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Walgreens pharmacy may not accept TRICARE after contract dispute

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Posted: Wednesday, September 21, 2011 12:00 pm

By Colleen Flaherty

Fort Hood Herald

A dispute between TRICARE's retail pharmacy contractor and Walgreens could leave Fort Hood area residents with fewer places to fill their prescriptions.

If contractual negotiations between Express Scripts and Walgreens aren't cleared soon, the pharmacy will drop from TRICARE's network effective Jan. 1.

In a statement last week, Navy Rear Adm. Christine Hunter, deputy director of the TRICARE Management Activity called the negotiations a "business matter" between the two companies.

Walgreens corporate spokesperson Michael Polzin said Monday the pharmacy wanted to keep providing for military personnel, but couldn't resolve certain issues with Express Scripts.

"It's not just the (contract) rates, but the terms of contract," he said. "Express Scripts wanted to have the sole right to define what is a generic drug and what's a brand drug, and that affects how we get reimbursed for the medication," he said.

Polzin said the contractor also had rejected Walgreens' proposals to create special terms solely for its TRICARE customers.

"We offered to contract especially for TRICARE, so that military personnel wouldn't be caught in the middle," to no avail, he said.

Express Scripts' public affairs department did not return requests for comment this week.

Hunter noted a similar impasse between the two companies in 2008 that ultimately was resolved by mid-November, about six weeks before the new contract was to take effect.

Should negotiations fall through this year, however, she said, TRICARE beneficiaries will still have other on- and off-post options for filling their scripts.

Hunter endorsed Express Scripts' mail-order and home-delivery program of generic drugs in particular for its efficiency and cost-effectiveness for the patient and Defense Department.

Walgreens is a big player in the TRICARE pharmacy network, with about 7,000 participating outlets that Hunter said have filled prescriptions for one in 10 TRICARE beneficiaries at one time or another.

Three months remain in Express Scripts' existing contract with Walgreen's.

Polzin encouraged TRICARE customers who wish for Walgreens to remain in their network to contact the insurer and Express Scripts.

Due to the lack of chain pharmacies other than Walgreens in Central Texas, Fort Hood family members, including Denise Harrell, said they were bothered by the possibility of losing the pharmacy as an option Monday.

"I feel that it will be inconvenient (for) some people because I rarely go on post, so I don't want to have to go on post to pick up my medication," Harrell said.

Spouse Vicki Ortego agreed.

"The pharmacies on post already take forever and this is just going to make it worse," she said. "I will probably just go to H-E-B."

The American Forces Press Service contributed to this report.

Contact Colleen Flaherty at colleenf@kdhnews.com.

More information

Other changes to TRICARE

As of Oct. 1, 2011, copay­ments for generic pre­scrip­tion med­ica­tions will be free of charge for 90-day supplies through TRICARE Home Deliv­ery, while the copay­ment for the same med­ica­tion will increase from $3 to $5 at retail phar­ma­cies.

The fol­low­ing changes to the TRICARE phar­macy copay­ments are sched­uled to go into effect Oct. 1:

Generic for­mu­lary drugs pur­chased at retail phar­ma­cies will go from $3 to $5.

Generic for­mu­lary drugs pur­chased through the Home Deliv­ery option will go from $3 to $0 for a 90-day sup­ply.

Brand name for­mu­lary drugs from retail phar­ma­cies will go from $9 to $12.

Non-formulary med­ica­tions will go from $22 to $25 in both retail and Home Deliv­ery.

Brand name for­mu­lary drugs pur­chased through Home Deliv­ery will have the same $9 copay­ment.

- The Defense Department

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