Express Scripts is a PBM and mail-order pharmacy. It often uses its own PBM to steer patients to its own pharmacy. Patients have faced life-threatening delays and interruptions in treatment, and some have been forced to receive medications not stored at proven safe temperatures as the only coverage option.

Express Scripts also uses their PBM portion of their business to restrict access to medications by restricting medications on the list of covered medications. Physicians are hiring additional staff to deal with long, exhaustive obstacle courses to obtain the medications needed for their patients.

Express Scripts has a 1-star rating on the Better Business Bureau that highlights this Pattern of Complaints:

“Better Business Bureau is advising consumers to use caution when considering doing business with Express Scripts.  BBB has received a pattern of consumer complaints alleging delays or failure to ship correct prescriptions or medications; failure to accept returns or medications which were shipped in error; failure to issue refunds; debiting credit or debit cards for prescriptions not shipped and poor customer service.”

When patients are so graciously allowed by their PBM to use their local pharmacies, PBMs like Express Scripts also oversee reimbursements to competitor pharmacies & often reimburse competitor pharmacies below their cost, causing closures of local pharmacies in the most underserved rural and urban areas across America.

Upon advocating for regulation, legislation, & protection from these pharmacies, advocates find themselves against one of the wealthiest lobbyist organizations in America, the Pharmaceutical Care Management Association (PCMA) that has in the last year doubled the amount they’re investing in lobbying of legislators and regulatory boards by the millions, making it almost impossible for protection & justice. It’s time to demand it! Patients deserve ethical treatment and safe access to their local pharmacies.

Often, many are “too sick to fight” & many pharmacists fear retaliation for speaking publicly about these issues.

This is why we need your voice. We look forward to meeting you there!

Please click here to register if you plan attending. Registration is preferred.

Protest Location Will Be Nearby 1 Express Way, St. Louis, MO 63121

Directions From St. Louis Airport: Take the ramp on the right for I-70 East and head toward St Louis. At Exit 240, head right on the ramp for MO-N toward University Blvd. Keep right, heading toward Touhill Arts Center / UMSL. Turn right onto University Place Dr.

Parking and Public Transportation: https://www.metrostlouis.org/park-and-ride/ The North Hanley Location is near the location of the Express Scripts protest. I stopped an officer while traveling through the lot and asked if it would be possible to park in the Metro parking lot on the day of the protest. He suggested reaching out to Metrolink. He said some do park here for a few hours. Most that are just parking, park on the back side of the parking lot closer to the road that runs alongside where we will be conveniently protesting. The lot does mention that it is for “Metro customers only.” You can buy a MetroStLouis Day Pass Online for $5 at https://www.metrostlouis.org/

University of Missouri St. Louis Visitor Parking Nearby: The location that we will be protesting in front of Express Scripts is on the University of Missouri St. Louis Public State Property. UMSL police are aware of our protest & have informed us that they will not disrupt our right to hold a peaceful protest. Parking Lots closest to the protest will be UMSL Parking Lot M & Parking Lot by the MIMH Professional Training building.

Per UMSL’s website. “If you are visiting campus, you may park in Lot C located in between the JC Penney Building and the Recreation and Wellness Center on North Campus for up to two hours. If you are visiting for longer than two hours or would prefer to park in a spot more convenient for your desired destination, you must acquire a Guest Permit for $1.00 per day at the Office of Parking and Transportation, located at 44 Campus Police Building.”

Nearby Hotels: If you would like to book a room for the night, there are several great hotels nearby.

- Renaissance St. Louis Airport Hotel, Hilton Garden Inn St. Louis Airport, Best Western Plus St. Louis Airport Hotel

Bring The Family & Explore The City: Our goal is to get our message across peacefully and safely to push forward change. People of all ages can attend. If you would like to make this a weekend trip. St. Louis has many great sightseeing opportunities. Here are some of our family’s favorite places: St. Louis Zoo (free entry), The City Museum, Grants Farm, The Botanical Gardens, & the St. Louis Arch. If you’re a baseball fan, The St. Louis Cardinals will have games 17th – 19th against the Boston Red Sox.

