DoD announces TRICARE rule changes for brand-name maintenance meds

WASHINGTON — The Department of Defense announced changes to rules for TRICARE beneficiaries on Friday. 

 

Starting Oct. 1, under the revised rules, patients who regularly take certain brand-name medication will have to get their prescriptions filled at a military treatment facility or through a mail-in program. The drugs likely affected, according to the agency, are brand-name medications used for maintenance in patients with chronic conditions. 

 

According to the Defense Health Agency’s pharmacy division chief, George Jones, the rules change are aimed at cutting costs for beneficiaries and taxpayers and are the result of the 2013 National Defense Authorization Act. 

 

“Based on estimates, the program is expected to save beneficiaries $16.5 million in reduced copays, and projected Defense Department savings is $88 million during the first year,” Jones said, adding that the change came after a successful pilot program last year. 

 

“It was very well received by beneficiaries and met reductions in beneficiary-put-of-pocket costs and reduced costs to the government,” he said.

 

Those affected by the rule change will be notified in mid-September and will also receive instructions on how to make the switch. Current active-duty military and TRICARE beneficiaries overseas will not be affected by the new rules, nor will nursing home residents or beneficiaries with other health plans with a prescription drug program.