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data source: TriCare.mil accessed 5/27 - 6/1/2025
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Express Scripts TRICARE Pharmacy Reimbursement: ESI Mail Order vs Independent Pharmacies
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Express Scripts Self-Owned Mail Order Reimbursement with BreakoutIn-Network Independent Pharmacy Reimbursement with Breakout
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Drug NameDrug UsePrescription QuantityExpress Scripts Mail OrderESI Pays PharmacyPatient CopayCalifornia Independent PharmaciesESI Pays PharmacyPatient CopayFlorida Independent PharmaciesESI Pays PharmacyPatient CopayIllinois Independent PharmaciesESI Pays PharmacyPatient CopayNorth Carolina Independent PharmaciesESI Pays PharmacyPatient CopayTexas Independent PharmaciesESI Pays PharmacyPatient CopayVirginia Independent PharmaciesESI Pays PharmacyPatient Copay
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Lisinopril 20 mgblood pressure90 days$94.77$81.77$13.00$2.49$0.00$2.49$2.49$0.00$2.49$2.49$0.00$2.49$2.49$0.00$2.49$2.49$0.00$2.49$2.49$0.00$2.49
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Atorvastatin 20 mgcholesterol90 days$519.62$506.62$13.00$9.33$0.00$9.33$9.33$0.00$9.33$9.33$0.00$9.33$9.33$0.00$9.33$9.33$0.00$9.33$9.33$0.00$9.33
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Tamsulosin 0.4 mgprostate therapy90 days$379.22$366.22$13.00$10.64$0.00$10.64$10.64$0.00$10.64$10.64$0.00$10.64$10.64$0.00$10.64$10.64$0.00$10.64$10.64$0.00$10.64
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Fingolimod 0.5 mgmultiple sclerosis90 days$33,314.58$33,301.58$13.00$515.64$467.64$48.00$515.64$467.64$48.00$515.64$467.64$48.00$515.64$467.64$48.00$515.64$467.64$48.00$515.64$467.64$48.00
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Donepezil 10 mgalzheimer's 90 days$700.78$687.78$13.00$5.67$0.00$5.67$5.67$0.00$5.67$5.67$0.00$5.67$5.67$0.00$5.67$5.67$0.00$5.67$5.67$0.00$5.67
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Metformin 1000 mgdiabetes90 days$129.78$116.78$13.00$1.19$0.00$1.19$1.19$0.00$1.19$1.19$0.00$1.19$1.19$0.00$1.19$1.19$0.00$1.19$1.19$0.00$1.19
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Abiraterone 250 mgprostate cancer60 days$5,824.50$5,811.50$13.00$48.34$16.34$32.00$48.34$16.34$32.00$48.34$16.34$32.00$48.34$16.34$32.00$48.34$16.34$32.00$48.34$16.34$32.00
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Droxidopa 300 mgblood pressure90 days$9,710.30$9,697.30$13.00$179.07$131.07$48.00$179.07$131.07$48.00$179.07$131.07$48.00$179.07$131.07$48.00$179.07$131.07$48.00$179.07$131.07$48.00
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Everolimus 5 mgcancer therapy56 days$654.16$641.16$13.00$343.76$311.76$32.00$343.76$311.76$32.00$343.76$311.76$32.00$343.76$311.76$32.00$343.76$311.76$32.00$343.76$311.76$32.00
