TriCare Contract
Recently, the Department of Defense awarded a $4 billion contract to Express Scripts and at the same time reduced the size of the retail pharmacy network. Express Scripts, which owns its own mail-order and specialty pharmacy and is a direct competitor to other community pharmacies, has cut reimbursements, in many cases less than what the pharmacy pays itself for the drugs, making it nearly impossible for a pharmacy to be able to participate and serve our military and our families. Over 15,000 community pharmacies will be forced out of the Express Scripts network. Additionally, ESI has notified TriCare beneficiaries that these pharmacies that did not sign a contract with ESI for 2023 for TriCare will be out-of-network beginning October 24, 2022 instead of the end of December.
Twenty-eight members of the House of Representatives joined on a letter led by Rep. Ralph Norman (R-S.C.) and sent to Secretary of Defense Lloyd Austin questioning Cigna/Express Scripts’ claim that 7,000 independent pharmacies remained in the Tricare network and demanding answers on how that figure was calculated and the patient harm it will cause.
IPA stands for fair reimbursement practices, fair market competition and patient choice. These resources are provided to help educate patients and to provide an opportunity to take action.
Nineteen Democratic members of Congress sent a letter to the Department of Defense expressing concerns with and requesting answers on the TRICARE pharmacy network changes that recently took effect. The letter, led by Rep. Peter Welch (D-Vt.) raises concerns that Cigna/Express Scripts is not treating pharmacies equally and urges DOD to closely monitor all actions by Cigna/Express Scripts.
The Idaho Congressional delegation also sent a letter to the Department of Defense expressing concerns with and requesting answers on the TRICARE pharmacy network changes that recently took effect. The letter, signed by all four members of the delegation, requests DOD to address several questions and concerns pertaining to the Department’s oversight of TRICARE.
Additionally, Sen. Jerry Moran (R-Kan.) sent his own letter to DOD raising similar questions and concerns.
Here is the January 2023 Tricare letter to NCPA
What can you do?
1. Sign the petition
https://www.change.org/p/express-scripts-contract-hurts-tricare-patients-dha-act-now
2. Contact your member of Congress
Two members of Congress — Buddy Carter of Georgia in the House (himself a pharmacist) and Tom Cotton of Arkansas in the Senate — have written a letter to the Department of Defense demanding answers from the DoD.
3. Please tell your representatives and senators in Washington to sign that letter. The more signatures, the more clout the letter will have! Simply say, “Please sign the Carter/Cotton letter.”
4. Only Congress can stop Express Scripts from cutting off thousands of servicemembers from their neighborhood pharmacies!
Don’t know how to reach them? No worries! Click here to look them up on OpenStates.org.
Information for Patients:
Flyer for Patients (prepared by NCPA)
Sample Letter for Patients to send to DOD (prepared by NCPA)
Recently, seven Members of the House Representatives took the House floor to urge the Biden Administration and the Department of Defense to make changes to the current TRICARE pharmacy program. The Members spoke to the patient access issues that are already occurring in their respective districts. You can watch the floor speeches here (starts at 4:50:25). March 2023.