Orphan Medical Names Express Scripts Exclusive Distributor of Xyrem®

SDS Subsidiary Will Manage Unique Distribution System for Cataplexy Medication

St. Louis, MO and Minnetonka, MN - August 22, 2002

Express Scripts (ESRX) and Orphan Medical, Inc. today announced that Express Scripts will be the sole distributor of Orphan Medical's Xyrem® (sodium oxybate) oral solution through its Specialty Distribution Services (SDS) subsidiary. The U.S. Food and Drug Administration (FDA) approved Xyrem® on July 17, 2002 for the treatment of cataplexy, a debilitating symptom associated with narcolepsy. It is the first and only medication approved to treat the disorder. Xyrem is expected to be available to patients through Express Scripts early in the fourth quarter of 2002.

Narcolepsy is a chronic, neurological sleep disorder affecting approximately 140,000 Americans. Between 60 and 90 percent of narcolepsy patients experience cataplexy, a sudden loss of muscle tone triggered by strong emotions such as laughter, anger, fright or surprise. In severe attacks, the patient may collapse and be unable to move for up to several minutes.

Clinical trials have shown Xyrem®, a formulation of the chemical compound gamma hydroxybutyrate, to be highly effective, reducing cataplexy attacks by approximately 70 percent and maintaining its effect long-term. Since the medicine is a Schedule III controlled substance approved under the FDA's Subpart H regulations governing distribution, Orphan Medical has developed a system that makes Xyrem available to patients exclusively from a single source -- the SDS specialty pharmacy. The system includes an educational program that physicians will receive before they can prescribe Xyrem and that patients will receive before first use.

SDS will provide pharmacy services to patients, collect patient-registry information, provide reimbursement support, distribute informational materials, and serve as a resource for product and educational program information. For more information, physicians and patients can call 1-866-997-3688 (1-866-XYREM88).

"Express Scripts is extremely pleased to work with Orphan Medical to bring this important medication to cataplexy patients, who previously have had no approved therapy available," said Barrett Toan, Express Scripts chairman and CEO.

Jean-Marc Quach, SDS vice president and general manager, added, "The administrative safeguards and distribution controls for Xyrem will be exceptionally rigorous; however, SDS has years of experience managing specialty products for unique markets and patient groups. We have the knowledge, the systems, and the patient-education and counseling capability required to distribute this medicine effectively within the safeguards defined by the Orphan Medical distribution system."

John Bullion, chairman and CEO of Orphan Medical, said, "SDS will be the only source through which Xyrem can be obtained. Distribution will comply fully with the risk-management controls jointly developed by Orphan Medical, the FDA, the Drug Enforcement Agency and law enforcement agencies. Express Scripts is the right choice to serve the physicians and patients we serve. Together, we will bring Xyrem - and new hope - to cataplexy patients in the United States."

About Express Scripts

Express Scripts (NASDAQ:ESRX), a Fortune 500, Forbes Platinum 400 and Nasdaq-100 company, is one of the largest pharmacy benefit management (PBM) companies in North America. Through facilities in eight states and Canada, the company provides pharmacy services and pharmacy benefit plan-design consultation for clients, including managed-care organizations, insurance carriers, third-party administrators, employers and union-sponsored benefit plans. Core services include pharmacy network management, mail and Internet pharmacies, formulary management, targeted clinical programs, integrated drug and medical data analysis, market research programs, medical information management, workers' compensation programs and informed-decision counseling. The company also provides non-PBM services, including distribution services for specialty pharmaceuticals through its Specialty Distribution Services subsidiary. Express Scripts is headquartered in St. Louis, Missouri. More information can be found at www.express-scripts.com.

About Orphan Medical, Inc.

Orphan Medical acquires, develops and markets pharmaceuticals of high medical value for inadequately treated and uncommon diseases treated by specialist physicians. Orphan Medical's Internet Web site address is www.orphan.com.

Express Scripts Safe Harbor Statement

This press release contains forward-looking statements, including, but not limited to, statements related to the company's plans, objectives, expectations (financial and otherwise) or intentions. Actual results may differ significantly from those projected or suggested in any forward-looking statements. Factors that may impact these forward-looking statements include but are not limited to:

• risks associated with our acquisitions of Phoenix and NPA, including integration risks and costs, risks of client retention, and risks associated with the operations of acquired businesses
• risks associated with our ability to maintain internal growth rates, or to control operating or capital costs
• continued pressure on margins resulting from client demands for enhanced service offerings and higher service levels, and the possible termination of, or unfavorable modification to, contracts with key clients or providers
• competition, including price competition, and our ability to consummate contract negotiations with prospective clients, as well as competition from new competitors offering services that may in whole or in part replace services that we now provide to our customers
• adverse results in regulatory matters, the adoption of new legislation or regulations (including increased costs associated with compliance with new laws and regulations, such as privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA)), more aggressive enforcement of existing legislation or regulations, or a change in the interpretation of existing legislation or regulations
• the possible loss of relationships with pharmaceutical manufacturers, or changes in pricing, discount or other practices of pharmaceutical manufacturers
• adverse results in litigation, including a pending case challenging Express Scripts' business practices under the Employee Retirement Income Security Act (ERISA)
• risks associated with our leverage and debt service obligations, including the effect of certain covenants in our borrowing agreements
• risks associated with our ability to continue to develop new products, services and delivery channels
• general developments in the health care industry, including the impact of increases in health care costs, changes in drug utilization and cost patterns and introductions of new drugs
• uncertainties regarding the implementation and the ultimate terms of proposed government initiatives, including a Medicare prescription drug benefit
• increase in credit risk relative to our clients due to adverse economic trends
• other risks described from time to time in our filings with The Securities and Exchange Commission

We do not undertake any obligation to release publicly any revisions to such forward-looking statements to reflect events or circumstances after the date hereof or to reflect the occurrence of unanticipated events.

Orphan Medical, Inc. Safe Harbor Statement

This information in this press release may contain forward-looking statements within the meaning of the Private Securities Litigation reform Act of 1995. A number of factors could cause actual results to differ materially from the Company's assumptions and expectations. These are set forth in the cautionary statements included in Orphan Medical's most recent Form 10-Q or Form 10-K filed with the Securities and Exchange Commission. (These documents can be accessed through the Orphan Medical Web site at www.orphan.com.) All forward-looking statements are qualified by, and should be considered in conjunction with, such cautionary statements.