Express Scripts Holding Co., the largest U.S. processor of drug prescriptions, gave a profit forecast for the year that exceeded analysts’ lowered estimates.

Profit excluding certain items will be $4.20 to $4.30 a share this year, St. Louis-based Express Scripts said Monday in a statement. Analysts expected $4.20, the average of 21 estimates compiled by Bloomberg. The estimates were reduced from an average of $4.50 in November when the company suggested the predictions were too high.

Express Scripts, which last year purchased Medco Health Solutions Inc. for $29 billion, manages drug benefits for insurers and for employers, and sells drugs through mail-order pharmacies. It said in November that analysts’ views for profit growth were overly aggressive, citing a business climate that may lead to a loss of members, less drug utilization and price pressure. Some analysts remain optimistic.

“The company, with its acquisition of Medco, has the opportunity to be the dominant industry leader,” Anthony Vendetti, an analyst at Maxim Group LLC in New York who has a buy rating on the shares, said in a Feb. 4 note. “We expect the company to achieve net new business wins in 2013 and build upon the positive momentum created in its Medicaid business.”

The integration of Medco is “on schedule,” he said, and all former Medco patients should be transferred to Express Scripts by the end of this year.

Express Scripts Monday reported that fourth-quarter net income from continuing operations rose to $516 million, or 62 cents a share, from $290 million, or 59 cents, a year earlier.

Profit excluding some items was $1.05 cents a share, the company said, topping the $1.04 average of 19 analysts’ estimates compiled by Bloomberg.

Sales in the quarter rose to $27.4 billion, from $12.1 billion, aided by the Medco acquisition.

Full-year profit for 2012 was $1.3 billion on sales of $94 billion, the company said.