{"database": "press", "table": "releases", "rows": [["https://www.warren.senate.gov/newsroom/press-releases/icymi-at-hearing-experts-agree-with-warren-more-transparency-will-lower-costs-for-military-pharmacy-system", "ICYMI: At Hearing, Experts Agree with Warren: More Transparency Will Lower Costs for Military Pharmacy System", "2025-10-23", "2025", "2025-10", "Democrat", "Senate", "MA", "Elizabeth Warren", "W000817", "www.warren.senate.gov", "warren", "https://www.warren.senate.gov/newsroom/press-releases", "scraper", "ICYMI: At Hearing, Experts Agree with Warren: More Transparency Will Lower Costs for Military Pharmacy System\n\nVideo of Exchange (YouTube)\n\nWashington, D.C. \u2014 At a hearing of the Senate Special Committee on Aging, Senator Elizabeth Warren (D-Mass.) asked Mark Cuban, founder of Cost Plus Drugs, and Dr. Jeanne Lambrew, Director of Health Care Reform and Senior Fellow at The Century Foundation, about the potential for greater transparency in the pharmaceutical industry to lower costs for taxpayers and military families.\n\nExpress Scripts negotiates contract terms, including reimbursement rates, with pharmacies in the TRICARE network, which is the health care system for the military, retirees, and their families. However, Express Scripts also owns pharmacies that participate in the TRICARE network, creating a conflict of interest that allows Express Scripts to under-reimburse unaffiliated pharmacies and give inflated payments to its own subsidiaries.\n\nDespite this conflict, the Defense Health Agency does not require Express Scripts to report the difference in reimbursement rates between affiliated and unaffiliated pharmacies.\n\n\u201cIt would save a lot of money, and it would keep smaller independent pharmacies in business,\u201d Mr. Cuban said about publishing this information.\n\nHowever, the Congressional Budget Office (CBO) claims doing so would raise TRICARE costs, because unaffiliated pharmacies would allegedly respond by demanding higher reimbursements from TRICARE.\n\nAs a result of changes Express Scripts made to the TRICARE pharmacy network, 13,000 pharmacies \u2013 the overwhelming majority of which were independent pharmacies \u2013 were forced to leave the TRICARE network. The Defense Health Agency (DHA) maintains that military families\u2019 pharmacy access has not been affected by these changes \u2013 but this is based on data submitted to the agency by Express Scripts, which the Government Accountability Office (GAO) reported contained multiple inconsistencies. GAO recommended that DHA periodically audit the Express Scripts data for accuracy.\n\nWhen asked if regularly auditing the Express Scripts data for accuracy, as GAO recommends, would help save taxpayers money, Dr. Jeanne Lambrew replied that it would.\n\n\u201cI hope to work with all of my colleagues to pass proposals to rein in self-dealing by the PBMs in TRICARE and beyond\u2026we need to stop these giant corporations from ripping off American taxpayers and get a little more competition in the drug market,\u201d Senator Warren concluded.\n\nSenator Warren filed amendments to the FY 2026 National Defense Authorization Act (NDAA) to require greater transparency and auditing of the TRICARE pharmacy contract. The amendments were ruled out of order after CBO determined the amendments would raise TRICARE costs. Senator Warren also has a bipartisan bill with Senator Josh Hawley (R-Mo.) that would prohibit joint ownership of pharmacy benefit managers and pharmacies.\n\nTranscript: Hearing on Modernizing Health Care: How Shoppable Services Improve Outcomes and Lower Costs\n\nU.S. Senate Special Committee on Aging\n\nOctober 22, 2025\n\nSenator Elizabeth Warren: So, military families keep us safe, and DoD\u2019s TRICARE program is supposed to keep those military families healthy. Since 2009, TRICARE pharmacy benefit has been administered by Express Scripts, the nation\u2019s largest pharmacy benefit manager, or PBM. Express Scripts decides which pharmacies are in-network or out, so when one of those 9 million military families needs to pick up a prescription, Express Scripts decides where they can go to have it filled and then they pay the pharmacy.\n\nNow, Express Scripts is owned by the multi-billion health insurance company Cigna, and Cigna also owns a mail order pharmacy called Accredo that participates in TRICARE. In other words, Cigna owns the company that pays pharmacies and it also owns the pharmacy chain that is getting paid. The result? Well, Express Scripts can under-reimburse other pharmacies and give inflated payments to its corporate cousin, Accredo.\n\nExpress Scripts has been caught doing exactly that kind of self-dealing in other government programs, but right now, the DoD refuses to check how much it\u2019s costing taxpayers in TRICARE.