Senior Care Pharmacy Coalition Releases Statement on New Congressional Letter Regarding ESI Contracts

DATE: June 27, 2024

The Senior Care Pharmacy Coalition (SCPC), the leading national voice for the long-term care pharmacy community, released a statement today in response to the recent letter to Assistant Secretary Martinez-Lopez and Lieutenant General Crosland regarding Express Scripts (ESI) contracts within TRICARE:

“We commend Senator Warren, Representative Carter and the 22 bipartisan co-signers of the recent letter to the Defense Health Agencyvoicing concerns with the decision to contract with Cigna-owned Express Scripts (ESI) – one of the largest PBMs in the country – to administer TRICARE’s pharmacy program.

“Since the shift to ESI in 2022, ESI has leveraged its market power to steer the 9.6 million TRICARE beneficiaries toward their own mail-order pharmacies. They deny and overcharge for critical health care while inadequately reimbursing the long-term care (LTC) pharmacies that provide specialized services to our active-duty service members, family members, and military retirees.

“This year, ESI has brought the same predatory practices to millions of Medicare Part D beneficiaries living in LTC facilities, especially low-income beneficiaries dually eligible for both Medicare and Medicaid. The result: inferior care for seniors and financial challenges for LTC pharmacies, all so ESI and its affiliated mail-order pharmacy can rake in even more money. This problem only underscores the pressing need for comprehensive PBM reform. 

“We urge Congress to take action to hold ESI accountable for its predatory and anticompetitive practices. This is crucial to ensure that TRICARE beneficiaries – and all Americans who rely on LTC pharmacy services – can continue to receive quality care, especially the unique services offered by LTC pharmacies,” said Alan Rosenbloom, President and CEO of SCPC.

###