Thirty-one U.S. Representatives have written to the leadership of the Department of Defense TRICARE health care program to protest a recent policy change that has drastically reduced coverage for customized (or "compounded") prescription medications.
ALEXANDRIA, Va. (Sept. 18, 2015) - Thirty-one U.S. Representatives have written to the leadership of the Department of Defense (DOD) TRICARE health care program to protest a recent policy change that has drastically reduced coverage for customized (or “compounded”) prescription medications. The lawmakers’ letter won praise today from the National Community Pharmacists Association (NCPA) and the International Academy of Compounding Pharmacists (IACP).
Reps. Earl L. "Buddy" Carter (R-Ga.), Peter Welch (D-Vt.) and others wrote that recent TRICARE billing changes have “greatly impacted” beneficiaries’ access to compounded drugs.
"We understand these recent changes are in response to deceptive marketing practices conducted by a select few compounders,” they wrote. “While we believe deceptive entities should be pursued and dealt with accordingly, TRICARE beneficiaries should not be denied access to compounded medications due to a few bad actors.”
They added, “We respectfully ask you to review and revise the current rule changes to ensure military personnel across the country have the ability to use the pharmacy of their choice for the medications they need while using targeted tools to eliminate current bad actors.”
"These representatives speak for many community pharmacists and their patients who struggle with this new policy and appreciate the lawmakers’ efforts,” said NCPA CEO B. Douglas Hoey, RPh, MBA. “Quite simply, TRICARE must achieve a better balance: ensure patient access to medication their doctor has prescribed and crack down on those out to abuse the program.”
"Each day, our pharmacy members have to inform TRICARE beneficiaries that the compounded medicines their doctor has prescribed for them are no longer covered. Although we may be able to work with the prescriber to develop a similar formulation that does not include bulk ingredients, some compounded prescriptions require the use of bulk ingredients and TRICARE’s policy not to cover bulk ingredients has a direct, negative impact on our service men and women,” says Baylor Rice, RPh, FIACP, IACP Vice President and Chairman of IACP’s Reimbursement and Third-Party Committee. “However, as compounders, we know how important continued therapy is to positive health care outcomes, and we should remain committed to finding a solution that will benefit those individuals serving our country and their families.”