Express Scripts is partnering with more independent pharmacies.
Cigna Group's pharmacy benefit manager is collaborating with pharmacy network CPESN USA in a bid to improve care delivery, according to a Thursday news release. The partnership, effective immediately, is focusing first on Medicare enrollees with hypertension and diabetes, the release said.
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Through the collaboration, the CPESN USA pharmacy network, which comprises 3,500 pharmacies in 44 states, will work to coordinate care with other providers and ensure proper medication management for individuals, the release said.
Eligible Express Scripts customers can take advantage of the offering at CPESN pharmacies in Express Scripts' pharmacy network, an Express Scripts spokesperson said. The organizations will assess this initial rollout and consider client and customer needs when evaluating partnership growth opportunities, the spokesperson said. The company did not provide financial terms of the agreement.
The collaboration is part of Express Scripts’ IndependentRx Initiative, announced last year, to grow partnerships with independent pharmacists. Last year, Express Scripts — then the second-largest PBM by market share — said it would increase reimbursement rates for rural independent pharmacies and pay them for providing preventive services, such as vaccinations and nutrition counseling. The company also formed an independent pharmacy committee to advise it on ways to support community pharmacies.
Cigna, which is working toward selling its Medicare insurance business, has been vocal about its commitment to continue serving the Medicare population through its Evernorth Health Services segment, which houses Express Scripts.
The partnership will improve Medicare patients’ access to care and underscore the value of community pharmacies, Adam Kautzner, president of Evernorth Care Management and Express Scripts, said in the release.
“Local pharmacies are the doorway to essential healthcare for many people, and independent pharmacies are critical to closing gaps in care for many communities,” he said.
In 2021, CPESN inked a partnership with Elevance Health's PBM CarelonRx with the stated goal of helping Medicaid members better manage asthma, chronic obstructive pulmonary disease, mental health conditions and opioid use disorders. Through the partnership, CarelonRx identified high-risk members using claims data and CPESN pharmacies then contacted members about medication delivery, social determinants of health screening and wellness coaching.
The PBM industry as a whole has faced criticism from associations representing community pharmacies for certain business practices, which PBM groups have in turn defended as necessary.
Express Scripts’ announcement comes on the heels of numerous modifications made by the major PBMs to their business models as regulators and lawmakers keep a sharp eye on how the companies influence drug prices and affect community pharmacy finances. The company in November announced a “cost-plus” pricing model for its employer, health plan and government organization clients seeking an alternative to the traditional drug pricing approach.
