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Tricare Promotes Mail-Order Pharmacy Option

By Donna Miles
American Forces Press Service

WASHINGTON, Oct. 8, 2010 – As Tricare officials explore ways to control costs while continuing to provide the best health care possible, they’re encouraging beneficiaries, especially those taking long-term medications, to get their prescriptions delivered to their doorsteps.

Navy Rear Adm. Christine S. Hunter, deputy director for the Tricare Management Activity, cited increased usage of the health care system’s home delivery option as a win-win situation that saves patients, as well as the government, money.

Tricare’s almost 9.7 million beneficiaries filled 10.5 million prescriptions through home delivery in 2009, officials noted. That’s up from just over 9 million in 2007, but still represents only about 8 percent of the 130 million prescriptions filled in 2009.

Thirty-seven percent of those prescriptions -- just over 48 million -- were filled at military medical facilities, which is the least expensive delivery method for the Defense Department, and patients pay no copayment, Hunter said.

But getting prescriptions filled at a military facility isn’t always convenient for beneficiaries, who are increasingly turning to retail pharmacies within the Tricare network.

Last year, beneficiaries filled more than half of their prescriptions -- 71.4 million -- at retail pharmacies. This is the fastest-growing of the Tricare delivery options, officials noted, up from more than 67 million retail pharmacy-provided prescriptions in 2008 and just under 63 million in 2007.

While retail pharmacies may be convenient and often the best choice for patients needing short-term medications, Hunter noted that they’re also the most expensive, all around.

Beneficiaries pay the same co-payment for a 30-day supply of medication at the corner drugstore that they’d pay for a 90-day supply delivered through Tricare’s home-delivery option.

“So the cost to them is one-third” using home delivery, Hunter said. “That’s a real incentive there.”

Mail order is the hands-down best choice even for those who value convenience over cost, she said. “I don’t know how it gets more convenient than in your own mailbox at your house, not having to go anywhere to get your prescription,” she said.

Tricare can mail order prescriptions almost anywhere in the world, including deployment sites where specific medications may not be available. The only exceptions are extremely hot climates that may affect some temperature-sensitive drugs.

In addition, beneficiaries who sign up for home delivery can get automatic refills -- a big plus for anyone taking medications for a chronic, long-term condition.

“We’ll send you an email saying, ‘It looks like your refill is due. Unless you say you don’t need it for some reason, we are going to ship it,’” Hunter said.

That eliminates last-minute dashes to the drugstore when a prescription runs out, or worse, gaps before patients resume taking the drugs they need.

“The key to staying healthy and using medications to help you manage your health is to take them,” Hunter said. “And if you don’t have them, you can’t take them.”

Regardless of where beneficiaries get their medications, they’re protected by a safety feature built into the Tricare pharmacy program, Hunter said. The patient data transaction service monitors the medications every Tricare beneficiary receives to flag potential adverse drug interactions or allergic reactions.

“Both the military services and Tricare are very focused on prevention and keeping people healthy,” Hunter said. “All of these programs are designed to support patients partnering with us to stay healthy.”

Partnering is a new emphasis in health care, she said, with patients playing an increasingly key role in their health.

“We are really moving toward partnering for health, and giving you the information and the services you need to be active and healthy for as long as possible,” Hunter said.


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Navy Rear Adm. Christine S. Hunter

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The opinions expressed in the following comments do not necessarily reflect those of the U.S. Department of Defense.

12/16/2010 5:41:04 PM
I have seizures, Lupes, neuropathy, I I find it very difficult to walk down to the end of the corner (long ways) to get my mail. I cannot go out in the sun, walking is difficult. The sun breaks my Lupes out worse. We go to the HEB, which is close by. Ok have to Pay $3, or $22 (90 day supply for medications yes is expensive considering I have several medications. If we could get UPS delivery, at resonable cost, or medications sooner or something at standard rates, between wife and I twelve medications all different dates. We its very complication anyway.
- R Lawrence, San antonio, tx

12/8/2010 12:40:38 PM
My husband and I have been driving to Ft. Jackson, SC to pick up phoned in and new prescriptions. For immediate medical prescriptions, we use local pharmacies. Would any of you advise switching to Express Scripts for long-term meds., or is it not worth the effort? I'd like to hear from someone who is happy with their use of Express Scripts. Thanks.
- B. Palmer, Western NC

10/27/2010 10:58:53 PM
I have taken Arthrotec for years for my arthritis. It is on the national formulary. Now a local medical Service Corps individual has decided that this post will no longer supply this drug. His reason: It contains misoprostol which could be harmful to pregnant women. Almost every drug I know carries precautions to pregnant women. I am a 75 year old male. I have never been pregnant and never expect to be. This drug remains on the national formulary but now I must obtain it at a cost of $9.00 Does this make any sense? If the military pharmacy is the most economical then why do they force me out? The pharmacy should supply this drug and let them give out a warning or refuse it to only pregnant women. How much longer will you allow just any individual who is probably in good health sit back and decide what medicine you can have. THAT IS THE DOCTORS JOB!
- B Kenney, DeRidder LA

