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TRICARE rules on compounded medicines should be reviewed, GAO says

October 21, 2014

TRICARE spends $259 million a year on medications it is not obligated to cover and should align its policies on compounded medications with existing regulations or change those rules, a federal watchdog agency says.

The Defense Department health program paid for 465,000 compounded medications in 2013, about one-third of 1 percent of all prescriptions covered by TRICARE for the year, at a cost 50 times higher than it spent on compounded medications in 2004.

According to the Government Accountability Office, the benefit — used largely by retirees and their family members, who filled more than 85 percent of all TRICARE compounded prescriptions last year — is more generous than coverage for these prescriptions under either Medicare or the Veterans Affairs Department health system, and offers a prime opportunity for cost-savings.

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