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Tricare delays decision to stop covering compounded medications

Jul. 24, 2013 - 10:47AM   |  
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Tricare has pushed off a decision to stop covering some compounded medications as it evaluates its policies regarding these prescriptions, the Pentagon announced Wednesday.

Coverage for certain compounded medications — those made with ingredients not approved by the Food and Drug Administration — was to cease July 24. But the benefit will continue another six months while Defense Department officials reexamine the decision, according to a Tricare release.

“We are working to ensure both excellent and safe care for our beneficiaries and clear communication with our providers and beneficiaries,” the release stated.

In June, Tricare pharmacy benefit manager Express Scripts sent letters to 44,000 beneficiaries who have these types of prescriptions, notifying them of the change.

Compounded medications are created for individuals by pharmacists, combining an active medication with other ingredients to tweak a dosage, change delivery (from a pill to a liquid or liquid to a patch, for example) or eliminate an allergen.

Many compounded prescriptions use inert ingredients such as bulk chemicals and powders that are not subject to FDA approval. Tricare had said it would no longer cover these types of prescriptions because they included substances that were not FDA approved.

This also might include some medications such as vitamins and nutrition supplements, which are regulated by different FDA guidelines than conventional drugs.

In 2012, Tricare beneficiaries filed 500,000 claims for compounded medications worth $330 million.

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