A recent investigation by the Wall Street Journal has highlighted significant issues with Express Scripts, a pharmacy benefit manager. In August 2022, Express Scripts offered pharmacies competing with its subsidiary Accredo contract terms so unfavorable that nearly 15,000 pharmacies left the TRICARE network, affecting 400,000 active duty and retired military families. The Defense Health Agency granted Express Scripts the exclusive TRICARE contract in 2009. Express Scripts, which acquired Medco in 2012 and was itself acquired by Cigna in 2018, has been accused of charging commercial insurers more than 27 times the price for certain generic specialty drugs at Accredo compared to independent pharmacies. Additionally, Express Scripts has been criticized for under-reimbursing pharmacies at cancer clinics, forcing patients to use Accredo’s mail-order pharmacy, which has been prone to delays and safety issues. These practices have drawn the attention of congressional representatives and senators, including Bernie Sanders and Joe Biden, who are questioning the Department of Health and Human Services (HHS) and the Federal Trade Commission (FTC) about measures to prevent abuse of power by pharmacy benefit managers who control approximately 80% of all U.S. prescriptions.
Pharmaceutical companies can make whatever excuses they want for their sky-high drug prices — we know it’s bullshit. And Biden and Bernie just called them on it. If Big Pharma won’t quell its own greed, it’s up to the government to do it for them. https://t.co/YiodsDIoQI
President Biden and I are working together to lower the outrageously high cost of prescription drugs in our country. Today, we wrote a joint op-ed that appeared in USA Today. Americans cannot continue to be ripped off by the pharmaceutical industry. https://t.co/m2RExPsq8e
Pharmaceutical firms have gotten away with using junk patent listings to block competition & hike drug prices. @SenatorDurbin & I explain how lawmakers & @FTC are tackling these tactics. No American should pay inflated prices due to corporate lawbreaking. https://t.co/gsgIFqbgUn
"There is no rational reason why Americans, for decades, have been forced to pay, by far, the highest prices in the world for the prescription drugs they need," write @POTUS Joe Biden and @BernieSanders. https://t.co/HapcIOFt5o
Bernie Sanders and Joe Biden just co-authored a piece laying into big pharmaceutical companies for over-charging Americans on obesity drugs. I realize Biden is senile, but would his replacements do anything like this? Most wouldn't. https://t.co/e6qUxGJTDk
Below is example of why congressional reps & senators have been asking HHS & FTC about what they're doing to prevent abuse of power by 3 prescription drug insurance companies/pharmacy benefit mgrs who control ∼80% of all US prescriptions & require patients to use pharmacies they… https://t.co/R1BPYavi63
Also according to the letter, the Defense Health Agency granted Express Scripts the exclusive TRICARE contract in 2009. In 2012, Express Scripts acquired Medco, making Accredo a wholly owned subsidiary of Express Scripts. In 2018, Express Scripts was acquired by Cigna. https://t.co/K6NFv7rgbh
"For example, Express Scripts appears to routinely under-reimburses pharmacies at cancer clinics for expensive cancer drugs. When pharmacies reject [ES's] predatory terms, patients are forced to use Accredo’s mail-order pharmacy, which is prone to delays & safety issues, but… https://t.co/K6NFv7rgbh
"In August 2022, Express Scripts offered pharmacies that compete with Accredo such usurious contract terms that nearly 15,000 pharmacies left the TRICARE network, forcing 400,000 active duty & retired military families to decide between searching for a new in-network pharmacy… https://t.co/K6NFv7rgbh
"According to a Wall Street Journal investigation, Express Scripts charged commercial insurers more than 27 times more for a selection of generic specialty drugs at Accredo compared to @costplusdrugs an independent pharmacy the WSJ used as a baseline." https://t.co/K6NFv7rgbh