One of the nation’s most powerful pharmacy intermediaries is quietly charging the military’s health insurance program $484 more on average per generic drug than independent and big chain pharmacies, according to exclusive data shared with The Lever. The scheme forces taxpayers to spend significantly more to inflate the company’s profits, while cutting off many military families from local, accessible pharmacy care.
Lawmakers are working to add language to the pending defense spending bill that could shed light on this overbilling by requiring the US Department of Defense to finally disclose how much it’s paying pharmacies for medicines. But standing in the way is the formidable lobbying arm of the pharmacy giant’s corporate owner, which has spent millions on military health insurance and other issues over the past six years.
Express Scripts — a pharmacy benefit manager owned by health insurance giant Cigna — has overseen pharmacy benefits for the military’s health insurance program, TRICARE, since 2003. The program serves more than nine million active-duty service members, retirees, and their families.
This government-granted monopoly has allowed the company to “steer patients to its own pharmacy while disadvantaging competitors” and charge significantly more for commonly used generic drugs, according to a 2024 letter by lawmakers to the Department of Defense.
It’s difficult to know how much excess profit Express Scripts has netted from the arrangement. Despite years of bipartisan complaints and requests for more information by independent pharmacists, there’s been no effort to collect comprehensive data on the total amount Express Scripts is charging TRICARE for the drugs it provides up to this point.
“This is happening with a government-funded contract where things are supposed to be transparent,” said Monique Whitney, executive director of Pharmacists United for Truth and Transparency, an advocacy group that supports…
Auteur: Helen Santoro
