“Express Scripts told us, ‘You can just go to CVS'... But that was kind of a mess because you can’t just go into CVS and get a $1,500 medicine. You have to be in their special pharmacy system.”
The move has upset customers and many independent pharmacies and has raised concerns among some service member advocates and lawmakers, especially those in rural states, who feel it disproportionally affects rural veterans.U.S. Sen. Jon Tester, D-Mont.
Peter Graves, a spokesperson for the Defense Health Agency, which oversees medical care and services for 9.6 million beneficiaries, including service members, military retirees, and their families, said the Pentagon does not participate in contract negotiations between its pharmacy benefit manager and retail pharmacies.
In a separate email, Express Scripts spokesperson Justine Sessions said the decision to leave the network was “up to the pharmacy and/or the wholesalers that negotiate on their behalf.” She added that roughly 80% of pharmacies being dropped from the network had fewer than 50 prescription claims in the past six months from Tricare and that 25% had none.
The move could delay care for patients with chronic conditions such as rheumatoid arthritis, myasthenia gravis, and Crohn’s disease, Davis said. Swapping out intravenous prescriptions isn’t simple, he said. “What reasons has Express Scripts given DHA for terminating the 2022 contracts early?” they asked. “This will only further reduce the pharmacy network for Tricare patients and their families, and may force beneficiaries to change pharmacies at a time when many receive annual vaccinations.”that asks affected patients, pharmacists, and health care providers for feedback so the lawmaker can catalog them and press the Biden administration for a reversal.
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