Page 12 - Mariner Winter 2023 Volume 65 Issue 3 Jan

NATIONAL MILITARY VETERANS ALLIANCE LETTER

28 November 2022

The Honorable Gil Cisneros The Honorable Seileen Mullen LTG Ronald Place, MC, USA
Under Secretary of Defense Acting Assistant Secretary of Director, Defense Health
(Personnel & Readiness) Defense for Health Affairs Agency

The Honorable Jack Reed The Honorable Jim Inhofe The Honorable Adam Smith
Chair, Senate Committee on Ranking Member, Senate Chair, House Armed Services
Armed Services Committee on Armed Committee
Services

The Honorable Mike Rogers
Ranking Member, House Armed
Services Committee

Dear Under Secretary Cisneros, Ms. Mullen, General Place, Chair Reed, Chair Smith, Senator Inhofe, and
Representative Rogers:

The organizations listed below, all members of the National Military & Veterans Alliance, express their
deep-seated concern regarding the recent announcement that nearly 15,000 local and independent

pharmacies have chosen to no longer participate in the TRICARE pharmacy program.

We collectively call on the Department of Defense to immediately reverse the changes to the TRICARE
program which led to the mass exodus of these pharmacies; and if the Department of Defense is
unable or unwilling to do so, we call on Congress to adopt a legislative solution in the FY 2023

National Defense Authorization Act.

Under current practices, Express Scripts acts as a pharmacy benefit manager for the TRICARE program
while serving as a mail-order and specialty pharmacy itself. Without question, this poses a conflict of
interest that must be reconciled to ensure TRICARE is compliant with federal procurement law and
provides for additional competition in the marketplace to drive down costs and expand options for
beneficiaries.

For service members past and present and their family members, the sudden and wrongful network
reduction goes far beyond simply reducing access to care for TRICARE beneficiaries. For those
beneficiaries who need specialty medicines, the cut-rate standard shipping processes used by Express
Scripts threaten the medicinal integrity of the shipped medicines and place beneficiaries at risk of
receiving crucial medications late, damaged, or at reduced or eliminated effectiveness. Of greater
significance, it eliminates the crucial role local pharmacists play in protecting beneficiaries’ health,
especially those requiring multiple medications where contraindications are always a concern.

Overall, these pharmacy network changes will put service members and their families at risk in receiving
the prescription drugs and treatment they need. NMVA’s longstanding conviction has been – and will
always be - to oppose any decisions made solely to ensure cost savings over the quality-of-care
beneficiaries are receiving. In our estimation, such an approach to taking care of service members and
their families will harm beneficiaries in the short term and readiness down range.

12 The Mariner • 2022 WINTER Edition • Volume 65 • Issue 3

National Military & Veterans Alliance
20 F St., NW, #703, Washington, DC 20001
www.NMVA.US, 202-779-1598