Pharmacy Users Get Mail Order Option

DoD enters into a contract Oct. 6 with Merck-Medco Managed Care of Maple Grove, Minn., to operate a national mail order pharmacy program. Those eligible to participate will include active duty service members and others enrolled in TRICARE Prime at military medical treatment facilities; CHAMPUS users in Alaska, Puerto Rico and with air or fleet post office addresses; uniformed services treatment facility enrollees; Medicare-eligible patients at base realignment and closure sites in Alaska and TRICARE Regions 1, 2 and 5. Medicare-eligible retirees enrolled in TRICARE Prime during an upcoming Medicare subvention demonstration also will be eligible.

Those enrolled in TRICARE Prime contractor programs won't have access to the DoD mail order pharmacy right away, but they already can use similar services required under managed care support contracts. A DoD health affairs official said the department plans to offer a single mail order plan to everyone because it would further reduce costs.

The mail-order program is free to active duty service members. Family members will be charged a $4 co-pay per prescription, and retirees and their families an $8 co-pay. Merck-Medco will provide up to a 90-day supply of maintenance medication for each prescription. However, prescriptions will be filled only for drugs contained in the program's national formulary.

"The national mail order pharmacy program is a step toward providing a pharmacy benefit that's uniformly available to all beneficiaries," said Army Brig. Gen. Robert Claypool, deputy assistant secretary of defense for health services operations and readiness. "It offers convenience and choice, and will particularly benefit those who because of time, distance or impairment have trouble getting to a pharmacy."

The service may be particularly attractive to travelers, for example, people on temporary duty. "You can put a note in the envelope with your refill slip, giving them [Medco] the temporary address, and they'll mail the medication there," said Air Force Col. Patricia Hobbs, deputy director of DoD pharmacy programs. This applies to any location in the United States and to air and fleet post office addresses overseas.

People using the mail order pharmacy plan still will be able to talk to a pharmacist about their medication. Merck-Medco will operate a toll-free telephone service around the clock, with several lines dedicated to DoD callers.

"When it's 2 a.m. and you're not sure why you're reacting to medication, you can call the toll-free number and a pharmacist will be there to help," Hobbs said.

Claypool sees the new program as a step toward improving one of the most used DoD health care benefits. "From the DoD perspective -- and certainly from patients' perspectives -- the pharmacy is a treasured benefit," he said. "But with the cost of pharmaceuticals rising, the challenge we're facing is trying to ensure our patients get the medications they need, while curtailing some of the costs.

"By developing a national mail order formulary, we can take advantage of federal best prices. As a result, the cost for medications goes down and the government's cost share will certainly be less."