Panels Split on Restricted Access to Compounded Medications for US Military Families

High level of need cited among 9.5 million active and retired servicemen and their families.

A pair of Defense Health Agency internal committees reached a split decision regarding restricted coverage of compounding medications for members of the US Armed Forces and their families.

The TRICARE Health Plan, which is administered by the Defense Health Agency, provides medical, dental, and pharmacy benefits to more than 9.5 million active service members, retired veterans, and military families. Approximately 140,000 TRICARE beneficiaries filled 360,000 prescriptions for compounded medications between June 2013 and May 2014, according to the Department of Defense.

Late last year, the Department of Defense Pharmacy and Therapeutics (P&T) Committee made recommendations for significant restrictions on commonly used ingredients in compounded medications. The committee also recommended a strict manual prior authorization process for both prescribers and their patients.

This week, however, the TRICARE Beneficiary Advisory Panel rejected the P&T Committee's recommendations, which were called unnecessarily restrictive and burdensome by advocacy groups Patients and Physicians for Rx Access and the International Academy for Compounding Pharmacists (IACP).

"We understand the Defense Health Agency's need to balance budget realities with patient access to care," Jay McEniry, executive director of Patients and Physicians for Rx Access, said in a press release. "In the span of a year, 140,000 military heroes and families filled 360,000 prescriptions for compounded medications. This includes children and veterans whose health care needs cannot be met by manufactured medicines. Clearly there is a need, and as a coalition we are committed to helping the Defense Health Agency find a way to manage costs without sacrificing care."

The final decision on compounded medication coverage for military members and their families now falls on the director of TRICARE Management Activity.

"IACP believes that all patients, regardless of their insurance plan, should have access to compounded medications whenever their physician determines that a compound is the best treatment for them," David Miller, RPh, executive vice president of IACP, said in a press release. "We strongly encourage the passing of laws and regulations that result in complete, consistent compounded prescription drug coverage across all government-funded programs, including TRICARE. We join Patients and Physicians for Rx Access in offering to work with the Defense Health Agency so that this important benefit remains available to uniformed service members and their families."