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Change to Military Pharmacy Contract is De Facto Exclusion of 15,000+ Independent Pharmacies by PBM Giant Express Scripts
WASHINGTON, D.C., UNITED STATES, October 24, 2022 /EINPresswire.com/ — Concerned that lively navy, veterans, and their households have misplaced entry to care from the pharmacy suppliers of their selection, the Community Oncology Alliance (COA) submitted a letter to the Defense Health Agency (DHA) and Congress final week expressing outrage at current modifications which have successfully eliminated 15,000+ impartial pharmacies from the TRICARE Pharmacy Benefits Program. For these battling most cancers, this alteration is forcing them to use an unreliable and wasteful mail order pharmacy owned by the pharmacy profit supervisor (PBM) contracted by TRICARE.
Tricare is the Department of Defense (DoD) well being care program for roughly 9.5 million navy and their households. It is run by the DHA by way of the Military Health System. Earlier this yr, the PBM Express Scripts was awarded a multi-year contract to function the only real PBM to administer the pharmacy profit supplied to TRICARE beneficiaries. Starting at present, TRICARE is forcing sufferers with most cancers and different critical ailments to use its Accredo Health, a mail-order pharmacy firm owned by Express Scripts’ guardian firm, Cigna.
– Click right here to learn COA’s full letter to TRICARE.
To take part within the TRICARE Pharmacy Benefits Program, suppliers will need to have a contract with Express Scripts. The 2023 contract supplied unreasonably low charges that will have pressured suppliers serving TRICARE sufferers to function at a assured loss. This has primarily served as a de facto termination of suppliers from the TRICARE community, together with a considerable share of group oncology and urology suppliers. Of course, Express Scripts is more than pleased to fill and revenue off this entry void with their Accredo mail order services.
The pressured use of PBM mail order pharmacies leads to costly prescription waste, entry issues, care continuity disruptions, and all too typically, pointless affected person struggling. COA has revealed numerous horror tales of sufferers with most cancers – together with a number of captured within the letter to the DHA – dealing with delays, increased prices, and denials when subjected to receiving their medicines by the mail. Additionally, payers expertise increased prices from waste as a scarcity of coordination between suppliers and PBMs, leading to PBMs persevering with to mail medicines when the drug dosage and even the medicine has been modified.
COA has heard from sufferers, practices, and pharmacies confused in regards to the change and expressing outrage that sufferers are being pressured to select a pharmacy they don’t need whereas making it more durable to obtain care. It is vitally essential that sufferers with most cancers have quick access to high-quality, built-in care. Requiring using mail-order PBM pharmacies exacerbate these issues, as there are well-documented points with the standard, security, and timeliness of prescription supply.
Read COA’s full letter concerning the TRICARE change at https://communityoncology.org/reports-and-publications/comment-letters/letter-to-defense-health-agency-on-tricare-pbm-concerns/.
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About the Community Oncology Alliance: COA is a non-profit group devoted to advocating for group oncology practices and, most significantly, the sufferers they serve. COA is the one group devoted solely to group oncology the place the vast majority of Americans with most cancers are handled. The mission of COA is to make sure that sufferers with most cancers obtain high quality, inexpensive, and accessible most cancers care in their very own communities. More than 5,000 folks within the United States are recognized with most cancers daily and deaths from the illness have been steadily declining due to earlier detection, prognosis, and remedy. Learn extra at www.CommunityOncology.org. Follow COA on Twitter at www.twitter.com/oncologyCOA or on Facebook at www.fb.com/CommunityOncologyAlliance.
Drew Lovejoy
Community Oncology Alliance
[email protected]
