Community Pharmacy Can Help Reduce Costs, Improve Health for TRICARE Patients

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Published in The Hill

Sometimes, what may look good on paper may not be the best solution to achieve budgetary savings, and may in fact prove counterproductive. A proposal by the Administration would increase copays for TRICARE beneficiaries who wish to utilize community pharmacies instead of mail order for prescription drugs. The National Association of Chain Drug Stores (NACDS) and the National Community Pharmacists Association (NCPA) have concerns with this approach to achieve savings at the expense of service men and women and their families, and are committed to working with TRICARE to implement initiatives that will aid in reducing prescription drug costs, while also improving patient health.

TRICARE – the Department of Defense (DoD) healthcare plan for military families and veterans – currently includes strong incentives for the use of mail order by allowing beneficiaries to obtain three times more medication from mail order as from retail for the same copayment.

DoD has made it clear that beginning this October, it will further induce mail order by increasing copayments for retail pharmacy, therefore limiting the choice of how TRICARE beneficiaries may obtain prescription medications.

Community pharmacy is part of the solution in containing costs and improving health. In fact, pharmacies have worked for years to save money in TRICARE and other health programs, by promoting affordable alternatives, such as the appropriate use of generic drugs. Generic medications, on average, cost one-sixth as much as brand name drugs.

One approach supported by NACDS and NCPA is to encourage TRICARE beneficiaries to use generic medications from retail pharmacies. This approach creates a co-payment structure that offers greater incentives for beneficiaries to use generic medications and other lower cost therapies.

Another cost-saving approach is to better promote the prevention services offered by community pharmacies for people with chronic illnesses such as diabetes. Pharmacists can help patients take their medications in the most safe and effective ways – also known as medication adherence – which is an important benefit of having the opportunity to choose where to fill prescription medications. A July 2009 report by the research group NEHI estimated that the overall cost of poor medication adherence, measured in otherwise avoidable medical spending, is as much as $290 billion per year, or 13 percent of total healthcare expenditures. Medication Therapy Management (MTM) – recognized federally in the Medicare Modernization Act of 2003 – is a professional service offered by pharmacists that helps ensure medications are taken appropriately, thus preventing higher-cost and preventable forms of treatment.

The Senate will soon debate and vote on the defense authorization bill. There are better ways to reduce expenses than to restrict community pharmacy as a choice for TRICARE patients by making them pay more for their prescription medications. Instead, the bill should offer TRICARE beneficiaries a level playing field in how they choose to receive their prescription medications.

Congress should adopt alternative cost-saving strategies, including utilizing local pharmacists, so that these brave men and women and their families have a choice in how they receive their prescription medications.

B. Douglas Hoey, RPh, MBA
Executive Vice President and CEO
National Community Pharmacists Association
Alexandria, Va.
  Steven C. Anderson, IOM, CAE
President and CEO
National Association of Chain Drug Stores

The full article in The Hill is available here.

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