AHF Blasts CIGNA for Shortchanging Pharmacies: ‘Cigna Doesn’t Care!’

In News by Ged Kenslea

Healthcare advocates from across the country protested at the corporate offices of Cigna to stand up against the company’s Express Scripts’ pharmacy benefits manager (PBM)


Advocates protested nation’s 2nd largest PBM over unfair charges to, and clawbacks from independent pharmacies that negatively impact patient care for those living with HIV and other critical illnesses

BLOOMFIELD, CONN. (October 18, 2022) Healthcare advocates from across the country affiliated with AIDS Healthcare Foundation (AHF) protested unethical charges and actions by Cigna via its pharmacy benefits manager (PBM), Express Scripts, to independent and specialty pharmacies providing the sensitive, lifesaving medical needs of individuals living with HIV and other critical illnesses. The protest took place Tuesday, October 18th in front of Cigna’s corporate headquarters in Bloomfield, CT.


Express Scripts, the second largest PBM in the US, controls 24% of the market according to Becker’s Hospital Review. In December, 2018, Cigna paid $67 billion to acquire Express Scripts, making it one of the nation’s largest combination medical insurance companies and PBMs.


Cigna’s Express Scripts PBM and rivals CVS Caremark and OptumRx have disproportionality impacted access to care for those living with critical illnesses by adding arbitrary penalties and fees to small, independent pharmacies, which has resulted in many patients not having their medicines covered at their pharmacy of choice, thus causing many to fall out of care.


Pharmacy Benefit Managers (PBMs), which began as a way to help patients access drugs they need, have spiraled out of control, with just 3 PBMs—CVS Caremark, Cigna’s Express Scripts and OptumRx—now controlling over 75% of the US market.

“Our David and Goliath battle between independent and smaller pharmacies and PBMs continues with this Cigna protest in Bloomfield Tuesday,” stated Tracy Jones, National Director for Grassroots Mobilization Initiatives for AIDS Healthcare Foundation. “Cigna’s actions rob specialty and independent pharmacies that many patients depend on, preventing those pharmacies from providing the lifesaving medicines and services patients need.  The situation has gotten so out of hand that we must continue to speak out against PBM abuses and health care consolidation to help protect struggling smaller mom-and-pop and independent pharmacies nationwide.”

A concise 3-minute PBM explainer video neatly distills the complex issue into easily understood language and imagery can be found here: (direct YouTube link).

AHF Pharmacies are vital to AHF’s mission to provide cutting-edge medicine and advocacy regardless of the ability to pay. Our pharmacists and staff work tirelessly with AHF medical providers to keep people living with HIV healthy and virally suppressed. PBMs interfere with that model of care. PBMs are parasitic middlemen that bring no value to patients, creating pharmacy deserts across the United States, as they steadily squeeze specialty pharmacies, preventing patients insured by their parent companies from using specialized pharmacies like AHF’s. They also engage in “take or leave it” contracts that force “clawback’ payments known cryptically as “direct and indirect remuneration” (DIR) fees.

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