NCPA implores Express Scripts to revise contract terms

NCPA April 15, 2024

Last week, NCPA pushed Cigna’s Express Scripts, Inc. (ESI), to revise contract terms to align with its obligation to offer “reasonable and relevant” terms and conditions for participation in a Medicare Part D pharmacy network, and to revise its “bonus pool fee” to align with federal policy. ESI should immediately address these concerns before more independent pharmacies close, NCPA CEO Douglas Hoey said in a letter (he faxed!) to Adam Kautzner, president of ESI, and David Cordani, chairman and chief executive officer of the Cigna Group.

“We cannot help but note that Cigna-Express Scripts has publicly announced a desire to work with independent pharmacies and has even formed an Independent Advisory Committee in the last year,” Hoey wrote in his letter, which NCPA publicized yesterday in a press release. “Unfortunately, and ironically, business conditions dictated by ESI to independent pharmacies have only gotten worse since ESI’s announcements – especially regarding Medicare Part D terms that our members tell us are out of market relative to Cigna-ESI’s competitors.” Hoey’s letter follows a February NCPA survey of independent pharmacy owners/managers in which almost half said that ESI was the PBM causing the most financial stress in Part D. CVS/Caremark came in at 35 percent. Read the press release here and stay tuned to qAM as we report on the outcome of this letter in the following weeks.