Kroger Health reups agreement with Prime Therapeutics

Kroger Health has extended its arrangement with pharmacy benefits manager Family of Pharmacies and Prime Therapeutics LLC (Prime) to provide medically necessary prescriptions for Kroger’s more than 17 million patients.

The agreement, which becomes effective on Jan. 1, 2023, follows Kroger’s termination of its contract with Express Scripts (ESI) last September.

Kroger said the initiative will increase health access, deliver pricing transparency, and ensure affordable prices for commercial, Medicare and Medicaid customers.

“Kroger is always looking for new opportunities and collaborations to make Medicare more accessible, and our direct agreement with Prime delivers benefits for our customers and for the thousands of communities we operate in daily,” Colleen Lindholz, president of Kroger Health, the healthcare division of Cincinnati-based The Kroger Co., said in a statement.

The agreement with Eagan, Minn.-based Prime will prevent disruption to Prime’s Medicare Part D members mitigating the end of year Kroger termination with ESI, Kroger said, noting that the Kroger pharmacies remain in-network for Prime's Medicare Part D Plan clients and nearly all national and regional Medicare Part D plans.

“It was critical for Prime to maintain the Kroger Family of Pharmacies as an option for our members in our network of high-quality pharmacy providers given their strong record of meeting and exceeding Centers for Medicare and Medicaid Services’ (CMS) quality metrics,” Dave Schlett, Prime executive vice president and president of PBM solutions, said in a statement.

In announcing its termination with ESI in September, Kroger said “our efforts to negotiate in good faith have not delivered an agreement in the best interest of our customers.” Customers who use ESI-sponsored commercial plans, Medicare Part D plans, or Tricare/Department of Defense (DOD) will no longer be able to use their ESI insurance pharmacy benefit to fill prescriptions at Kroger pharmacies as of Jan. 1, 2023.

Kroger Health, which more than 2,200 pharmacies and 220 clinics in 35 states with a team 24,000 healthcare practitioners, including pharmacists, nurse practitioners, dietitians and technicians, said the Kroger Family of Pharmacies remains in-network for the majority of all national and regional Medicare Part D plans because they are not managed by ESI.