ALEXANDRIA, Va. (Dec. 6, 2022) – Decisions by Cigna and Express Scripts to eliminate the option for Tricare beneficiaries to obtain prescriptions at their pharmacy of choice should not disrupt patient access to needed medications, a group of pharmacy organizations emphasized today to Amy Bricker, president of Express Scripts, and David Cordani, president and CEO of Cigna. The National Community Pharmacists Association, 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 argued that to keep beneficiary access to pharmacy care, all pharmacies that were included in the 2022 Tricare network remain in the 2023 network at the 2022 terms and conditions.
The pharmacy network changes by Express Scripts, the Cigna-owned pharmacy benefit manager that administers the Tricare benefit on behalf of the Department of Defense, are estimated to impact 400,000 Tricare beneficiaries by shrinking the retail network by almost 15,000 pharmacies, effective Oct. 24, 2022. 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. After the Kroger grocery chain announced that its 2,200 pharmacies in 35 states would not participate in the Tricare provider network, Cigna/Express Scripts is extending another opportunity to pharmacies to participate. However, although a “new” solicitation for the Tricare pharmacy network was recently sent out, the pharmacy organizations said, “our members report that the contracts are virtually identical in terms of reimbursements to the ones sent out this summer, which would likely reimburse well below cost for many prescription medications.”
Tricare beneficiaries have gone public with their displeasure in news reports and opinion pieces across the country, and members of Congress are demanding answers on the contracts and the consequences for their constituents.
The pharmacy organizations said, “Tricare patients earned their benefits, and it is imperative that they retain convenient access to their health care providers especially those with whom they have established, trusted relationships. Independent community and specialty pharmacies take great pride in caring for those who honorably serve or have served in our armed forces. … The relationships between pharmacists and patients are built on trust, and for many patients is not something easily transferrable. Keeping patients’ trusted pharmacies in network is critical to the patients’ care.”
To view the letter to Bricker and Cordani, click here.
About the National Community Pharmacists Association
Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 19,400 pharmacies that employ nearly 240,000 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 www.ncpa.org.
About the Alliance for Pharmacy Compounding
The Alliance for Pharmacy Compounding is the voice for pharmacy compounding, representing compounding pharmacists and technicians in both 503A and 503B settings, as well as prescribers, educators, researchers, and suppliers. Every day, APC members play a critical role in patients’ lives, preparing essential, custom medications for a range of health conditions, including autism, oncology, dermatology, ophthalmology, pediatrics, women’s health, animal health, and more.
About the American Pharmacists Association
APhA is the only organization advancing the entire pharmacy profession. Our expert staff and strong volunteer leadership, including many experienced pharmacists, allow us to deliver vital leadership to help pharmacists, pharmaceutical scientists, student pharmacists, and pharmacy technicians find success and satisfaction in their work and advocate for changes that benefit them, their patients, and their communities. For more information, please visit www.pharmacist.com.
About the Senior Care Pharmacy Coalition
The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies, representing 75% of the sector overall. Its members operate in all 50 states and serve 850,000 patients daily in skilled nursing and assisted living facilities across the country. Visit seniorcarepharmacies.org to learn more.