TRICARE beneficiaries can skip co-pay during two-year test

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FALLS CHURCH, Va. (AFPN) --  A two-year test authorized by the 2007 National Defense Authorization Act allows TRICARE beneficiaries to substitute over-the-counter versions of certain prescription drugs without a copayment.  

For now, the test includes the TRICARE mail order pharmacy only. Plans call for expansion to retail network pharmacies once program details are ironed out. 

"The drugs included in this test initially are among the most widely prescribed, those treating gastro-intestinal disorders," said Army Maj. Gen. Elder Granger, the deputy director for TRICARE Management Activity.  

Known as "proton pump inhibitors," this class of medications includes the prescription drugs Nexium, Prevacid, Aciphex, Protonix, Zegerid and Prilosec. 

Under the test, beneficiaries receiving a prescription proton pump inhibitor are eligible to receive Prilosec OTC, the only proton pump inhibitor available over the counter. The Department of Defense Pharmacy and Therapeutic Committee found there is no significant clinical difference between Prilosec OTC and its prescription-only counterparts. 

"By requesting that their doctors prescribe the OTC version, beneficiaries can save money on their copay and there is the additional potential to save the government money as well," General Granger said. 

OTC drugs are generally less expensive, by as much as 400 percent in some cases.
Once the OTC test works its way to retail pharmacies, beneficiaries, however, should not expect to walk into any drug store and get OTC products for free at the register, caution TRICARE officials. Beneficiaries will still have to get a prescription from their doctor for the OTC drugs. 

Beneficiaries already taking the selected prescription proton pump inhibitors through the mail order pharmacy will get a letter telling them about the new program whenever they order medications that qualify them to participate in the OTC test project. 

TRICARE encourages beneficiaries who have not used the mail order pharmacy in the past, but are taking medications included in the test, to get information on how to sign up at www.tricare.mil/pharmacy/tmop.cfm. 

"Through the mail order program, initially beneficiaries can get up to a 90-day supply and have it delivered right to their mailbox. Remember, it's free so it saves money for beneficiaries and potential savings to the government may help sustain the Tricare benefit," said General Granger. 

Medication classes under consideration for future testing include topical anti-fungals and non-sedating antihistamines.