Exhibit 10.46


     STOCK  OPTION  AGREEMENT  made as of the April 30,  2002  between  NATIONAL
MEDICAL HEALTH CARD SYSTEMS,  INC., a New York corporation (the "Company"),  and
James Bigl (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 one hundred  thousand  (100,000) Common Shares
of the Company (the "Option Shares") during the following periods:

          (a) All or any part of thirty three  thousand  (33,000)  Common Shares
     may be purchased during the period commencing one year from the date hereof
     and terminating at 5:00 P.M. on April 11, 2007 (the "Expiration Date").

          (b) All or any part of thirty three  thousand  (33,000)  Common Shares
     may be  purchased  during  the  period  commencing  two years from the date
     hereof and terminating at 5:00 P.M. on the Expiration Date.

          (c) All or any part of thirty three  thousand  (34,000)  Common Shares
     may be  purchased  during the period  commencing  three years from the date
     hereof and terminating at 5:00 P.M. on the Expiration Date.

     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
nine ($9.00)  dollars (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. 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.

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     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. CHANGE IN CONTROL.  In the event of a Change in Control (as  hereinafter
defined),  any Options granted hereunder which have not vested as of the date of
the Change in Control  shall  automatically  vest on such date.  For purposes of
this Agreement, the term "Change in Control" shall mean:

          (a) the  transfer,  through  one  transaction  or a series of  related
     transactions,  either  directly  or  indirectly,  or  through  one or  more
     intermediaries,  of beneficial  ownership (within the meaning of Rule 13d-3
     promulgated  under the  Securities  Exchange Act of 1934) of 50% or more of
     either the then  outstanding  Common Shares or the combined voting power of
     the Company's then outstanding voting securities entitled to vote generally
     in the election of directors,  or the last of any series of transfers  that
     results in the transfer of beneficial ownership (within the meaning of Rule
     13d-3 promulgated under the Securities Exchange Act of 1934) of 50% or more
     of either the then  outstanding  Common Shares or the combined voting power
     of the  Company's  then  outstanding  voting  securities  entitled  to vote
     generally in the election of directors;

          (b)  approval  by the  stockholders  of the  Company  of a  merger  or
     consolidation,  with respect to which persons who were the  stockholders of
     the  Company  immediately  prior to such  merger or  consolidation  do not,
     immediately  thereafter,  own more than 50% of the combined voting power of
     the merged or consolidated  company's then outstanding  voting  securities,
     entitled to vote generally, in the election of directors or with respect to
     a  liquidation  or  dissolution  of  the  Company  or  the  sale  of all or
     substantially all of the assets of the Company;

          (c) the  transfer,  through  one  transaction  or a series of  related
     transactions, of more than 50% of the assets of the Company, or the last of
     any series of  transfers  that  results in the transfer of more than 50% of
     the  assets  of  the  Company.   For  purposes  of  this   paragraph,   the
     determination  of what  constitutes  more  than  50% of the  assets  of the
     Company shall be determined based on the most recent  financial  statements
     prepared by the Company's independent accountants; or

          (d) during any fiscal year,  individuals  who at the beginning of such
     year  constituted  the board of directors of the Company (the  "Board") and
     any new director or directors whose election by the Board was approved by a
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     vote of a majority  of the  directors  then still in office who either were
     directors at the beginning of the year or whose  election or nomination for
     election was  previously so approved,  cease for any reason to constitute a
     majority  thereof;  or

          (e) Bert  Brodsky  no longer  being the  Chairman  of the Board of the
     Company or Bert Brodsky ceases to be the Company's largest stockholder.

     7. DEATH OR PERMANENT DISABILITY OPTIONEE.  If the Optionee dies or becomes
permanently disabled (as defined herein) while employed by the Company, then the
Grant of Options vested  hereunder at the time of Optionee's  death or permanent
may be exercised by the estate or guardian of the Optionee pursuant to the terms
of this Option Agreement.  Moreover,  any options Granted by this Agreement that
remain unvested at the time of Optionee's  death or permanent  disability  shall
continue  to  vest  in  favor  of the  Optionee  or  designated  beneficiary  of
Optionee's  estate  and  become  exercisable  pursuant  to  the  terms  of  this
Agreement. "Permanent Disability" shall have occurred if as a result of physical
or mental  incapacity,  the Employee  shall have been  incapable  of  performing
Employee's duties for a period in excess of 26 consecutive weeks in any calendar
year, or an aggregate of 30 weeks in any 12 month period.


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

     9. 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.

     10. 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.

     11. 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.

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     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:

                                                     -------------------------
                                                     Bert E. Brodsky, Chairman



                                                     -------------------------
                                                     Signature of Optionee


                                                     -------------------------
                                                     Name of Optionee


                                                     -------------------------
                                                     Address of Optionee



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                                    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.


                                                       -----------------------
                                                       Name of Optionee


                                                       ------------------------
                                                       Signature of Optionee


                                                       ------------------------
                                                       Address of Holder


                                                       ------------------------
                                                       Date