View Full Version : Tricare increases price for birth control drugs

08-15-06, 02:57 PM
August 21, 2006

Tricare increases price for birth control drugs

By Gayle S. Putrich
Staff writer

The price of six birth control drugs will soon jump for women in the military and anyone else using Tricare’s prescription drug plan.

A new drug formulary will bump the price of pills up to $22 for a 30-day supply when the medications are demoted to “third tier,” or nonformulary, drug status for Tricare.

Anzemet, the lone progesterone-only contraceptive to be dropped from the list, will be taken off the formulary as of Sept. 27.

Five other medications — Seasonale, Ovcon-35, Ovcon-35 chewables, Ovcon-50 and Estrostep Fe — will be dropped to Tier 3 status as of Jan. 24.

Seasonale is the first extended-cycle birth control pill approved by the Food and Drug Administration. With a 91-day cycle, women who take it have four periods a year.

The changes are part of the Pentagon’s ongoing efforts to control its pharmacy costs by promoting generic drugs over more expensive brand names.

Medications on the first tier of the formulary — usually generics — are available at $3 for a 30-day supply from brick-and-mortar Tricare retail pharmacies and $3 for a 90-day supply through Tricare’s mail-order system. Second-tier drugs follow the same pattern but the patient cost is $9. Third-tier drugs are $22 in either venue.

If no comparable generic alternative exists, or if there are medical reasons for prescribing a specific medication that is no longer on the formulary, it can still be obtained at the lower prices.

Co-pays for any drug tier may be higher at retail pharmacies outside the Tricare network.

Duane Tackitt, a retired Navy captain who is director of federal pharmacy programs at the American Pharmacists Association, said that while the Defense Department has not previously reviewed its Tricare oral contraceptives formulary, other kinds of drugs have been reviewed, and any managed care organization has a regular formulary review process.

“It’s a normal process,” Tackitt said. “It’s a cycle. It’s a continual process where they review and update formularies.”

Over the years, he said, formulary reviews have become more efficient and more effective, especially for the military, as sharing information between medical facilities has become much easier.

“They have better controls now, and data. This is a much-improved process, even though some people may not like it if they can’t get the drug they have been using,” he said.

This marks the first time that the entire list of contraceptives available to Tricare beneficiaries has been evaluated and updated, defense officials said.

Parts of the formulary are evaluated each quarter by the Defense Department’s Pharmacy and Therapeutics Committee. The committee, made up of doctors, pharmacists and representatives from the Department of Veterans Affairs, conducts a clinical review to examine safety, effectiveness and clinical outcomes of various drugs, and reviews prices for cost-effectiveness.

The Uniform Formulary Beneficiary Advisory Panel, which includes active-duty family members, retirees and outside medical officials, reviews and comments on the recommendations of the Pharmacy and Therapeutics Committee. The information is passed to the Pentagon’s top doctor, Dr. William Winkenwerder, for a decision.

At its next meeting, scheduled for Aug. 15-17, the Pharmacy and Therapeutics Committee will discuss thiazolidinediones, used for treating Type II diabetes; cholesterol-lowering medications; and ulcer drugs.