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Imatinib 100 mgcancer therapy60 days$99.71$86.71$13.00$63.38$15.38$48.00$63.38$15.38$48.00$63.38$15.38$48.00$63.38$15.38$48.00$63.38$15.38$48.00$63.38$15.38$48.00
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Escitalopram 20 mgantidepressant90 days$406.31$393.31$13.00$6.57$0.00$6.57$6.57$0.00$6.57$6.57$0.00$6.57$6.57$0.00$6.57$6.57$0.00$6.57$6.57$0.00$6.57
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Fluoxetine 20 mgantidepressant90 days$235.32$222.32$13.00$1.45$0.00$1.45$1.45$0.00$1.45$1.45$0.00$1.45$1.45$0.00$1.45$1.45$0.00$1.45$1.45$0.00$1.45
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Amlodipine 10 mgblood pressure90 days$213.60$200.60$13.00$0.84$0.00$0.84$0.84$0.00$0.84$0.84$0.00$0.84$0.84$0.00$0.84$0.84$0.00$0.84$0.84$0.00$0.84
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Carvedilol 25 mgblood pressure90 days$192.06$179.06$13.00$1.89$0.00$1.89$1.89$0.00$1.89$1.89$0.00$1.89$1.89$0.00$1.89$1.89$0.00$1.89$1.89$0.00$1.89
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Clopidogrel 75 mgblood thinner90 days$626.40$613.40$13.00$6.44$0.00$6.44$6.44$0.00$6.44$6.44$0.00$6.44$6.44$0.00$6.44$6.44$0.00$6.44$6.44$0.00$6.44
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Metoprolol ER 25 mgblood pressure90 days$94.84$81.84$13.00$9.42$0.00$9.42$9.42$0.00$9.42$9.42$0.00$9.42$9.42$0.00$9.42$9.42$0.00$9.42$9.42$0.00$9.42
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Ezetimibe 10 mgcholesterol90 days$1,016.70$1,003.70$13.00$12.23$0.00$12.23$12.23$0.00$12.23$12.23$0.00$12.23$12.23$0.00$12.23$12.23$0.00$12.23$12.23$0.00$12.23
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Timolol 0.5%
glaucoma/blood pressure
15 days$1,042.95$1,029.92$13.00$368.31$140.31$228.00$368.31$140.31$228.00$368.31$140.31$228.00$368.31$140.31$228.00$368.31$140.31$228.00$368.31$140.31$228.00
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Omeprazole 40 mgacid reflux90 days$665.58$652.58$13.00$6.19$0.00$6.19$6.19$0.00$6.19$6.19$0.00$6.19$6.19$0.00$6.19$6.19$0.00$6.19$6.19$0.00$6.19
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Montelukast 10 mgasthma90 days$509.09$496.09$13.00$3.09$0.00$3.09$3.09$0.00$3.09$3.09$0.00$3.09$3.09$0.00$3.09$3.09$0.00$3.09$3.09$0.00$3.09
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Express Scripts TRICARE Pharmacy Reimbursement: ESI Mail Order vs Major Chains
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Express Scripts Self-Owned Mail Order Reimbursement with BreakoutMajor Pharmacy / Grocery Chain Pharmacy Reimbursement with Breakout
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Drug NameDrug UsePrescription QuantityExpress Scripts Mail OrderESI Pays PharmacyPatient CopayCVSESI Pays PharmacyPatient CopayCostcoESI Pays PharmacyPatient CopayEncore PharmacyESI Pays PharmacyPatient CopayHEBESI Pays PharmacyPatient CopayIngles PharmacyESI Pays PharmacyPatient CopayKrogerESI Pays PharmacyPatient CopayOsco DrugESI Pays PharmacyPatient CopayPublixESI Pays PharmacyPatient CopaySave-OnESI Pays PharmacyPatient CopayWalgreensESI Pays PharmacyPatient Copay