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Please see below for more information on how PBMs like Express Scripts intefere with patients safe access to medications. If you plan on joining us, you can attend in support of one of the issues or all of those listed below.

Pharmacy Benefit Managers (PBMs) like Express Scripts play a significant role in the healthcare system, but their practices have drawn criticism from various stakeholders, including patients, pharmacies, and communities. Here are 100 ways PBMs are perceived to harm these groups:

Drug Pricing Manipulation: PBMs have been accused of inflating drug prices and driving up costs for patients, pharmacies, and communities.

Rebate Schemes: PBMs often negotiate rebates with drug manufacturers, but these savings may not be passed on to patients or pharmacies.

Tiered Formularies: PBMs use tiered formularies that may require patients to pay more for certain drugs, even if cheaper alternatives are available.

Exclusionary Practices: PBMs may exclude certain drugs or pharmacies from their networks, limiting patient choice and access.

Gag Clauses: PBMs may impose gag clauses on pharmacies, preventing them from informing patients about lower-cost alternatives.

Steering Practices: PBMs may steer patients to pharmacies they own or have financial relationships with, rather than independent pharmacies.

Drug Switching: PBMs may require patients to switch to different drugs for non-medical reasons, disrupting their treatment and potentially causing harm.

Mail Order Requirements: PBMs may mandate patients to use mail-order pharmacies, limiting access to local community pharmacies.

Medication Adherence Programs: PBMs' adherence programs may incentivize pharmacies to pressure patients into unnecessary refills, leading to overmedication.

Prior Authorization Delays: PBMs' prior authorization processes can delay patients' access to vital medications, impacting their health outcomes.

High-Deductible Health Plans: PBMs may push high-deductible health plans that burden patients with higher out-of-pocket costs.

Lack of Transparency: PBMs' lack of transparency in pricing and rebate negotiations makes it difficult for patients, pharmacies, and communities to understand the true costs of medications.

Spread Pricing: PBMs engage in spread pricing, where they charge health plans more for drugs than they reimburse pharmacies, pocketing the difference.

DIR Fees: PBMs impose Direct and Indirect Remuneration (DIR) fees on pharmacies, which can be unpredictable and financially burdensome.

Undermining Independent Pharmacies: PBMs' practices favor large chain pharmacies over independent pharmacies, threatening the viability of small businesses in communities.

Drug Shortages: PBMs' purchasing practices contribute to drug shortages, affecting patient access to essential medications.

Pharmacy Closures: Due to financial pressures from PBMs, many community pharmacies are forced to close, leaving patients in underserved areas without access to care.

Provider Status Recognition: PBMs' resistance to recognizing pharmacists as healthcare providers limits patients' access to pharmacist-provided services.

Telemedicine Restrictions: PBMs may restrict patients' access to telemedicine services, limiting their ability to receive care remotely.

Specialty Medication Access: PBMs' restrictive specialty medication access policies can prevent patients from obtaining life-saving treatments.

Generic Drug Pricing: PBMs' practices may suppress generic drug prices, disincentivizing the production of affordable alternatives.

Provider Reimbursement Cuts: PBMs may impose reimbursement cuts on pharmacies, jeopardizing the financial viability of these businesses.

Pharmacy Ownership Restrictions: PBMs may impose ownership restrictions that limit pharmacists' ability to own and operate their own pharmacies.

Drug Wastage Policies: PBMs' drug wastage policies may encourage overdispensing of medications, leading to unnecessary costs and environmental harm.

Failure to Pass on Discounts: PBMs often negotiate discounts with pharmacies but may not pass these savings on to patients or health plans.

Limited Network Access: PBMs' narrow pharmacy networks can restrict patients' access to pharmacies, particularly in rural or underserved areas.

Adverse Formulary Changes: PBMs may make sudden formulary changes that disrupt patients' access to medications they rely on.

