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NCPA to DOD: Express Scripts jeopardizing Tricare patients’ pharmacy access

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ALEXANDRIA, Va. Recent Express Scripts decisions to eliminate the option for Tricare beneficiaries to obtain their prescriptions at their pharmacy of choice should be rectified to ensure their continued access to needed medications, the National Community Pharmacists Association emphasized Tuesday to U.S. Defense Secretary Lloyd Austin.

This appeal follows significant outreach from NCPA to agency officials to understand how they intend to take care of beneficiaries’ medication needs, to inform Department of Defense and the Defense Health Agency of what community pharmacy owners are reporting on these issues, and to work to protect pharmacy access for those who serve or have served in the armed forces.

“Tricare patients earned their benefits, and it is imperative that they retain convenient access to their health care providers,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA, in his letter to Sec. Austin. “With a vast majority of independent pharmacies out of the network, along with large chains such as Kroger and Walmart, it is difficult to see how Cigna/Express Scripts is meeting even the reduced access standards in its new contract with DOD. We therefore urge you to take steps to ensure all pharmacies that were included in the 2022 Tricare network remain in the 2023 network at the 2022 terms and conditions. Without this action, access to needed medications for Tricare beneficiaries is in peril.”

The pharmacy network changes by Express Scripts, the Cigna-owned pharmacy benefit manager that administers the Tricare benefit on behalf of DOD, are estimated to impact 400,000 Tricare beneficiaries by shrinking the retail network by almost 15,000 pharmacies, most of which are independent community pharmacies located in underserved rural and urban areas. On top of that, it became clear in September that Cigna/Express Scripts made the unilateral decision to make these changes effective Oct. 24, 2022, surprising and confusing patients and pharmacies who expected the 2022 contract to last through the remainder of the year.

NCPA has been engaged on this issue with legislators as well, which has resulted in several members of Congress demanding answers on the recent Tricare pharmacy contracts and the consequences for their constituents. Sen. Jon Tester (D-Mont.), chairman of the Senate Committee on Veterans’ Affairs, blasted the changes that threaten beneficiaries’ access to community pharmacies, especially in rural areas. He calls Express Scripts’ network changes “unacceptable” and asks DOD to take immediate steps to address these urgent concerns. Additionally, 100 bipartisan members of the House and Senate sent another letter led by Sen. Tom Cotton (R-Ark.) and Rep. Buddy Carter (R-Ga.), asking for answers about Express Scripts stripping local pharmacy access away from Tricare families. Rep. Mike Johnson (R-La.) also sent a letter citing his concerns, especially for those in the areas surrounding Barksdale Air Force Base and Fort Polk in north Louisiana, and asking how DOD would ensure adequate access to retail pharmacies and for justification for the early termination of the 2022 contract. Additional congressional outreach is expected.

For a one-pager with more information on the changes and what they will mean for patients and small-business pharmacies, click here.


ECRM-08-202222

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