FOR IMMEDIATE RELEASE
Contact: Sara Robertson (Sara.Robertson2@mail.house.gov)

Rep. Crawford: Express Scripts has Come Crawling Back to Arkansas Independent Pharmacies After Cutting Contracts with them Early

11/14/2022

Jonesboro – After announcing in September it would be ending contracts with thousands of community pharmacies, Express Scripts, the Pharmaceutical Benefit Manager (PBM) for TRICARE, has partially reversed course. It delivered a letter Friday to some independent pharmacies in Arkansas asking them to re-join its network. The Express Scripts letter attributes the change to its inability to reach agreement with Kroger to join the Express Scripps network.

“It shouldn’t have taken failure to come to an agreement with Kroger for Express Scripts to work with Arkansas’ independent pharmacies to provide choice and excellent care for our military families,” said Representative Rick Crawford (AR-1). “Express Scripts’ initial decision to thumb its nose at independent pharmacies and its apparent less-than-complete reversal are ominous signs for the ability of Express Scripts to provide our service members and their families with superior healthcare access and support.” 

For months, Arkansans have voiced frustration with changes the Defense Health Agency (DHA) is making to TRICARE pharmacy benefits, which will significantly limit healthcare access for TRICARE beneficiaries, particularly those in rural areas. Recently, DHA awarded a new $4 billion contract to Express Scripts, after which Express Scripts announced a reduction of up to 15,000 pharmacies from its retail pharmacy network. Express Scripts owns a mail-order and specialty pharmacy and is a direct competitor to independent pharmacies. Express Scripts has also slashed payments to community pharmacies below drug acquisition costs, forcing many independent pharmacies out of the TRICARE system.

“The Arkansas Pharmacists Association recently surveyed Arkansas based community pharmacies and found that 60% or 450 of 750 Arkansas local pharmacy locations will be out of network with Tricare and Express Scripts for 2023. The current Tricare community pharmacy network remains a disaster for military and families living in rural states like Arkansas. The latest round of communication from Express Scripts is smoke and mirrors and excuses rather than real solutions to save lives and provide needed pharmacy services in Arkansas. The current large chains and Express Scripts owned mail order options usually do not offer extended hours, weekend hours, emergency services, pediatric compounding, nursing home service, or adherence packaging required for long term care residents. The current Tricare network is often nonexistent in many communities in Arkansas where independent pharmacies are the only healthcare access for miles and miles. The Arkansas Pharmacists Association appreciates Congressman Crawford and other members of the Arkansas Congressional delegation for asking tough questions to the United States Department of Defense and to their pharmacy insurance companies, Cigna and Express Scripts,” said John Vinson, CEO of Arkansas Pharmacists Association.

Pharmacy benefit managers (PBM’s) are the middlemen between pharmacies and third-party payers, such as insurance companies, that are supposed to negotiate fair drug prices for consumers. PBMs have merged to a point where just three PBM’s control roughly 80% of the entire US market. However, in recent years, they have also merged with huge healthcare corporations, such as pharmacy chains and health insurance companies. These massive conglomerates can squeeze independent pharmacies through a number of anti-competitive practices, while using their opaque transactions with insurers and drug companies to pocket the bulk of the savings that were supposed to be shared with Americans by means of lower retail drug prices. Instead, PBM’s are driving “mom and pop” pharmacies out of business and reducing choice for rural patients in particular.

“A few PBM’s have become too powerful, as reflected by the pressure being put on TRICARE beneficiaries and independent pharmacies in Arkansas and elsewhere, particularly across rural America. All cards must be on the table, including potential antitrust enforcement, as my colleagues and I work in the new Congress to investigate the best ways to rein in these predatory practices,” concluded Crawford.

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