Military Officer - September 2007 - (Page 46)

washingtonscene Among prostate drugs, the plan is to move Avodart to the third tier, leaving the generic Proscar on the formulary for $3. DoD is reevaluating certain acid-reﬂux medications that originally were reviewed in February 2005. At the time, DoD moved multiple drugs, including Nexium, to $22 based on a relative high cost. Now, DoD has gotten a reduced price on Nexium and proposes to reduce its copayment all the way down to $3, even though it’s not a generic drug. However, DoD is proposing to put a “prior-authorization” requirement for this class of drugs, requiring beneﬁciaries to try either Nexium or Prilosec before being authorized to use other drugs in the same class. Current prescriptions for the other acid-reﬂux drugs would be grandfathered at $22. But future prescriptions wouldn’t be covered for those drugs, even for the $22 copayment, unless TRICARE approves a doctor’s statement that there’s a “medical necessity” to prescribe them (e.g., because Prilosec and Nexium aren’t effective or have adverse effects for the patient). Finally, among drugs for hypertension and chronic heart failure, DoD proposes to move Avapro, Avalide, Benicar, and Diovan to the third tier. This would leave Atacand, Cozaar, Hyzaar, and Micardis on the formulary at the lower copayment. MOAA’s Cmdr. John Class, USN-Ret., a member of the BAP, commented at the meeting that beneﬁciaries using the affected drugs aren’t being given adequate notiﬁcation about either the copayment increase or about which medications still are available for the lower copayment. Because DoD doesn’t notify beneﬁciaries at all, nor does it allow military associations like MOAA time to print the notices in their magazines, most beneﬁciaries don’t ﬁnd out about the changes until their pharmacist starts charging them $22 instead of $9. Without an education program to make these beneﬁciaries aware of lower46 MILITARY OFFICER SEPTEMBER 2007 cost alternatives, they tend to grind their teeth and pay $22. This insensitive process causes both the beneﬁciary and the government to pay far more than they need to. Class urged providing more advance notice of such changes and making a greater effort to educate patients on alternatives so they can discuss the options with their doctors before getting hit with higher charges. That would help ease major irritants for beneﬁciaries and their doctors and also save money for all concerned. As things stand now, the intended purpose of the copayment increase — to encourage beneﬁciaries to choose lower-cost medications — is unlikely to be realized. The beneﬁciary panel’s concerns will be submitted to Assistant Secretary of Defense for Health Affairs Dr. S. Ward Casscells for a ﬁnal decision. ON THE WEB ■ For more information about these and other drugs, visit www.tricare.mil/pharmacy. COLA Watch Inﬂation continues to ﬂip-ﬂop. V olatile food and energy costs have generated a “feast or famine” situation for the consumer price index (CPI). Down for the ﬁrst ﬁve months of the ﬁscal year, inﬂation surged 2.4 percent during the next three months — but cooled off in June, rising only onetenth of a percentage point. Next year’s COLA is still anybody’s guess — depending on a “hot” or “cold” CPI for the last three months of the year. MO — Contributors are Col. Steve Strobridge, USAF-Ret., director; Col. Mike Hayden, USAFRet.; Col. Bob Norton, USA-Ret.; Cmdr. René Campos, USN-Ret.; Cmdr. John Class, USN-Ret.; Col. Ana Smythe, USMC-Ret.; Col. Phil Odom, USAFRet.; Cass Vreeland; and Bret Shea, MOAA’s Government Relations Department. http://www.tricare.mil/pharmacy

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Military Officer - September 2007 Contents From the Editor From the President Your Views MOAA Directory Rapid Fire Washington Scene Financial Forum Ask the Doctor Chapter Activities Plan for Your Future At Home in a High-Rise Lone Star Living Common Ground Insert: Community Source Cover Story: Waging War on Disease More Than Beaches MOAA Scholarship Donors Pages of History Faces of MOAA Information Exchange Advertising Index MOAA Calendar Sounding Taps MOAA Member Services Encore

Military Officer - September 2007

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