
Elizabeth Warren
20:44 - 21:54
"DOD actually requires the TRICARE pharmacy contractor both to own a PBM and its own pharmacy. I don't know who talked them into that, but it is an open invitation for Express Scripts to milk the federal government, to kick out the competition, and to steer a lot of money its own way."
“DOD actually requires the TRICARE pharmacy contractor both to own a PBM and its own pharmacy. I don't know who talked them into that, but it is an open invitation for Express Scripts to milk the federal government, to kick out the competition, and to steer a lot of money its own way.”
And that seems to me to be a pretty clear conflict of interest, and yet DOD actually requires the TRICARE pharmacy contractor both to own a PBM and its own pharmacy. I don't know who talked them into that, but it is an open invitation for Express Scripts to milk the federal government, to kick out the competition, and to steer a lot of money its own way. The squeeze play is not hard to pull off. In a traditional PBM contract, when the same company owns a PBM and a pharmacy, it can leverage the vertical integration through tactics like spread pricing, in which PBMs charge insurers more than what they reimburse pharmacies for, uh, for a drug. Or engage in steering, in which they under-reimburse the competitors and send more business to the PBM's own pharmacy.
A Senate Armed Services subcommittee hearing Wednesday put Express Scripts' 23-year TRICARE contract under sharp scrutiny, with Sen. Warren citing DOD data showing the contractor's mail-order pharmacy costs 12.5% more than retail for generic drugs, and the company's president declining to voluntarily submit to an independent audit.
