In a statement delivered during a hearing before the Senate Armed Services subcommittee on personnel, NACDS voiced its opposition to a proposal in President Obama’s budget that would raise co-payments for those covered by the government’s Tricare health care coverage who opt to fill prescriptions at a retail pharmacy rather than using a mail-order pharmacy.
The hearing was conducted late last month to consider health care recommendations of the Military Compensation and Retirement Modernization Commission. The commission, which was established by the Fiscal 2013 National Defense Authorization Act, had developed recommendations, including health care proposals, with the objective of encouraging recruitment and retention in the armed forces and thereby assuring the long-term viability of all-volunteer armed forces.
Another goal of the recommendations, which were submitted in late January, was to both modernize and achieve fiscal sustainability for compensation and retirement systems in the armed forces.
NACDS lauded the commission’s recognition that Tricare beneficiaries should be able to obtain their prescriptions from their preferred source, whether a retail pharmacy, a mail-order facility or a military treatment facility. “Moreover, we applaud the commission for specifically recommending that the Tricare pharmacy benefit should integrate pharmaceutical treatment with health care and implement robust MTM,” NACDS stated.
The Department of Defense has authorized Tricare beneficiaries to obtain vaccinations at retail pharmacies for zero co-payment, and estimates that during the first six months of the immunization program more than $1.8 million had been saved by having vaccinations administered through pharmacies. That estimate, NACDS pointed out, did not include the savings in medical costs that would have resulted from treating flu and other illnesses if Tricare beneficiaries had not been vaccinated.
Noting that Congress has recognized the importance of MTM by including it as a required offering in the Medicare Part D program, NACDS also emphasized the value of MTM in increasing medication adherence, thereby optimizing medication use while reducing overall health care costs.
The industry group cited a study published in Health Affairs in January 2012 that found that a pharmacy-based MTM program increased adherence among diabetes patients and yielded greater benefits for those patients who were counseled in person rather than by telephone conversation with a mail-order pharmacist.
A provision in the president’s budget intended to promote use of mail-order pharmacy will boost the cost of a 30-day supply of a formulary drug to as much as $46 if it is obtained from a retail pharmacy, and as much as $92 for a 90-day supply of a non-formulary medication.
“In addition to unfairly penalizing Tricare beneficiaries who prefer to use local pharmacies, NACDS believes that although this proposal may seem penny-wise, it is ultimately pound-foolish,” NACDS stated.
“Threatening beneficiary access to prescription medications and their preferred health care provider will only increase the use of more costly medical interventions,” asserted NACDS.