Landstuhl pharmacy chief: Patients will still get access to non-formulary meds
August 2, 2005
LANDSTUHL, Germany — Changes in the status of prescription drugs available to military beneficiaries should not cause concern among recipients, said a Landstuhl Regional Medical Center doctor.
Some well-known medications available through Tricare — the military’s health coverage plan — recently were reclassified as non-formulary, namely for cost-saving reasons. Those medications include Viagra and Cialis, used to treat erectile dysfunction; Nexium, which treats heartburn/acid reflux; and Teveten, prescribed in treating high blood pressure.
This year, the Department of Defense Pharmacy & Therapeutics Committee determined after analysis that other drugs were cheaper and just as clinically effective as Viagra, Cialis, Nexium and Teveten.
And because it is deemed more cost effective to purchase these other drugs, the committee recommended that Viagra, Cialis, Nexium and Teveten be deemed non-formulary. Dr. William Winkenwerder Jr., director of Tricare, subsequently approved the committee’s recommendations on the drugs.
The drug classes that Nexium and Teveten fall under are both in the top 10 of the military health system’s drug expenditures, and erectile dysfunction drugs are within the top 50.
Moving Viagra and Cialis to non-formulary status is alone expected to save taxpayers $13 million a year.
Nexium and Teveten became non-formulary on July 17. Viagra and Cialis will not longer be available as of Oct. 12.
The reclassification means that drugs deemed non-formulary will be more difficult and possibly more expensive to obtain. Medical treatment facilities are prohibited from carrying non-formulary medications.
But as Dr. (Col.) Ricke Weickum — director of the department of pharmacy at Landstuhl Regional Medical Center in Germany — noted, a process exists for providers to obtain non-formulary drugs for patients.
“Some products may not be as readily available, but if a patient needs a product, there is a way to receive it,” he said. “We want to take away that fear factor that we’re taking away a benefit.”
Given that 90 percent of the 142,000 military beneficiaries on erectile dysfunction drugs take either Viagra or Cialis, many patients will likely wish to stay with their same medications.
To receive non-formulary medications, a military treatment facility provider has to write the prescription and a medical necessity form must be completed for the drug.
Active-duty military can and will receive the non-formulary medication free of cost, only if medical necessity is established. Non-active-duty military beneficiaries using a Tricare retail network pharmacy or a Tricare mail order pharmacy may receive the non-formulary medication at $9 if medical necessity has been determined, or they can pay $22 for up to a 30 or 90-day supply of non-formulary drugs.
Non-active-duty military beneficiaries will not have to pay for non-formulary drugs if they fill their prescription at a military treatment facility.
Although they are not required, military treatment facilities can fill prescriptions for non-formulary medications written by non-military treatment facility providers. To do so, patients had to be referred to that provider and medical necessity for the non-formulary drug must be established.
The process of reclassifying medications, which began this year, will continue, Weickum said.
“The bottom line is we’re trying to do the best we can to manage the resources that we’re given in a responsible manner,” he said. “This is one way the Department of Defense has elected to do that. It really is pretty much how the rest of the health care industry operates.”
On the list
Tricare non-formulary medications and effective dates: