TRICARE Pharmacy Services Contract Awarded to Express Scripts Inc. for $647.4M

Contract Overview

Contract Amount: $647,401,029 ($647.4M)

Contractor: Express Scripts Inc

Awarding Agency: Department of Defense

Start Date: 2018-03-22

End Date: 2019-04-30

Contract Duration: 404 days

Daily Burn Rate: $1.6M/day

Competition Type: FULL AND OPEN COMPETITION

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: TRICARE PHARMACY SERVICES

Place of Performance

Location: SAINT LOUIS, SAINT LOUIS County, MISSOURI, 63121

State: Missouri Government Spending

Plain-Language Summary

Department of Defense obligated $647.4 million to EXPRESS SCRIPTS INC for work described as: TRICARE PHARMACY SERVICES Key points: 1. Significant contract value of over $647 million for pharmacy services. 2. Express Scripts Inc. is the sole contractor for this delivery order. 3. Potential risk associated with single-source provider for essential healthcare services. 4. Spending falls within the Defense Health Agency's sector.

Value Assessment

Rating: good

The contract value of $647.4M for TRICARE Pharmacy Services appears reasonable given the scope of providing prescription drug benefits to military personnel and their families. Benchmarking against similar large-scale government health insurance contracts would provide a more precise assessment.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The contract was awarded under full and open competition, suggesting a competitive bidding process. This method is generally expected to yield fair pricing and good value for the government.

Taxpayer Impact: The competitive award process aims to ensure taxpayer funds are used efficiently for essential pharmacy services.

Public Impact

Ensures prescription drug access for millions of TRICARE beneficiaries. Impacts the cost and availability of medications for military families. Contributes to the overall healthcare delivery system for the Department of Defense.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

  • Potential for price increases in future contract renewals.
  • Dependence on a single vendor for critical pharmacy services.

Positive Signals

  • Awarded through full and open competition.
  • Provides essential healthcare services to a large beneficiary population.

Sector Analysis

This contract falls under the Healthcare sector, specifically direct health and medical insurance carriers. Government spending in this area is substantial, driven by the need to provide comprehensive health benefits to federal employees and military personnel.

Small Business Impact

The data does not indicate any specific set-asides for small businesses in this contract, suggesting it was awarded to a large prime contractor. Further analysis would be needed to determine if small businesses are involved as subcontractors.

Oversight & Accountability

The contract was awarded by the Defense Health Agency, part of the Department of Defense, which has established oversight mechanisms for healthcare contracts. Monitoring performance and costs is crucial for accountability.

Related Government Programs

  • Direct Health and Medical Insurance Carriers
  • Department of Defense Contracting
  • Defense Health Agency Programs

Risk Flags

  • Sole provider risk
  • Potential for price escalation in future
  • Dependence on contractor performance
  • Limited visibility into subcontractor performance

Tags

direct-health-and-medical-insurance-carr, department-of-defense, mo, delivery-order, 100m-plus

Frequently Asked Questions

What is this federal contract paying for?

Department of Defense awarded $647.4 million to EXPRESS SCRIPTS INC. TRICARE PHARMACY SERVICES

Who is the contractor on this award?

The obligated recipient is EXPRESS SCRIPTS INC.

Which agency awarded this contract?

Awarding agency: Department of Defense (Defense Health Agency).

What is the total obligated amount?

The obligated amount is $647.4 million.

What is the period of performance?

Start: 2018-03-22. End: 2019-04-30.

What is the projected cost savings or value added by using Express Scripts Inc. compared to alternative pharmacy benefit managers?

Without specific comparative data on alternative bids or performance metrics, it's challenging to quantify the exact value added. However, the full and open competition process implies that Express Scripts' proposal was deemed the most advantageous. Future contract performance reviews and comparisons with industry benchmarks will be key to assessing long-term value.

What are the key performance indicators (KPIs) used to evaluate Express Scripts Inc.'s service delivery under this contract?

Key performance indicators likely include metrics such as prescription fulfillment rates, drug cost containment, beneficiary satisfaction, claims processing accuracy, and adherence to formulary requirements. The Defense Health Agency would monitor these KPIs to ensure the contractor meets contractual obligations and provides high-quality pharmacy services.

How does this contract contribute to the overall cost-effectiveness of the TRICARE program?

This contract is a significant component of the TRICARE program's pharmacy benefit. By leveraging Express Scripts' capabilities, the DoD aims to achieve economies of scale and potentially negotiate favorable drug pricing. The effectiveness in controlling overall healthcare costs depends on ongoing contract management and market dynamics.

Industry Classification

NAICS: Finance and InsuranceInsurance CarriersDirect Health and Medical Insurance Carriers

Product/Service Code: MEDICAL SERVICESGENERAL HEALTH CARE SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Parent Company: Priority Healthcare Distribution Inc

Address: 1 EXPRESS WAY, SAINT LOUIS, MO, 63121

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Not Designated a Small Business, Special Designations, U.S.-Owned Business

Financial Breakdown

Contract Ceiling: $647,401,029

Exercised Options: $647,401,029

Current Obligation: $647,401,029

Contract Characteristics

Commercial Item: COMMERCIAL PRODUCTS/SERVICES PROCEDURES NOT USED

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: HT940214D0002

IDV Type: IDC

Timeline

Start Date: 2018-03-22

Current End Date: 2019-04-30

Potential End Date: 2019-04-30 00:00:00

Last Modified: 2025-08-06

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