House Oversight Committee Chairman James Comer (R-Ky.) has expanded the committee’s investigation into Pharmacy Benefit Managers (PBMs) by requesting information about the use of foreign-headquartered group purchasing organizations (GPOs). The committee is examining whether these GPOs are being used to avoid transparency and oversight in the United States.
Comer sent letters to the Chief Executive Officers of The Cigna Group and Optum Rx, seeking documents related to their respective GPOs based overseas. In his letter to The Cigna Group, Comer wrote: “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.”
In July 2024, a House Oversight Committee report outlined how PBMs can act as middlemen enacting anticompetitive policies and creating additional pricing complexity through GPOs. The report noted that foreign-based GPOs may help PBMs retain more revenue while avoiding U.S. regulations. Emisar Pharma was established by UnitedHealth Group’s Optum Rx in 2021 and is based in Ireland. Ascent was set up by Cigna Group’s Express Scripts in 2019 with headquarters in Switzerland.
In a letter addressed to Optum Rx, Comer stated: “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.”
James Comer has represented Kentucky’s 1st district in Congress since 2016 after succeeding Ed Whitfield. Before serving in Congress, he was a member of the Kentucky House of Representatives from 2001 to 2012. Born in Carthage, Tennessee in 1972, Comer currently lives in Tompkinsville. He earned a Bachelor of Science degree from Western Kentucky University in 1993.
The committee's letters were addressed to Mr. David Cordani, Chairman and CEO of The Cigna Group, and Dr. Patrick Conway, CEO of Optum Rx.
