Benjamin Jolley

Pharmacist, Senior Fellow, Healthcare at AELP, obsessed with breaking up Big Medicine

[Benjamin Jolley @Jolleyben]

If such a 340B-esque model were implemented, the only remaining benefit to the current model would be pre-deployment drug supplies being provided at once. However, this could be coordinated by the TRICARE PBM providing authorization for deployment-length dispensing at retail.

[Benjamin Jolley @Jolleyben]

I tried to negotiate the TRICARE agreement and my family's pharmacy also ended up leaving the TRICARE network after receiving this response:

[Benjamin Jolley @Jolleyben]

This suggests that the TRICARE mail order model could be replaced by a distributed network of pharmacies receiving replenishment of their TRICARE product either directly or virtually a la 340B. This would provide the government the advantages of the lower cost w/o the hassles.

[American Economic Liberties Project @econliberties]

Dr. Micah Lansford, Pharmacist and Owner of Roden-Smith Pharmacy, describes his experience:

"We've been able to serve this community for as long as I can remember. We did, anyways, up until 2023 when Express Scripts forced us out of the TRICARE program."

[Benjamin Jolley @Jolleyben]

For what it's worth, this is a reference to ESI's complaints against the State of Arkansas and the State of Tennesse in an attempt to block the laws that those states have passed prohibiting PBMs from owning pharmacies. ESI is either a PBM for TRICARE or they aren't.

[American Economic Liberties Project @econliberties]

Express Scripts wants to claim the TRICARE program is run differently than its commercial business but, as @Greg_Reybold lays out, that's all smoke and mirrors:

"First of all, in federal pleadings, Express Scripts doesn't call themselves a PBA for TRICARE. They call themselves a PBM.

In court filings, Express Scripts has said that they manage the TRICARE retail pharmacy network in a manner that's indivisible and indistinguishable from their other networks, including the Federal Employee Health Plan.

That's Express Scripts' words. In court filings, there's no difference with how they manage that program. That's stunning, and it's damning."

[American Economic Liberties Project @econliberties]

Vice President of Public Policy @_APCI @Greg_Reybold: "I would posit that what Express Scripts did in the TRICARE Retail Network is the poster child for why PBMs should not be allowed to own pharmacies."

[Emma Freer @freer_emma]

As Dr. Micah Lansford, an independent pharmacist in New Mexico who was forced out of the TRICARE network by Express Scripts’ unfair contract terms, testified: “No military contractor should be able to referee the game while also playing in it.”

[Benjamin Jolley @Jolleyben]

Take a look at the FEHBP audit: https://t.co/osNx1mByXR