UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934
(Amendment No.)*

NATIONAL MEDICAL HEALTH CARD SYSTEMS, INC.

(Name of Issuer)

Common Stock, $0.001 Par Value

(Title of Class of Securities)

636918302
(CUSIP Number)

February 21, 2008
(Date of Event which Requires Filing
of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:

[ ] Rule 13d-1(b)
[X] Rule 13d-1(c)
[ ] Rule 13d-1(d)

*The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.

The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).

Page 1 of 8

------------------- ------------------
CUSIP No. 636918302 13G Page 2 of 8 Pages
------------------- ------------------

---------- ---------------------------------------------------------------------
 1 NAME OF REPORTING PERSON
 I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

 S.A.C. Capital Advisors, LLC
---------- ---------------------------------------------------------------------
 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
 (a) [ ]
 (b) [X]
---------- ---------------------------------------------------------------------
 3 SEC USE ONLY

---------- ---------------------------------------------------------------------
 4 CITIZENSHIP OR PLACE OF ORGANIZATION

 Delaware
--------------------- ----- ----------------------------------------------------
 5 SOLE VOTING POWER

 0
NUMBER OF ----- ----------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY
OWNED 202,778 (see Item 4)
BY ----- ----------------------------------------------------
EACH 7 SOLE DISPOSITIVE POWER
REPORTING
PERSON 0
WITH ----- ----------------------------------------------------
 8 SHARED DISPOSITIVE POWER

 202,778 (see Item 4)
---------- ---------------------------------------------------------------------
 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 202,778 (see Item 4)
---------- ---------------------------------------------------------------------
 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES

 [ ]
---------- ---------------------------------------------------------------------
 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 3.6% (see Item 4)
---------- ---------------------------------------------------------------------
 12 TYPE OF REPORTING PERSON*

 00
---------- ---------------------------------------------------------------------
 *SEE INSTRUCTION BEFORE FILLING OUT


 Page 2 of 8


------------------- ------------------
CUSIP No. 636918302 13G Page 3 of 8 Pages
------------------- ------------------

---------- ---------------------------------------------------------------------
 1 NAME OF REPORTING PERSON
 I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

 S.A.C. Capital Management, LLC
---------- ---------------------------------------------------------------------
 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
 (a) [ ]
 (b) [X]
---------- ---------------------------------------------------------------------
 3 SEC USE ONLY

---------- ---------------------------------------------------------------------
 4 CITIZENSHIP OR PLACE OF ORGANIZATION

 Delaware
--------------------- ----- ----------------------------------------------------
 5 SOLE VOTING POWER

 0
NUMBER OF ----- ----------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY
OWNED 202,778 (see Item 4)
BY ----- ----------------------------------------------------
EACH 7 SOLE DISPOSITIVE POWER
REPORTING
PERSON 0
WITH ----- ----------------------------------------------------
 8 SHARED DISPOSITIVE POWER

 202,778 (see Item 4)
---------- ---------------------------------------------------------------------
 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 202,778 (see Item 4)
---------- ---------------------------------------------------------------------
 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES

 [ ]
---------- ---------------------------------------------------------------------
 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 3.6% (see Item 4)
---------- ---------------------------------------------------------------------
 12 TYPE OF REPORTING PERSON*

 00
---------- ---------------------------------------------------------------------
 *SEE INSTRUCTION BEFORE FILLING OUT


 Page 3 of 8


------------------- ------------------
CUSIP No. 636918302 13G Page 4 of 8 Pages
------------------- ------------------

---------- ---------------------------------------------------------------------
 1 NAME OF REPORTING PERSON
 I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

 Steven A. Cohen
---------- ---------------------------------------------------------------------
 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
 (a) [ ]
 (b) [X]
---------- ---------------------------------------------------------------------
 3 SEC USE ONLY

---------- ---------------------------------------------------------------------
 4 CITIZENSHIP OR PLACE OF ORGANIZATION

 United States
--------------------- ----- ----------------------------------------------------
 5 SOLE VOTING POWER

 0
NUMBER OF ----- ----------------------------------------------------
SHARES 6 SHARED VOTING POWER
BENEFICIALLY
OWNED 202,778 (see Item 4)
BY ----- ----------------------------------------------------
EACH 7 SOLE DISPOSITIVE POWER
REPORTING
PERSON 0
WITH ----- ----------------------------------------------------
 8 SHARED DISPOSITIVE POWER

 202,778 (see Item 4)
---------- ---------------------------------------------------------------------
 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON

 202,778 (see Item 4)
---------- ---------------------------------------------------------------------
 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES

 [ ]
---------- ---------------------------------------------------------------------
 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)

 3.6% (see Item 4)
---------- ---------------------------------------------------------------------
 12 TYPE OF REPORTING PERSON*

 IN
---------- ---------------------------------------------------------------------
 *SEE INSTRUCTION BEFORE FILLING OUT


 Page 4 of 8


Item 1(a) Name of Issuer:

National Medical Health Card Systems, Inc.

