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NCPA questions TRICARE preferred pharmacy plan

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ALEXANDRIA, Va. — The National Community Pharmacists Association is giving a thumbs-down to a proposed preferred pharmacy pilot program for TRICARE, the health benefits program for the nation’s armed forces.

NCPA said Monday that the program, contained in the National Defense Authorization Act for Fiscal Year 2016 (H.R. 1735), is scheduled to be considered by the House Armed Services Committee on Wednesday.

“Pharmacists have seen this movie before, and we know how it ends: significant disruption to patients, including those homebound or with serious health challenges. We encourage Congress to rethink this proposal and to modify it in light of the lessons learned from Medicare preferred pharmacy drug plans,” NCPA chief executive officer B. Douglas Hoey said in a statement.

“Many Medicare beneficiaries are surprised after enrollment to learn that the pharmacy they rely on is not a preferred pharmacy in their drug plan, even if the patient’s pharmacy was willing to accept the terms and conditions of the preferred pharmacy network,” he explained. “Patients then may have to pay more or face an inconvenient trip to reach the closest preferred pharmacy.

In urban areas, more than half of such drug plans failed to meet the government standard for convenient access, while in rural areas patients and caregivers may have to drive 20 miles or more each way, Hoey noted.

He called on lawmakers to scrap the proposed preferred pharmacy program or, at least, to modify it.

“First, there should be safeguards to ensure any preferred pharmacy network features meaningful participation by small business pharmacies. The Medicare experience has shown how oftentimes community pharmacies are never given the opportunity to participate in preferred pharmacy networks, even though these pharmacies are substantially more likely to be located in underserved inner city and rural communities,” Hoey stated. “Second, require that the preferred’network comply with existing TRICARE retail pharmacy access standards. Our men and women in uniform and their families should have convenient access to their prescription medications.”


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