Preferred Retail Pharmacies Included in Defense Budget

Next year’s federal defense authorization bill approved today by the House Armed Services Committee includes a proposal to pilot a “preferred” retail pharmacy network for Tricare beneficiaries.

The program, which would run from May 1, 2016, to September 30, 2018, could potentially lead to financial savings for the Department of Defense, the legislation suggests.

“The pilot program would include, but not be limited to, best practices from non-Tricare health plans that use preferred retail pharmacy networks,” the bill states.

Retail pharmacies included in the preferred network would buy prescription drugs, including maintenance medications, for beneficiaries “at rates available to the federal government” and share at least some of the savings through lower co-pays.

Beneficiaries would then receive prescription medications through either the preferred retail network or the national mail-order pharmacy program.

The National Community Pharmacists Association (NCPA) released a statement on May 1, 2015, praising revisions to the proposed program.

NCPA CEO B. Douglas Hoey, RPh, MBA, specifically commended the revision to allow small business community pharmacies to be included in the preferred pharmacy network.

“This will help enhance patient access to medication and pharmacies because independent pharmacies are often located in inner-city and rural areas where few, if any, other practical pharmacy options are available,” Dr. Hoey said.

He also praised the stipulation that the preferred pharmacy network would have to comply with Tricare pharmacy access standards.

“We appreciate the committee’s dedication to supporting both patient access to care as well as meaningful participation of small business community pharmacies in this taxpayer-funded program.

The 2016 National Defense Authorization Act (NDAA), HR 1735, states the defense secretary would choose which retail pharmacies would be included in the preferred network.

“In making such selection, the secretary may require that retail pharmacies opt-in to the network and agree to the reimbursement rates paid by the secretary.”

The secretary may also “use a competitive process” and request that the pharmacies meet certain criteria, the bill states.

While it does not mention the military community where the pilot program would launch, it does state that the secretary would choose at least 1 region with a certain number or percentage of members of the Armed Forces community serving active duty, on reserve, or retired. The community would need to have a large enough number of beneficiaries to see statistically significant results.

In addition, the region would have to have at least 1 retail pharmacy with 10 operational locations in the region, and it must have at least 1 military installation with a military medical treatment facility that includes a pharmacy.

If the bill is enacted, the secretary would have to submit reports to the congressional defense committees on how the program would be implemented, as well as semiannual reports while the program is carried out and a final report on whether or not to expand the program.

Following today’s 60-2 vote in favor of the 2016 NDAA draft, a full House vote will occur sometime in mid-May 2015.