Thousands of Pharmacies Will Return to Tricare in January

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Pharmacy technician at Walter Reed National Military Medical Center,
Hospital Corpsman 3rd Class Mark Duong, a pharmacy technician at Walter Reed National Military Medical Center, organizes medication in the Arrowhead Pharmacy at WRNMMC in Bethesda, Maryland, Oct. 4, 2022. (DOD photo by Ricardo J. Reyes)

About 2,000 independent pharmacies will rejoin Tricare's network next month, the company in charge of administering the pharmacy benefits confirmed Friday.

"Since we issued the new solicitation on Dec. 1, we are pleased that more than 2,000 pharmacies have accepted the terms and will rejoin the Tricare network, and other pharmacies still have several more days to respond," Express Scripts spokesperson Justine Sessions said in an email.

That brings back a fraction of the nearly 15,000 pharmacies that left the network in October, which prompted outrage from advocacy groups, lawmakers and patients.

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Pharmacies that accepted the contract will be back in the network Jan. 15. The deadline for responding to the contract offer is Thursday.

Many of the 14,963 retail pharmacies that were dropped from the network Oct. 24 declined the contract to stay on because of lowered reimbursement rates they said would mean they had to operate at a loss. They also said they were blindsided by the October date, thinking they would stay in the network until the end of the year.

Other pharmacies were unaware their wholesaler or agency that represents them in negotiations had declined the contract on their behalf.

The reduction affected an estimated 400,000 Tricare beneficiaries, the Defense Health Agency told the Congressional Research Service in a report released last week.

After weeks of pressure from members of Congress and groups lobbying on behalf of the pharmacies -- as well as an announcement from grocery giant Kroger that it too would leave the network -- Express Scripts announced last month it would send out a new contract solicitation to give the pharmacies an opportunity to rejoin the network.

Officials from Express Scripts have declined to comment on whether the contract offered in December was any different than the one the pharmacies previously rejected, though advocacy groups have said they heard from members that the terms are largely the same.

Because of that, Express Scripts' announcement did little to placate critics, and lawmakers and advocacy groups have continued to demand the company and the Defense Health Agency allow all the pharmacies to come back under a more favorable contract.

"Tricare patients earned their benefits, and it is imperative that they retain convenient access to their health care providers, especially those with whom they have established, trusted relationships," six pharmacy organizations, led by the National Community Pharmacists Association, wrote in a letter Tuesday to Express Scripts. "Independent community and specialty pharmacies take great pride in caring for those who honorably serve or have served in our armed forces."

And even as some pharmacies rejoin, more major departures could be on the horizon.

Kroger has said its 2,200 pharmacies will leave the Tricare network at the end of the month unless Express Scripts offers a more "equitable" contract. Kroger is also pursuing a merger with Albertsons, which could mean another 5,000 stores leaving the network if the acquisition goes through as planned in 2024.

As part of awarding Express Scripts a new contract last year, the Defense Health Agency agreed to allow it to "downsize" the network from 50,000 pharmacies to 35,000, according to the Congressional Research Service report.

Express Scripts and the Defense Health Agency have stressed that 90% of Tricare beneficiaries will still have at least one pharmacy within a 15-minute drive.

But advocates say the reductions will harm those in rural areas, seniors and people with serious and long-term illnesses who need specialty pharmacies.

"The relationships between pharmacists and patients are built on trust, and for many patients is not something easily transferable," the pharmacy groups wrote in their letter. "Without access to the pharmacy of their choice, Tricare patients will suffer."

-- Rebecca Kheel can be reached at rebecca.kheel@military.com. Follow her on Twitter @reporterkheel.

Related: Thousands of Tricare Pharmacy Locations Could Be Lost Due to Kroger-Albertsons Merger

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