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Key changes to TRICARE between 2021 and 2024 could make it more difficult for service members and their families to access pharmacies and medications they need, according to a report from a congressional watchdog.
The Feb. 13 report from the Government Accountability Office found TRICARE changes made by the Department of Defense’s Defense Health Agency have reduced the number of pharmacies where prescription orders can be filled, which is impacting some beneficiaries’ timely access to their prescription drugs.
One of the key changes DHA made was reducing the minimum number of retail pharmacies it requires contractors to maintain in the TRICARE network. Per GAO, DHA administers the TRICARE pharmacy program through a contract.
“This minimum [number of pharmacies] dropped from 50,000 to 35,000,” the report said. “As a result, fewer pharmacies are accepting TRICARE.”
GAO recommended DHA begin auditing contractor-reported data for accuracy to help solve these problems and DHA should monitor the contractor's timeliness in dispensing mail-order specialty drugs.
DOD partially concurred with one recommendation and concurred with the other, per the report.
Currently, DoD provides a pharmacy benefit to over 9 million beneficiaries, including active-duty and retired Guardsmen and their families, through TRICARE.
TRICARE users can have prescriptions filled at military-operated pharmacies, some retail pharmacies or via mail order.
The report said DHA made changes to the pharmacy benefit with two goals in mind: improving service for beneficiaries and saving money.
“Medications would be more competitively priced for service members and their families and a smaller network of pharmacies would be more efficient, cutting costs for DOD and beneficiaries,” the report said.
DHA officials told GAO a smaller network could result in government savings.
Prior to GAO releasing its report, TRICARE announced on Feb. 5 the Kroger Family of Pharmacies had rejoined the TRICARE Pharmacy Program network.
Beneficiaries now have access to an additional 2,200 pharmacies across 35 states. Kroger originally left the TRICARE network on Jan. 1, 2023.
— By Donald Lambert
