Comment: Loss of pharmacy access for military a crisis

By Gerard Scimeca / For The Herald

Earlier this month, Sens. Maria Cantwell and Patty Murray sent a joint letter to Federal Trade Commissions Chair Lina Khan expressing concerns around the Kroger-Albertsons merger, stating “underserved communities throughout Washington benefit from these stores and what they provide in price competition, convenience, high-quality nutritional access and pharmacy services.”

The senators’ mention of pharmacy services was especially interesting, given the recent cut of pharmacy services to Washington’s large military population due to the greed of pharmacy benefit managers – the actual threat to Washington consumers, workers and underserved communities.

Last month, Tricare, the federal insurance program that provides prescription drugs benefits to veterans and active military families, abruptly cut 15,000 independent, local and rural pharmacies from their network. The reason? Express Scripts, Tricare’s exclusive pharmacy benefits provider, decided it can make far greater profits by prioritizing self-owned pharmacies over widespread access for Tricare beneficiaries.

Express Scripts, with revenue exceeding $120 billion, highlights the larger problem with benefit managers across America’s health care system. More than 80 percent of the prescription drug market is controlled by three powerful providers, who act as middlemen between drug makers and pharmacy outlets. The pharmacy benefit managers decide what they pay drug manufacturers, what drugs will be covered in health plans, and what patients will pay, including out-of-pocket costs. Benefit practices deliberately lack transparency; actual costs are hidden from consumers, making the benefit providers the leading driver in higher prescription drug prices.

It would be difficult to find a more appalling betrayal of our veterans. Express Scripts is making access to care more difficult and certainly more expensive for hundreds of thousands of military families nationwide. As 100 members of Congress recently wrote in a bipartisan letter — which neither Cantwell nor Murray signed — Express Script’s craven and callous dismissal of thousands of local pharmacies is not only a conflict of interest — clearly intended to boost profits at the expense of beneficiaries — but is also a direct assault on the health and well-being of America’s veterans and military personnel.

The omission of Cantwell and Murray on this joint letter is disheartening, as is their absence from bipartisan efforts to address this issue. Cantwell helped introduce the Pharmacy Benefit Managers Transparency Act of 2022, so she is well-versed in how managers like Express Scripts harm underserved communities. Express Scripts’ attack on prescription drug access for Washington’s military and veteran communities demonstrates that they wield immense, unchecked power over pharmacies regardless of ownership.

In fact, Kroger, which owns Fred Meyer and QFC, was recently forced to cut ties with Express Scripts due to exceptionally unfavorable contract terms that would have forced the grocer to increase prices on their customers or accept rates below the industry standard.

As representatives to one of the largest active-duty military member and veteran populations in the country, Cantwell and Murray should be highlighting the shameful and egregious behavior of Express Scripts and calling on the Defense Health Agency to demand an investigation.

The Department of Defense is adding insult to injury by siding with the special-interest insurance companies over our men and women in uniform. It’s time Cantwell and Murray do what is right for Washington’s veterans and military families.

Gerard Scimeca is an attorney and chairman of CASE, Consumer Action for a Strong Economy, a non-partisan, non-profit consumer advocacy organization.