Pharmacy by Mail
TRICARE Management Activity is looking toward the future; using technology to improve service to its more than 9.1 million beneficiaries. Since its inception, TRICARE Mail Order Pharmacy has proven to be a valuable tool for savings, service and convenience.
By Jean Hogue
TRICARE Management Activity (TMA) is looking toward the future; using technology to improve service to its more than 9.1 million beneficiaries. Since its inception, TRICARE Mail Order Pharmacy (TMOP) has proven to be a valuable tool for savings, service and convenience. It allows TRICARE beneficiaries, consisting of the members of the seven uniformed services, retirees and their families, to receive up to a 90-day supply of most medications for the same amount they would pay for a 30-day supply at a retail pharmacy. Some beneficiaries save as much as 66 percent on medications for conditions such as high blood pressure, asthma or diabetes.
In all, a beneficiary’s savings with TMOP could range from $24 a year for each regular formulary generic drug to as much as $176 a year for each non-formulary brand-name drug. The savings increase with each additional prescription.
As an added bonus, the DoD is paying 30–40 percent less for prescriptions filled through the mail-order service compared to retail pharmacies. DoD could save $22 million a year with just a 1 percent shift of prescriptions from retail to mail order.
Saving money is not the only thing people are talking about. It seems TMOP’s easy operation and high-tech convenience is starting a buzz with TRICARE beneficiaries. Technology has led to unprecedented efficiencies and economies of scale, paving the way to appealing “home delivery.”
The TMOP pharmacists are available 24 hours a day, any day of the week. Beneficiaries can ask questions about their personal drug treatment in complete privacy over the phone—rather than in public at a retail pharmacy counter.
Express Scripts Incorporated, TRICARE’s mail order pharmacy benefit provider, can refill a beneficiary’s prescription by mail, phone, fax, or online and allows payment by check or credit card.
“Many of TRICARE’s beneficiaries are converting their prescriptions using the online option,” said Rear Admiral Thomas McGinnis, chief of the pharmaceutical operations directorate, TRICARE Management Activity. “We are finding that our beneficiaries are very computer savvy and enjoy the convenience of managing their health care needs online. TRICARE beneficiaries use the online refill option 34 percent of the time, which is four percent higher than the industry standard.”
The impressive package of Web services addresses the needs of patients. When a TRICARE beneficiary visits the site to convert a prescription to TMOP, all maintenance medications that are eligible to be transferred to the TMOP will be displayed. The beneficiary may select the medications they would like the TMOP to dispense, and initiate a request for Express Scripts to obtain a new prescription from their civilian provider, taking the work away from the beneficiary.
Express Scripts, along with two other pharmacy benefit management companies, founded RxHub, an electronic utility that links physicians who use electronic prescribing technology with pharmacies, pharmacy benefit managers and health care plans, further enhancing prescription safety and efficiency for physicians and patients. When a provider faxes or phones a prescription to Express Scripts, the prescription is filled by licensed pharmacists and safely shipped in plain, weather-resistant pouches; arriving directly at the beneficiary’s home, with no shipping or handling fees. TMOP can even fill a prescription for a controlled substance. The prescribing provider must provide his or her individual Drug Enforcement Administration number on the prescription and a complete street address. An adult’s signature is required upon delivery.
That’s not all. An electronic alert is e-mailed to beneficiaries when their prescription is about to expire, giving them time to arrange for a renewal from their physician. In addition, an e-mail is sent to beneficiaries when prescriptions are shipped and an additional reminder is sent when they are eligible to refill the prescriptions. There has been a recent change to the management of non-formulary drugs, and now there is a letter mailed to beneficiaries notifying them when their medication is switching to the third tier, which has the most expensive co-pay. The beneficiary can then ask their doctor to switch them to a formulary drug with a lower co-pay and request a new prescription.
Named one of Information Week’s 500 Most Technologically Progressive Companies, ESI has invested heavily in technology, enabling them to focus on TRICARE’s patients and increasing convenience. “Our beneficiaries like being able to check their order status on the Web site 24 hours a day, seven days a week,” said Army Major General Elder Granger, deputy director, TRICARE Management Activity. “They appreciate that the system ensures proper payment and identifies savings opportunities too.”
TMOP has gone a step further by providing the service to warriors on the battlefield through the Deployed Prescriptions Program (DPP). The TMOP model for the DPP calls for regular prescription flow between soldier readiness processing/mobility (SRP/MOB) predeployment sites, the DoD pharmacy operations center (POC), TMOP, as well as the deployed theater, to provide deployed servicemembers in Iraq and Afghanistan with their chronic and maintenance medications through TMOP. It allows for direct receipt of medication by deployed beneficiaries to their respective APO/FPO address. This program has been utilized to ensure more than 31,807 prescriptions for eligible deployed beneficiaries were shipped to the appropriate address in FY 2007 alone.
New modifications allow eligible deployed beneficiaries an enhanced view of prescription status, user-friendly profile updates, and continued support of any inquiries. The PEND feature allows servicemembers to view their prescription when a prescription is holding in the system. TMOP sends an e-mail
to the servicemember reminding them to register with the TMOP, and then another e-mail when their prescription can be filled. Once the servicemember enrolls into the TMOP, they may view the prescription in the PEND mode online and initiate the process to update their FPO/APO address at any time. This process has become the preferred model for receipt of medication and refills in the deployed theater for all branches of service. DPP has received positive feedback and continues to thrive in 2008.
“TRICARE works to stay at the forefront of today’s growing technology and to utilize tools that enhance service, savings and convenience for the beneficiary,” said Granger. “It’s part of our dedication to servicemembers and their families. The success of TMOP is a clear indication that TRICARE’s advancements are valued.” ♦
Jean Hogue is a senior public affairs specialist and writer for TRICARE Management Activity in Falls Church, VA.