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Express Scripts mails millions of prescriptions every year. Photo: Scott Varley/Digital First Media/Torrance Daily Breeze via Getty Images

Express Scripts sent a notification this month to pharmacies saying its networks will expand to include "pharmacies predominantly engaged in mail-order practice" by the first quarter of 2019.

Why it matters: Express Scripts, which negotiates drug prices for 80 million Americans, may be opening the door for any mail-order pharmacy — including Amazon's newly acquired PillPack — to get full access to its large network, as long as the pharmacy agrees to Express Scripts' contract terms.

What they're saying: The company said it took this action because many pharmacies — even those that said they were retail pharmacies — conduct more than half of their business via mail order.

  • "Having pharmacies be clear about what they do — mail order or retail — helps our clients to determine what they need from their pharmacy network. Also, it ensures pharmacies are in legal compliance with their contracts," Express Scripts spokesman Brian Henry said.
  • The company did not provide an update on its relationship with PillPack, which was in a contract dispute with Express Scripts over the summer. PillPack declined to comment on contract negotiations.

Between the lines: Express Scripts, a dominant pharmacy benefit manager that is getting gobbled up by Cigna, owns a massive mail-order drug business that represents almost half of its revenue. The company has been criticized (and sued) for steering patients toward itself, by excluding other pharmacies that deliver drugs to people's homes.

  • Mail order is big business for Express Scripts. While these changes could be spurred by the looming threat of Amazon, Express Scripts is not going to leave money on the table.

The big question: What's included in the company's contracts with mail-order pharmacies? The secretive terms will dictate how much mail-order pharmacies get paid and what credentials they need to be part of the network.

  • "If a pharmacy decides not to participate due to the terms and conditions imposed by Express Scripts, this avoids the perception that Express Scripts is blocking or kicking out mail-order pharmacies from their network," said Stephen Buck, a pharmaceutical industry expert.

What to watch: Whether CVS Caremark and OptumRx, the other two dominant PBMs, follow suit. CVS said it includes "mail-order pharmacies as a subset of our retail pharmacy network." OptumRx has "other mail-order pharmacies in network" but did not say which ones.

Update: The story has been updated with comments from CVS, OptumRx and PillPack.

Go deeper

Updated 1 hour ago - World

Australia joins U.S. in diplomatic boycott of Beijing Winter Olympics

Australian Prime Minister Scott Morrison. Photo: Darrian Traynor/Getty Images

Australia is joining the U.S. in a diplomatic boycott of the 2022 Beijing Winter Olympic Games in protest of human rights abuses committed by China's government, Prime Minister Scott Morrison confirmed Wednesday.

Driving the news: After the Biden administration's announcement that U.S. officials won't attend the Games due to the ongoing genocide of Uighurs and other Muslim minorities in the Xinjiang region of China, Morrison said at a Sydney briefing that Australia would follow suit as "it's the right thing to do."

Progressives to file resolution to strip Boebert's committee seats

Rep. Lauren Boebert walking through the Senate side of the U.S. Capitol earlier this month. Photo: Drew Angerer/Getty Images

House progressives are planning to introduce a resolution on Wednesday to strip Rep. Lauren Boebert (R-Colo.) of her committee assignments, according to a Democratic aide familiar with the matter.

Why it matters: The move, which was first reported by the Washington Post, comes as progressives — anxious to see the right-wing firebrand face retribution for her recent comments — have grown frustrated by Democratic leadership's inaction on the issue.

Roger Stone won't cooperate with Jan. 6 panel

Longtime Trump confidante Roger Stone speaking in front of the Supreme Court on Jan. 5 in Washington, D.C. Photo: Tasos Katopodis/Getty Images

Longtime Trump confidante Roger Stone won't cooperate with the House select committee investigating the Jan. 6 Capitol riot and will invoke the Fifth Amendment right not to testify, his attorney said Tuesday evening.

Why it matters: The announcement, first reported by ABC News, came hours after former White House chief of staff Mark Meadows said he wouldn't cooperate with the probe.

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