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Tricare Users Must Approve Mail-Order Drug Prescription Renewals

Mario Blount, pharmacy technician, verifies prescription labels at the David Grant USAF Medical center pharmacy. (Photo: U.S. Air Force/ Staff Sgt. Liliana Moreno)

Receiving prescription drugs through Tricare's mail-order system will soon require an extra step for users, thanks to an upcoming change in the system's refill order policy.

Currently, medications received monthly by mail, often used for treatment of chronic medical conditions, can be set for automatic refills.

Express Scripts, Tricare's mail-order pharmacy contractor, contacts the user's doctor when the prescription runs out or expires. The doctor can choose to OK the refill or file a new prescription, allowing the patient to receive medication without interruption.

The latest change, however, will require patients to certify that they want the refill before Tricare contacts the doctor. The switch, which will start Sept. 1, affects all Tricare beneficiaries who receive medication by mail through Express Scripts.

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The move is expected to save Tricare money, since it will likely cut down on patients who automatically receive mailed medication that they no longer use.

Officials did not have an estimate for how much the change could save. Express Scripts dispensed 29 million prescriptions to Tricare users over the last 12 months, Tricare officials said.

"This new process gives beneficiaries more control over their medications and keeps the convenience of automatic refills," Amy Aldighere, senior director of Express Script's Tricare program, said in a press release announcing the change.

"It also makes it easier to opt out of the auto refill program and helps to prevent beneficiaries from receiving medications that they no longer need or shouldn't receive," she said.

To opt-in to a refill, each user will need to grant "consent" through the Express Scripts website, via an automated phone call from the system, or through an Express Scripts patient care advocate, officials said in the release.

When the last refill of a patient's prescription ships, Express Scripts will contact them by mail, phone or email, depending on the user's contact preferences, officials said.

If the patient does not respond within 10 days, the medication will be removed from the auto refill program. To be added back into the program, the user can re-enroll online or by phone at 1-877-363-1303.

Patient contact preferences can be updated online or by phone.

Tricare beneficiaries are required to use either the mail-order system or a military treatment facility pharmacy for "maintenance" or long-term medications such allergy drugs, birth control and daily blood pressure medication, or pay out of pocket, thanks to a 2015 rule change.

At the time of that rule change, officials estimated that the swap would save Tricare $85 million annually, while also cutting users' costs, since drugs received by mail instead of at civilian retail pharmacies cost both the system and patients less.

-- Amy Bushatz can be reached at amy.bushatz@military.com.

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