Following Hearing, Warren Presses Trump Military Official to Release Data Revealing Whether Military Contractor is Overcharging Military for Prescription Drugs

Following Hearing, Warren Presses Trump Military Official to Release Data Revealing Whether Military Contractor is Overcharging Military for Prescription Drugs

Largest pharmacy benefit manager in the U.S. may be sending affiliated pharmacies inflated payments, elbowing out competitors

"[T]axpayers deserve to know that (government funds) are being used for their intended purpose, not for potential self-dealing by DHA contractors."

Text of Letter (PDF)

Washington, D.C. - U.S. Senator Elizabeth Warren (D-Mass.), a member of the Senate Armed Services Committee (SASC), wrote to Assistant Secretary of Defense for Health Affairs Keith Bass, urging him to follow through on commitments he made to release data that would allow Congress to evaluate whether Express Scripts, the largest pharmacy benefit manager in the United States and military pharmacy contractor, may be sending inflated payments to its own pharmacies and under-reimbursing competing pharmacies.

"[T]axpayers deserve to know that [government funds] are being used for their intended purpose, not for potential self-dealing by [Defense Health Agency] contractors," said Senator Warren.

The Defense Health Agency (DHA) spends billions of dollars to provide TRICARE pharmacy benefits - as part of the military health care system - to 9.6 million service members, retirees, and family members. Since 2009, DHA has awarded Express Scripts an exclusive TRICARE pharmacy contract, which involves running the military's retail pharmacy network and mail order program.

But Express Scripts also owns mail order and specialty pharmacies that participate in the TRICARE network. Reporting has revealed that Express Scripts appears to be charging the military $484 more, on average, to dispense generic drugs through Express Scripts' own mail-order pharmacies than through competing pharmacies.

"[This] creates a clear conflict of interest," said Senator Warren. As a result of onerous contract terms offered by Express Scripts, more than 13,000 retail pharmacies have left the TRICARE network since 2022, leaving hundreds of thousands of military families without an in-network pharmacy.

In a recent hearing, Senator Warren pressed Assistant Secretary Bass to commit to conducting annual audits of TRICARE's pharmacy contract and providing Congress with the difference in reimbursement rates, fees, and other price concessions for Express Scripts-owned pharmacies and their competitors in the network. Bass agreed, but with no particular timeline in place.

"You gave me your commitment that you would do so. I appreciate your prompt attention to this matter and request that you provide my office with all relevant and pertinent data in accordance with these commitments by June 22, 2026," concluded Senator Warren.

Senator Warren has led the fight for affordable health care and fair practices for military families:

• In May 2026, at a hearing of the Senate Armed Services Subcommittee on Personnel, Senator Warren (D-Mass.) pushed DHA head Keith Bass to commit to an annual audit of Express Scripts' contract and releasing both pharmacy reimbursement data and the results of audits to Congress. Bass agreed to do so following Senator Warren's questioning.
• In October 2025, at a hearing of the Senate Special Committee on Aging, Senator 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. Cuban agreed with Senator Warren that requiring Express Scripts to report the difference in reimbursement rates between affiliated and unaffiliated pharmacies would save money and help smaller independent pharmacies stay in business.
• In March 2025, at a hearing of the Senate Armed Services Committee, Senator Warren (D-Mass.) questioned Lieutenant General Dr. Douglas J. Robb of the U.S. Air Force about price gouging in the military's prescription drug system. Lieutenant General Robb agreed that this taxpayer overcharging is "unfair" and said that Express Scripts needs to "follow what is the business policy and what is the contractual law."
• In June 2024, Senators Warren (D-Mass.), Mike Rounds (R-S.D.), Peter Welch (D-Vt.), U.S. Representative Buddy Carter (R-Ga.), and 20 other lawmakers wrote to the then Assistant Secretary of Defense for Health Affairs and Director of the Defense Health Agency, raising concerns over Express Scripts' exclusive contract to administer TRICARE's pharmacy program, the healthcare system for the military, retirees, and their families.
• In August 2020, Senator Warren (D-Mass.) and then-Senator Bob Casey (D-Pa.) requested information from five of the largest mail-order pharmacies and pharmacy benefit managers (PBMs) about any delays or other problems with mail-order deliveries of medications as a result of operational changes at the United States Postal Services (USPS) by Postmaster General Louis DeJoy. Reports indicated that President Trump and Postmaster General DeJoy's sabotage of the USPS is resulting in significant delays for every type of mail - including life-sustaining prescription drugs for seniors, veterans, and millions of other patients.

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