Patient Privacy Concerns: PBMs' data practices raise concerns about patient privacy and the security of sensitive health information.

Pricing Disparities: PBMs' pricing disparities between pharmacies can create inequities in access to care based on patients' location or insurance plan.

Lack of Fair Reimbursement: PBMs' reimbursement rates for pharmacy services may not reflect the true cost of providing care, leading to financial strain on pharmacies.

Increased Administrative Burden: PBMs' complex administrative requirements burden pharmacies with paperwork and bureaucratic hurdles.

Provider Exclusion Policies: PBMs may exclude certain pharmacies or healthcare providers from their networks without adequate justification, limiting patient choice.

PBM-Owned Pharmacies: PBMs' ownership of pharmacies creates conflicts of interest and undermines fair competition in the market.

Pricing Opacity: PBMs' opaque pricing practices make it difficult for patients and pharmacies to compare prices and make informed decisions.

Inadequate Drug Utilization Review: PBMs' drug utilization review processes may fail to identify and prevent harmful medication interactions or misuse.

Incentives for Overutilization: PBMs' incentives may encourage overutilization of healthcare services or unnecessary prescriptions.

Financial Impact on Patients: PBMs' practices contribute to rising healthcare costs, imposing financial strain on patients and families.

PBM Consolidation: Consolidation in the PBM industry reduces competition, giving PBMs more power to dictate terms to pharmacies and health plans.

Lack of Accountability: PBMs' lack of accountability to patients or oversight bodies allows them to operate without sufficient scrutiny.

Failure to Address Drug Abuse: PBMs may not adequately address prescription drug abuse or diversion within their networks, putting patients and communities at risk.

Medication Non-Adherence: PBMs' policies and practices may contribute to medication non-adherence among patients, leading to worse health outcomes.

Failure to Address Health Disparities: PBMs may exacerbate health disparities by limiting access to care for marginalized communities or individuals with low incomes.

Limited Specialty Pharmacy Access: PBMs' restrictions on specialty pharmacy access can delay or deny patients access to specialized care and treatments.

Inadequate Medication Therapy Management: PBMs' medication therapy management programs may lack sufficient resources or oversight to effectively improve patient outcomes.

Failure to Address Drug Counterfeiting: PBMs may not adequately address the risk of counterfeit drugs entering the supply chain, endangering patient safety.

Inadequate Patient Education: PBMs may not provide patients with adequate education or support to help them understand their medications and treatment plans.

Provider Burnout: PBMs' administrative burdens and reimbursement cuts contribute to provider burnout, affecting the quality of care patients receive.

Inadequate Specialty Pharmacy Networks: PBMs' limited specialty pharmacy networks can create barriers to access for patients with complex medical needs.

Impact on Medication Access for Chronic Conditions: PBMs' policies may disproportionately impact patients with chronic conditions who rely on consistent access to medications.

Failure to Address Drug Interactions: PBMs may not effectively identify or address potential drug interactions, putting patients at risk of adverse reactions.

Inadequate Patient Assistance Programs: PBMs' patient assistance programs may not reach all eligible patients or provide sufficient support to cover medication costs.

Inadequate Reimbursement for Clinical Services: PBMs' reimbursement rates for clinical services provided by pharmacists may not reflect the value of these services, discouraging their provision.

Impact on Healthcare Workforce: PBMs' practices contribute to workforce shortages in healthcare, particularly in underserved areas where pharmacies may struggle to stay open.

Inadequate Chronic Disease Management: PBMs' chronic disease management programs may lack resources or coordination to effectively support patients in managing their conditions.

Failure to Address Drug Diversion: PBMs may not effectively address the risk of drug diversion within their networks, contributing to substance misuse and addiction.

Inadequate Oversight of Specialty Drug Dispensing: PBMs' oversight of specialty drug dispensing may be inadequate, leading to errors or misuse of these high-cost medications.

Impact on Patient-Provider Relationships: PBMs' policies and practices can strain patient-provider relationships, as providers may struggle to navigate complex reimbursement processes or treatment restrictions.