Right to choose should apply to all Rx patients

MMR, August 21, 2006

ALEXANDRIA, Va. -- Military families deserve a choice when filling prescriptions.

That is the message of community pharmacy advocates opposed to changes in the Tricare health insurance program for active and retired military personnel and their families. The changes, part of the federal Deficit Reduction Act, would mandate mail-order prescriptions for Tricare enrollees.

"Citizens who fight for our freedom deserve the right to choose how they get their medicine," says Catherine Polley, copresident of the Coalition for Community Pharmacy Action (CCPA).

Congress is considering legislation that could force millions of military families to get their maintenance medications by mail, she says. This would eliminate choice and force beneficiaries to sacrifice the personal touch and hands-on expertise of community pharmacists.

The issue driving the legislation is cost. The Department of Defense (DOD) receives discounted pricing for prescriptions dispensed at military treatment facilities and via mail order. Most drug manufacturers refuse to provide the discounts to DOD for prescriptions dispensed by retail pharmacies, despite legal requirements. Prescriptions filled through Tricare mail-order facilities, military treatment facilities, Medicare, Medicaid and the health plan for federal employees all receive some type of discount or rebate from drug manufacturers. However, most manufacturers refuse to provide discounts for Tricare retail pharmacy prescriptions, making prescriptions filled in community pharmacies more expensive to DOD.

Congress needs to adopt language so it is clear that these discounts are available to Tricare retail prescriptions. Tricare enrollees should not be denied access to community pharmacies because manufacturers do not provide lower prices for retail prescriptions.

"The key to savings for DOD is similar pricing between retail pharmacy prescriptions, mail-order prescriptions and those prescriptions filled at military health facilities," says CCPA co-president Charles Sewell.

DOD has reported that discounted pricing for retail prescriptions would save Tricare $251 million in 2007, he notes.