strategize at a high level of sophistication," He added, "Express Scripts has grown dramatically and been able to weather a few speed bumps, which Barrett has navigated with exquisite adroitness."
See also entry on Express Scripts Inc. in International Directory of Company Histories .
Droog, Pam, "Pharmaceutical Genius," St. Louis Commerce, August 2001.
MacDonald, Elizabeth, "Drug Lord," Forbes , February 16, 2004, p. 72.
Manning, Margie, "Moving Up," St. Louis Business Journal , March 30, 2001, p. 2.