Giving Our Military Equal Access to Vaccines Through Pharmacy

By Kevin Schweers

In December, the U.S. Department of Defense (DoD) began covering three pharmacist-administered vaccines under the TRICARE health plan. Patients, taxpayers and community pharmacists all benefited. Now, we’re asking the Pentagon to recognize additional vaccines to give military health beneficiaries the same immunization services as their civilian counterparts.

Presently, TRICARE beneficiaries have to visit an in-network doctor or hospital in order to receive most vaccinations. Compared to vaccines given by local pharmacists, the practice is costlier for the health plan and less convenient for patients.

The new interim final rule changed that by covering pharmacist-administered vaccinations against H1N1, seasonal influenza, and pneumococcal disease. These and other immunizations are increasingly being offered by independent community pharmacies as a patient service. We’re hearing that tens of thousands of TRICARE beneficiaries have already taken advantage of their new vaccination options since December.

The Pentagon’s rule also solicited public comment on “also including other TRICARE-covered immunizations in the future for which retail network pharmacies will be authorized.” NCPA took advantage of that opportunity to seek broader TRICARE coverage. What follows are excerpts from comments we recently submitted to DoD in advance of the February deadline. The complete copy can be viewed here.

“NCPA applauds the Department of Defense’s issuance of an interim final rule in December 2009 allowing a TRICARE retail network pharmacy to be an authorized provider for the administration of the H1N1 vaccine, seasonal influenza vaccine, and pneumococcal vaccine in the retail pharmacy setting. The rule brings the program in line with other insurers that have covered pharmacist-administered vaccinations for years…This is truly a case where everyone wins. The 9.5 million TRICARE-eligible patients gain a convenient new vaccination option and taxpayers and plan administrators will save money when vaccines are administered at pharmacies instead of costlier doctors’ offices or hospitals.”

“Pharmacists may now provide vaccinations in all 50 states. So far over 88,000 pharmacists are certified to immunize. In addition to initial training, pharmacists must demonstrate continued competence…Each year pharmacists are providing millions of vaccines to patients, making them a valuable public health resource. Pharmacist provided immunizations allow physicians, nurses, and other healthcare providers to engage in patient care activities unique to their practice area.”

“NCPA urges that additional vaccines be covered. Depending on state law, there are a multitude of other vaccines that pharmacists can provide to help increase the number of vaccinated patients and decrease the incident of vaccine-preventable disease. NCPA encourages the Department of Defense cover all vaccines at network retail pharmacies that are TRICARE eligible vaccines and those that are included on the Centers for Disease Control and Prevention (CDC) adult immunization schedule. This includes vaccines such as Hepatitis A&B, Herpes Zoster, Human Papillomavirus, Meningitis, Measles, Mumps and Rubella (MMR), Tetanus, and Varicella. This is not an exhaustive list and given the nature of the TRICARE population NCPA also urges consideration of expansion to any vaccines recommended for travel.”

“NCPA also hopes that TRICARE covered vaccines provided in retail network pharmacies will not require a referral from a physician, but would be open to any patient who wishes to be vaccinated…In keeping with the CDC immunization recommendations, pharmacists can help the entire health care team keep their patients on track with goals the whole team aims for. Requiring patients to get a referral for vaccines can increase cost and inconvenience for patients visiting multiple providers to coordinate care and increase recordkeeping requirements for physicians and pharmacists. NCPA applauds DoD processing immunization claims through the pharmacy benefit, taking advantage of the electronic process for real-time claims adjudication. We encourage the Department to use one standard format for the processing of claims, as varying requirements for different vaccines could create difficulties related to claims administration.”

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