A portion of the 2013 federal budget proposed by the Obama administration last month has community pharmacy advocates up in arms.

Tricare, community pharmacy, 2013 federal budget, Obama administration, pharmacy advocates, prescription drugs, co-payments, pharmacy choice, Tricare's formulary, generic drugs, brand name drugs, National Association of Chain Drug Stores, Steve Anderson, National Community Pharmacists Association, B. Douglas Hoey, Senate Budget Committee, community pharmacies, Kelly Ayotte, Mike Enzi, health care benefits, Leon Panetta, Ron Johnson, Richard Monks

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Community pharmacy irked over proposed Tricare changes

March 12th, 2012

WASHINGTON – A portion of the 2013 federal budget proposed by the Obama administration last month has community pharmacy advocates up in arms.

Under the fiscal package released by the president in mid-February, pharmacy patients covered by the military’s Tricare program would see their co-payments for some prescription drugs more than double — something that pharmacy advocates say will severely limit their pharmacy choice.

Under the proposal, which the Pentagon says would save $28 billion over 10 years, co-pays at retail outlets would remain $5 for generics but would more than double to $26 for brand names, then go up $2 per year through 2017.

Co-pays for drugs not listed on Tricare’s formulary would be decided on a case-by-case basis.

However, generic drugs obtained from a mail-order facility would remain free for a 90-day supply, while brand name drugs obtained through the mail would increase to $26 from $9 and rise by $2 a year through 2017. Nonformulary drugs would cost $51, up from $25.

The new rates would go into effect at the start of the government’s fiscal year on October 1.

“Congress should reject, and the Obama administration should drop, short-sighted policies that would penalize Tricare beneficiaries accessing essential health services provided at community pharmacies,” National Association of Chain Drug Stores president and chief executive officer Steve Anderson and National Community Pharmacists Association CEO B. Douglas Hoey said in a joint statement released immediately after the budget proposal was released.

“A greater reliance on mail-order pharmacies will circumvent proven community pharmacy-provided services that have demonstrated savings by encouraging the utilization of more affordable medicines, detecting chronic illness early, and increasing patients’ proper utilization of medicine as prescribed,” they said.

The association’s objections to the co-pay hikes and the administration’s plan to also raise Tricare enrollment fees are being echoed by some members of Congress.

Three Republicans on the Senate Budget Committee, for instance, have questioned why federal workers and other people receiving government-provided health benefits are not facing the same increases, making it seem that the government is balancing the budget on the backs of veterans.

“Do you think this is fair?” says Sen. Kelly Ayotte (R., N.H.). “All of us should be sacrificing, but I see [the military] as being asked to go first.”

The lawmakers say that many of their constituents have been asking that same question.
Sen. Mike Enzi (R., Wyo.), for instance, has noted that he has received a complaint from a retiree who wanted to know why he was going to be asked to pay more for health care than his sister, who is on welfare; and Sen. Ron Johnson (R., Wis.) has complained that federal workers, including unionized workers, are being treated better than military veterans when it comes to health care fees.

Meanwhile, Defense Secretary Leon Panetta has declined to respond to the comparison between military and federal civilian health care because he only controls Tricare benefits for retirees.

But he defended hiking fees for health care benefits and co-payments for prescription drugs as a way to cut defense spending and said he expected the military would accept the changes. “They go when they are told to go and do what they are supposed to do,” he noted during recent testimony before a Senate committee, saying these are traits that he sees as part of service members’ strength and willingness to sacrifice.