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Lisinopril 20 mgblood pressure90 days$94.77$81.77$13.00$2.12$0.00$2.12$2.38$0.00$2.38$2.59$0.00$2.59$1.88$0.00$1.88$2.98$0.00$2.98$2.98$0.00$2.98$3.44$0.00$3.44$1.95$0.00$1.95$3.19$0.00$3.19$1.97$0.00$1.97
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Atorvastatin 20 mgcholesterol90 days$519.62$506.62$13.00$1.67$0.00$1.67$1.99$0.00$1.99$4.42$0.00$4.42$2.62$0.00$2.62$4.42$0.00$4.42$2.36$0.00$2.36$2.74$0.00$2.74$2.19$0.00$2.19$3.62$0.00$3.62$1.56$0.00$1.56
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Tamsulosin 0.4 mgprostate therapy90 days$379.22$366.22$13.00$3.73$0.00$3.73$3.03$0.00$3.03$8.83$0.00$8.83$4.64$0.00$4.64$8.83$0.00$8.83$5.25$0.00$5.25$5.96$0.00$5.96$3.23$0.00$3.23$5.46$0.00$5.46$3.46$0.00$3.46
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Fingolimod 0.5 mgmultiple sclerosis90 days$33,314.58$33,301.58$13.00$9,994.37$9,946.37$48.00$9,994.37$9,946.37$48.00$9,994.37$9,946.37$48.00$9,946.37$9,898.37$48.00$9,994.37$9,946.37$48.00$13,454.43$13,406.43$48.00$9,994.37$9,946.37$48.00$9,994.57$9,946.57$48.00$9,994.47$9,946.47$48.00$9,994.37$9,946.37$48.00
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Donepezil 10 mgalzheimer's 90 days$700.78$687.78$13.00$3.64$0.00$3.64$10.83$0.00$10.83$8.10$0.00$8.10$7.20$0.00$7.20$8.10$0.00$8.10$5.12$0.00$5.12$5.83$0.00$5.83$11.03$0.00$11.03$18.92$0.00$18.92$3.38$0.00$3.38
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Metformin 1000 mgdiabetes90 days$129.78$116.78$13.00$2.32$0.00$2.32$1.84$0.00$1.84$2.86$0.00$2.86$2.00$0.00$2.00$2.86$0.00$2.86$3.28$0.00$3.28$3.75$0.00$3.75$2.04$0.00$2.04$3.36$0.00$3.36$2.16$0.00$2.16
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Abiraterone 250 mgprostate cancer60 days$5,824.50$5,811.50$13.00$2,038.58$2,006.58$32.00$2,038.68$2,006.68$32.00$2,041.31$2,009.31$32.00$2,006.68$1,974.68$32.00$2,041.31$2,009.31$32.00$2,038.58$2,006.58$32.00$2,038.68$2,006.68$32.00$2,041.51$2,009.51$32.00$2,006.68$1,974.68$32.00$2,038.58$2,006.58$32.00
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Droxidopa 300 mgblood pressure90 days$9,710.30$9,697.30$13.00$2,524.68$2,476.68$48.00$2,524.68$2,476.68$48.00$2,524.68$2,476.68$48.00$2,476.68$2,428.68$48.00$2,524.68$2,476.68$48.00$2,524.88$2,476.88$48.00$2,524.78$2,476.78$48.00$2,524.88$2,476.88$48.00$2,476.68$2,428.68$48.00$2,524.68$2,476.68$48.00
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Everolimus 5 mgcancer therapy56 days$654.16$641.16$13.00$12,891.35$12,843.35$32.00$17,930.56$17,898.56$32.00$12,891.35$12,859.35$32.00$12,859.35$12,827.35$32.00$12,891.35$12,859.35$32.00$12,891.35$12,859.35$32.00$12,891.45$12,859.45$32.00$12,891.55$12,859.55$32.00$12,859.35$12,827.35$32.00$12,891.35$12,859.35$32.00
