400,000 affected as Defense health plan drops 15K pharmacies

About a fourth of the pharmacies that are part of the Defense Department's health plan, Tricare, have been dropped, which could affect more than 400,000 military beneficiaries, Kaiser Health News reported Nov. 8. 

In late October, Express Scripts — the pharmacy benefit manager for Tricare — cut out nearly 15,000 pharmacies, most of which were local and rural.

"Reducing payments to community pharmacies hurts not just choice, but could be seen as a move to monopolize," Idaho lawmakers wrote in a letter to the acting assistant secretary of defense for health affairs. "Additionally, this could impact pediatric healthcare needs for families enrolled in TRICARE, because these children must go to independent pharmacies for specialized compounding services due to traditionally manufactured drugs not being able to meet their needs."

Montana Sen. Jon Tester penned a similar letter in September, calling the decision "unacceptable" after Tricare moved up the implementation date by two months and planned to slim reimbursement rates for dispensed prescription drugs in 2023. 

In mid-October, the Defense Health Agency advised its beneficiaries to transfer their services to chain pharmacies and independent locations. The DHA added that 90 percent of Tricare members will have at least one network pharmacy within 15 minutes near their home.

"Some independent pharmacies are leaving, but Tricare families will continue to have access to an excellent network of pharmacies," Edward Norton Jr., chief of the DHA's pharmacy operations division, said in an Oct. 13 statement.

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