ALEXANDRIA, Va. (April 21, 2023) – The National Community Pharmacists Association expressed skepticism that a recent announcement by the pharmacy benefit manager Express Scripts, owned by Cigna, will evolve the one-sided business relationship PBMs exploit that results in decreased transparency, higher patient prescription drug costs, and stifled competition. In its most recent move, Cigna-Express Scripts claims to be expecting to benefit thousands of independent pharmacies across the country by expanding patient access to care in rural communities – based on criteria that Cigna-Express Scripts determines. Local networks of independent pharmacies providing a variety of health screenings, testing, and clinical services already exist in the marketplace for Cigna to engage with rather than recreate these networks under their vision. Vertically integrated PBMs are under intense scrutiny by federal and state officials, including active inquiries by Congress and the Federal Trade Commission. Based on past actions by Cigna-Express Scripts, NCPA believes there is no basis for independent pharmacies to have confidence they will actually see increased reimbursements from Cigna-Express Scripts. The focus on rural pharmacies is ironic, NCPA says, as the business practices of vertically integrated PBMs are one of the biggest drivers of the growth of pharmacy deserts that are hitting communities with health inequities especially hard.
“For years, Cigna-Express Scripts and the other big PBM-insurers have faced repeated accusations of monopolistic practices,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “This announcement has the makings of merely changing the conversation without addressing the underlying, structural issues within the vertically consolidated PBM-insurer-pharmacy industry that position health insurer-owned PBMs as ‘judge, jury, and executioner.’ These one-sided business practices are choking independent community pharmacies and making it hard for patients to receive convenient, affordable care from the pharmacy of their choosing.
“Those investigating PBMs – whether at agencies like the Federal Trade Commission, in Congress, or in the states – should not be fooled by these and other attempts to mislead or redirect or make it appear that they’re rehabilitating their detrimental business practices to reflect widespread concerns about their anticompetitive behaviors. Vertically integrated PBMs have had decades to voluntarily change their ways but have vigorously fought doing so. Now that momentum for meaningful industry-wide change is building, investigations must proceed and reforms must be put in place. Small-business pharmacies and the patients they serve depend on it.”
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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.
