Two advisory committees to the Defense Health Agency are at odds over whether Tricare should reimburse for compounded medications.
The Defense Department Pharmacy and Therapeutics Committee in December recommended strict guidelines on compounded medication prescriptions — rules that would allow Tricare to reimburse for the medicines even through its own regulations don't require the defense health system to do so.
The P&T Committee agreed on a plan that would approve coverage if the person who prescribed the medicine provided information on whether the patient had tried already available products, the duration of the therapy and its purpose.
Active ingredients in the prescriptions would have to be an FDA-approved drug and approved by the FDA for the specific use needed, according to the requirements, and the patient must need the special formulation because he or she can't use a commercially available product.
But the Defense Department Beneficiary Advisory Board on Jan. 8 elected not to accept the committee's recommendation, leaving the decision on these costly medicines to Defense Health Agency officials. more
