NCPA Calls on State AGs to Scrutinize Express Scripts-Prime Therapeutics Tag Team

NCPA October 22, 2020

PBM giants’ “collaboration” will smother competition and limit choices, says National Community Pharmacists Association

ALEXANDRIA, Va. (Oct. 22, 2020) — In a recent letter to state attorneys general, the National Community Pharmacists Association warned that a partnership between two massive pharmacy benefit managers will squash local pharmacies and ultimately limit consumer choices.

“These two companies operating separately already exert tremendous downward pressure on independent pharmacies. By joining forces, they can put many out of business and steer their patients to larger competitors,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “There’s nothing competitive or fair about that, and in the end, patients will lose access to their preferred local health care providers.”

NCPA urged the National Association of Attorneys General to scrutinize a partnership between Express Scripts and Prime Therapeutics, two of the biggest PBMs in the country. Express Scripts, which is owned by Cigna, controls prescriptions for 75 million patients across the country. Prime Therapeutics is owned by a consortium of Blue Cross Blue Shield companies that cover 30 million patients in 18 states. In April of this year they formed a partnership to combine their negotiating leverage. According to NCPA, it has already triggered sharp cuts in reimbursements to pharmacies.

“It puts the pharmacy small businesses in a completely untenable position,” said Hoey. “They can offer a take-it-or-leave-it contract to the pharmacy, under which the pharmacist must accept reimbursements that are lower than the cost of filling prescriptions, or say goodbye to his patients who’ll be steered to a larger competitor or into Express Scripts’ mail order pharmacy.”

NCPA pointed out that Express Scripts has already been sued for its anti-competitive practices, and that the partnership with Prime Therapeutics gives the giant PBM an even bigger club to hold over local pharmacies.

“This collaboration is a risk to patient access and a clear and present danger to local pharmacies,” said Hoey. “At the state level is where some of the strongest oversight is taking place. Now we are urging the attorney general in every state to look at this relationship very carefully and consider whether it’s beneficial for consumers and small businesses rather than two of the biggest and most profitable corporations in the pharmacy sector.”


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit