EXHIBIT 10.9


     STOCK OPTION  AGREEMENT  made as of the 1st day of  February,  2000 between
NATIONAL  MEDICAL  HEALTH  CARD  SYSTEMS,  INC.,  a New  York  corporation  (the
"Company"), and Mary T. Casale (the "Optionee").

     WHEREAS,  the  Optionee  is an  employee  of the  Company  or a  subsidiary
thereof;

     WHEREAS,  the  Company  desires to provide to the  Optionee  an  additional
incentive to promote the success of the Company;

     NOW,  THEREFORE,  in  consideration  of the  foregoing,  the Company hereby
grants to the Optionee  (the  "Grant")  the right and option to purchase  Common
Shares of the Company under and pursuant to the terms and conditions of the 1999
Stock Option Plan (the "Plan") and upon and subject to the  following  terms and
conditions:

     1. GRANT OF OPTION. The Company hereby grants to the Optionee the right and
option (the  "Option")  to purchase up to Two Hundred  Fifty-Five  Thousand  Six
Hundred Eighty-Nine (255,689) Common Shares of the Company (the "Option Shares")
during the following periods:

          (a) All or any part of  Fifty-One  Thousand  One Hundred  Thirty-Eight
     (51,138) Common Shares may be purchased  during the period  commencing July
     1,  1999 and  terminating  at 5:00 P.M.  on July 1,  2005 (the  "Expiration
     Date");

          (b) All or any part of  Fifty-One  Thousand  One Hundred  Thirty-Eight
     (51,138) Common Shares may be purchased  during the period  commencing July
     1, 2000 and terminating at 5:00 P.M. on the Expiration Date;

          (c) All or any part of  Fifty-One  Thousand  One Hundred  Thirty-Eight
     (51,138) Common Shares may be purchased  during the period  commencing July
     1, 2001 and terminating at 5:00 P.M. on the Expiration Date;

          (d) All or any part of  Fifty-One  Thousand  One Hundred  Thirty-Eight
     (51,138) Common Shares may be purchased  during the period  commencing July
     1, 2002 and terminating at 5:00 P.M. on the Expiration Date;

          (e) All or any part of  Fifty-One  Thousand  One Hundred  Thirty-Seven
     (51,137) Common Shares may be purchased  during the period  commencing July
     1, 2003 and terminating at 5:00 P.M. on the Expiration Date;

     Notwithstanding anything to the contrary contained in Section 12 (a) of the
Plan,  the Option must be exercised in whole (or in part, if not fully  vested),
on a date one year after  termination of Optionee's  employment with the Company
or July 1, 2005, whichever is earlier.

     2.  NATURE OF OPTION.  Such  Options  to  purchase  the  Option  Shares are
intended to meet the requirements of Section 422 of the Internal Revenue Code of
1986, as amended, relating to "incentive stock options".

     3. EXERCISE PRICE. The exercise price of each of the Option Shares shall be
Five Dollars and 87/100 ($5.87) (the "Option Price").  The Company shall pay all
original issue or transfer taxes on the exercise of the Option.

     4. EXERCISE OF OPTIONS.  The Option shall be exercised in  accordance  with
the  provisions  of the Plan,  Section  12(a) of the Plan  excepted.  As soon as
practicable  after the receipt of notice of exercise (in the form annexed hereto
as Exhibit A) and payment of the Option Price as provided  for in the Plan,  the
Company shall tender to the Optionee  certificates issued in the Optionee's name
evidencing the number of Option Shares covered thereby.

     5. TRANSFERABILITY. The Option shall not be transferable other than by will
or the laws of descent and  distribution  and,  during the Optionee's  lifetime,
shall not be exercisable by any person other than the Optionee.

     6.  INCORPORATION  BY REFERENCE.  The terms and  conditions of the Plan are
hereby incorporated by reference and made a part hereof.

     7. NOTICES.  Any notice or other  communication  given  hereunder  shall be
deemed  sufficient  if in writing and hand  delivered or sent by  registered  or
certified mail, return receipt  requested,  addressed to the Company,  26 Harbor
Park Drive,  Port Washington,  New York 11050,  Attention:  Secretary and to the
Optionee at the address  indicated  below.  Notices shall be deemed to have been
given on the date of hand  delivery  or  mailing,  except  notices  of change of
address, which shall be deemed to have been given when received.

     8. BINDING  EFFECT.  This Agreement  shall be binding upon and inure to the
benefit  of the  parties  hereto  and their  respective  legal  representatives,
successors and assigns.

     9. ENTIRE AGREEMENT.  This Agreement,  together with the Plan, contains the
entire  understanding  of the parties  hereto with respect to the subject matter
hereof and may be modified only by an instrument executed by the party sought to
be charged.

     IN WITNESS WHEREOF,  the parties have executed this Agreement as of the day
and year first above written.

                                        NATIONAL MEDICAL HEALTH CARD
                                          SYSTEMS, INC.
                                        By:

                                        /s/Bert E. Brodsky
                                        Bert E. Brodsky, Chairman

                                        /s/Mary T. Casale
                                        Signature of Optionee

                                        Mary T. Casale
                                        Name of Optionee

                                        Address of Optionee



<PAGE>
                                   EXHIBIT A

                   NATIONAL MEDICAL HEALTH CARD SYSTEMS, INC.

                              OPTION EXERCISE FORM

     The  undersigned  hereby  irrevocably  elects to exercise the within Option
dated _____________ to the extent of purchasing  ________________  Common Shares
of National  Medical Health Card Systems,  Inc. The  undersigned  hereby makes a
payment of $_____________ in payment therefor.

                                        Mary Casale
                                        Name of Optionee


                                        Signature of Optionee


                                        Address of Optionee


                                        Date