According to Cigna/Express Scripts, more than 2,000 independent pharmacies will rejoin the Tricare retail pharmacy network.

"Since we issued the new solicitation on Dec. 1, we are pleased that more than 2,000 pharmacies have accepted the terms and will rejoin the Tricare network, said Justine Sessions, a spokesperson for Express Scripts, in an email to Military.com.

In October, 14,963 independent pharmacies (out of 55,586 retail pharmacies) left the network due to their objections about low reimbursement rates.

According to the National Community Pharmacists Association, the reduction affects approximately 400,000 Tricare beneficiaries, especially those living in rural areas. Advocates and lawmakers have expressed concern - and some anger - about the decrease in pharmacies and its effects on those who depend on them.

In response, Express Scripts sent out new solicitations on Dec. 1 to the pharmacies that left the network. Pharmacies had until Dec. 15 to indicate if they want to rejoin said Express Scripts officials in an email to Military Times.

Pharmacies that accept Express Scripts' terms will rejoin the network effective Jan. 15.

According to Military.com, Express Scripts declined to comment on whether the new contract offered differs from the one the pharmacies previously rejected, although advocacy groups say that the terms are largely the same. More than 7,000 independent pharmacies have accepted the proposed 2023 rates.

Beneficiaries who use the pharmacies that are no longer affiliated with the Tricare retail pharmacy network pay full price for their medications and then file for reimbursement, which is subject to the deductible as well as a higher out-of-network cost share.

"Tricare patients earned their benefits, and it is imperative that they retain convenient access to their health care providers, especially those with whom they have an established, trusted relationships," officials with the National Community Pharmacists Association wrote in a letter to Express Scripts, Military.com reported.  

But even with the rejoining of over 2,000 independent pharmacies, possible major departures loom.

Kroger has said its 2,200 pharmacies will leave the Tricare network at the end of the month unless Express Scripts offers a more "equitable" contract. Kroger is also pursuing a merger with Albertsons, which could mean another 5,000 stores leaving the network if the acquisition goes through in 2024.

According to a Congressional Research Service report, the Defense Health Agency agreed to let Express Scripts "downsize" the network from 50,000 to 35,000 independent pharmacies. Both the Defense Health Agency and Express Scripts also say that 90 percent of Tricare beneficiaries will still have at least one pharmacy within a 15-minute drive.

But advocates counter by saying the reductions harm those in rural areas, seniors and people with serious and long-term illnesses who need specialty pharmacies.

"This is without a doubt a cut to the Tricare pharmacy benefit that ... disproportionately impacts those who need the pharmacy benefit most - beneficiaries with chronic conditions or disabilities and the elderly," commented Karen Ruedisueli, director of health affairs in government relations at the Military Officer Association of America.