Item 1(b) Address of Issuer's Principal Executive Offices:

26 Harbor Park Drive, Port Washington, New York 11050

Items 2(a) Name of Person Filing:

This statement is filed by: (i) S.A.C. Capital Advisors, LLC ("SAC Capital Advisors") with respect to shares of common stock, $0.001 par value ("Shares"), of the Issuer beneficially owned by S.A.C. Capital Associates, LLC ("SAC Capital Associates"); (ii) S.A.C. Capital Management, LLC ("SAC Capital Management") with respect to Shares beneficially owned by SAC Capital Associates; and (iii) Steven A. Cohen with respect to Shares beneficially owned by SAC Capital Advisors, SAC Capital Management and SAC Capital Associates.

SAC Capital Advisors, SAC Capital Management and Steven A. Cohen have entered into a Joint Filing Agreement, a copy of which is filed with this Schedule 13G as Exhibit 99.1, pursuant to which they have agreed to file this Schedule 13G jointly in accordance with the provisions of Rule 13d-1(k) of the Securities Exchange Act of 1934, as amended.

Item 2(b) Address of Principal Business Office:

The address of the principal business office of (i) SAC Capital Advisors and Mr. Cohen is 72 Cummings Point Road, Stamford, Connecticut 06902 and (ii) SAC Capital Management is 540 Madison Avenue, New York, New York 10022.

Item 2(c) Citizenship:

SAC Capital Advisors and SAC Capital Management are Delaware limited liability companies. Mr. Cohen is a United States citizen.

Item 2(d) Title of Class of Securities:

Common Stock, $0.001 par value

Item 2(e) CUSIP Number:

636918302

Item 3 Not Applicable

Page 5 of 8

Item 4 Ownership:

The percentages used herein are calculated based upon the Shares issued and outstanding as of February 6, 2008 as reported on the Issuer's quarterly report on Form 10-Q filed with the Securities and Exchange Commission by the Issuer for the quarterly period ended December 31, 2007.

As of the close of business on February 26, 2008:

1. S.A.C. Capital Advisors, LLC
(a) Amount beneficially owned: 202,778
(b) Percent of class: 3.6%
(c)(i) Sole power to vote or direct the vote: -0-
(ii) Shared power to vote or direct the vote: 202,778
(iii) Sole power to dispose or direct the disposition: -0-
(iv) Shared power to dispose or direct the disposition:


202,778

2. S.A.C. Capital Management, LLC
(a) Amount beneficially owned: 202,778
(b) Percent of class: 3.6%
(c)(i) Sole power to vote or direct the vote: -0-
(ii) Shared power to vote or direct the vote: 202,778
(iii) Sole power to dispose or direct the disposition: -0-
(iv) Shared power to dispose or direct the disposition:


202,778

3. Steven A. Cohen
(a) Amount beneficially owned: 202,778
(b) Percent of class: 3.6%
(c)(i) Sole power to vote or direct the vote: -0-
(ii) Shared power to vote or direct the vote: 202,778
(iii) Sole power to dispose or direct the disposition: -0-
(iv) Shared power to dispose or direct the disposition:


202,778

SAC Capital Advisors, SAC Capital Management and Mr. Cohen do not directly own any Shares. Pursuant to investment management agreements, each of SAC Capital Advisors and SAC Capital Management share all investment and voting power with respect to the securities held by SAC Capital Associates. Mr. Cohen controls each of SAC Capital Advisors and SAC Capital Management. By reason of the provisions of Rule 13d-3 of the Securities Exchange Act of 1934, as amended, each of SAC Capital Advisors, SAC Capital Management and Mr. Cohen may be deemed to own beneficially 202,778 Shares (representing approximately 3.6% of the Shares outstanding). Each of SAC Capital Advisors, SAC Capital Management and Mr. Cohen disclaim beneficial ownership of any of the securities covered by this statement.

Page 6 of 8

Item 5 Ownership of Five Percent or Less of a Class:

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following. [X]

Item 6 Ownership of More than Five Percent on Behalf of Another

Person:

Not Applicable

Item 7 Identification and Classification of the

Subsidiary Which Acquired the Security Being
Reported on By the Parent Holding Company:

Not Applicable

Item 8 Identification and Classification of Members

of the Group:

Not Applicable

Item 9 Notice of Dissolution of Group:

Not Applicable

Item 10 Certification:

By signing below the signatory certifies that, to the best of his knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

Page 7 of 8

SIGNATURE

After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.

Dated: February 27, 2008

S.A.C. CAPITAL ADVISORS, LLC

By: /s/ Peter Nussbaum
 -------------------------------
Name: Peter Nussbaum
Title: Authorized Person

S.A.C. CAPITAL MANAGEMENT, LLC

By: /s/ Peter Nussbaum
 -------------------------------
Name: Peter Nussbaum
Title: Authorized Person

STEVEN A. COHEN

By: /s/ Peter Nussbaum
 -------------------------------
Name: Peter Nussbaum
Title: Authorized Person

Page 8 of 8
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