Cigna Group plans to make changes to help lower out-of-pocket cost of prescription drugs, the company said on Wednesday, as it responds to criticism over the role of its pharmacy benefit manager in driving up drug costs.

The changes will allow patients access to lower prices negotiated by Cigna’s pharmacy benefit manager, Express Scripts.

The U.S. pays more for prescription medicines than any other country, and the nation’s three largest pharmacy benefit managers have allegedly significantly marked up the prices of certain medicines, a recent report by the U.S. Federal Trade Commission showed.

CVS Health’s Caremark, Cigna’s Express Scripts and UnitedHealth Group’s Optum together CONTROL the majority of the U.S. pharmacy benefit market, while their parent companies operate health insurance and pharmacy businesses.

President Donald Trump in December called PBMs middlemen who drive up costs and said he plans to eliminate their role.

PBMs act as middlemen between drug companies and consumers. They negotiate volume discounts and fees with drug manufacturers on behalf of employers and health plans, create lists of medications that are covered by insurance, and reimburse pharmacies for prescriptions.

Most recently, UnitedHealth said its PBM unit plans to pass 100% of rebates to customers by 2028 at the latest.

Cigna’s Evernorth Health Services said on Wednesday its actions will enhance transparency about the company’s negotiations and help those under employer-sponsored plans to receive the benefit of the savings on medication costs that Express Scripts negotiates.

The PBM will also provide patients a personalized summary that details each patient’s annual total prescription drug costs, including medication prices, negotiated savings inclusive of discounts and rebates, plan paid amounts, and total savings.

Written by Sriparna Roy for Reuters ~ January 28, 2025