Is your pharmacy leaving the Tricare network in a few days?

With just days before 15,000 community and independent pharmacies will leave the Tricare retail pharmacy network, questions remain about the impact on patients’ ability to get their medications.

Other changes, coming with the new year, will affect those who rely on specialty medications for chronic, complex conditions such as cancer, rheumatoid arthritis, multiple sclerosis and other diseases.

On Monday, Tricare and Express Scripts will shrink the pharmacy network, affecting an estimated 400,000 Tricare beneficiaries, according to the National Community Pharmacists Association. Of the roughly 55,586 retail pharmacies in the Tricare network, 14,963 will leave after refusing to accept the terms for reimbursement and other conditions.

Those pharmacies will now be out of network, and beneficiaries who continue to use them will pay full price for their medications then file for reimbursement, which is subject to the deductible as well as a higher out-of-network cost share, said U.S. Public Health Service Cmdr. Teisha Robertson during a Tricare pharmacy webinar Oct. 20. Robertson herself is a pharmacist in the pharmacy operations division at the Defense Health Agency.

The loss of those almost 15,000 in-network pharmacies has raised alarms.

“I live in a rural area and Express Scripts is cancelling the in-network status [of] local pharmacies, which in some cases means a patient would have to drive up to 50+ miles to access an in-network pharmacy,” wrote one Minot, North Dakota, pharmacist on a Change.org petition started by the Georgia Pharmacy Association.

“This does NOT benefit the patient — especially with the high prices of gas and having to drive two hours round trip to fill a prescription.”

The petition had garnered 3,614 signatures as of Oct. 21.

Lawmakers have written to Secretary of Defense Lloyd Austin about their concerns, as have several pharmacy associations.

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