10/27/2010 10:44:29 PM
The so called best way (military pharmacy) is turning out to be the worst way because of service. My wife was on Nexium. After two or three refills we were turned down and told that we would have to take Aciphex. This meant a trip to the doctor to to get a new prescription. This cost an office call. After taking Aciphex for a year or so the military decided they would not furnish Aciphex and she would have to take Nexium. Nexium caused hip problems and it took a month or more to justify Aciphex. Two different doctor forms and now she is back on Aciphex.
- B Kenney, DeRidder LA

10/19/2010 3:35:49 PM
I just read the above article encouraging TriCare Beneficiaries to use the mail order pharmacy, which is a smart idea. However it appears convenience is a bigger draw for many. What about extabalishing satellite military pharmacies in areas where a large number of military and retired military live. Provide them with a closer option and speak to the absence of a copay. Just a quick thought!!
- James M. Boyer, San Francisco, CA

10/17/2010 6:49:33 PM
My Husband is retired Air Force and we have been with the mail order program for several years now and it is wonderful. That is untill this year, when I went to refill my script which I've been taking for 20 years, Tricare tells me I must take the generic, even though I don't do well on the generic. My doctor has written to them and filled out forms that are not very self-explaintory and still they won't approve. I don't understand WHY this new rule is making it so hard for me to get my prescription.
- L. Heckman, Noblesville, IN

10/15/2010 1:15:14 PM
I am a full time RV-er. I live in an RV park & travel as much as I can. Is it possable for Meds to be sent to different address when it is time to refill? I understand you need a perminit address, the only problem with that is I am not at my address all the time. I have other meds sent one time a month, that are not supplied by you, sent to the place I am staying at the moment, & have never had a problem. I have to be there to sign for the Meds when they arrive. I just call before the monthly send date & give them the address I am at and they tell me the deliver date. Can I do that with your mail order meds also? I like the idea of your program & it would save money. Thank you R/ Rich
- Richard Chase, MS

10/13/2010 9:33:59 PM
There are tooooo many "ifs", "ands" and "buts" in using TMOP. Plus the patient definitely needs a pharmacist on the spot to answer questions. Plus, there are so many more retail pharmacies in the network that using mail order which is: (1) inconvenient, (2) the pharmacist in the network can manage the medication faster, better and give better personal service than someone at the end of a 800 #, (3) with new federal legislation, the prices paid to retail providers are close to what TMOP pays and the rebates manufacturers pay to DOD are suppose to be the same for the drugs. (4) For those retirees who travel, if some medication is forgotten, the retail network is much easier to get the medication faster and smoother. Many times is not about money savings to users of the system but rather the personal attention, professional relationship and services a local pharmacy provider can give vs the TMOP system. This is worth something as well.
- JOHN W. OWEN, Columbia, SC

10/13/2010 9:10:25 PM
Before trying to sell the service, please get Express Scripts customer service fixed. I had an issue and asked to talk to a supervisor. When I was connected to one, I was told that any and all errors were my fault. So I canceled all further mail-service and won't use them ever again. Too late, I found out from fellow service members that this is very common. Fix the customer service and we may come back.
- T. Vavrek, Indianapolis, IN

10/13/2010 8:09:47 PM
How do you start this home delivery?

10/13/2010 7:29:34 PM
Information found on the National Community Pharmacy Association's (NCPA) website: Given the choice, patients prefer their local pharmacy over mail order. Given equal copays and days supply, 83% of consumers prefer filling a prescription at their community pharmacy over mail order.1 72% of consumers oppose mandatory mail order.1 Almost half (46%) of consumers disagree that mail order is more convenient.1 Half of all consumers feel they would be more likely to make mistakes taking medications obtained through mail order.1 71% of consumers indicated they would be concerned about not having the advice and personal attention of their local community pharmacist if they had to obtain medications through mail order.1
- Billy, Alabama

10/13/2010 6:39:55 PM
Mail order can jeopardize a patient’s quality of care. A United States Pharmacopeia study found that about one quarter of packages delivered through the mail were exposed to "excessive heat"—above 104 degrees, which can diminish some medications' effectiveness. In addition, calculations showed that almost one third of the packages were exposed to mean kinetic temperatures above 170 degrees for as long as 21 days in transit through the system. Pharmacists employed by Pharmacy Benefit Managers (PBMs) do not have to be licensed in the individual consumer’s state. Therefore, if patients have a problem with a medication they received from a PBM, they have no recourse with the state board of pharmacy or other regulatory bodies that help protect consumers.
- Billy, Alabama

10/13/2010 3:33:52 PM
Rrior to November 2009, my local pharmacy prescriptions used to cost me nothing. since then I have been using my medicare part B and then the Tricare - just like I always did. Now the medication with part B costs me $2.16, however if I include Tricare to the payment the cost to me is $3.00. What happens to the $2.16 that I had credited by part B?
- Ray Mc Manus, Massachusetts

10/13/2010 3:07:13 PM
I am a retired USAF LtCol over 65 years old. I have Medicare and Tricare for Life. In addition I am covered by my wife's Blue Cross/Blue Shield (she is a USAF Civil Service retiree). I would use TMOP, but because of the Other Insurance, you say I am not eligible. So, I get my medications at the local CVS drugstore. If these drugstores can figure out how to process my insurances, why can't TMOP????
- T. Hawk, Cary, NC

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