photography by Dominic Michael, Stock News Photos

Earlier today PUTT issued a statement on behalf of our members who are also CPESN members correcting Express Scripts (ESI) for its overreaching May 23rd announcement of a “collaborative” agreement with CPESN that doesn’t exist. (It exists with Cigna, not ESI)

We’re a bit surprised. We didn’t think we’d have to call out ESI so soon after protesting at their St. Louis headquarters on May 17th along with about 1300 fellow protesters online and in person, but we were wrong (BTW shout out to everyone who joined us onsite, including AIDS Healthcare Foundation, St. Louis Arthritis Center, Missouri Pharmacy Association, PSSNY members, Illinois Pharmacists Association and of course a very special thank you to protest organizer Loretta Boesing and Unite for Safe Medications!)

Poor Express Scripts. These must be difficult times with all the negative press and lawsuits (e.g. the State of Hawaii’s “deceptive business practices” lawsuit; the price-fixing lawsuit news that broke in January, not quite a year after a similar lawsuit in March 2023 brought by the State of Ohio. Then there was the wave of negative publicity in late 2022 after dropping 15,000 community pharmacies from the TRICARE network with almost no notice, etc.). The added scrutiny from Congressional and Senate hearings can’t be much fun either.

But now we’re learning the May 23rd announcement may have been distributed to Congress in addition to a widespread blast on PR Newswire — a surprisingly risky publicity stunt considering whose names are actually on the agreement. If that’s true, we’ll have to call out Express Scripts again, this time for their bluff ahead of the House Committee on Oversight’s PBM hearing next month.

We’ve never been afraid to call out Express Scripts. When ESI launched its “IndependentRx Initiative” and organized its Independent Pharmacy Advisory Council (IPAC), our president Deborah Keaveny penned a direct and unambiguous missive to Dr. Stephanie Cooney, former independent pharmacy owner and now head of the IPAC, offering step-by-step advice on how ESI could best work with independent pharmacies to fulfill its stated purpose to “enable an expanded role for pharmacists.”

Not surprisingly, our letter, sent via registered mail, went unanswered by Cooney or ESI. Also not surprisingly, ESI reportedly used IPAC members’ time to explain how ESI works, which if we are to believe, is to say ESI doesn’t work. It’s apparently a series of silos in which no division talks to another and senior contracting officials become “misty eyed” when learning the contract addendums they thought were being sent and executed via digital signature are in fact arriving by fax, no signature needed. (The only surprise here is that anyone would believe that story)

Critics of the IndependentRx initiative have pointed to numerous instances of ESI’s failure to follow through with promises. Complaints have included ESI devoting more time and attention to promoting the IPAC than convening IPAC meetings to work with members; operating in bad faith with pharmacy services administrative organizations (PSAOs) that contract on behalf of independent pharmacies; offering individual pharmacies worse repayment terms than those given to PSAOs representing pharmacies in the same geographic area; and creating duress by giving pharmacies short timeframes in which to review and decide whether or not to accept the non-negotiable contract terms.

We’re not surprised. Are you?

We’ve linked Express Scripts crappy reimbursements to walk outs in major retail chain pharmacies and questioned their relationship with GoodRx in the past. We’ve collected ESI “oops we goofed” patient steering letters and tracked a mountain of below-cost reimbursement data from them. We’re never shocked to hear ESI takes discussions and attempts at renegotiating terrible contracts off the table. We expect them to behave badly and they never disappoint.

So why should we or anyone else be surprised that Express Scripts would try to nab credit for an agreement that’s not theirs? Why would anyone even consider making an agreement with such reliably bad actors?

Express Scripts is under enormous pressure to appear like they’re the good guys. ESI is using the agreement between CPESN and Cigna to give themselves unearned cover from the increased scrutiny by lawmakers, the FTC, and the Department of Justice.

We’re not surprised — obfuscation and deception are what Express Scripts does best. But you will be if you think partnering with Express Scripts, Cigna or any of the major health insurers will be working in your pharmacy’s best interest.



Pharmacists United for Truth & Transparency

PUTT is a nonprofit organization dedicated to advocating on behalf of independent pharmacy & fighting against PBM anti-competitive business tactics.