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Imatinib 100 mgcancer therapy60 days$99.71$86.71$13.00$1,820.33$1,772.33$48.00$1,820.30$1,772.30$48.00$1,820.30$1,772.30$48.00$1,772.33$1,724.33$48.00$1,820.30$1,772.30$48.00$1,820.33$1,772.33$48.00$1,820.43$1,772.43$48.00$1,820.50$1,772.50$48.00$1,772.33$1,724.33$48.00$1,820.33$1,772.33$48.00
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Escitalopram 20 mgantidepressant90 days$406.31$393.31$13.00$4.13$0.00$4.13$3.38$0.00$3.38$7.66$0.00$7.66$4.96$0.00$4.96$7.66$0.00$7.66$5.82$0.00$5.82$6.61$0.00$6.61$3.58$0.00$3.58$4.96$0.00$4.96$3.84$0.00$3.84
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Fluoxetine 20 mgantidepressant90 days$235.32$222.32$13.00$2.78$0.00$2.78$7.66$0.00$7.66$3.16$0.00$3.16$2.31$0.00$2.31$3.16$0.00$3.16$3.92$0.00$3.92$4.48$0.00$4.48$2.41$0.00$2.41$2.31$0.00$2.31$2.58$0.00$2.58
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Amlodipine 10 mgblood pressure90 days$213.60$200.60$13.00$1.43$0.00$1.43$1.27$0.00$1.27$1.65$0.00$1.65$1.24$0.00$1.24$1.65$0.00$1.65$2.03$0.00$2.03$2.36$0.00$2.36$1.65$0.00$1.65$1.24$0.00$1.24$1.33$0.00$1.33
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Carvedilol 25 mgblood pressure90 days$192.06$179.06$13.00$2.93$0.00$2.93$2.49$0.00$2.49$2.82$0.00$2.82$2.24$0.00$2.24$2.82$0.00$2.82$4.11$0.00$4.11$4.70$0.00$4.70$2.82$0.00$2.82$2.24$0.00$2.24$2.71$0.00$2.71
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Clopidogrel 75 mgblood thinner90 days$626.40$613.40$13.00$10.90$0.00$10.90$5.74$0.00$5.74$5.74$0.00$5.74$5.74$0.00$5.74$5.74$0.00$5.74$15.35$0.00$15.35$14.77$0.00$14.77$5.74$0.00$5.74$5.74$0.00$5.74$10.13$0.00$10.13
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Metoprolol ER 25 mgblood pressure90 days$94.84$81.84$13.00$2.65$0.00$2.65$5.72$0.00$5.72$16.90$0.00$16.90$9.15$0.00$9.15$16.90$0.00$16.90$3.73$0.00$3.73$4.27$0.00$4.27$16.90$0.00$16.90$9.15$0.00$9.15$2.46$0.00$2.46
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Ezetimibe 10 mgcholesterol90 days$1,016.70$1,003.70$13.00$3.38$0.00$3.38$4.77$0.00$4.77$16.19$0.00$16.19$7.99$0.00$7.99$16.19$0.00$16.19$4.76$0.00$4.76$5.43$0.00$5.43$16.19$0.00$16.19$7.99$0.00$7.99$3.14$0.00$3.14
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Timolol 0.5%blood pressure15 days$1,042.95$1,029.92$13.00$638.31$410.31$228.00$638.31$410.31$228.00$801.77$573.77$228.00$334.34$106.34$228.00$857.10$629.10$228.00$638.31$410.31$228.00$638.41$410.41$228.00$801.77$573.77$228.00$638.31$410.31$228.00$638.31$410.31$228.00
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Omeprazole 40 mgacid reflux90 days$665.58$652.58$13.00$3.85$0.00$3.85$3.11$0.00$3.11$3.97$0.00$3.97$2.93$0.00$2.93$3.97$0.00$3.97$5.54$0.00$5.54$6.28$0.00$6.28$3.97$0.00$3.97$2.93$0.00$2.93$3.65$0.00$3.65
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Montelukast 10 mgasthma90 days$509.09$496.09$13.00$2.80$0.00$2.80$2.85$0.00$2.85$9.43$0.00$9.43$5.67$0.00$5.67$9.43$0.00$9.43$4.01$0.00$4.01$4.59$0.00$4.59$9.43$0.00$9.43$5.67$0.00$5.67$2.65$0.00$2.65
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