PUTT BLOG | PUTT's "Audit Tricare" Initiative

PUTTbulletin May 2025

Something is seriously wrong with military prescription drug pricing, and it's time we talked about it.

In the coming weeks PUTT will launch what we hope to be a provocative campaign focused on some troubling - but largely unacknowledged - questions: why are our military families and taxpayers paying dramatically inflated prices for generic prescription drugs through Tricare's PBM, Express Scripts? And what are we doing about it?

It’s a Problem We Can’t Ignore

Picture this: A civilian walks into a pharmacy and pays $7 cash for a common generic medication. Meanwhile the widow of a career serviceman purchases the same medication through Tricare’s heavily advertised PBM mail order pharmacy and Tricare pays 250 times more than the civilian’s cash price for the same medication. 

How can it be that Express Scripts—Tricare's PBM—charges the federal government potentially hundreds of dollars for a drug that, if purchased without insurance, would be less than a Starbucks specialty coffee? Do they not know it’s happening? When was the last time anyone checked? 

By asking these and other questions, the "Audit Tricare" campaign aims to open a national conversation involving everyone, because as taxpayers, as Americans with loved ones currently serving or having served in the military, we should all be able to understand why we’re being asked to pay far more for our military’s prescription medications than we would pay if not using Tricare at all. 

What's at Stake

This isn't just about numbers on a spreadsheet. When PBMs like Express Scripts operate with minimal oversight and maximum opacity, the consequences ripple throughout military healthcare:

Military families potentially pay hundreds of dollars for common, inexpensive generics because someone (Express Scripts) is almost certainly prioritizing profit over patient care. Taxpayer dollars that could expand healthcare access for service members, veterans and their families instead are paid out in excessive administrative fees. Decisions about patient and plan sponsor costs are made by corporate executives with allegiance to shareholders and corporate growth goals. 

A Long Overdue National Conversation

The "Audit Tricare" campaign is intended to spark the national conversation our military families deserve on topics ranging from transparency and accountability to ensuring those who serve our country aren't burdened with inflated bills by PBM middlemen. 

It starts with a simple question: why are some drugs so incredibly expensive on Tricare, but so cheap if you pay out of pocket? Our goal is to take the conversation deeper: Where is all that extra money paid to Express Scripts going? How is this expensive PBM construct improving the health and wellbeing of our military families? Or is it improving their health and wellbeing? And what about the “industrial complex” our government dollars are supposed to help facilitate? How does a government-contracted service provider like Express Scripts get away with taking several hundred times its fair share of available funding and squeeze out the community pharmacies it is required by law to have in order to fulfill its lawful “network adequacy” requirement?

Obviously PUTT members know many - if not all - of the answers to these questions but generally speaking lawmakers and the public do not, and that’s why we’re launching the “Audit Tricare” campaign - to get people asking the difficult questions that actually have answers, if we’re willing to push the issue hard enough to get them.

When Express Scripts charges exorbitant prices for medications available at competitive rates elsewhere, someone needs to ask why—and demand better.

Stay Tuned

In the coming weeks, PUTT will unveil the full "Audit Tricare" campaign, complete with our personally-sourced data and analysis, and recommendations for a clear path forward for Tricare prescription drug pricing transparency. Our military families have earned honest drug pricing, and American taxpayers deserve to know where their dollars go.

The conversation is coming. The push for the transparency our military families deserve starts now.