Diabetes, Cholesterol Drug Prices Cut Under TRICARE Pharmacy Pilot

Diabetes, Cholesterol Drug Prices Cut Under TRICARE Pharmacy Pilot
Photo by Airman 1st Class Jackson N. Haddon/Air Force

This article by Amy Bushatz originally appeared on Military.com, the premier resource for the military and veteran community.

Take a daily drug for diabetes or high cholesterol? Your medication now could cost less or be free thanks to a new TRICARE pilot program.

The Medication Adherence Pilot Program, ordered by Congress in 2016, started Feb. 1 and will run until 2023.

Under the program, Lantus Pens, a brand-name insulin shot used to manage diabetes, will be available for reduced cost. Rosuvastatin, the generic version of the cholesterol management drug Crestor, will be free.

About 136,000 beneficiaries will be included in the pilot, officials said. About 16,000 orders for Lantus Pens are placed monthly through TRICARE at retail and mail order pharmacies, while about 40,000 orders of Rosuvastatin are filled, they said.

The change hits even as prices for all other medications go up. That includes, for the first time ever, a new, out-of-pocket fee for generic drugs received through the system's mail-order pharmacy.

In the past, those medications had been free.

Starting Feb. 1, they carry a $7 fee for a 90-day supply. That means Rosuvastatin is now the only medication available by mail or at a retail pharmacy that carries no out-of-pocket cost.

Drugs received at a military treatment facility continue to be free.

Before the pilot program, Lantus Pens cost $28 for a 30-day supply at an in-network retail pharmacy, and $24 for a 90-day supply through mail-order. Under the program, the drug will cost $11 for a 30-day supply at a retail pharmacy and $7 for the 90-day supply received by mail.

Rosuvastatin, which had cost $11 for a 30-day supply at an in-network retail pharmacy or $7 for a 90-day supply by mail order, will instead be free from both sources.

The pilot program is designed to test whether patients are more likely to follow their medication treatment plans when the required drugs are reduced in price or free, officials said.

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