Pharmacy Groups Criticize Express Scripts’ Tricare Decision

Independent pharmacies are no longer part of Tricare’s pharmacy network for uniformed service members and their families. The pharmacy groups say this will impact 400,000 beneficiaries.

Several pharmacy groups have criticized decisions made in October 2022 by Cigna and Express Scripts to eliminate 15,000 independent pharmacies from Tricare’s retail pharmacy network. Tricare is the healthcare program for uniformed service members, retirees and families. Express Scripts manages the Tricare pharmacy retail network under a contract with the Department of Defense. This network change will be implemented in preparation of the next pharmacy contracts, Tricare said.

But the changes made by Express Scripts, owned by Cigna, are estimated to impact 400,000 Tricare beneficiaries, the National Community Pharmacists Association (NCPA) said in a news release.

The NCPA — along with the Alliance for Pharmacy Compounding, the American Pharmacists Association, the National Association of Specialty Pharmacy, the National Home Infusion Association, and the Senior Care Pharmacy Coalition — said in a letter to Express Scripts President Amy Bricker and Cigna President and CEO David Cordani that all pharmacies that were included in the 2022 Tricare network should remain in the 2023 network at the 2022 terms and conditions.

“The contract terms offered were far below pharmacy acquisition costs for drugs, forcing most pharmacies to make the difficult choice to reject the terms, with no opportunity to renegotiate,” NCPA said. Even large corporations such as Kroger “found the contract terms unsustainable” with below cost reimbursements,” NCPA and the other organizations wrote in the letter.

In a statement, Tom Jenkins, Express Scripts vice president of Account Management, DoD Programs, said "Express Scripts is privileged to continue serving the men and women of the United States Armed Forces, military retirees, and their families. Our recent network change ensured TRICARE beneficiaries can access their prescription medication safely, affordably, conveniently, and at the best value for the Department of Defense and taxpayers."

“Tricare patients earned their benefits, and it is imperative that they retain convenient access to their healthcare providers especially those with whom they have established, trusted relationships…Keeping patients’ trusted pharmacies in network is critical to the patients’ care,” NCPA and the other organizations said in the letter.

However, Edward Norton, Jr., chief of the Pharmacy Operations Division at the Defense Health Agency said in a news release that the DHA “is confident that the new pharmacy contract maintains the quality of the Tricare retail pharmacy network.”

“Some independent pharmacies are leaving, but Tricare families will continue to have access to an excellent network of pharmacies,” Norton said. More than 90% of beneficiaries will have at least one network pharmacy within 15 minutes of their home, according to Tricare.