House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) has expanded an ongoing investigation into Pharmacy Benefit Managers (PBMs) by requesting information about their use of foreign-based group purchasing organizations (GPOs). Letters sent to the Chief Executive Officers of The Cigna Group and Optum Rx seek documents regarding the PBMs’ overseas GPO operations.
“The Committee is investigating whether Cigna Group’s Evernorth Health Services, the parent company of Express Scripts, uses its foreign headquartered group purchasing organization (GPO)—Ascent Health Services, Inc. (Ascent) which is headquartered in Switzerland—to evade transparency and oversight in the United States. The Committee requests documents and communications regarding the creation and role of Ascent,” wrote Chairman Comer in a letter to The Cigna Group.
In July 2024, the House Oversight Committee released a report outlining how PBMs have influenced prescription drug markets through policies that can limit competition. The report noted that GPOs add complexity to pricing structures, especially when they are based outside the U.S., as these entities may be used to retain additional revenue streams and avoid domestic regulations. According to the committee, Emisar Pharma was established by UnitedHealth Group’s Optum Rx in 2021 with headquarters in Ireland, while Ascent was created by Cigna Group’s Express Scripts in 2019 and is based in Switzerland.
“The Committee is investigating whether UnitedHealth Group’s Optum Rx, uses its foreign headquartered group purchasing organization (GPO)—Emisar Pharma Services, LLC (Emisar Pharma) headquartered in Ireland—to evade transparency and oversight in the United States. The Committee requests documents and communications regarding the creation and role of Emisar Pharma,” wrote Chairman Comer in a letter to Optum Rx.
James Comer has represented Kentucky’s 1st district in Congress since 2016 after succeeding Ed Whitfield. Before his tenure in Congress, he served from 2001 to 2012 as a member of the Kentucky House of Representatives. Comer was born in Carthage, Tennessee, currently resides in Tompkinsville, Kentucky, and graduated from Western Kentucky University with a Bachelor of Science degree.
Letters were addressed to Mr. David Cordani, Chairman and CEO of The Cigna Group; and Dr. Patrick Conway, CEO of Optum Rx.
