Your Thoughts on TRICARE's Pharmacy Benefit

February 24, 2017

The TRICARE pharmacy benefit is a hot topic for our members. After soliciting feedback from members, MOAA's director of health affairs, Capt. Kathryn Beasley, USN (Ret) met with Express Scripts Inc. officials to share their concerns.

We asked for your experience with TRICARE Pharmacy's Home Delivery, and we thank our members who took the time to respond.

You sent over 300 responses, which included excellent feedback. We use this information to provide unvarnished perspective to the professionals at Express Scripts.

Positive responses centered on service attributes and attractive medication pricing.

Responses like these were typical:

“I've used Express Scripts for a number of years for my maintenance medications. Overall, I'm quite happy with the program. The cost savings have been significant. The people are courteous. Once the script has been filled the first time each year delivery and refills arrive fairly quickly.”

Responses reflecting less satisfactory experiences included comments focused on: cumbersome and time consuming processes; medication temperature control concerns; pre-authorization and appeal process issues; and providers' lack of ease using the system.

These responses capture some of the frustration:

“I cannot get Express Scripts authorization for [the brand name]. I have tried every generic type of this drug and they cause me discomfort. I am not trying to abuse the system. My physician has tried several times over the years to obtain a waiver for me to get [the brand name], but was unsuccessful. I have also lost the appeals process. I simply can't afford the $30 per pill on my fixed income. I just was forced to order [the brand name] from a Canadian online pharmacy, but the medication is coming from Turkey.”
“On a number of occasions, Express Scripts did not have common generic drugs on hand to dispense when I needed them. Another matter is that Express Scripts has apparent website problems affecting communications with me and probably others. They used to send me emails to notify me that it was time to refill a maintenance prescription; let me know that my prescription request had been received; that the prescription had shipped, etc. I no longer get such notifications. I have brought this to the attention of Express Scripts, who acknowledged that I should be getting the notifications.”

MOAA is working to engage our members to provide feedback on the programs in which they are enrolled. Our partners in TRICARE value it, and your contributions to this effort matter. We see our ability to make these contributions to DHA, TRICARE, and Express Scripts as providing direct value to our members.

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