tricare

TRICARE

Express Scripts, the Cigna-owned pharmacy benefit manager, continues to administer the TRICARE pharmacy benefit on behalf of the Department of Defense despite shrinking the pharmacy network by nearly 15,000 pharmacies in 2022, impacting 400,000 TRICARE beneficiaries. Adding to the patient disruption, ESI continues to list many pharmacies that were either terminated or who have voluntarily left the network due to poor contract terms as still in network. Despite these egregious errors, ESI has never been penalized or held accountable.

The bid process for the next Tricare contract starts in 2026, and as that gets underway, bipartisan legislation has been introduced in both chambers of Congress to enhance transparency in the TRICARE pharmacy program. H.R. 6400/S. 4106, the RX ACCESS Act would restore pharmacy choice for beneficiaries, provide for fair reimbursements to pharmacies, and promote transparency and accountability of the TRICARE pharmacy program by requiring an annual audit.

Ultimately, Tricare beneficiaries suffer when access is limited. Their choice of healthcare provider is removed, and they are forced to use mail order or drive long distances to a military treatment facility (MTF). These options are not always best for many beneficiaries.

The resources below will assist pharmacies and patients in advocating the need for these important changes to the new TRICARE pharmacy contract.

Pharmacy/Patient Resources

Congressional/Governor Letters to Department of Defense re TRICARE

NCPA's Communications with Department of Defense and Cigna/ESI

Change.org Petition