Tricare beneficiaries with prescriptions for specialty drugs can now get more of them at the lower copays of Tricare Home Delivery with the addition of Accredo, a specialty pharmacy, to the program.
Two pharmacies, Express Scripts and Accredo, are now part of Tricare Home Delivery. Defense Health Agency officials confirmed that some users will have mail-order prescriptions with both Express Scripts and Accredo if they have both non-specialty and specialty prescriptions.
Accredo joined Tricare's retail network in 2023, delivering prescriptions by mail, but it wasn't formally part of Tricare Home Delivery until this year. Tricare copays are higher at retail network pharmacies, with copays for a 30-day supply ($14 for generic, $38 for brand name) from a retail network pharmacy costing more than a 90-day supply ($12, $34) from Tricare Home Delivery.
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The new contract adding Accredo to Tricare Home Delivery began March 1. DHA officials told Military.com that it "reduces beneficiary cost by increasing the number of specialty drugs available at mail order co-pays" and that Accredo's "enhanced clinical services," beyond just filling the prescription, promote "positive clinical outcomes."
The Military Health System lists more than 1,300 specialty drugs, many of them for the same drug in different doses. They include drugs to treat cancer, Parkinson's disease, multiple sclerosis, immune deficiency, inflammatory conditions, "miscellaneous specialty conditions" and more.
The addition of Accredo to Tricare Home Delivery, with its access to specialty drugs at government-negotiated rates, "will give military families with complex and chronic health conditions more support in managing their drugs," U.S. Public Health Service Cmdr. Teisha Robertson, deputy chief of the Purchased Care Branch at the Defense Health Agency, said in a news release announcing the change this month. "Specialty drugs are essential for a lot of our beneficiaries."
From December through February, 107,000 Tricare beneficiaries filled specialty medications, DHA officials told Military.com. Of those, 45,400 got them from Express Scripts through Tricare Home Delivery. In the fourth quarter of 2023, Accredo's first year in the retail network, it filled the specialty prescriptions of 21,900 beneficiaries.
Tricare automatically transferred the current specialty prescriptions of Tricare Home Delivery users -- the ones Express Scripts was filling -- to Accredo.
"This automatic and seamless transition ... minimized the risk of missed therapy for beneficiaries taking specialty medications to manage chronic and complex conditions," DHA officials told Military.com.
When Accredo fills a prescription, they said, it comes with "personalized clinical services" from Accredo's "Therapeutic Resource Centers" with "specialized pharmacists and nurses for complex and chronic conditions."
While Accredo will provide most of the specialty drugs for Tricare Home Delivery, the officials said Express Scripts will "continue to provide a small portion ... that Accredo may not be able to access." If a specialty drug isn't available at a government-negotiated rate, a customer can still get it from Accredo, but network pharmacy copays will apply.
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