The expansion from Express Scripts offers increased reimbursement opportunities and creates an Independent Pharmacy Advisory Committee to expand the role of rural, suburban and urban pharmacies in the healthcare system.
Express Scripts, the pharmacy benefits management (PBM) business of Evernorth, a subsidiary of The Cigna Group, is expanding access to healthcare in rural communities with its new IndependentRx Initiative.
The program offers increased reimbursement opportunities and additional care services to rural independent pharmacies, and creates an Independent Pharmacy Advisory Committee to expand the role of rural, suburban and urban pharmacies in the healthcare system, Express Scripts said.
The IndependentRx Initiative is expected to benefit “thousands” of independent pharmacy partners across the country and will expand significantly over time, according to the PBM.
“One in five Americans live in rural areas, yet less than 10 percent of physicians practice in those locations – creating critical access gaps. Independent pharmacists often can close those gaps as the front lines of care in their local communities,” said Adam Kautzner, Pharm.D., president of Express Scripts. “That’s why we’re committed to leveraging and supporting the clinical expertise of pharmacists who want to do more for their patients.”
Express Scripts also launched a copay assistance program last week to increase access to affordable medicines. Its new Copay Assurance plan ensures consumers pay less out-of-pocket by capping copays on prescription drugs at $5 for generics, $25 for preferred brand drugs, and $45 for preferred specialty brand drugs.
With the new IndependentRx Initiative, Express Scripts will increase reimbursements to pharmacies that are independently owned and unaffiliated with a drug wholesaler in areas with only one pharmacy within 10 or more miles from an Express Scripts customer. “This includes enhancing performance- and incentive-based programs that pay pharmacies more when they drive better outcomes, such as prescribing 90-day supplies of prescription drugs that improve adherence. In addition, all independent rural pharmacies will have increased opportunities to participate in Express Scripts’ retail pharmacy networks,” the company said.
Additionally, Express Scripts — in collaboration with other Evernorth Health Services businesses — will increase access to certain routine, preventive and chronic care services at independent pharmacies, which the PBM says will new business growth opportunities for pharmacy owners and provide convenient care options for consumers.
This includes reimbursing independent pharmacists for a variety of health screenings, testing and clinical services, such as: COVID-19 and other routine vaccinations; trainings to empower pharmacists to recognize and combat substance use disorders, including opioid addiction and naloxone administration; additional prescriptions for acute infections; acute viral condition testing (i.e., influenza, strep A, A1C); lifestyle counseling, such as nutrition and smoking cessation; and annual behavioral health screenings.
“Independent pharmacies already add value beyond dispensing medications – and they can do even more. We need to ensure rural communities have access to the same quality, affordable care as those living in densely populated communities,” Kautzner said. "Where you live shouldn’t dictate the type of care you receive or how long you have to wait for it.”
Express Scripts will establish the industry’s first Independent Pharmacy Advisory Committee that will convene a diverse group of pharmacy leaders across rural, urban and suburban areas. The leaders will focus on continuing to drive competitive reimbursement practices, learning from each other’s business models, and creating new solutions that leverage independent pharmacists to alleviate provider shortages across the health care delivery system, the PBM said.