\n\nMr. Cuban, you understand this business, so let me ask you. Would requiring Express Scripts to disclose the difference between what it pays its affiliated and the unaffiliated pharmacies help save taxpayers money or cost taxpayers money?\n\nMark Cuban, Founder of Cost Plus Drugs: It would save a lot of money, and it would keep smaller independent pharmacies in business.\n\nSenator Warren: Okay, you know, that makes sense to me. It seems pretty common sense here: more transparency would save taxpayer money. But the Congressional Budget Office disagrees with you and me on this. According to CBO, price transparency would cost taxpayers money because other pharmacies would allegedly band together to demand higher reimbursements, that\u2019s their argument here.\n\nMr. Cuban, you talk with pharmacists a lot. Do you think that independent pharmacists don\u2019t know that Accredo, right now, is getting a sweetheart deal and that the independents are just waiting for information to be told so they can demand more money?\n\nMr. Cuban: I can't speak for all the independents, but I can speak for costplusdrugs.com, and so, I went to TRICARE, and I have done this in the past many times, and looked up the price of some common, low-cost drugs. So I, you know, just recently, I looked up Tadalafil, right? And our price is lower, whether it's 30 or 90 pills, than the TRICARE price is for anybody who is in-network, but off-base, and if they're out-of-network, we're dramatically lower. So we don't need to band together to know that we can be cheaper. All we have to do is look at some of their prices, and it's obvious that we're cheaper.\n\nSenator Warren: Okay, so this information is actually already out there?\n\nMr. Cuban: Yeah, I mean, it's just by looking at, and I'm just talking about the co-pays.\n\nSenator Warren: Yeah.\n\nMr. Cuban: We're not even talking about what Express, what the taxpayers still have to pay to Express Scripts, Accredo, right? Which is more, they're not doing this for nothing. And so, I mean, taxpayers are getting ripped off, period. End of story.\n\nSenator Warren: Okay, and this is where I want to see more transparency\u2014\n\nMr. Cuban: Correct.\n\nSenator Warren: You think that's a good thing?\n\nMr. Cuban: That's a great thing.\n\nSenator Warren: Okay, that's a great thing. Good. I'll settle for that answer. All right, so, DoD claims that this hasn't affected military families, but that is based on data from\u2014\n\nSenator Rick Scott: They said it hasn\u2019t?\n\nSenator Warren: Has not. This has not affected military families based on data from, you guessed it, Express Scripts.\n\nMr. Cuban: [Laughs]\n\nSenator Warren: So when the Government Accountability Office reviewed just a little slice of this data, they discovered, quote, \u201cpersistent inaccuracies,\u201d including misreporting the number of people who lost access to their local pharmacies because the pharmacies were pushed out of the TRICARE network. They left, for the very reasons you described, but that was just a one time review, so I'm pushing DoD to audit this information every single year. Dr. Lambrew, you served as Commissioner of the Maine Department of Health and Human Services, so you understand the importance of program integrity. Do you think that auditing this program would help save taxpayers money or cost taxpayers money?\n\nDr. Jeanne Lambrew, Director of Health Care Reform and Senior Fellow at The Century Foundation: Senator, it would save money.\n\nSenator Warren: It would save money. So, you know, I just want to point out here, Mr. Chairman, self-dealing by the pharmacy benefit managers keeps the cost of prescription drugs high, both for the taxpayers and for consumers. I'm going to keep pressing CBO to update their analysis of the PBMs, and I hope to work with all of my colleagues to pass proposals to rein in self-dealing by the PBMs in TRICARE and beyond, including my bill with Senator Hawley that would make the same company, say the same company, cannot own a PBM and an insurance company\u2014and a pharmacy, at the same time. Look, we need to stop these giant corporations from ripping off American taxpayers and get a little more competition in the drug market. Thank you, Mr. Chairman.\n\n###", 1, "2026-03-30T01:40:41Z", "2026-04-06T19:32:54Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["https://www.warren.senate.gov/newsroom/press-releases/icymi-at-hearing-experts-agree-with-warren-more-transparency-will-lower-costs-for-military-pharmacy-system"], "units": {}, "query_ms": 1.7078272067010403, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}