World’s largest HIV/AIDS healthcare provider sends personal letter detailing how lack of Express Scripts oversight is ripping apart nation’s healthcare system

AIDS Healthcare Foundation (AHF), the world’s largest HIV/AIDS healthcare provider, sharply criticized health care behemoth Cigna today over its management of Express Scripts, the nation’s second largest Pharmacy Benefit Manager (PBM), which Cigna acquired in a 2018 merger. AHF’s criticism comes on the heels of a so-called “transparency” campaign Cigna and Express Scripts recently launched.

In a letter to Cigna CEO David Cordani, AHF President Michael Weinstein details how Cigna, through its Express Scripts PBM, “…is ripping apart the healthcare system through its rapacious, self-serving, member-unfriendly practices…”

Issues concerning AHF and hundreds of independent and mom-and-pop pharmacies nationwide include the following:

• Express Scripts (ESI) actively drives pharmacies out of its networks through reimbursements that don’t even cover a pharmacy’s drug costs, let alone the costs associated with dispensing the drugs and consulting with patients. This predatory practice is contributing to the bankruptcy of independent pharmacies and to the creation of pharmacy deserts, leaving members stranded.

• ESI is hopelessly conflicted – preferring to drive pharmacy benefit to its own specialty mail order pharmacy Accredo than broker honest deals with competing pharmacies. Members with chronic diseases like HIV suffer because when forced into mail order, they lose their tie with their trusted pharmacy care team member and are thrown into an anonymous service that often doesn’t understand the sensitivities around serving people with HIV.

• ESI operates secret, offshore entities like Ascent Health Services, apparently to negotiate sweet deals with manufacturers that only profit ESI/Ascent.

• ESI creates so-called quality performance programs, which essentially are rigged “pay to play” schemes.

AHF also cautions that “Cigna has a responsibility to bring [ESI’s] greed into check,” concluding “If you do not, federal and state lawmakers, regulators, the press, the public, and ultimately, members will do it for Cigna.”

A concise 3-minute PBM explainer video online here neatly distills the complex issue into easily understood language.

About AHF

AIDS Healthcare Foundation (AHF), the world’s largest HIV/AIDS healthcare organization, provides cutting-edge medicine and advocacy to more than 1.75 million individuals in 45 countries in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region, and Eastern Europe. To learn more about AHF, visit us online at AIDShealth.org, find us on Facebook, follow us on Instagram and Twitter, and subscribe to our Ahfter Hours podcast.

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In a letter to CEO David Cordani, AHF wrote, “Cigna has a responsibility to bring Express Scripts' greed into check,” concluding, “If you do not, federal and state lawmakers, regulators, the press, the public, and ultimately, members will do it for Cigna.”