ALEXANDRIA, Va. — Obama administration budget proposals would hike out-of-pocket costs and implement other policies for beneficiaries of TRICARE, the U.S. military’s health and prescription benefits plan, that would force patients away from community pharmacies and into mail-order drug programs, according to the National Association of Chain Drug Stores.
NACDS said it has submitted comments to the U.S. Senate Armed Services Subcommittee on Personnel, which held a hearing Wednesday on the Fiscal Year 2013 Defense Authorization, that calls for the adoption of policies to rein in spending and preserve patient pharmacy choice and access.
The White House’s proposed fiscal 2013 budget for the Department of Defense (DoD) includes "draconian changes" that would prevent TRICARE beneficiaries from getting many prescription drugs at their local pharmacy and raise cost sharing by as much as $34 for a 30-day supply of medications from a retail pharmacy, according to NACDS.
"In addition to unfairly penalizing TRICARE beneficiaries who prefer to use local pharmacies, NACDS believes this proposal is pennywise and pound foolish," NACDS stated in its comments. "Threatening beneficiary access to prescription medications and their preferred health care provider will only increase the use of more costly medical interventions, such as physician and emergency room visits and hospitalizations."
NACDS cited ways to cut costs without impacting pharmacy access or health outcomes, such as increases in TRICARE use of less costly generic medications, which would reduce DoD drug outlays.
"The utilization of generic medications by TRICARE beneficiaries is low in comparison with other plans," NACDS said in its statement to the subcommittee. "Modest increases in generic utilization by TRICARE beneficiaries would have a dramatic impact on the DoD budget."
The association also proposed that DoD conduct a demonstration on the effectiveness of medication therapy management (MTM), which can reduce health care costs and improve medication adherence, and recommended the development of a "drug stock replacement" program for community pharmacies that could lead to savings of up to 30%. That model, currently used by the TRICARE mail-order pharmacy, would implement depot pricing for prescription drugs provided at retail pharmacies and would enable DoD to obtain more rebates from drug manufacturers.
"NACDS believes using depot pricing for covered prescription drugs provided through the retail pharmacy network would assist DoD in negotiating additional discounts from drug manufacturers, beyond the Federal Ceiling Price (FCP) discounts currently required by law," NACDS stated.
