4 May 2020 Military.com | By Patricia
Kime
The Defense Health Agency and its Tricare pharmacy
benefits manager, Express Scripts, are limiting prescriptions for several
medications used by hospitals to treat patients with the novel coronavirus.
Pentagon officials said last week they have limited
prescriptions containing albuterol and levalbuterol, also known by the brand
names ProAir, Proventil, Ventolin and Xopenex, to one inhaler every 30 days to
prevent shortages of these medications, which also are used to help COVID-19 patients
breathe.
The drugs are widely prescribed to asthma sufferers for
emergency respiratory use, as well as daily asthma control.
The DHA's announcement coincided with Express Scripts
placing limitations on hydroxychloroquine, also known as Plaquenil, a medicine
commonly used to treat autoimmune disorders such as lupus and rheumatoid
arthritis that President Donald Trump promoted as a promising treatment for
COVID-19.
DHA officials said the restrictions are in line with
guidance from health systems, the American Medical Association and other health
organizations to ensure that these drugs remain available for all patients who
need them.
"Our goal is to provide you with the prescription drugs
that you need," Air Force Col. Markus Gmehlin, DHA chief
of pharmacy operations, said in a release. "We must be good stewards
of health care resources during this national emergency."
Under the restrictions on albuterol and levalbuterol, if a
patient has available refills, they can get one starting on or after the 22nd
day after filling their prescription. If a physician deems it medically
necessary to have more than one inhaler, a pharmacist can provide it, according
to Tricare.
Mail-order quantities for new prescriptions for
hydroxychloroquine are also limited to 30 days, although Express Scripts told
the Military Officers Association of America that it is not experiencing
shortages of the drug.
In March, Trump expressed support for hydroxychloroquine as
a COVID-19 treatment after the results of a small non-clinical study in France
showed it lowered the viral counts in coronavirus patients. The president
continued to promote it for several weeks as the pandemic spread across the U.S.
But last month, physicians began raising concerns about the
use of the medication, which can cause an irregular heartbeat and death. An
analysis of Department of Veterans Affairs patients
last month showed that more veterans with COVID-19 died while taking
hydroxychloroquine or a combination of hydroxychloroquine and azithromycin than
those who received routine care.
The study has yet to be peer reviewed or published, although
the researchers said they had adjusted for the patients' concurrent medical
conditions, other medications and additional circumstances.
The Food and Drug Administration, which granted an emergency
authorization March 28 for physicians in hospitals to use hydroxychloroquine
and chloroquine to treat patients with COVID-19, issued a warning last week
about the risks of serious heart rhythm problems in patients receiving the
medications in hospitals and as prescriptions.
"Hydroxychloroquine and chloroquine have not been shown
to be safe and effective for treating or preventing COVID-19. They are being
studied in clinical trials for COVID-19," FDA officials said.
According to the DHA, co-payments for these medications will
remain the same at retail network pharmacies and through Tricare Pharmacy Home
Delivery; however, a prescription obtained through mail order will cover 30
days instead of the 90 days usually distributed through mail order, so
co-payments actually will triple in cost across three months.
Tricare officials said they will remove the limits as
supplies become more plentiful.
"We're monitoring the availability of these medications
on a daily basis," Gmehlin said. "All manufacturers of these products
are increasing production levels to meet this increased demand. There are no
current long-term shortages projected."
-- Patricia Kime can be reached at Patricia.Kime@monster.com.
Follow her on Twitter @patriciakime.
https://www.military.com/daily-news/2020/05/04/tricare-limits-some-prescription-refills-during-pandemic.html
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