Pharmacy benefit manager, Express Scripts Holding Company ESRX posted first-quarter 2016 earnings per share (excluding special items) of $1.22, a penny below the Zacks Consensus Estimate but higher than $1.10 reported in the year-ago quarter. On a reported basis, earnings came in at 81 cents per share, up from the year-ago figure of 60 cents.Quarterly HighlightsRevenues of $24.8 billion missed the Zacks Consensus Estimate of $25.5 billion and were roughly in line with the year-ago quarter figure.Adjusted gross profit dipped 1.6% to $1.9 billion in the reported quarter. Adjusted selling, general and administrative expenses were flat at $497.2 million.Total adjusted claims amounted to 323.5 million, up 5.2% year over year.In Jan 2016, Express Scripts closed the 2015 accelerated share repurchase (ASR) program and received 9.1 million additional shares, thereby resulting in the repurchase of a total of 64.2 million shares under the program. In Feb 2016, it entered into an agreement to repurchase shares for an initial payment of $2.8 billion and received 32.1 million shares of the common stock for the initial payment. This ASR program will be complete in the third quarter of 2016.OutlookExpress Scripts has raised its outlook for 2016. The company now anticipates earnings in the range of $6.31 to $6.43 per share, up from the previous projection of $6.10–$6.28. The pre-earnings Zacks Consensus Estimate of $6.17 is well below guided range. The company expects revenues related to a large client contract to be realized in the second quarter due to the structure of the same.The company estimates adjusted claims for 2016 in the range of 1,255 million to 1,295 million. Claims volume will be determined by retention rate, organic growth and new sales.For the second quarter, Express Scripts expects earnings in the range of $1.55 to $1.59 per share, while adjusted claims are projected in the range of 312 million to 322 million.Our TakeExpress Scripts’ first-quarter results were disappointing, with both earnings and revenues missing estimates. Results were impacted by the expected transition of the Catamaran business (as a result of acquisition) at the end of 2015 and into 2016, the expected roll-off of the Coventry Medicare business on Jan 1, 2016 and the renewal of the company’s second-largest client contract in May 2015, which initially results in lower margins.On the other hand, the company’s present Chief Executive Officer (CEO), George Paz, will step down from his position to be succeeded by Tim Wentworth.Meanwhile, the company believes that its 10-year contract with Anthem, Inc. ANTM running through 2019 (signed in 2009) might not be renewed or renewed at less favorable terms given the recent litigation. Hence, the company began amortizing its agreement with Anthem over the remaining term of the contract. Express Scripts carries a Zacks Rank #3 (Hold). A couple of better-ranked stocks in the health care sector are Gilead Sciences GILD and Shire SHPG. Both the stocks sport a Zacks Rank #1 (Buy). Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report >>Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report GILEAD SCIENCES (GILD): Free Stock Analysis Report ANTHEM INC (ANTM): Free Stock Analysis Report EXPRESS SCRIPTS (ESRX): Free Stock Analysis Report SHIRE PLC-ADR (SHPG): Free Stock Analysis Report To read this article on Zacks.com click here. Zacks Investment Research