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Tricare program is audited by DoD.

WASHINGTON -- The Tricare mail-order pharmacy program was found to be "more efficient and effective than retail programs," according to a recent Department of Defense (DoD) audit.

Tricare, the health care plan for 10 million active and retired military personnel, changed its pharmacy co-payments in fiscal year 2012 to encourage plan participants to fill their prescriptions by mail-order rather than at retail pharmacies. Beneficiaries could get a 90-day supply of a generic medication through the mail-order program, for example, but would face a $15 co-pay if they used a retail network pharmacy.

Because a number of members of Congress expressed concern about whether the Tricare mail-order program was providing prescription drugs in the most efficient and cost-effective manner, The Office of the Inspector General (OIG) of the DoD conducted an audit, which included seeking the answers to some specific questions: Is higher utilization of mail order resulting in waste and increased health care costs? Are controls in place that ensure patients do not receive medications they no longer need? Do processes exist to halt shipments when a patient's physician changes the type of medication, dosage, strength, or other changes? And do beneficiaries have the opportunity to opt out of automatic refill programs?

The audit found that Tricare has imposed strong operational controls, including auto-refill programs, to ensure beneficiaries receive only necessary pharmaceuticals. The OIG also showed that mail-order dispensing saved 16.7% compared to retail, and that accuracy was higher.

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Title Annotation:RX: RETAIL PHARMACY: Government; Department of Defense
Publication:Chain Drug Review
Article Type:Brief article
Date:Sep 30, 2013
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