Tricare to Slash Veteran’s Access to Compounded Medication: QmedRx Responds

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As a specialized home pharmacy, QmedRx understands that Americans everywhere depend on compounded medication to combat their unique ailments. However, not everyone recognizes the importance of these specialized prescriptions.

Beginning July 24, the government healthcare program known as Tricare plans to cut funding that provides veterans, retirees and American military families nationwide with the necessary compounded medications that many cannot otherwise afford. In light of this decision, many of these individuals will not have access to the personalized medications they have come to depend on.

According to QmedRx, compounded medication is what a patient receives when manufactured drugs do not meet his or her personalized medical needs. For instance, if one medication contains an allergen or the dosage is not compatible for that individual, the physician may suggest that a customized medication be created by pharmacists as a way of tailoring to the patient. The pharmacists may be told to mix two existing medications together, reduce the dosage amount or even change the physical form from tablet to liquid.

Previously, veterans and retirees could receive these prescriptions through Tricare.

Now, the professionals at customized pharmacies like QmedRx fear that thousands with specific medical needs will be left out in the cold.

In June, 44,000 current Tricare recipients were alerted by express script that their daily medications would no longer be covered. These individuals will now have to have frank discussions with their physicians as to what feasible alternatives they can access – if those alternatives even exist. According to, Tricare received about 500,000 compound prescription claims in 2012 that cost them $330 million. While Tricare claims these cuts are to protect its beneficiaries, the figures suggest ulterior motives.

QmedRx professionals report that Tricare’s tragic decision comes after the agency’s contract was picked up by UnitedHealthcare. It was the first switch in over 16 years, making for an understandably bumpy transition. Beginning in April, healthcare providers began noticing a few unwelcome changes such slow payments and fewer services. However, this unprecedented cut will essentially leave military veterans and their families with very few alternatives for medications.

Tricare says that they will stop coverage on these prescriptions because the individualized combinations often contain ingredients that have not been approved by the Food and Drug Administration, and they have been banned from providing coverage for unapproved ingredients. They describe this as a safety decision to protect Tricare beneficiaries.

Unfortunately, many of those beneficiaries are allergic to the inactive ingredients in common FDA approved medications. Compounded prescriptions often contain bulk chemicals and inactive ingredients that by law are not subject to approval by the FDA. In fact, there is no FDA approval process in existence for those items. From that fact alone, effected parties are begging for a change in policy to continue to be reimbursed for prescriptions that they have received for quite some time. QmedRx joins in this fight to provide patients with the medical care they both need and deserve.

QmedRx: FDA Makes Exceptions To Its Own Rules

Of all the manufactured drugs currently on the market, 25 have never been approved by the FDA. However, they existed before the FDA installed a new approval process and were then “grandfathered” in. Yet, these drugs, which have never been proven safe by the organization, will continue to be reimbursed under Tricare’s new coverage plan. This sends a varied message to American veterans requiring a reimbursement for their prescriptions. Why are some drugs that have never been FDA approved covered, while others are not?

Additionally, Tricare under UnitedHealthcare has affected the in-person medical care that beneficiaries are able to receive. Now Tricare has stopped referrals from primary care providers, which beneficiaries need when seeking help from specialists such as physical therapists. Not only does this deter military personnel from gaining access to services they may medically require, it also hurts the medical industry as patient numbers decline. Also, autistic children who receive coverage under the military’s healthcare program will be required to jump through hoops regularly to maintain access to Applied Behavior Analysis (ABA).  Access to this life-changing therapy will be severely limited and could even be capped after a span of two years.

After 16 years of uninterrupted service, Tricare beneficiaries are about to have their worlds rocked by the healthcare program’s newest budget cuts. However, medical care coverage is no item to toy around with – it may very well cost a life. QmedRx urges beneficiaries not to idly sit by as corporations make health decisions for them. There are existing outlets to get your voices heard. If these coverage cuts will affect your, or another military family’s health, contact your representatives, the Department of Defense, or Tricare themselves to ask them to change their minds. With the July 24 deadline quickly approaching, the issue could quickly be out of your hands.

The Affordable Care Act is also looming over the heads of insurance company executives, meaning that other companies may soon follow Tricare’s lead in denying coverage for compounded medications if successful. According to their website, even the FDA believes that pharmacists who compound prescriptions provide an important medical service to patients with allergies to dye or other drug difficulties.

Companies like QmedRx, as well as varied healthcare professionals, have dedicated themselves to making sure the general public is given access to the medications they need to maintain proper health. Compounding medications is a process that for years has safely worked for individuals with customized medical care needs. While we all recognize that in difficult times budget cuts need to be made, they should not be made in areas that could directly affect a family’s quality of life. American veterans have sacrificed much of their life for this country and in return deserve to be respected by their healthcare programs. The professionals at QmedRx, and the families who they serve, wholeheartedly ask Tricare to reevaluate such a life-altering decision.

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