07/11/2025
While we appreciate Colonel Manessâs commitment to veterans and agree that ensuring reliable access to medication is paramount, his recent guest column is misguided. Prohibiting pharmacy benefit managers (PBMs) from owning pharmacies addresses the conflict of interest that drives veterans to less reliable options.
PBMs were created to broker fair drug prices, but Cigna-owned Express Scripts has leveraged its TRICARE contractâheld exclusively since 2009âto squeeze out independent pharmacies and steer 9.6 million beneficiaries into its own mail-order arm, Accredo.
In August 2022 alone, more than 15,000 pharmacies left the TRICARE network under outrageous contract terms, forcing 400,000 military families to choose between going out of network or relying on mail order, with all the delays and communication breakdowns that entails.
The significant overpayments in the picture below illustrate how PBMs and their affiliate-owned pharmacies pad their bottom lines while restricting access to our service members.
Furthermore, independent pharmacies often struggle to participate due to PBMs setting non-negotiable reimbursement rates below dispensing costs. Consequently, many local pharmacies opt out, limiting veterans' choices and convenience.
Far from expanding access, these tactics undermine patient care by delaying critical medications, complicating pharmacistâpatient communication, and stripping away personalized support that community pharmacists provide daily.
And while some warn that PBM reform would shutter pharmacies, states with similar laws have seen independent and non-integrated chains expand services, not reduce them.
The recent hardship of large chains like Rite Aid underscores a different lesson: over-consolidation makes the system brittle. Independent pharmacies, rooted in our communities, proved more resilient and responsive, especially when corporate giants faltered during times of crisis.
What our veterans, and all Louisianans, need is real reform: transparent PBM pricing, fair reimbursement tied to true dispensing costs, and clear firewalls preventing PBMs from steering patients toward their own pharmacies. Thatâs patient-focused, practical, and builds a sustainable pharmacy ecosystem.
We urge our legislators to support targeted PBM reform, not pharmacy bans, to safeguard choice, preserve community pharmacies, and ensure timely, affordable access to medications for those whoâve served and for all citizens of our state.
For more information on Tricare, please see this 2024 letter from several U.S. Senators expressing grave concerns with the contract.
https://www.warren.senate.gov/imo/media/doc/final_-_warren_rounds_welch_carter_letter_to_tricare_on_express_scripts.pdf